Yummy diet ideas to stimulate appetite...cholangiohepatitis

PucciNPoni

PucciNPoni

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My old lad has been diagnosed with cholangiohepatitis.

He is on a cocktail of antibiotics, liver support and something else to help flush the bile ducts. He is 13 years old and usually has a very healthy appetite. Last week he stopped eating and I immediately knew something was up. He also has a bit of arthritis in his jaw (as well as other places) so has been on tramadol and onsior (anti-inflame) and joint supplements.

Hospital has released him in to my care with strict instructions that if he stops eating or is getting dehydrated that he needs to be hospitalised to be force fed or on a drip. That would be bad news for him as he tries to eat his way out of the kennels (he breaks teeth doing this!) and trashes the bed. I know he gets A1 care in the hospital because all the nurses are my co-workers and they adore him, but he stresses too much so I think if I can keep him eating that he's far better.

He is however, still not eating very well.

I give him an appetite stimulant (dorwest herbs malted kelp) before feeding and that does help a bit, but he's only picking out little bits here and there. I have made him poached chicken breast, boiled carrot and rice. That went down okay last night, but he picked at it this morning. I'm hand feeding him because he seems happier taking one bit at a time.

I'm going to do some shopping in a bit, and think I'll try getting some chicken thighs and other veg that I know he likes (but carrot is his favourite).

Any suggestions? I can try poaching some white fish too...

I know turmeric is supposed to be good for this sort of thing, but a friend said it has a weird taste, I'm frightened to put him off completely.
 
Tuna in sunflower oil. Mums jr was very very fussy and would not eat we also used to give her cat food believe it or not. She was a stray and mum had her for 17 years.
 
If he stops eating the chicken and veggies,you could try puree img them...I'd also consider adding boiled pastini...the very tiny pasta that babies get.
We used carnithine as an appetite stimulant at times for my sick dog..seemed to help weight stabilize .
I also used hills a/d puree tinned food on her worst days,as she could tolerate that.
 
I don't know if it is contra indicated for his conditions but when my 18 yr old jrt stopped eating a while ago (teeth :( ) I got some nutrition into her with skimmed milk with honey added
 
Pastini literally means tiny pasta..so even spaghetti chopped really finely would do...
Over here the kids are brought up as babies and toddlers on pastini..it's pasta ,made in small pieces,often in different shapes and forms and easily digestible..
Anther thought is to give Zantac..or ranitidine which helps a damaged stomach,and is used to reduce nausea...we used the injectable form,but they do make it in tablet form...I'd ask the vet if he would recommend this with your dogs condition..
Just googled this condition...recommends a low fat and high protein diet,easily digested...so puree as above would help him..plus vitamins e ,b and K.....maybe a doggy,multivitamin supplement?
 
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thanks - some good things to try. He's restricted to fairly low fat contents so pasta should be okay and rice and potato. He can have steamed veg too and chicken or white fish. One of the nurses has just suggested some chicken stock. I tried the water from his poached chicken on the rice, he didn't even look at it. I think low sodium stuff in small doses might be okay. Also worried about chopping and changing too much in case he gets the runs.
 
None of mine have ever enjoyed rice,but pasta is usually well accepted. at his age and with this condition you are going to be a bit limited,but need to keep his weight up and interest in the food..I feel your pain,my last girl had eleven years on a restricted diet and it was really tough to get her to eat at times.
Also consider a bit of garlic in the food will enhance its flavor.
 
P_NP, a couple of simple questions;

Have you asked for a clear and realistic prognosis, considering your dog's age, and do you have an unfaltering faith in your vet's ethical stance?

I'm sorry to read that your dog is struggling, and I fully appreciate how distressing it will be for you too.

Alec.
 
My vet is my employer - and there are other vets who are friends of mine who have no stake in this whatsoever who have all said to me that this condition tends to respond well to medication.

I won't for a minute carry on treating him if I feel he will deteriorate. Despite his age (and the fact that he's a bit stiff) up til last week he was still very much a running around barking playing happy dog. He still wants to have a chase about with my young bitch. As long as he's doing all that I will do what I can to keep him eating.

Like you Alec, I am a fairly pragmatic person when it comes to handling my dogs. I feel confident that at this stage that treating is the right thing to do.

If it gets to the stage where a more aggressive management has to be done, I don't think that would be right for him given that he will stress and make himself worse (for example if he has to be hospitalised he will try to eat his way out of the kennel, breaking all his teeth in the process).
 
PucciNPoni said:
Like you Alec, I am a fairly pragmatic person when it comes to handling my dogs. I feel confident that at this stage that treating is the right thing to do.

If it gets to the stage where a more aggressive management has to be done, I don't think that would be right for him given that he will stress and make himself worse (for example if he has to be hospitalised he will try to eat his way out of the kennel, breaking all his teeth in the process).
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I'm glad you said that, in your first post I thought you were considering it as an option. I hope he is soon better.
 
Our old boy would take small balls of raw minced beef fed by hand and also good quality pieces of grilled sausages. not ideal I know but it was such a relief to get any food into him. Sardines also went down well.
 
PucciNPoni said:
…….., I am a fairly pragmatic person when it comes to handling my dogs. I feel confident that at this stage that treating is the right thing to do.

If it gets to the stage where a more aggressive management has to be done, I don't think that would be right for him given that he will stress and make himself worse (for example if he has to be hospitalised he will try to eat his way out of the kennel, breaking all his teeth in the process).
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A good response. It's a difficult subject to broach, but thankfully, you're already in full possession of the facts, both possible and imagined, and equally prepared to make the right decisions.

Well done, and I wish your woofer, well! :)

Alec.
 
It's much appreciated - and I do realise that it's not an easy subject.

I'm in a position where I see dogs who are on varying stages of illness and I sometimes think that the owners hang on too long. I have very close friends who have done the same, and I KNOW they feel they're doing right by keeping them going just a little bit longer. Ending treatment and life is a really big decision and one I don't take lightly. But also I consider the whole picture and what sort of outcome will this have. My vet friends know how I feel about this and I think they would be dropping clues to me if they felt that this dog's prognosis wasn't reasonable.

Treatment can take weeks to months. He will need blood work done in two weeks time. We'll get a better picture of how things are going I assume then. Meantime I want to build him up as best I can. The fortunate thing is that he's always been a greedy dog and as such always carry more weight than less. He is a border terrier, and about a year ago his weight was down to a trim 7.5 kgs. One of my vets suggested we get is weight up to about 8 to 8.5kg which is unusual for a vet to say put weight on LOL. He is actually about 9kg at the moment, so he's not wasting away. In fact his weight looks pretty good for an ageing pet Border.

But I want to make sure that nutritionally he has every chance he has to get back to perfect health. :) I think diet is often overlooked when treating illness (human and animal). However, the vets I work with are reasonably holistic in their approach (without being "Holistic" if you know what I mean).

I was expecting a worse outcome from his abdo scans Friday - as there was a possibility of a liver tumor. In which case, depending on what they'd said I had expected some palliative care rather than aggressive treatment.

Thank you for your suggestions. I'm much appreciative :)
 
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druid said:
What about really smelly things like tripe to stimulate his appetite?
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I've had that suggested a few times -

where would one find tripe? I've never fed it before.

How fatty is it? He's got to be fairly restricted to fairly low fat food. But yes, something smelly and aromatic would be the idea I think.
 
I have some of the fussiest, least food motivated dogs I have ever met, so far I find the following works:
Beef tripe (I buy mine from Manifold Valley Meats but you can get Natures Menu ones from Pets at Home)
Home made liver cake
Cubes of beef or veal
Goats milk yoghurt
Coconut oil
Good luck and fingers crossed he finds something he likes soon!
 
Yes, I'm warming everything up for him.

Last night he got a lovely chicken breast poached - put some carrots and a pinch of salt in the water. Boiled white rice. He had a better dinner than I did! My other dogs went nuts for it and he sort of picked at it.

From what I understand stuff like white rice, potato and chicken or fish are easily digested and help rid the body of the toxins.

I offered him the same this morning and he turned his nose up.

So I've gone down the shops and picked up some baby potatoes, some tuna steak in water, some frozen plain cod fillet that I can just microwave.
 
PucciNPoni said:
where would one find tripe? I've never fed it before.

How fatty is it? He's got to be fairly restricted to fairly low fat food. But yes, something smelly and aromatic would be the idea I think.
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http://www.naturesmenu.co.uk/product-mince-tripe.aspx

It gives fat content as 10.6%.

A friend is having quite a bit of success in tempting her oldie with the hunter range from the same company; they are 4% fat and easy on the jaw as a 'solid mince' and are quite aromatic if warmed in the microwave.......more so than the trip anyway! :D
http://www.naturesmenu.co.uk/category-raw-meals.aspx
 
Little update:

Chester is now eating again on his own - albeit yummy cooked chicken, rice, potato and some veg. There were a couple of days that he would only eat a tiny amount from the hand and then run off.

So I'm happy that he's nearly cleaning his bowl. However, he's getting wise to the regime of medicines! Used to be that I could just wrap his usual tramadol or anti-inflams in a bit of chicken and it disappeared. Now he's got a rather lot of things to take and he's mastering the art of eating the chicken and spitting out the tablet. I tried a tiny tiny smear of peanut butter -first couple of times he thought that was great. But that too he has worked out.
 
What a relief he,s eating g again.Ive been through literally.years of this with my last dog and know how much better you feel when" at least" they are eating. I hope you have a few months of respite...time to breathe, fingers crossed.
 
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