The Best Dog Food for Dogs with Diabetes Mellitus

The goal for choosing a dog food for dogs with diabetes is not to “cure” the dog. But instead to minimize the clinical signs and complications that can arise in a diabetic dog. The nutritional management of each individual dog with diabetes is unique. And we can see that consistency is probably the most important factor for successful blood glucose management of diabetic dogs.

What is Diabetes?

On a very basic level diabetes in dogs happens when there are changes to how glucose, fats and amino acids (proteins) are moved around and utilized. Resulting in high blood glucose levels that do not drop into normal levels.

In a healthy dog, after consuming a meal, foods are broken down into glucose by digestive enzymes. The resulting glucose is then absorbed into the bloodstream causes blood glucose to rise. This higher blood glucose signals to the pancreas beta cells that they need to produce insulin. Insulin then works to influence glycogen storage, and glucose uptake by the cells. In the liver glucose is converted to glycogen for storage to utilization later. In tissues glucose is used as an energy source for basic cellular functions. Between both these mechanisms glucose levels return to normal levels within a couple of hours.

In a diabetic dog insulin isn’t able to do its job of lowering blood glucose. This leads to glucose being unable to be utilized by cells as a source of energy, and blood glucose remains high. The lack of glucose within cells then leads to metabolic starvation.

Problems with Insulin in the Diabetic Dog

There are several reasons why insulin may not “work” the way it is supposed to. Some dogs may have one or a combination of factors contributing to their issues with insulin.

1. The number of receptors that signal the production of insulin is decreased.
2. There is an issue in cellular communication following the binding at insulin receptor sites.
3. Or just not enough insulin is released by the pancreatitis beta cells.

Clinical Signs of Canine Diabetes

Dogs who have diabetes most commonly present between 7-9 years of age. Typically the most common signs you might see as an owner of a dog with diabetes is increased thirst, increased urination, weight loss (though dogs may be emaciated to obese), and cloudy eyes. However there are many other clinical signs that may be present.

Other signs of diabetes in dogs are:

• Unkempt coat
• Enlarged Liver
• Cataracts
• Dehydration

It is important to note which clinicals signs your dog presents with and their severity. Much of the clinical management of diabetes in dogs has to do with management of clinical signs.

Diagnosis of Canine Diabetes

Usually veterinarians will diagnose diabetes by a combination of bloodwork (a complete blood cell count with full blood chemistry), along with urinalysis. The reason why veterinarians do not just test suspected diabetic dogs for blood glucose is because there are many other diseases and conditions that can artificially inflate blood glucose values. Including even just stress.

Once diagnosis occurs dogs are typically started on insulin to help regular blood glucose levels.

Are Dogs Type 1 or Type 2 Diabetic?

The typical classification system of type 1 and type 2 diabetes doesn’t really apply to dogs (or cats), but diabetes in dogs tends to fit the model for type 1 diabetes closest. In the sense that they require insulin in order to regulate their condition. The full term for this is Insulin Dependent Diabetes Mellitus. Cats on the other hand are closer to type 2 diabetics in the sense that they can go into full remission with diet change alone.

Nutritional Management of Dogs with Diabetes

If you take away nothing from this entire text on the nutritional management of diabetes in dogs, understand this – the diabetic dog thrives with consistency of routine. The most success is seen when a diabetic dog’s feeding times, insulin timing, exercise and snacks are kept as consistent as possible.

We will be going into timing of insulin and meals, dietary composition, safe treats for diabetic dogs, and common concurrent conditions, but consistency is gold.

When to give Insulin and Food in the Diabetic Dog?

The timing of insulin and food in the diabetic dog is extremely important, and can sometimes be the hardest thing to keep consistent. Life is busy – owner’s may have other appointments, or commitments that makes the timing of both food and insulin difficult.

Some dogs who are picky may be extremely difficult to manage with diabetes as it’s hard to know when is the right time to give them their insulin. Dogs may also HATE getting their insulin if there is a negative association with getting their medication.

The first part of an effective management strategy is to consider the owner and the dog’s needs based on their temperament, lifestyle, and needs. Sadly these lifestyle factors lead to almost 20% of diabetic dogs being euthanized within the first year of diagnosis.

Twice Daily Meal and Insulin Schedule for Diabetic Dog

Once daily Insulin Injection (*typically less ideal)

• Insulin 30-90 minutes before Meal #1 = ⅔ daily feeding amount
• 10 hours later
• Meal #2 = ⅓ daily feeding amount

Twice daily Insulin Injection (*ideal)

• Insulin 30-90 minute before Meal #1 = ½ daily feeding amount
• 12 hours later
• Insulin 30-90 minutes before Meal #2 = ½ daily feeding amount

A note about insulin and picky eaters.

If you happen to have a picky dog that has diabetes the best thing you can do is find a diet they LOVE that will make them eat consistently. Considering a canned or fresh food diabetic diet or even a homemade diet may be your best option.

However if you are still having issues with your pup eating consistently most veterinarians will advise an adjusted insulin schedule.

Basically what this looks like is instead of giving insulin prior to meal and accidently causing hypoglycemia if your pup refuses to eat or doesn’t eat enough – we taper the dose of insulin to the portion of the meal they have eaten.

An example of what this might look like:

• Full meal = they get their full dose of insulin.
• Half Meal = half dose of insulin
• Quarter Meal = quarter dose of insulin.

IMPORTANT: If you dog is picky and is having trouble eating consistently speak to your veterinarian ASAP. Never adjust insulin dosing without first having a conversation with your vet. Too much or too little insulin could cause life-threatening problems. The above is a "generalized" example and not appropriate for all dogs.

Diet Composition for Diabetic Dogs

The ideal diet for a dog with diabetes can vary a lot depending on concurrent medical conditions (like pancreatitis), and body condition (obese vs. emaciated). Because of these concerns there are many “exceptions” to general recommendations for dog food for dogs with diabetes.

For otherwise healthy diabetic dogs – at normal body condition, and who do not have any concurrent medical conditions (like pancreatitis) we typically want to choose diets higher in protein, moderate in fat, and higher in mixed fiber (both soluble & soluble).

Generally dogs with diabetes should avoid simple carbohydrates, sweeteners (like honey), semi-moist foods (which contain humectants), open-label diets (lack of consistency of products), and added flavors as these may cause issues with regulating blood glucose.

Diabetic dogs should also have as consistent of a routine as possible. Having walks or exercise twice daily, meals twice-daily, and small snacks of fibrous vegetables, fruit or lean proteins.

Protein in Dog Food for Dogs with Diabetes

If tolerable – diabetic dogs should be on a diet that contains moderate to high protein that is highly digestible. The reason why higher protein diets are recommended is because many diabetic dogs can have issues with amino acid metabolism. This is due to metabolic changes associated with the disease process. These changes can cause dogs to have issues with building and maintaining lean muscle mass.

This couples with the fact that the typical onset of diabetes in dogs is older – 7-9 years of age. And older dogs already tend to have a slightly lowered ability to utilize protein and amino acids due to in the gastrointestinal tract.

For dogs who are overweight and diabetic a higher protein, low fat, high fiber diet may be recommended. This is because this composition helps with satiety and aid in weight loss over time. And as excess body fat can cause insulin resistance in dogs – working towards ideal body condition is very important for blood glucose regulation.

Some of the reasons why we may need to lower protein within a diet would be due to severe pancreatitis, or due to other concurrent conditions like kidney or liver disease.

If no other concurrent medical conditions aim for diets with 30-35% protein on a caloric basis, with a dry matter protein digestibility of over 82%.

Fat in Dog Food for Dogs with Diabetes

Diabetic dogs are usually advised to be on moderate to low levels of dietary fats. The reason why lower amounts of fats are advised for diabetic dogs is that many dogs who have diabetes also have either pancreatitis or are overweight. There is also some clinical research that suggests that feeding a diabetic dog a higher fat food can cause insulin resistance and greater amount of fat metabolites. However for diabetic dogs who need to gain weight a higher fat, calorically dense food may be advised to assist in weight gain.

According to Small Animal Clinical Nutrition – diabetic dogs should not get more than 25% dry matter, or 45% of calories on a caloric basis coming from fat.

Pancreatitis and Diabetes in Dogs:

For dogs with concurrent medical conditions like pancreatitis or obesity fat content should be kept below 10-15% dry matter, or 20-30% on a caloric basis. For dogs with diabetes and pancreatitis the lowered fat content helps decrease stimulus of pancreatic secretion of enzymes, thus helping with inflammation.

Obesity and Diabetes in Dogs:

For dogs who suffer from obesity, we look for lower-fat diets in order to help aid in weight loss. Fat is the most calorically dense macronutrient, and thus lowering fat content can help reduce caloric density of a diet. Couple this with increased protein to help build lean muscle, and increased fiber to help with satiety and this can greatly help with achieving weight loss goals. Getting an overweight diabetic dog to their ideal body condition can be extremely important as excess body fat can cause insulin resistance in diabetic dogs.

Important Note about Omega 3 Fatty Acid Supplementation:

There is no research on the use of omega 3s for diabetic dogs. And though some dogs with diabetes may find omega 3s beneficial, others may find the addition of additional fats to the diet cause issues. In humans the addition of omega 3 fatty acids showed an increase to dysregulation of blood glucose values. So always discuss if supplementation is in your pet’s best interest with your vet.

Carbohydrates in Dog Food for Dogs with Diabetes

General recommendations for carbohydrates for diabetic dogs has a lot of controversy around it. The main reason for this is because we have limited comparative research between low and high carbohydrate diets for dogs with diabetes.

There also seems to be a general confusion between the different types of diabetes and how they are managed. Many people have inferred that cats and dogs would do best on a low carbohydrate diet. For cats – this is actually true – many cats thrive and even go into complete remission of their diabetes on a low carbohydrate diet. But it is important to note that the type of diabetes that we see in cats (type 2 diabetes) is different from the type of diabetes we typically see in dogs (type 1 diabetes). Thus nutritional management strategies are likely to differ.

Research on Carbohydrates and Diabetic Dogs

• A 2009 research study which compared low carbohydrate (5% ME) to moderate carbohydrate (23% ME) with high fiber. This study did not find a significant difference in the amount of insulin needed for blood glucose regulation. It is important to note that all of the diets in this research were not over 25% carbohydrates on a caloric basis.
• Further research published in 2011 which looked at blood glucose levels in healthy adult dogs fed high fiber diets. This research found that blood glucose “peak” was lower on diets that contained 25% carbohydrates in comparison to those that contained 55% carbohydrates.
• Previous research published back in 1998 found that insoluble fiber can be very helpful for dogs with diabetes. The reason for this is because it slows down the breakdown of carbohydrates in the digestive tract. Thus allowing for a slower release of glucose into the bloodstream.
• Further research published in 2020 found that combinations of higher insoluble and soluble fiber can help with fat metabolites and blood cholesterol levels in dogs with diabetes. Suggesting a diet containing complex carbohydrates may be a good choice for dogs with diabetes rather than just diets high in insoluble alone.

General Recommendations for Carbohydrates in Dogs with Diabetes

Recommendations by boarded nutritionists as to composition of diets for dogs with diabetes is less than 55% carbohydrates, and 7-18% fiber on a dry matter basis. This doesn’t mean that dogs have to be given 55% percent carbohydrates – rather this is the upper limit of carbohydrates that dogs with diabetes should consume. With a recommendation of a higher fiber content proportionate to the carbohydrates consumed to control blood glucose levels.

Higher carbohydrate diets may be advised for dogs with pancreatitis who need a low-fat diet in order to help with decrease inflammation of the pancreas. They also may be advised for dogs who need to lose weight, as lower fat diets will typically have lower caloric density. In both these causes we would be lowering fat, and increasing carbohydrate content on a caloric basis. It is important to note that dogs who need to lose weight may do well with a higher protein, moderate fat diet that is high in fiber as well.

Lower carbohydrate diets that are lower in fiber (towards 7%) may be advised for dogs who need to gain weight, or that are otherwise relatively healthy. 

As you can see – there is not “one size fits all” when it comes to carbohydrate content for dogs with diabetes. Multiple other factors may need to be considered.

Important Note About Fiber:

Though fiber is very beneficial for dogs with diabetes, higher amounts of fiber can cause decreased protein digestibility. Based on this fact, it is important that high fiber diets are formulated and tested using digestibility/feeding trials to prove nutritional adequacy.

If your dog is on a high fiber diet, know that they will have more “bulk” to their stools – this means your dog may defecate multiple times per day. They also may need more bathroom breaks throughout the day so they do not have accidents.

Other Dietary Considerations for Diabetic Dogs

Though this has been mentioned several times throughout this blog post – consistency is key! Keeping your diabetic dog eating consistently is key to dietary management of diabetes in dogs. Thus one of the most important things you should look for in a diet for your dog is that they enjoy eating it. You should choose a diabetic dog food that is tasty to your dog. This also may mean you are combining two different diets in order to keep your pup eating. This is fine as long as the diets are consistent each day. Any diet changes can cause problems with the amount of insulin needed and blood glucose regulation.

We want to reduce changes to the diet – ideally we don’t want to feed a diabetic dog an “open label” formula. What this means is that the recipe changes depending on availability in order to reduce cost. Many budget-brands have open-label formulas that allow for companies to source the least expensive ingredients. They typically will not have minimum AND maximum fat levels, and will not be able to provide a typical analysis of their product.

Finally, we want to avoid giving our dogs treats that contain simple carbohydrates, sweeteners, or added flavors. We also want to avoid semi-moist diets, these are diets that come in “logs” that are shelf-stable. Canned or fresh-frozen diets are totally fine for diabetic dogs, and may help with keeping dogs eating consistently.

Prescription Dog Food for Dogs with Diabetes

There are three foods that have been designed specifically for dogs with diabetes. All of these diets tend to be higher in fiber to help to slow the release of glucose into the bloodstream, however other parameters such as protein, fat and carbohydrate content differ quite a lot.

1. Hill’s w/d line of foods tend to be lower in protein, and higher in carbohydrates than most other brands on the market. The lower protein content of these recipes may lend them to being better options for dogs with concurrent medical conditions like kidney disease or pancreatitis.
2. Royal Canin Glycobalance tends to be the lowest in carbohydrates, and highest in protein of all of the prescription diabetes options currently on the market. In particular their canned food may be a good option for an otherwise healthy diabetic dog.
3. Just Food For Dogs Metabolic recipe is a lightly cooked dog food for dogs with diabetes. The recipe is higher in protein, moderate in fat and lower in carbohydrates while still being high in fiber.

The canned diets from Royal Canin or Just Food For Dog’s fresh food diet may be a great option for dogs who have trouble eating consistently as they are tastier than a dry kibbled diet. These moisture rich options may also be good choices for dogs who have trouble keeping hydrated.

Diet Name	Energy Density	Protein% calorie	Fat% calorie	Carbohydrate% calorie	Fiber% dry matter
Hill’s w/d dry	255 kcal/cup	22%	34%	44%	16%
Hill’s w/d canned	307 kcal/can	20%	30%	50%	14%
Royal Canin GlycoBalance dry	307 kcal/cup	39%	31%	30%	11%
Royal Canin GlycoBalance wet	286 kcal/can	42%	45%	13%	22%
Just Food For Dogs Metabolic	27 cals/oz	34%	34%	32%	12.5%

Homemade Dog Food for Dog with Diabetes

For some dogs who are picky or that need to gain weight and are not eating prescription diet options well, a homemade dog food for a diabetic dog may be the best option. There are several options for people looking to cook for their dogs. It is important to note that diabetic dogs thrive on consistency thus frequent changes to recipe, ingredient sourcing or mis-measuring of ingredients can cause significant changes to blood glucose levels and insulin needs. So if you plan to take on cooking for your diabetic dog, understand that your consistency is extremely important.

Where to Find a Dog Food Recipe for Diabetic Dog

There are several ways you can go about getting a balanced homemade dog food for dogs with diabetes. Probably the easiest way to find a recipe for your pup will be using BalanceIT. The second option is to speak directly with a board-certified veterinary nutritionist. If you have an uncontrolled diabetic dog, or a dog with multiple con-current medical conditions speaking with a boarded nutritionist may be your best option.

BalanceIT Premade Diabetic Dog Food Recipes

The first of which is using the BalanceIT EZ Recipe Generator for Vet Patients. BalanceIT is a software designed by a board-certified veterinary nutritionist that allows pet parents access to hundreds of recipes for different diseases and conditions.

In order to find a recipe for a diabetic dog, head over to balanceIT.com and hover over “homemade food”. This should open up a drop-down menu, click on “FREE Autobalancer EZ for Vet Patients”, then select “Diabetes mellitus”. From there you will have a choice to see “high fiber” or “lower carbohydrate” recipes (I suggest selecting both). Then click the green “done” button.

This will show you some recipe options from here you can click “edit” on the recipe you would like. Then edit for your dog’s weight, and if you would like a recipe for a daily meal, or a weekly batch. Then click “rerun autobalancer based on edits”. Finally you can press “view” – when this happens you will be asked to request approval for the recipe from your veterinarian. Simply enter your vet’s info and a prescription request will be sent to them. Approval of the recipe will usually come in about 3 business days.

Once you receive approval for your homemade diabetic dog food recipe from your vet you can choose to either use the BalanceIT multivitamin supplement or switch to human supplements using the two green arrows.

Board-Certified Veterinary Nutritionist (ACVN Diplomat)

If you have a dog who has a very complicated medical history with multiple concurrent medical conditions like kidney disease, allergies, pancreatitis, or urinary stones it may be a good idea to contact a board-certified veterinary nutritionist to create a custom recipe for your dog. You can find a board-certified veterinary nutritionist at the ACVN.org directory. Currently there are only 20 boarded nutrition veterinary specialists that offer remote client consults.

Safe Treats for Dogs with Diabetes

There are prescription treat options for dogs with diabetes – both Royal Canin and Hill’s does make treats for diabetic dogs. However when it comes to treats there are a couple things to keep in mind…

1. Keep All Treats to 10% of daily caloric needs
2. Avoid simple and “naked” carbohydrates. Try pairing a complex carbohydrates with fibrous vegetables, fat or protein to slow glucose release into the bloodstream.
3. Avoid added sugars – such as corn syrup, honey, coconut sugar.
4. Avoid semi-moist treats.
5. Give treats 4-8 hrs after insulin or with a meal.

Fresh Dog Food for Dogs with Diabetes

Fresh, whole foods that are okay to give to dogs with diabetes tend to be lower in calorie and high in fiber. This combination typically works well because blood glucose levels will not be, or will be minimally affected by their ingestion.

For dogs who need to gain weight, a higher calorie lean meat can be used as a treat. But monitoring blood sugar is extremely important, and adjustments may need to be made. Also keep track of the calories so you are not over-feeding above the 10% caloric needs.

Vegetables:

• Green Beans
• Cucumber
• Brussel Sprouts
• Celery
• Cauliflower
• Broccoli
• Bell Pepper
• Zucchini
• Mushrooms (button, portobello, turkey tail, or lions mane)
• Spinach
• Kale

Fruits:

• Blueberries
• Strawberries
• Cherries
• Cranberries
• Raspberries
• Blackberries
• Apples (with skin)

Monitoring and Transitioning to a New Routine

When you just get the diagnosis of diabetes in your dog it can be overwhelming. Suddenly you may need to be hyperaware of how much and when your dog eats. Instigating a strict routine where before you had so much flexibility.

The transition is the hardest part. You don’t know exactly what protocol is going to work best, you may need to see your vet every one to two weeks for rechecks. You might be scared and overwhelmed. All of this is normal.

Don’t feel bad about asking questions or getting a second opinion. If you are struggling with management – reach out to an internal medicine specialist in your area.

Usually at the start of your journey you will be asked to keep a detailed log of when you give the insulin to your dog, how much you are giving, when and what you are feeding. If your vet does not give you a Nutritional Monitoring Chart you can use this chart to log your dog’s food and insulin. The chart can then be used by your vet to help with adjustments of your dog’s diet and insulin depending on blood glucose levels.

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thecaninehealthnut@gmail.com

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