The Last Red Bell Pepper

That’s one of our diabetics, Allie Mae, who came to us as a blind dog a few years ago from Virginia. Our veterinary ophthalmologist was able to restore her vision with cataract surgery. Not only did Allie Mae immediately steal our hearts, but she quickly became the boss of the place.

In that dish is a small piece of red bell pepper, the last remaining morsel of the full meal she just finished. Allie Mae will not relinquish that bowl until she has retrieved that pepper, as I’ll show you in a bit. But first, I should explain the diet she’s on.

About a year ago we had transitioned our diabetic dogs to a low-carb diet, using Dr. Harvey’s “Paradigm” — a veggie base mix — with home-cooked ground beef and fish oil. We had a veterinary nutritionist at the University of Tennessee review and adjust the diet as necessary to make sure it was nutritionally sound. She had us add the BalanceIt vitamin and mineral mix (the “Carnivore” version) and also add walnut oil.

Dr. Harvey’s website says “Paradigm contains low glycemic vegetables that digest slowly to prevent glucose level spikes.”  The ingredient list is:

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Broccoli, Green Beans, Bone Broth, Red and Green Bell Pepper, Cabbage, Pumpkin, Crushed Eggshell, Celery, Kelp, Alfalfa, Turmeric, Spirulina, Ginger, Red Clover, Milk Thistle, Slippery Elm, Dandelion, Cinnamon, Tricalcium Phosphate, Zinc Proteinate, Iron Proteinate, Vitamin E Supplement, Manganese Proteinate, Vitamin A Acetate, d-Calcium Pantothenate, Thiamine Mononitrate, Pyridoxine Hydrochloride, Riboflavin Supplement, Biotin, Vitamin B12 Supplement, Vitamin D3 Supplement, Folic Acid

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Type 1 vs. Type 2 Diabetes

Dogs have Type 1 diabetes, meaning the pancreas is no longer making any insulin to manage glucose levels in the blood. In Type 2 diabetes, the pancreas is still producing insulin, but the body’s cells aren’t responding as effectively, which is called insulin resistance. Humans can have either Type 1 diabetes (less common) or Type 2 diabetes. (For a great explainer on the difference between them, see this page from the Joslin Diabetes Center.)

We went down this route to a low-carb diet because we had seen presentations by medical doctors who had Type 1 diabetes themselves explain how adopting a low-carb diet had significantly improved their glucose management, allowing them to reduce their insulin dosage and get off other diabetes medications. They would show their personal “before and after” Continuous Glucose Monitor charts and it was a real eye-opener.

(If you have any doubt as to the effect of carbohydrates on insulin, see this chart from the medical journal Diabetes Care.)

One of the most persuasive was Dr. Jake Kushner, Associate Professor at the Baylor College of Medicine and for 6 years the Chief of Pediatric Diabetes and Endocrinology at the Baylor College of Medicine and Texas Children’s Hospital. His presentation is here:

https://www.youtube.com/watch?v=4t8_wvnlaNM&t=8s

Given that we had made little progress in getting good control of Allie Mae’s and Daisy’s diabetes, despite the best efforts of our veterinarians, we wondered if we could apply some of these lessons from the management of human Type 1 diabetes to our canine diabetics. (Recognizing that dogs are not people, etc.!)

There are also plenty of medical doctors — like Dr. Eric Westman at Duke University and Dr. David Ludwig at Harvard University — and innovative health organizations (like Virta Health) who are using low-carb diets to make dramatic improvements in people with Type 2 diabetes … including reversing Type 2 diabetes altogether in some cases.

While it’s not possible to reverse Type 1 diabetes, medical experts like Dr. Kushner are showing it is possible to improve the management of this disease with a low-carb diet. Here’s a fact sheet on low-carb diets and Type 1 diabetes from a medical clinic in Australia that specializes in this field.

About the same time we were beginning to transition our diabetic dogs to a low-carb diet, we took them to see experts in canine diabetes at Tufts University for a full-up review of their treatment protocols. These veterinary specialists made significant changes in Allie Mae’s insulin dosage and switched Daisy to an entirely different type of insulin.

When I mentioned to one of these specialists that I had searched and couldn’t find anything in the veterinary literature on research into using low-carb diets with canine diabetics, he said that veterinary medicine is about 10 years behind human medicine when it comes to diabetes management. Interestingly, the veterinary nutritionist at the University of Tennessee had told me exactly the same thing!

What’s Wrong with Commercial Diabetic Diets?

Our problem with the commercial diabetic diets (Royal Canin’s Glycobalance and Hill’s W/D) is they are loaded with carbohydrates (roughly 35% and 45% respectively), which they seem to “cover” by using lots of fiber, i.e., to slow the rapid digestion of the carbs that are converted into glucose. (Wheat is the very first ingredient in the W/D dry food!)  And of course, they contain the cheap byproducts and fillers. Needless to say, these are ultra-processed foods anyway.

When I contacted Royal Canin to ask if we could see the research (i.e., results from a clinical feeding trial) showing the efficacy of their Glycobalance food for diabetics, they told me it wasn’t publicly available. No, really. They refuse to make this research public. Here’s the transcript of my “chat” with a Royal Canin customer representative.

Dr. Benjamin Bikman, a scientist who manages a diabetes research lab at Brigham Young University, said: “If a person has a disease that makes it difficult to metabolize glucose, the simplest solution is to eat less glucose.” In other words, fewer carbohydrates! That’s the kind of statement that convinced us to try something different when it comes to what we’re feeding Allie Mae and Daisy.  And it certainly makes us question why these “prescription” diabetic dog foods are based on carbohydrates.

What Do Dogs Want?

One final piece of research that told us we were on the right track was research published in 2018 in the Journal of Animal Physiology and Animal Nutrition. This study was based on a clinical feeding trial of dogs who were allowed to eat whatever macronutrient (protein, fat and carbohydrate) they wanted. The researchers found that the dogs in the trial selected an average energy intake of 38% protein, 59% fat, and only 3% carbohydrate.

In their summary, the researchers noted that “The study also shows that given the option, dogs do not select carbohydrate to be a significant portion of the diet. The health implications of such dietary selection are of interest.”

Let’s take another look at the chart I linked to above, showing the insulin response to carbohydrates:

Do dogs instinctively know something we don’t?

And for a diabetic, whether human or canine, it would only seem to be common sense to reduce the amount of carbohydrates in the diet. This is what Dr. Bikman was referring to.

Based on the analysis done by the veterinary nutritionist at the University of Tennessee, for example, Allie Mae’s new diet is 42.6% protein, 46.9% fat, and only 10.5% carbohydrate. That’s the percentage of calories coming from each of those macronutrient groups. Daisy’s is similar.

It was that research that led us to transition all of our dogs over to a low-carb diet using Dr. Harvey’s Paradigm and home-cooked ground beef (along with the BalanceIt supplement and oils). And what a hit was! When we were first feeding only Allie Mae and Daisy this food, the other dogs were always trying to come over and lick their bowls when the girls were done. It wasn’t just the ground beef … all the dogs were already getting cooked ground beef with the organic kibble we were feeding them. Somehow it was the combination of the Paradigm with the ground beef that really got their interest.

Even our finicky eaters — the ones who might or might not eat breakfast, or who might not finish their dinner — now lick their bowls clean. No one ever leaves food behind!

Getting That Last Piece

Which brings us back to Allie Mae and that last red bell pepper piece. For some reason it’s only the red pepper that is left at the end, and only one small piece. Yet she is determined to get it, so she keeps going:

And then she’s finally got it:

Now, because we were changing their diabetic diets to low-carb about the same time the specialists at Tufts were changing their medications, we can’t attribute any specific benefit to just the diet or the medication changes. But combined, what we did see with Continuous Glucose Monitors was on average fewer wild swings in glucose and a steadier pattern overall.

What we also saw was an entire group of dogs, diabetic and non-diabetic, far more excited about their meals now! Allie Mae, for example, dances around while I’m mixing up the food for her bowl, and her eyes just light up. That alone is worth it.

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(Note:  We have no relationship with Dr. Harvey’s other than purchasing the Paradigm product, one of many different food types they make. They do give us a “rescue” discount on our purchases, the same discount they give any other qualified nonprofit.)