Food for a friend's dog with pancreatitis history and IBD?

[J and Riley (and Luna)]

One of Luna's friends (a mini schnauzer named Maggie) has recently been diagnosed with IBD.  They thought she had a bowel obstruction so she had an operation to remove it... only to discover that there was no obstruction, so they've now diagnosed her with IBD after some testing.  She spent 6 days in the ICU but is now on the mend.  Poor baby!

Anyhow... she is currently feeding Maggie the vet's Rx food (blech).  She's on a low fat diet due to a history of pancreatitis and now she has the IBD on top of it.

I initially suggested she try Orijen (thankfully some of Luna's other friends were around, who seconded my suggestion of Orijen as a good food), but then I wasn't sure if it would work because of the low fat requirement.  Maggie's owner said she's going to keep her on Rx for now, but she will "think about" something like Orijen in the future after the recovery process.

Any suggestions for a new food for Maggie?  Our neighbourhood pet shop carries Orijen, Acana and Fromm for sure so something in those lines would be the best.

Thanks!

[Karen, Jasper and Jackdoodle]

Dogs with IBD must be on diets supervised by their Internal Medicine Specialists or by a Veterinary Nutritionist. Maggie's test results from the lab would have shown whether or not there is an allergic component to her IBD, which is usually indicated by the presence of a certain type of inflammatory cell. Biopsies are the only way to diagnosis IBD and the treatment depends on the types and locations of the inflammatory cells found. 

If your friend does not have Maggie under the care of an IMS, I urge her to do so TODAY. 

It is very dangerous for your friend to take any food recommendations from well-meaning friends, relatives, people in chat rooms, etc. and that includes this group. 

And nobody could make a good suggestion anyway, because Maggie must have a diet composed of a single novel protein source and a single novel carbohydrate source ("Novel" meaning something the dog has never eaten before, like an LID Rabbit and Lentil formula, for example) and since nobody here knows Maggies' food history, nobody can make a good or safe suggestion. But any multiple protein food like Orijen will not work for Maggie, and the fat content is also too high. (One of the Acana Singles formulas might work, but this can only be determined by examining Maggie's former diets) A hydrolyzed protein Rx food can sometimes be the only alternative for a dog with IBD, unless the owner can work with a nutritionist to formulate a diet. 

[J and Riley (and Luna)]

Thanks Karen!

She was a rescue so unfortunately her whole history is unknown.  I'm unsure as to at what age she was rescued, but I know she was an adult dog.  I think she has been on Rx food since then due to the pancreatitis issue.

The hospital where Maggie had her surgery is the best in the city and they have 3 internal medicine specialists on staff.  I'm sure she saw at least one of them during her visit.  Maggie's owner is also a health care worker so she is in good hands.  She may just have to stay on the Rx food then because of the fat issue!  

[Karen, Jasper and Jackdoodle]

Chances are the Rx food is one that utilizes hydrolyzed protein, which is broken down so much that the immune system cannot recognize it as any one particular protein, and therefore does not create an allergic response. A lot of IBD dogs have to be on this type of diet, and this is one of the rare types of cases in which the use of an Rx food is justified, but only because you can't buy a hydrolyzed protein diet from a good company. 

[Karen, Jasper and Jackdoodle]

BUT...chances are Maggie has not eaten rabbit before, and there are a couple of LID formulas made by decent companies that use rabbit as the sole protein source. 

[Diana Erhart]

My daughter's maltese is on a low fat diet due to having high lipids in her bloodstream which is causing her to have eye problems (she will eventually lose her eyesight).  We tried many low-fat foods for her and she would not eat them.  She has ended up feeding her dog the Fromm's Whitefish and Potato formula.  I believe it has 11% fat content.  That is the lowest (besides the crap Rx food) that her dog would eat.  Also, for treats she gets cut up carrots (which she loves).  If your friend has the time and the willingness to make homemade food let me know, I had at one time found some ideas for that.  I can try to find the websites if there is interest.  

[Jill, Woody & Maxi]

I am so sorry to hear this about Maggie..but it sounds like she is in good hands.  Do you know if they did a biopsy while she was in surgery?

[J and Riley (and Luna)]

I haven't had much of a chance to ask a lot of questions - I just saw them Monday when she was out for a walk with us.  Poor Maggie's belly was full of staples :(

 I do know that her visit cost $6000.  She has pet insurance, so hopefully they'll pay most of it.  Yikes.

I've been to that vet hospital once with Luna and the care there was excellent... you do pay a premium though because they have something like 13 specialists on staff.

[Karen, Jasper and Jackdoodle]

I've found that a lot of the costs at the Veterinary Specialty Center here are lower than at my regular vet. JD's B12 shots are half the price. So it just depends what it is. A lot of what they do, the GP vet can't, like endoscopies, so you really can't compare the costs.

I hope that they took biopsies on Maggie. To have her opened up and spend all that money, it would really be a shame if they didn't, because the only way you can definitively diagnosis IBD is through endoscopy or surgery. :(

And in order to treat it, you need the lab findings from the biopsies. 

[J and Riley (and Luna)]

Yeah I'll ask her when I see her Monday about the biopsy.  This vet hospital gives good care but is super expensive... I took my old dog there once when she got scratched by a rabbit... they didn't give her anything except a bit of a wash (just held her for a few hours because her ear wouldn't stop bleeding... man that was a lot of blood from a tiny cut lol).  It cost $500!  Yikes. 

[J and Riley (and Luna)]

A little update on Maggie - I saw her again today.  The staples are out, she's off her pain meds and seems to be doing great!

Apparently they did not do a biopsy during her surgery (the Internal Medicine Specialist said that it was an oopsie and they should have while they're in there).  They diagnosed her by a process of elimination for now.  Maggie's mom said she will request they do a biopsy endoscopically the next time she has her teeth cleaned or if she has another incident.

[Karen, Jasper and Jackdoodle]

That's a big "oopsie", considering that an endoscopy costs about $3000. If the dog is already under for something else, it would be less, but certainly there's still a significant cost.

So they don't really know if she does have IBD, or if she does, what type it is. That affects treatment, because certain drugs are more effective for the large intestine, some for the small intestine. And without a biopsy, you don't know if there is an allergic component that would cause certain proteins/foods to be triggers or not. Hopefully the vet who did the surgery at least took notice of which parts of the GI tract seemed to be ulcerated or inflamed.

[J and Riley (and Luna)]

Yeah, it was a second specialist (not the one who did the original consult and surgery) who admitted it was a big mistake.  For now she's on hydrolyzed protein kibble and special treats of some kind so hopefully that will help prevent any further incidents.