Nutrition for the Canine Oncology Patient
AN INDIVIDUALIZED APPROACH TO NUTRITIONAL MANAGEMENT OF OUR PATIENTS
Nutrition is an important part of giving your dog a good quality of life during and after cancer therapy. Your dog’s nutritional needs can be affected by his/her appetite, the specific cancer diagnosis, the treatment approach used to manage the cancer, and concurrent medical conditions. We believe this complexity requires an individualized approach to nutritional management for each of our patients. Cancer and its treatment can be associated with side effects that influence nutritional status. The most common side effects include hyporexia (decreased appetite) or anorexia (no appetite). Hyporexia or anorexia may develop for 1-2 days, or may last for a prolonged period of time. Our concerns with your dog’s nutritional status increase as the frequency of hyporexic or anorexic episodes expands.
NUTRITIONAL NEEDS FOR DOGS WITH CANCER
There are many sources of information that attempt to deal with the nutritional needs of dogs with cancer. A one-size fits-all approach to the dietary needs of the cancer patients is not realistic. A tailored approach focused on your dog’s nutritional needs is the best approach.
CARBOHYDRATES AND CANCER
Several online sources recommend a high protein, low carbohydrate, and grain-free diet for all cancer patients. It is believed that feeding a low carbohydrate diet decreases fuel available for cancer cells, and provides more energy in the form of fats and proteins for the patient. In fact, data on this issue is quite limited. Indeed, there are no good medical studies that can show the benefit of feeding high, low, or medium carbohydrate diets to dogs with cancer. The theory behind a low carbohydrate diet is that cancer cells use glucose as their primary energy source. When cancer cells use glucose they create a compound called lactate. Lactate leaves the cancer cell and is converted back to glucose in the dog’s liver. This conversion of lactate to glucose requires energy. During this process the cancer gains energy, but the patient loses energy. This can contribute to the condition called cancer cachexia (severe, uncontrolled weight loss). In reality, most dogs with cancer will not develop cancer cachexia. As such the approach and concern is over-stated and potentially harmful. Feeding a low carbohydrate diet has not been shown to improve survival, or response to chemotherapy, or radiation therapy for canine cancer patients. Low carbohydrate diets are very high in protein and fat, and high protein or fat intake is contraindicated in patients with kidney, liver, gastrointestinal, and pancreatic problems. In some cancers proteins may be a preferential fuel source over glucose. For these cancers, such a diet may be harmful.
BALANCING FATTY ACIDS
Considerable debate and discussion has focused on the use of Omega-3 fatty acids in dogs with cancer. Omega-3 fatty acid supplementation has been evaluated in single study of dogs with lymphoma. In this study using fatty acids may have improved survival for some dogs. Replicated studies are needed to confirm these potentially promising results. Much has been made of this study; however, these results are likely pertinent to our nutritionist, is recommended prior to starting any supplements including fatty acids.
INTEGRATING NUTRITION INTO THE CARE OF YOUR DOG
If your dog is eating a regular diet at the beginning of therapy we recommend that you continue to feed this diet until the end of the initial treatment cycle. This will allow us to evaluate your dog’s nutritional status and how his/her body reacts to the therapy. This assessment can be then used to determine whether there is a need for a diet change. Based on specific considerations related to your dog, the development of an individualized nutritional plan may be helpful. We encourage you to discuss all dietary concerns with your oncologist.
MANAGEMENT OF DECREASED APPETITE IN CANINE CANCER PATIENTS
If your dog is hyporexic you should offer an energy dense diet that he/she likes. Feeding enough calories is the most important means to address nutritional concerns. Providing a palatable diet that your dog will eat consistently is more important than providing a specialized diet. There are a few highly palatable, energy dense, ‘recovery diets’ that your dog may like including Hill’s Prescription Diet a/d, Iams Maximum Calorie, or Royal Canin Recovery RS. Other diets that may be considered include canned or dry puppy foods and diets for active dogs. Heating foods so that they are warm to the touch can enhance the smell and may encourage food intake. In some cases ‘recovery diets’ are not recommended especially if your dog has kidney, liver, or pancreas problems. These diets should not be used for long periods of time. Once your dog is eating more consistently he/she should revert back to a regular type of food (i.e. adult maintenance, senior or active adult). It is important to discuss these changes in diet with your oncologist or primary care veterinarian.
WHAT ABOUT “PEOPLE” FOOD?
Feeding ‘people food’ can often stimulate your dog’s appetite. You can offer a variety of foods such as cooked unsalted meats (roasted, boneless, skinless chicken; pan brown ground turkey or ground beef), cooked eggs (scrambled or hard boiled), cottage cheese, rice, bread, pasta, white or sweet potatoes, oatmeal, cereal crackers or other foods. Some dogs like sweet carbohydrates such as flavored oatmeal or sweet potatoes better then bland carbohydrates. Adding a small amount of yogurt, animal fat, oil, margarine, or grated cheese can enhance the flavor. Chicken or beef broth can be used as gravy; however, make sure that it does not have garlic or onion in it. Dairy products should be introduced to your dog slowly to make sure that your gastrointestinal upset does not develop.
What to avoid: Never feed your dog raisins, grapes, garlic, onion, chocolate, or artificial sweeteners (xylitol), since these can be toxic. If your dog is eating an unbalanced diet for a prolonged period of time (greater than 2 weeks), vitamin/mineral supplementation is recommended.
MANAGING DOGS WITH NO APPETITE
For dogs that are anorexic, providing a variety of foods is often beneficial. If you have a small dog (less than 20 lb), syringe feeding may be an option. For larger dogs, it is often difficult to syringe feed the amount of food needed to meet daily caloric needs. Do not force feed your dog, since this can sometimes make the problem worse. If the anorexia is going to be a persistent problem and your dog otherwise has a good quality of life, a feeding tube may be considered to provide nutritional support. A discussion with the oncologist and nutritionist is necessary to make sure this would be the best decision for your dog.