Canine Intestinal Lymphangiectasia 102:

Canine Intestinal Lymphangiectasia 102:  

Read Canine Intestinal Lymphangiectasia 101 .

Seriously!

I love that we’re all talking about this disease, but it’s good to read everything here, too.

I don’t have a lot of time to spend here, so I’ve tried to put the information that I’ve learned in a place where it is available to everyone.  If I don’t respond to every question here, it might be due to the fact that your answer is already here.

A few quick reminders:

  • Don’t feed a dog with primary CIL a high fat diet.  ULTRA low fat and HIGH protein is the way to feed.  If your dog improves on a fatty diet, your dog does not have primary CIL, but may have CIL secondary to IBD.
  • If things aren’t working, eliminate chicken.  It’s often not tolerated well.  Lists of well-tolerated, low fat foods can be found in several posts here about feeding.
  • Protein loss causes muscle wasting and you will not get weight on a CIL dog until you get the intestinal protein loss under control.  DO NOT feed fatty foods to put weight on.  You will kill your dog quickly that way.
  • STOP worrying about grains and raw foods and corn-free and every other trendy feeding advice you’ve ever heard.  NONE of that will help your CIL dog, and holding fast to those trends while refusing to feed what does help will quickly kill your dog.  Feed what works and stick with that until they day they die– hopefully from something other than CIL.
  • It can take several months to find what works and get your dog stable.  Don’t overreact to a lack of progress.  Steady wins this race.
  • Mashed potato flakes (just plain potatoes, nothing fancy) are your best friend.  They contain no fat, therefore you can cut back the fat content of any meal simply by adding potato.  If your food isn’t working and you think it’s the fat content, you can experiment with adding potatoes until you find a ratio of food-to-potato that works for your dog.
  • What you’ve really found by doing that is a percentage of fat that is tolerable for your dog.  You may not have a number, but you do have a feeding success, and that is what counts.
  • Once you reach stability, you may have to add one or two meals per day to keep your dog from losing weight.
  • If your dog does not eat his/food, it’s probably because of indigestion.  DO NOT start swapping foods to encourage eating.  Instead, give a little pepcid to control the tummy ache.  You probably wouldn’t eat, either, if you felt as bad as this disease makes your dog feel.

Feel free to add your own simple advice in the comments section.  What has worked for you that every CIL owner should know about?

 

 

 

20 comments to Canine Intestinal Lymphangiectasia 102:

  • Jill Jones

    Thank you for the wonderful article and blog! So nice to find a source of information on Lymphangectasia and to link up with other pet owners dealing with the issue.

    My five-year old Norwich Terrier was diagnosed in December. With much success, she has been eating Royal Canin’s canned LOWFAT Gastrointestinal formula. This is the only lowfat GI formula (dry or canned) I have found that does not contain chicken. She does not tolerate chicken…causes lots of itching. For treats, I have been using Rice Chex cereal…no fat, low calorie, and very little fiber.

  • Amy

    Great reminder list! I would add:
    – If things aren’t working, eliminate rice.
    – If low-fat dog food isn’t working, switch to a home-cooked diet.

  • Debbie Winkens

    I found that a combination of boiled red potatoes, boiled chicken, 20 ml of vivonex and occassionally some frozen peas have worked miracles for my yorkie Lizzie. We took her home from A & M hospital because she was not getting any better. We just knew that CIL was winning. We started feeding her boiled chicken, boiled red potatoes and 20 ml of vivonex. Her last blood tests on Mar. 26th showed her blood work is almost perfect now….We are very strict with her diet. She is also on 5 mg of prednisone in the am; and 1/2 of the 5 mg prednisone in the evenings. She is also on two meds for a long time now for CIL. (Cyclosporine and Cloplygrel(spelling) This is given once per day 2 ml each. This has been a very up hill battle. My Lizzie has more energy than she has had in a really long time…. Regards, Debbie

  • Louie

    Yep, Amy! I switched from rice to potato because the rice was not being digested well and that was driving up the fat percentage of the digestible food in his meals. Potato flakes (add water, of course) were more easily digested than the rice.

  • Morgan'sMom

    Good info here! I think it is also good to point out that, while we all need the help of our vet when our dogs are ill, there are many excellent vets out there that are not as knowledgeable about diets as we’d like them to be. Prescription dog foods can be helpful, but just because it is prescription does not mean it is right for our dog. Dogs react differently.

  • Jess

    In Aug of last year my yorkie, Tweek, was on his deathbed, he was so thin and could barely walk. The information on this site was such a tremendous help in getting him better! The vets called his condition “grave” and could only recommend low-fat vet brands of food. I quickly learned that those dog foods would not help Tweek. After doing a lot of research online and some trial and error we came up with a diet that he tolerates really well and now he even has more energy than before he got sick!

    I tried the potato flakes but Tweek does not like the texture and refused to eat them, he could not handle chicken either.

    I cook for Tweek about every day and a half to 2 days. I make him medium-cut barley groats, which he loves (they have 1 gram of fat per cup – 1%). Also for protein I boil tilapia fillets and mix that with the barley. I buy bags of frozen tilapia at Costco which is much cheaper.

    In addition to the barley and tilapia, I add in “Balance IT” supplements for dogs and once a day he gets “Nusentia Probiotic Miracle”.

    About 2-3 times per week I make him some Quaker Quick Oats which he also really likes.

    I make Tweek’s treats myself, I can’t seem to find anything in the pet stores that he can have, or if I do it’s really expensive. I make his treats by grinding up Quaker quick oats, on the side I mix an egg white with some water and then combine it with the ground up oatmeal. I break up the dough into quarter size pieces and then stick them in the oven for about 15-20 minutes.

    On top of all that he is on some meds, in the morning he takes Prednisolone, which I have been VERY SLOWLY weaning him off of to the lowest dose possible, at the moment he is on 3/8th of a 5mg pill. Yes I know it’s an odd measurement but when I tried to go from half a pill to a quarter it didn’t go well. In the afternoon he gets a quarter of a pepcid pill. At night he gets one 50mg Tylosin pill, in the past I’ve tried to stop giving him this medication but it’s possible he’s been on it for too long to stop. I’ve done some reading and it looks like after a while some dogs become dependent on Tylosin, when they stop taking it diarrhea comes back. So he may be on this medication for the rest of his life. I found that concealing his pills in a small piece of fish works the best for us, until we discovered this Tweek always found a way to spit the meds back out.

    I hope this info is helpful!

  • Louie

    Thanks, everyone. There’s great info here.

  • Louis

    Can someone help me with how they prepare the potatoes for their dog?

    I feed him the wet version of Royal Canin Gastrointestinal low fat as treats. (he gets the dry food as a meal). He cant really tolerate much else.

    I would really like to mix in something else as treats and want to try potato, but would like something simple but I am a gut who doesn’t cook.

    Does anyone know a simple potato recipe?

  • Amy

    Nuke ’em! Seriously, microwaving a potato is the easiest cooking on the planet. (I’m a girl who doesn’t really cook either.) Just put the potato in a glass dish and microwave for about 10 minutes, depending on the size of the potato. My dog seems to do a little better on sweet potatoes than russet. But sweet potatoes are much more irregular in shape and size, so you have to be more mindful of how many minutes you’re cooking them.

  • Louies Mom

    Even easier than that. I just bought potato flakes, the kind that you use for making mashed potatoes. Make sure they only have potato in them, as you can buy them with butter and other flavorings that add fat– you just want the plain kind. If you’re not sure, check the label and make sure the fat content is 0.

    You don’t even need to cook these, just add water to them and stir it in until you like the consistency. They fluff up just fine even when they’re cold.

  • Louies Mom

    PS: I don’t much like to cook, either!

  • Louis, I make potato chips. Use a box grater to have very thin chips, lay them on parchment paper on cookie sheet pan. Bake in 375° oven until brown and dried out. My Ella loves them . She gets 1/2 baked potato twice a day and 1 egg white twice a day in addition to Rc low fat soft and kibbles. She is maintaining ok. Could have better protein levels. Try the chips, it is easy

  • Chubs mom

    My Charlie is 4 years old maltese. He weighs about 9 lbs. The first vet I’ve seen suspected IBD, it all started when I gave birth to my first child. A month later, Charlie started diarrhea, the vets put him on metronidize. The diarrhea got worst, it went from bloody to shooting out brown water. He eventually put him on perdesidone. However, with that his body started getting bloated, and I asked why is he so bloated.. and losing weight, despite a big appetite. Soon his tummy was filled with protein. Just 3 days ago, they removed 3 cups of water from his little body. They put him with injectable predesidoine… that I have to inject in his little body. They’ve also drew blood and tested him, along with the ultrasound. His protein level is now at 1.0. All his organs are functioning well, all he saw were thicking of intenstines. No, inflammation… I do not know what to do! The specialist also told me treatment options is very low. I started crying after I heard this. I held my Charlie and told him he needs to get better. I’ve been reading a lot of the post on here, and Louie’s mom, I cannot thank you enough for sharing this information, and gathering a great forum and having people share their experiences.
    Today, I started with the Talipia and potatoe diet. I’m just wondering tho, how much to give him? He nearly ate the whole piece of fish and two red potatoes. He devoured it! I’m pretty happy he has great appitite, but his stools are formed but very mushy. What should I do? I’m so scared. So blessed to have child 1 and fight this battle of first canine child!

  • Amy

    I’m so sorry to hear about your Charlie. I don’t know what perdesidone is. There’s a number of medications that can be prescribed to treat this disease, but the two most common ones seem to be Prednisone and Azathioprine, so you might ask your vet about that. The medication along with an ultra low-fat diet with potato should firm up Charlie’s stool fairly quickly, so hang in there. I’ve been using the recipes at BalanceIt.com and for a 9-pound dog they call for about 7 1/2 ounces of potato and 1 1/2 ounces of fish, which ends up being about 80% potato and 20% tilapia. Congratulations on your first baby!

  • Lisa Smith

    Hi there,

    I run a rescue sanctuary for geriatric, special needs and hospice pugs. Currently I have 15 that I care for, several are incontinent, paraplegic, deaf and blind so the level of care I provide is fairly intensive. I do not solicit donations, most expenses are out of my pocket. I have been a big proponent of raw feeding – high protein, high fat, and very low carbs, this usually suits most of the dogs with a few notable exceptions.

    I recently took in a 6 year old, spayed female pug named P-Nut. I should note I had babysat P-Nut about a year and a half ago. At that time P-Nut was a chubby and adorable 16 lbs and needed to be closer to 14 lbs. When her owners surrendered her to me recently I never would have recognized her. She was emaciated with a little pot belly, no muscle tone and little energy. The owners claimed to have been feeding her Ziwipeak dehydrated raw food, which is excellent quality. They said they thought that her weight loss was because they needed to feed more. She weighed only 11.5 lbs. She looked generally “unwell” and I was very concerned.

    I immediately started her on a raw diet and her weight went up to 12.5 lbs. but she was having intermittent diarrhea. I took her in and they did an x-ray which showed fluid in the abdomen, but no masses or anything else he could see through the cloudiness of the fluid. He also ran bloodwork and a urinalysis. The urinalysis was great, no protein in the urine.

    The bloodwork on the other hand was horrible, low albumin (0.9), low globulin (1.6), low total protein (2.5), low cholesterol, low calcium, low RBC (4.36), low hemoglobin (11.2), low hematocrit (33.9). Her WBC, MCV, reticulocytes, platelets, neutrophils and and monocytes were high as well as her potassium level. Her lymphocytes were nicely within normal range as were her kidney and liver values (ALT was slightly low and creatinine was slightly high, but not enough for concern).

    With my vet we formulated a medication, supplement and diet for her and have been tweaking it as we go. A week later, a re-check showed an albumin level of 2.2! Yeah! Also a little more energy and better appetite. However she has progressed into constant diarrhea. Being semi-incontinent to begin with, this is a big problem. Luckily the diarrhea is not bloody or mucousy, just yellowish, brownish pudding poop. Smells HORRIBLE.

    Yesterday (2 weeks since diagnosis) I took her in for a repeat blood draw and the results came back today. Albumin 1.8, Total protein 3.7, Globulin 1.9. lymphocytes still normal. WBC’s still high, cholesterol and calcium still low. Potassium still high, neutrophils and platelets high.

    She is happier and has a much better appetite this week though, and last night she had a soft, but formed stool. This morning’s was pudding again though. She is now on weekly shots of B-12 too.

    This is the diet/med/supplement program I currently have her on: http://i215.photobucket.com/albums/cc187/truckmountgirl/Mobile%20Uploads/2014-08/20140828_141407_zpsvalzt3xp.jpg

    I have not been feeding carbs because I was told high protein, low fat and since dogs don’t need carbs and often have difficulty with them, I haven’t added potatoes or rice or any vegetables other than what is in the crappy Z/D food.

    It seems I may need to re-think that position?

    Thank you so much for any help you can provide.

    • Bailey's Mom

      Hi Lisa,

      I would talk to the vet about switching to Hill’s i/d instead of z/d (I can’t say from personal experience since Bailey is on Iam’s low residue, but I’ve read through these posts that the i/d is better for these pups!) I too had issues with Bailey having constant loose stools or even diarrhea. I just a month ago started adding a teaspoon of mashed pumpkin and a dash of fiber. His stools are completely firm. I’ve also noticed he has no more belly bloat (even being clear of abdominal fluid for six months, he still had a slight belly). Between cutting back on meds, lowering the fat in his diet and adding more fiber…he is acting like a puppy again! I feed him dried turkey as treats (you can get these in pet stores or online and is 100% turkey breast and no other ingredients). As far as smell…once you get the lymphangectasia managed, his stools won’t be so foul smelling. Talk to the vet about adding some fiber….couldn’t hurt! Good luck with P-nut and keep us posted!

      • Amy

        Yes, I think you should re-think your position on a grain-free diet. It’s just a whole different world with a CIL dog. Read Louie’s Mom’s article on the potato. It can really help with the diarrhea. And I agree with Bailey’s Mom that SD i/d is probably better than z/d for this disease.

        • Lisa Smith

          Thanks Amy and Bailey’s Mom!

          We have not had tests other than bloodwork, urine, fecal and x-rays. P-Nut is too debilitated for a biopsy, and from what I read they are frequently inconclusive and whatever the finding they basically treat all the same anyway…..SO with the bloodwork now twice showing normal lymphocyte values and abnormal lymphocyte values being a hallmark of CIL, does that mean her severe PLE has another cause? If so, what and how would her treatment differ from the treatment of a PLE dog with CIL? Any non-invasive, anesthesia free tests we can perform to further narrow the cause of her PLE? I started adding 1/4 cup of dry potato flakes to her current food. She HATES the potatoes, but if I lock her in a room herself for an hour or so, she eventually eats it. So far still has pudding poops. My vet ordered some Royal Canin Gastro/lowfat and it came in yesterday. Will start it as soon as the current can of Z/D is finished.

          • Kyla

            Im reading this blog and its been a few years. I have a pug that is 13 that has developed this. Can you update on how your protocol went with P-Nut since your post a few years ago? Thanks.