Before discussing Cosmo’s diet, he is doing well. He turned 11 in November 2019, and as of August, he had no more bladder stones. His hyperlipidemia seems to be under control, and the soft stool problem he had for most of 2018 has also abated through the use of daily doses of Tylosin and Metamucil.
I do think that the Pet Diet Designer software has had a significant positive impact on his health. Without it, I would have been stuck with expensive prescription dog foods of dubious value, which Cosmo often refused to eat. With it, I have been able to adjust his diet easily to his specific needs while still ensuring it is nutritionally complete. Cosmo has been on the following diet for about a year and still loves it.
As mentioned in updates to previous posts about Cosmo’s diet, the recipe for his homemade food has evolved over the last couple of years to the following, as shown in the Balance Screen of the Pet Diet Designer software.
Cosmo’s Current diet 12/24/19
The left side shows the percentages of recommended allowances for various essential nutrients. The right side shows vitamins. All of these nutrients, except vitamin K, are above the RA (recommended allowance), but not excessively so. PDD provides safe upper limits for total fat (597%), linoleic acid (582%), EPA+DHA (omega fatty acids, 2545%), vitamin A (4221%), and vitamin D (588%). None of these ingredients come close to exceeding these safe upper limits. The “radial gauges” next to the RAs show the calcium-to-phosphate ratio is balanced, as are the amounts of the various fatty acid components of the diet. Since gut bacteria produce vitamin K, food sources are less important.
Below is the first page of the Nutrient Report from PDD. Note that this report and the balance screen shown above include all the food Cosmo gets each day, including his “soup” and treats.
Some of the important items to note in this report are:
- The protein/fat/carbohydrate calorie ratio is 25%/19%/56%, which is typical for a diet for dogs with hyperlipidemia, with fat calories below 20%. This has worked well to keep his blood lipids within the normal range. The relatively large amounts of omega fatty acids may also help control this condition. A moderate amount of protein and calcium are consistent with most dietary recommendations for dogs that tend to form calcium oxalate bladder stones.
- Percentage of fiber: Without Metamucil, our Tucson vet thought the fiber content of this diet was too low. So now he gets about 6.5 g of unflavored Metamucil each day divided between his soup and meals. This seems to have helped his soft stool problems. The unflavored Metamucil contains an unknown amount of citric acid, which contributes to raising the pH of his urine. The manufacturers of Metamucil refused to provide information on the amount of citric acid included. Here is a reference on using Metamucil to manage large bowel diarrhea.
- Total moisture: Cosmo’s diet, including his “soup”, contains 600 ml of water. This is about 53 ml/kg/day, which is close to the recommended daily water intake for a dog. He also has ad-lib water available during the day but rarely drinks more than an ounce or two.
- Nutrient content: The rest of the nutrient report is available here. The nutrient amounts listed in this report are hard to evaluate because the report does not include the RA amount. Take, for example, calcium. The report states that the recipe contains 0.67 g. The 0.67 g is the amount of calcium in this recipe that Cosmo would eat each day, which is 740 grams. But how does this amount compare with the RA for calcium? For that analysis, you need to look at another PDD report, the Analysis by Lifestyle report, shown here. According to NRC standards, the RA for calcium is 1 gram per 1000 calories. Another way to define the RA is in the amount per 1000 grams of the food rather than 1000 calories. Cosmo’s recipe contains 780 calories per 1000 grams, or 0.78 calories per gram. So that means the RA is 0.78 g per 1000 grams of the food. That is shown in the right column. The left column shows the actual amount of calcium in his diet per 1000 g, which is 0.91 grams. Dividing the two values (amount present, 0.91 g, divided by amount required, 0.78 g) gives 116% of the R, as shown in the balance report. So if you look through this report and compare the values in each column, you can see if any are less than the RA and, if not, how much they exceed the RA. The balance report above shows all those percentages (on the left and right sides).
Some other changes in the diet:
- Beef removed: Cosmo may have an allergy to this meat, which is common in dogs. As mentioned elsewhere, Cosmo has had off-and-on diarrhoea for several years, but it became a persistent problem in December 2017. His diarrhoea seemed worse and more frequent when beef was in his diet. Removing beef from his diet helped but did not completely resolve the stool problem.
- Turkey is the main protein source: Turkey has worked well as a protein source since it is very low in fat. The ground turkey we use has about 1% fat. Using this meat made it fairly easy to reduce the fat calories in his diet to less than 20%.
- Supplement capsules: I use several nutrient-containing capsules used as supplements for humans as a source of minerals needed in his diet. These are available from Amazon and are easier to find than pure powders. I open the correct number of capsules and pour the contents into the food mix. I use these capsules to add iodine, potassium, magnesium, and copper to the recipe. Normally, I use the citrate salt since that anion is useful otherwise in his diet, as mentioned below.
- Citrate: One problem dogs with oxalate stones often have is that their urine is quite acidic (e.g., pH 5), which can encourage calcium oxalate crystallisation. To address this, many sources recommend administering 75 mg/kg of potassium citrate twice daily. The citrate is metabolised to carbon dioxide, which is excreted in the urine, thus raising its pH. If any citrate is excreted intact in the urine, it can compete with oxalate for calcium. The amount of citrate salts (calcium, magnesium, and potassium) used in the diet corresponds to the recommended amount of potassium citrate. As mentioned above, Metamucil also contains citric acid, but I don’t know how much. So he gets plenty of citrate in his diet.
- Tylosin administered daily: This is a macrolide antibiotic similar to erythromycin, but it is only used in animals. In low doses (e.g., 5mg/kg), it is useful in treating some forms of chronic diarrhoea. Since Metamucil did not completely relieve Cosmo’s problem, his Tucson vet prescribed Tylosin to be given daily, probably for the rest of his life. I mix it with his breakfast food, and Cosmo doesn’t seem to mind. Tylosin doesn’t taste good, but mixing it with the Urinary SO may mask the taste. I tried not giving it to him for a month last fall, but his diarrhoea returned within 30 days. So I restarted it. You can find a reference on Tylosin here. It works remarkably well.
- Mixing the recipe: Most of Cosmo’s diet is white rice. The grains sometimes stick together, which can make it hard to mix the other ingredients evenly. I have found that if I mix one of the oil ingredients (e.g., canola oil) with the rice at the start, the grains don’t stick together and mixing is much easier.
- Corn flakes for treats: We’ve been using these for about a year, and Cosmo loves this low-fat and crunchy treat. Inexpensive too.
Well, that is the current state of Cosmo’s diet. I’ve discussed the other ingredients in previous posts. Don’t hesitate to contact me if you have any questions.
