Nutritional Management of Fat-Responsive Gastritis and Enteritis in Dogs and Cats
Enteritis is inflammation in the intestines. This inflammation can occur in the small or large intestine, though often inflammation that occurs in the large intestine is referred to as colitis. Gastritis is inflammation in the stomach. Gastroenteritis refers to inflammation in both the stomach and intestines. Fat can be a particularly difficult nutrient to digest, so management with a low-fat diet is often recommended for patients suffering from gastrointestinal upset. Gastritis and enteritis can have various underlying causes and appropriate dietary management can focus on managing each underlying cause. Management might look like a highly digestible diet, low-fat diet, hypoallergenic diet, high fiber diet, which uses both soluble and insoluble fibers to improve gut health, or a diet that implements a combination of some, or all of these strategies. Understanding how fat can play such a role in the development and management of some gastroenteropathies is important as companies strive to make diets that are healthy for the vast majority of pets.
Gastritis and fat
Gastritis typically manifests as vomiting or regurgitation, but inappetence is also common as cats or dogs may feel nauseous. One trick to managing gastritis is to get the food to move through the stomach quickly. This will help to limit the amount the stomach is stretched, which may increase the feeling of nausea or result in food being left in the stomach, which allows for an increased chance of regurgitation. Fat stimulates a hormone called cholecystokinin (CCK) which slows the process of stomach emptying. Higher fat meals pass through the stomach more slowly, potentially resulting in increased nausea and the chance of regurgitation and vomiting. When looking for a low-fat diet to help manage gastritis, aim for something that is 10% dry matter (DM) fat or less for dogs and about 20% dry matter for cats. Using a highly digestible canned diet, which can move the stomach even quicker, is also advised. Further, breaking the daily feeding amount into more frequent, smaller feedings will also decrease the amount of stretch in the stomach and help to decrease nausea.
Enteritis and fat
It is important to remember that enteritis can occur due to a variety of causes including infectious agents (viral, bacterial, and parasitic) as well as inflammation from stress, dietary indiscretion, allergies, inflammatory bowel disease (including protein-losing enteropathy or lymphangiectasia), cancer and chemotherapeutics, or other medications. Finding and managing the underlying cause of enteritis, in addition to management with diet, is crucial.
The use of low-fat diets with intestinal inflammation may help by reducing the amount of hydroxylated fats in the gut, which may result in secretory diarrhea. In some severe cases of enteritis, such as when there is lymphangiectasia or protein-losing enteropathy (or both), high-fat diets result in an increase of protein in the lymph and lymph flow through the lymphatic tissue in the gastrointestinal (GI) tract. If the lymphatics are impaired, this excess lymph can get into the intestine and damage the lining, causing further inflammation.
To help manage generalized diarrhea, a diet that contains about 10-15% dry matter fat for dogs and about 20-21% for cats is recommended. If a dog has protein-losing enteropathy and/or lymphangiectasia, ultra-low-fat diets are recommended. These should be about 7-9% dry matter fat.
The pancreas generates digestive enzymes and releases them into the small intestine so they can do their job. When inflammation of the pancreas occurs, these digestive enzymes can get released outside of the small intestine and result in inflammation of the surrounding gastrointestinal tract. This is not only painful but can result in vomiting and diarrhea which may be mild or can be severe enough to require hospitalization and even result in death. Fat ingestion stimulates pancreatic digestive enzyme secretion. In dogs, pancreatitis can be caused by the ingestion of high-fat meals or dietary indiscretion. For acute cases that perhaps were caused by a dog getting into drippings from the grill or eating from the butter dish, the dietary fat restriction can be about 10% dry matter for dogs. If a dog gets pancreatitis and they aren’t typically consuming a very high-fat diet or has not gotten into fat, then feeding an ultra-low-fat diet of about 7-9% fat dry matter may be needed. Cats have a higher fat tolerance than dogs and can be managed with a dietary dry matter fat content of 20-21%.
General tips and thoughts
Over the years I’ve found that many dogs do well with moderate to low-fat diets in general and that many gastrointestinal diseases can be treated, at least in part, with a low-fat, highly digestible diet. That said, there are several chronic enteropathies and other specific gastrointestinal issues where a highly calorie-dense, high-fat diet would be more beneficial for the management of that particular patient than a low-fat diet in helping them maintain an appropriate body condition. Some healthy dogs also seem to do better and maintain weight better with a high-fat diet. So, while in general I’m classified as fat-phobic when it comes to pet food, each pet is an individual, and managing them and their illness should be done on an individual basis.
About the Author: Dr. Streeter is a Doctor of Veterinary Medicine and a Diplomate of the American College of Veterinary Nutrition. She obtained her undergraduate degree in animal science from Cornell University and served as a farm animal nutritionist for a major feed company before attending veterinary school at Ross University. Her clinical rotations were done at Cornell University’s college of veterinary medicine, where she stayed on to do her Clinical Nutrition residency. There, she saw clinical nutrition cases and researched the relationship between omega-3 fatty acids, adipokines, and canine obesity as well as selenium deficiency and white muscle disease in horses. While working in general practice and clinical nutrition for the next six years, Dr. Streeter also founded her own veterinary nutrition consulting company. She currently helps industry clients through her position as the Nutrition Practice Principal at BSM Partners and helps veterinary patients as a Clinical Nutritionist, taking referrals through veterinarians and seeing patients remotely at a specialty hospital in Upstate NY. She has given student lectures at Cornell University, presented an abstract at AAVN symposium, and given multiple continuing education lectures for pet owners, veterinarians, and other pet food industry professionals.
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