Care and Feeding (Repost from the blog)

[LouiesMom]

(I'm closing these sticky threads so that we can start new discussion based on what might be going on with the members today. Thanks so much for being here! )

Today I’d like to talk about diets for dogs with Canine Intestinal Lymphangiectasia (CIL). Simply put, there are two common forms of this disease which have somewhat different, but overlapping, dietary requirements. These are:

• Primary lymphangiectasia (lymphangiectasia by itself), and
  
  
• Lymphangiectasia secondary to Inflammatory Bowel Disease (IBD).
  

“Secondary” here means that your dog has a disease (IBD) which is causing another disease (lymphangiectasia).  When a disease is “secondary,” it means that treating the first (primary) disease will often fix the secondary disease.  What this means is that, with lymphangiectasia that is secondary to IBD, treating the IBD is more important.
So, what you need to feed your dog will differ somewhat, depending upon which form your dog has.  And here’s the catch:  Even with all the testing you’ve done, and even with your vet’s best guess, YOU may not know which form your dog has.  In this case, how your dog reacts to food will provide important information about his dietary needs.
There are generally two items in the diet that may need to be strictly controlled (FAT andPROTEIN), and what you need to do will depend upon which form of the disease is present.  We’ll look at this separately, and then we’ll look at what typically happens in a case where the situation is unclear.
PRIMARY LYMPHANGIECTASIA (FAT is the enemy)
In primary lymphangiectasia, the big enemy is fat.  If you can control the amount of fat in the diet, you can (in some cases) control the disease.  Treatment is simple and straightforward and typically consists of anti-inflammatory drugs and an ultra low-fat diet.  The diet may also be high in protein.  With luck, treatment will resolve the disease as long as strict dietary adherence is maintained.
LYMPHANGIECTASIA SECONDARY TO IBD (PROTEIN is the enemy*)
If lymphangiectasia is secondary to IBD, your path is not so clear.  IBD is usually caused by protein intolerance (a negative reaction to certain kinds of proteins), so it becomes important at this point to determine whether or not your dog is reacting negatively to proteins in the diet.  The protein source in most diets is some kind of meat, so this is where you will need to look.  It is still critically important to reduce dietary fat, especially early in treatment.
Steps to take:

1. Eliminate commonly fed proteins (especially chicken)
   
   
2. Feed a hypoallergenic prescription diet, OR
   
   
3. Slowly, and one at a time, introduce LEAN proteins that your dog has never eaten (examples of lean meats are bison, venison, kangaroo, whitefish such as tilapia or cod, or turkey).
   
   
4. Observe over 24 hours what changes, if any, are seen in your dog after exposure to these proteins.
   

There are commercial, prescription diets available which can be tried initially.
Low fat diets include:

• Royal Canin Gastrointestinal Low Fat
  
  
• Hills w/d® Canine Low Fat
  

Hypoallergenic diets include:

• Purina HA hypoallergenic dog food
  
  
• Royal Canin Hypoallergenic dog food
  
  
• Hills z/d® Canine ULTRA Allergen-Free
  

Your vet may recommend one of these diets.  These diets can provide a good starting point, but may not provide you with the full answer.
IF PRIMARY LYMPHANGIECTASIA IS SUSPECTED BUT YOUR DOG FAILS TO RESPOND TO THE LOW FAT DIETS
This happens quite a lot.  What it usually means is that your dog has an additional protein sensitivity that hasn’t been diagnosed.  You will need to begin to conduct low-fat protein trials to try to find a protein source that agrees with your dog (see “steps to take,” above).
ADDITIONAL TREATMENTS THAT MAY BE RECOMMENDED

• Anti-inflammatory drugs are frequently prescribed.  These are often steroids, like prednisone.
  
  
• Metronidazole (flagyl) is an antibiotic with anti-inflammatory properties.
  
  
• Tylan (tylosin) is also sometimes recommended, especially in cases where the intestinal disease is suspected to be complicated by Small Intestinal Bacterial Overgrowth (SIBO).
  

So far we’ve talked about dietary needs and prescription products.  Many owners of lymphie dogs have found these products to be inadequate, and have turned to homemade or “hybrid” diets (diets containing but not limited to commercial products).  We’ll talk about these in another post.
— Louie’s mom
*SPECIFIC proteins, and you may have to figure out which ones.