Canine Intestinal Lymphangiectasia: My Gripe with MCT / Coconut Oil

I’ve done a lot of griping over these past two years about the use of Medium Chain Triglycerides in this disease.  One of the things that bugs me the most about this is that they aren’t even meant to TREAT the disease.  They are meant to add calories and fat to the diet, to aid in digestion of fat soluble nutrients.  But they won’t make your dog recover from CIL and they may, in fact, make your dog worse.

After multiple attempts to get this information across on the CIL forum, I eventually realized that I needed to back up, start at the beginning, and explain my position on this all the way through.  I wrote this post:

You may be asking yourself why I am always going off about this issue of MCTs and coconut oil. I realize I owe a full explanation of this to the group, and I probably have only given bits and pieces of my reasoning in various threads around this forum. I’m going to try to pull my thoughts and experiences together in one place.

First, my own experience. I wrote about this in another post, so I’ll repost this here, with a little embellishment:

Quote:
Back when Louie was first diagnosed, I looked up everything I could find on the internet about how to approach this disease. There was no forum like this one at the time. MCTs (and coconut) oils kept cropping up in all the various places I’d read, and I couldn’t understand why our vets did not suggest these for Louie. I got very upset with the fact that the vets at UC Davis were not prescribing this for him, so I (foolishly) decided that I should take matters into my own hand and give them myself. Well, of course, they made him sicker, and so I did more reading here at work, where I have access to veterinary journals online, and as I read more I began to discover why, and to discover that the most recent papers on their use recommend against them.

So, that is our anecdotal experience with this particular treatment. The vets here at UC Davis are working within the framework of the most recent protocols, and in my opinion, they knew better. I foolishly took it upon myself to think that I knew better, and Louie was the one who suffered the consequences.

One of the vets here has given a nice talk to the World Small Animal Veterinary Association, where he specifically talks about this. His name is Stanley Marks, and his paper is one that I frequently cite here because it is easily accessible to anyone and you do not need access to scholarly journals to read it. You can read it here:

http://www.ivis.org/proceedings/wsava/2 … 21_abs.pdf

Here is what Dr. Marks, a veterinary researcher and renowned expert, has to say about the use of MCT (which includes coconut oil):

Quote:
Administration of medium chain triglycerides (MCT’s) to enhance the caloric 
density of the diet are not recommended due to their unpleasant taste and 
potential for inducing diarrhoea. Recent evidence also suggests that MCT’s 
are not transported entirely via the portal circulation to the liver, and can 
exacerbate the lymphangiectasia.

So, after making my own dog sick with this stuff, I found this paper which was presented by a vet at my own teaching hospital, explaining why they didn’t tell me to give it.

Doing more digging, I also found some additional materials and studies which gave me a historical trail of why these fats were originally thought to be good for our CIL dogs–alluded to in the above quote where Dr. Marks talks about how they are not portally transported directly to the liver.

This is a somewhat simplified, layperson’s synopsis of what I found.  The original thinking (from a paper published in 1979) was that these fats BYPASS the lymphatic lacteals, which would make them digestible for dogs with lymphangiectasia. Research done much more recently has tested this theory and found it to be lacking. The evidence now suggests that these fats are digested in the body just like other fats are– meaning that they DO come into contact with intestinal lacteals and thereby have the potential to cause lacteal distention, just like other fats do.

Let’s back up a minute and go back to my early days of researching this disease again. Along with lots of information suggesting that MCTs were a treatment of choice for this disease, I was also reading lots and lots of gloom and doom regarding the prognosis for this disease. There is actually a published paper which states that no dog has ever survived for more than two years after being diagnosed with this disease! Discussions about prognosis use words like “guarded” and “poor.”

I have a mind that likes to put two and two together. We have a historically accepted and widely used treatment protocol which newer evidence suggests is perhaps not working the way it was originally believed to work and may, in fact, be harmful to our dogs.

We have a lot of vets out there prescribing this treatment, and a lot of dogs not making it past two years. It does not require a huge leap in my own mind to begin to wonder if there isn’t a causal relationship between these two things. The image that comes to mind is one of a doctor giving poison to all of his patients and then lamenting the fact that none of them live very long.

You’d think that, now that we have evidence that suggests that this treatment is not necessarily useful, and may in fact be harmful, all the vets would be lined up to cross it off their lists of treatment protocols. But that’s not really how it works. Another thing I wrote in an earlier post that I’m going to quote:

Quote:
I work in a research department in a University (also UC Davis, in fact) dealing with human medicine, and I know how long it takes for important findings in human medicine to become accepted practice among clinicians treating human patients. It’s something like 10-20 YEARS! That’s not the kind of time we have to wait for our vets (or our doctors, for that matter) to catch up on the latest evidence in treatment protocols, so we need to do our research on our own and present the evidence we find to our vets in order to educate them. Hopefully we can guide them to make better informed treatment decisions, but some vets will dismiss anything that wasn’t handed down to them by their own mentors in veterinary school. So at that point we just make the best decisions we can.

Do I know for sure that MCTs are a treatment we should avoid at all costs? No. I don’t think there is sufficient evidence to say with 100% certainty that MCT makes CIL dogs sick every time it’s given. But I respect the mounting scientific evidence and the opinions of the researchers more than I respect the opinions of clinical practitioners who are not doing research on these diseases and are not treating (or saving) large numbers of patients who have this disease.

My gut instinct tells me that the heavy reliance on MCTs by veterinarians treating this disease may be killing more dogs than not. I would love to see more research being funded and conducted on this, but until I see more definitive proof that it helps, I will not recommend it on this forum and I will not hesitate to comment when I see it mentioned by others.

I should point out here that, although I don’t advocate their use, I do know that some have used them without apparent problems.  It’s worth mentioning here that the guiding principle of treatment is always to do what works for your own dog.  If you are using these products and your dog is in a good remission, do not change what you are doing.  

34 comments to Canine Intestinal Lymphangiectasia: My Gripe with MCT / Coconut Oil

  • Kali

    My lymphangiectasia dog gets coconut oil, but we’re talking tiny quantities. Her overall base diet is so low in fat to begin with–the only potential source is the tiny amount of coconut in her Preference. I use egg whites for protein, so no fat there. So the 1/2 tsp of coconut oil I put in each meal does not bother her at all and her stools and bloodwork has been normal for two years. However, I assume it’s *just* enough fat to keep her coat and skin from being in terrible shape–she’s got a bit of shine to it. It’s entirely possible that if I added the same amount of fish oil instead of coconut oil, it would be the same result but as you point out–when you find something that works, you don’t want to change it!

    I’ve never tried to use it to add calories. Anytime I wanted to add calories, I used carbs (usually rice). I’m lucky she’s always had a good appetite and never turned down a meal. She had lost about 6-8 pounds of muscle and fat before she was diagnosed, and gained her weight back after switching her diet to Preference, egg whites, rice, and the small amount of coconut oil.

    Whenever I had to use low fat chicken as her protein instead of the usual egg whites, I would remove the coconut oil from her ration just to be safe, and that has worked for us. She has no food allergies, except possibly beef.

    We never tried actual MCT oil. Also, my vets were utterly unhelpful in crafting a diet. They just said “low fat” and sent me home with cans of Science Diet I/D. I had to just figure it out myself. I’ve always fed the ultra premium holistic etc foods (Orijen, Evo, Great Life, Nature’s Logic etc) and so I wasn’t comfortable resorting immediately to prescription vet foods. Luckily we figured something out that worked for us. The only time she ever regressed was when I tried to use raw meat for protein instead of egg whites (Primal’s Vension formula which was their lowest fat one). Her stools never got bad but her bloodwork slipped. Once she was back on the egg whites she went back to normal.

  • Louie

    Glad to hear that she’s doing well with the limited fat she gets and the egg white protein. I had forgotten about the egg white and should probably add that to the list of proteins in my earlier post.

    I would agree that it may well be she could tolerate that much of any type of fat, but if you have her doing well with what you are doing now, there’s no reason to change it.

    I am probably going to start experimenting with adding a drop of olive oil to Louie’s meals to see if I can get a bit more fat into him.

  • Louie

    I didn’t continue it because his stool got a little runny, but I’m starting to add it again as he’s having some problems that make me think he’s not getting enough vitamin A. Since that’s a fat soluble vitamin, he probably needs a little more fat.

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  • Liz Dempsey

    thank you my dog was just diagnosed and I was questioning why my vet said no to coconut oil- glad I listened to her.

    thank you

  • Have just read your article here and comments on the coconut oil and other oils. My dog, Scooby has just been diaognoised withLymphangiectsia along with Inflamatory Bowel Disease which really complicates things. We are hunting for natural foods he can eat and the only thing the vet says he can have is a food made by Purina called HA that we can only buy from the vet! Scooby HATES this food! The vet says to “talk” to him (the dog) which is really rather silly especially since he is deaf! Scooby and I do cummunicate very well but find it difficult to talk him into eating anything he doesn’t like and that little mouth clamps shut and that is it! I should tell you that Scooby is an 8 year old male Maltese and we have had him since rescuing him from a very unhappy home at age 2. We love this little guy very much and would do anything possible to find food that will work . We have some treats that are very like the food so those don’t even work for him. I am hoping that someone knows of any foods that can be fixed that are more palatable for the little guy and work for him health wise! It is very fortunate that he was tested at a very early stage of this disease and has only lost a pound or so to this time!

    • Suzie Bender

      Ken, my Bernese Mountain Dog Rigby was diagnosed 4 months ago with both IBD and Lymphangiectasia. It’s been so terribly difficult to find food that she will eat. She is on the Purina HA along with Prednisone. when we first started her on HA, she turned her nose up. And then the steroids kicked in and she didn’t care what she ate. She lost 11 lbs! The vet had us add either pumpkin, bananas, vegetables, marsh mellows and coconut oil. Now that her dosage of steroids keeps getting reduced, her appetite is getting back to normal and now she really won’t eat it at all. So this is a whole new dilemma. I’m glad we’re not the only ones having problems. Oh also, Purina makes “snacks” called Snackers that Scooby can eat

  • MJ

    My Maltese was diagnosed with Lymphangiectasia almost 2 years ago. At that time the IM specialist told me to change her diet to equal amounts of white turkey and white rice. She started to improve immediately. I now add Honest Kitchen Preference to her diet of turkey and rice. She’s still on a low dose of prednisone and plavix, but has been stable since her diagnosis and the diet change (knock wood.) Good luck with Scooby!

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  • Tricia

    Wow this is the first time I have heard from others who have been thru this And my frenchie has been sick since February and was diagnosed in Sept. It has been a long journey to diagnose and treat. We were on Purina Ha for awhile as chicken seemed to be aggravating her symptoms and that was the lowest fat hypoallergenic food out there. Her stools never got solid on it and she desided to stop eating it when we switched her steroid to budesonide from medrol due to severe muscle wasting. I struggled to get her to eat and resorted for awhile to feeding her those gental snackers until even those she didnt wand. Her weight got to her lowest it had been and she was starting to fade. I thought for sure I was going to be putting her down before Christmas. We had run out of options and decided to go back to a home cooked diet using the hillary’s vitamin supplements for home cooked food and start weaning her off the steroids. With in less then a week she was looking better and in a week and a half she gain 0.2 kg! The diet is cod, peas, blueberries, safflower oil and cod liver oil with the Hilary’s vitamin mix (the recipe comes from the Hilary’s diet plans). I did add MCT oil to her food (only 1/2 tsp per day) as my vet had recommended trying it for extra fat and calories and I have to say that after 10.5 months her stools have never been this close to solid! She is eating again and I now feel she might live to see her 7th Birthday in may hopefully! This has been a draining time as I had my son in march and have spent my entire Maternity leave trying to fix my dog. Our specialist for our dog was killed a month after he diagnosed our dog with Lymphangiectasia in a freak mountain biking accedent so my vet and I have been left to figure it out on our own!

    My personally beef is with steroids! I completely understand their role in reducing inflammation etc, but I strongly believe they are what put us here in the first place. About a month to two months before my dog started to become ill she hurt her back and was put on a month long coarse of prednisone. I really feel like it help to trigger the Lymphangiectasia. She presented with pancreatitis in the beginning and so we treated her with enzymes at the start but again once we started her back on steroids to treat her intestinal imflamation she seemed to get sicker and sicker. Has anyone else had these issues or had their dog on steroids before they were sick and diagnosed?

    • Elyse

      My dog did get steroids right before he got sick. He got an infection. But I am not sure if that is a coincident.

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  • Linda

    Hi, one thing I wish this site had was a search bar. My question today is about lymph node biopsies. Machi (9 yo male Maltese) was diagnosed about 4 months ago with CIL. His lymph nodes are huge, but overall he is doing well. The vet ruled out infection from his last blood work (have you ever seen two women trying to hold still a 6 lb Maltese while the vet draws blood??? He is a fighter!!!), so I think the other option is lymphoma. I am so tempted to have a biopsy done, but on the other hand, why go to the expense, just accept that that is what it is and treat accordingly. Your thoughts will help a lot. Linda

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  • Elie

    Our 8 years old fox terrier was diagnosed with lymphangiectasia in october 2014 and it has been a difficult road to care for him. I am very thankful for the website as I was researching MCT oil, which he had been taking for a week. His normal weight is 25lbs and he is down to 14.4lbs. His level of albumin has been low. It did rebound a month ago and then decreased again. Initially the oil seemed to boost both his energy and appetite and within the last two days he seemed to have hit the wall and does not want to eat anything. I am curious if Louie’s owner sees any similarities in what I described with what he experienced with MCT oil. Today, we tried chicken filet, tilapia, canned tuna and egg white. he puts the food in his mouth and drops it back in the bowl. Not sure what he is trying to communicate. He then vomited the little food he ate. We are at a very low point and while it is good to see a lot of you have gone through similar situations and have saved your dogs, I would love to hear suggestions as to how to manage providing him a minimum amount of food to sustain him until his appetite comes back.

    • Linda Hoover

      Hi, Elie, is your terrier on Prednisone? That is the only thing that has kept my little Maltese, Machi, going for the last 15 months. He seems healthy, although his protein level usually runs a little below normal. I feed him the best raw organic beef I can find and add a little organic baby food, I get the kind with greens like kale, etc. They come in packages. I also add some rice or potatoes for a little. There is another steroid but my vet doesn’t think it is as good as Prednisone. I know what you are going thru. When Machi was first dx’d he was so rolly, polly fat but it was all fluid in his abdomen. As soon as he was started on Prednisone, he got very thin. He had lost .5 lb, and he only weights 6 lb. Hope this helps.

    • Bailey's Mom

      Hi Elie,

      It took Bailey at least a month to get back on track as far as eating. Now he’s ravenous. Between his IV colloid and Budesonide, it brought a lot of the swelling down and he was able to keep food down. Donovan’s mom gave me the idea of adding ginger for the nausea. May help keep his food down. I give it to Bailey anytime he seems to have an upset stomach. I have steered away from chicken since chicken seems to make him worse and the swelling returns. If I cook his food I choose boiled turkey breast and potato (mostly sweet). For a while he would only eat the turkey out of it but again, once his swelling went down I was able to switch him back to a vet formula food and he’s been doing great ever since. Keep your head up, you still have many options! 🙂

  • Linda Hoover

    after the potatoes I wrote “for a little carbs.” Don’t know what happened to that word. lh

  • Linda Hoover

    Hi, again, I didn’t mention that I give Machi the raw beef, not cooked. I think the fat composition is changed when the meat is cooked. I do that about 3-4 times a week, otherwise I use organic chicken or turkey (cooked). I’m not comfortable giving them raw chicken due to the possibility of infection. I add a mix of brewer’s yeast, Vit. C, calcium, ect. that I made up on their food. I have three little ones so feed them all the same. lh

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  • Am aflat aceasta pagina, dupa ce am cautat despre Canine Intestinal Lymphangiectasia:
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    Se pare ca informatia dvs e foarte valoroasa, mai ales ca am
    mai gasit aici si despre ora, ora exacta,
    lucruri interesante si folositoare. Mult succes in continuare!

    • Linda

      Ora Exacta, please use another forum to post your comment, this is for people who are dedicated to taking care of their sick, little ones.

      My little guy went to the vet this week for a teeth cleaning and had a senior panel done beforehand and everything came back in the normal range, Praise the Lord, and I say Praise the Lord, since I live near Roseburg, Oregon, I say that proudly. If anyone doesn’t know what I am talking about, respond to me and I will tell you. Linda

  • Julia

    I have just taken on a foster dog with CIL and have been advised by the vet to give her 40g of MCT per day ( she is just over 13kg and losing approx. 500g per week). I have read your thoughts on giving MCT to CIL dogs and would like your advice on an alternative.
    Many thanks

    • Louie's mom

      Hi Julia,

      Don’t take my word as gospel; I only know what worked and didn’t work with my dog, and I know there have been others who seemed to have success with MCTs. I would go ahead and try it, but be very careful to monitor for any signs that your dog isn’t tolerating it well. It can be a real crap shoot to figure out what these kiddos can tolerate!

      • Linda

        I agree with the above comments. My little guy isn’t taking Prednisone anymore and seems to be doing well. I cont. to feed them a home cooked mean, organic chicken or beef with organic grains, rice, potatoes, oats, barley, etc. I add a little supplement that I got from a pharacist caled “Solid Gold Seameal” which has seaweed, etc. I add a little flax oil because one of my dogs has psoriasis. A couple of times a week I give them organic beef raw. I have read that cooking the beef changes the conposition of the fat and makes it less digestible. It has been two years, I have a little Yorkie that is almost 17 and still going. They all eat the same and my little Maltese with the CIL seems healthier than ever. I accidentally stopped the Prednisone when I got sick and forgot it for several days. The lymph glands in his neck were always large, and when I realized what I had done I checked his neck and they seemed a little smaller. They have cont. to stay small. I haven’t had bloodwork done on him recently because of the cost, just can’t afford a lot of vet bills right now, and he is healthy and full of energy. I hope this helps. If your dog were mine, I would probably start feeding her a good organic grass fed raw 93% beef (with a little tofu, maybe) with a little bit of white rice to get as much protein in her as possible. There would be very little fiber, thus decreasing the transport time of the food thru the gut and possibly increasing absorbtion. Just a suggestion. (I am an RN, have worked with people on dietary issues)

    • Elyse Darby's mom

      Hi Julia, Are you home cooking? I spoke to Dr. Delaney at Balance IT a company that makes supplements for home cooked diets, when I was trying to figure out how to get my dog to gain weight. They require you get an ok from your vet because they are regulated by the Federal government, then they will supply precise calculated nutrition for your dogs diagnosis. He was aware of my dogs issue with Moderate to Severe Food restrictions and possible IBD. He suggested Walnut Oil. Just a very small amount. It is one of the approved oils in the recipe for this diet for these dogs. They actually tell you how much to add per their formulated personal recipe. I would not dare to try to tell you how much. My dog weighed 7 lbs. I went to IT Balance because I felt I had help with formulating a proper amount of food for calories and what should be included or supplemented. I did not feel comfortable without a dietician or Vet giving g me guidance. My Texas A&M vet was hesitant to approve any fat. But she did approve me going through IT Balance who I believe was started by Davis University. I felt helpless as my dog continued to lose weight, but had no idea of how much I should be feeding him. Since my dog lost so much weight I was not confident on how much (too little too much)I should feed him while home cooking. I also worried would I cause a setback if I gave him to much fat that would then make it difficult to get my dog back on track to wellness. It is a personal decision and also like Louie’s mom said a crap shoot. I chose not to try either one. But if you do, don’t give the 40mg, start off at a very small amount, see how it reacts. Progress to the 40mg. Just my two cents.

  • Marie

    My Westie was diagnosed in July 2013 with IBD and suspected Lymphangiectasia at UC Davis. She had a stomach biopsy and blood for the diagnosis and then was seen by the Nutrition Department to create her diet. Prior to her biopsy, the team of doctors at UC Davis ran her on a trial home cooked meal under her Nutrition doctors supervision and guidance, my Westie did not respond and continued to lose weight and got sicker. After the biopsy and official diagnosis, she was placed on Prednisone and Royal Canin Moderate Calorie Potato Whitefish dog food, she was also placed on children’s probiotics. The probiotics made a difference in 24 hours for her stool consistency, however, the Prednisone changed her personality dramatically…she became lethargic, depressed and was bloated all of the time. Six months later, we returned to UC Davis for a follow-up. I expressed my concerns about her personality changes to her UC Davis Vet and he changed her to Budesonide. After one week on the Budesonide , I had my bubbly, bouncy, energetic and happy dog back. She has been thriving on the Royal Canin P/W RX diet, Budesonide and probiotics since. It was explained to me that dogs with Lymphangiectasia need to be on a low fat diet. Recently, her local Vet recommended that we put her on fish oil. I hesitated to do this and am glad I decided not to proceed. If your dog is doing well with their diet and supplements, do not change them.

    • Ani

      Glad you found something that works. High fat diets don’t benefit anyone!
      I have to smile at how you seen the Nutrition Department and the vet. Obviously not a holistic vet..
      Everything you mention there compromises the dogs immune.
      Good luck doggy!

      • Marie

        4 years later and she’s doing great!! She competes in Coursing, Earthdog, Nosework and models. She is exceptionally healthy and this past fall saw the Holistic Vet at UC Davis for a routine follow-up. The vet was very pleased with her blood tests and overall health. She encouraged us to continue with all foods and medications currently prescribed. Btw, before the Hypoallergenic diet we ran several trials on Raw, and novel protein diets and her condition deteriorated even more, so this was the best course of action to save her life.