# HELP! Need Advice on Protein Ratio Dog Food for 18 Month NIKO with asymptomatic MVD



## NikoDenali (May 19, 2017)

Hi Everyone,

Just got back from a one week stay in NY. Our nephew died in a motorcycle accident, just 22 years old. Very sad time for our family. My maltese, Niko-Denali went to a Bed & Breakfast / Boarders home for a week. He lost 1 pound even though our sitter said he ate very well and all his food! He must have been extremely active while there to lose this kind of weight. He was 6 lb. 8 ounces before we left, came home one pound less. :huh:

Niko Denali was recently dx with MVD (May 2017). High ALT's, and we had a Bile Acid Test and Protein C Test, so he has a high probability it is MVD. He has zero symptoms that I can see. I did not pursue any further testing at this time. He seems very healthy at this time. He is an excellent eater too.

Here are my questions: 
Should he be on a low protein diet? My vet say's no, I have read the contrary on many sites. 

If so, what is the Protein Fat Carb percentages supposed to be for an MVD dog? Should I only be concerned with his PROTEIN amount only? It seems dog foods vary greatly on the P/F/C ratios. So confusing!!

I bought some trial size The Honest Kitchen, Zeal (Fish) he isn't loving it. He loves all food, but this was just ok to him. It also is kinda watery. I added the recommended about of water to the 1 ounce dry packet and waited 5 minutes. It was super green and watery. He ate some, left some and came back later to finish. That is not my Niko. He loves to eat and always looks for more at every feeding. He eats fast and leaves nothing on his plate ever. So I know he isn't loving this Zeal recipe. Also he had green food face after he ate. :blink:

Niko is only 5 lbs. 8 ounces. He feels kind of thin and a little bit boney. I normally feed him a total of 3/4 cup food (wet) per day. He gets 1/4 cup M N and Night. He would eat more if I let him. He is 18 months old and I am wondering if I should feed him more if he is still hungry? This is my first and only Maltese dog, so I don't know if he is getting enough food or not. It seems he should have more meat on his bones than this. I don't mind his weight being what it is, I am wondering if he should have more fat on him? Should I free feed for a while to add a little fat on him? Or put on a higher fat food like a Wellness Puppy Brand? I know you are supposed to decrease food when they become an adult but this boy really likes to eat a lot so I am surprised he feels so thin. Even before he lost the one pound, he felt thin. Maybe I am just worried for nothing??? :w00t: 

I also give him The Honest Kitchen dog treats, Pumpkin and Fish Cuddles bite size cookies. Maybe 4 a day. They only have 8 kcals each. He does like these little treats. Started these 2 weeks ago. Also loves Cheerios. I limit this snack. He also loves raw fresh green beans. 

I would prefer to get him on a dog food that is dry kibble. Maybe give the same brand of Wet food once a day and or mix it. Something I can buy at my local PetSmart, PetSupermarket, or PetCo. I've read the Dog Food Advisor web site and they have great 5 star foods, but I want to choose one best for a dog with MVD. Again, he has NO symptoms right now. I can give test result numbers if that would help you to see a better picture of his MVD.

Are these good for MVD dogs? 1) Merrick Dry 2) Wellness Complete 3) Wellness Toy Breed look like they got excellent 5 STAR ratings, but I am concerned about what his protein level intake should be. These are available at my local pet stores. There must be some excellent dry & wet food there that has 5 STAR ratings AND good for an MVD dog.

Also, he is given Denmarin Chewable Tablets, and Animal Essentials Plant Enzyme Probiotics Supplement.

Any food recommendations are greatly appreciated. I value each and every opinion from all of you. This forum has been a Godsend to me. :innocent:

Photo attached is one I took of our boy on his 1st Birthday, 12/26/16. He is pure sweetness & joy to our family. :heart:

Sincerely,
Niko-Denali's Mommy, ~Jamie


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## wkomorow (Aug 26, 2011)

Very controversial topic. All I can tell you is what I do for Luck. He gets RC hepatic because of its mineral content along with Natural Balance vegetarian. I was interested in v-dog, but the bag is too big. He also gets dairy protein. According to Cornell some proteins are better than others for dogs with liver problems. RC hepatic is not a good food for a dog with MVD. Luck has a shunt. To supplement his proteins, he gets dairy and plant based proteins. He loves most of the tofu dishes I make, he gets feta cheese, he get frozen yogurt and ice cream, he gets peanut butter as a treat. He does not get meat protein. 

I know your situation is different, but I would say ND should not get less protein, but be careful of what kind of protein it is. Most dogs foods have too much protein for a maltese. With MVD and a shunt what happens is the meat proteins are turned into ammonia in the digestive system. This ammonia is filtered through the liver into urea acid which is safer for the body. Dogs with liver issues can not filter the ammonia, so it goes into the bloodstream causing problems (attacking) the organs including the brain. Darker meats are more problematic than lighter ones. Honestly most vets know little about liver disease in small dogs.

Cornell was concerned that Luck was not getting enough protein, so they told me to increase the low fat dairy I give him. He literally has a prescription for ice cream with each meal.

Hope that helps. Word of caution, just like humans, dogs can be allergic to milk or peanuts or soy, etc. Low fat cottage cheese a couple of times a week is a great protein as is a scrambled egg once or twice a week.

Good luck.


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## sherry (Jan 4, 2013)

I'm so sorry to hear about your nephew. What a tragedy for such a young man. Condolences.
This is what I feed Riley who was diagnosed with MVD 3 years ago. And at the time his body was so polluted with ammonia, he was very sick. But with diet, lactulose, and good food he is thriving. For breakfast and dinner he gets The Honest Kitchen Keen, which is turkey protein. First thing when we get up he gets his denamarin, then we wait an hour before breakfast. He gets lactulose on his breakfast and dinner. For lunch he gets a teaspoon of cottage cheese, and for afternoon snack he gets a chicken and apple cookie. It took a while to get all the ammonia out of his system, and then probably several more months before he started acting normally. 
You are way ahead of the game finding this out before he got sick. It sounds like maybe he could stand to eat a little more, maybe add a scrambled egg or some cottage cheese or ice cream and see if he gains some weight back.
I really don't have advice on any other foods as this is what works for me and he and Sissy love it. Oh, I forgot to mention I boil chicken thighs and put about a teaspoon on their meals.


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## maddysmom (Mar 8, 2012)

Jaimie...honest kitchen zeal is very low fat. It's 8% on a dry matter basis which is very low. Fiber is also very low being under 7%. I feed this to my one girl because she has IBD/pancreatitis issues. If you want ND to gain weight, it's not going to happen on this food.
Also, I make THK food on the thicker side so it's not soupy. My girls would never eat it if I was to follow their directions on how to make.


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## sherry (Jan 4, 2013)

:goodpost:


maddysmom said:


> Jaimie...honest kitchen zeal is very low fat. It's 8% on a dry matter basis which is very low. Fiber is also very low being under 7%. I feed this to my one girl because she has IBD/pancreatitis issues. If you want ND to gain weight, it's not going to happen on this food.
> Also, I make THK food on the thicker side so it's not soupy. My girls would never eat it if I was to follow their directions on how to make.


I also make this thicker @ Riley and Sissy's instructions. The Keen is 19 % protein and I think would be much better for Rico. And like I said, I top it with some organic chicken thigh. What I do is buy a pack of it and boil it. Then I shred it and put it in baggies and freeze. Thaw out as needed. It is not a big deal.


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## NikoDenali (May 19, 2017)

Thanks. I think I will do that and give him an egg and or cottage cheese in addition to his food. At least until he gains that pound back. Do you buy low fat cottage cheese? Also, what kind of ice cream can you give a dog? Do you mean dog ice cream? They sell that at our local Public grocery. I think it is called Frosty Paws by Purina. I am leaning towards getting him Fromm Four-Star Nutritionals Grain-Free Salmon Tunalini Recipe Dry. I believe the protein is 28%. Do you think that is good for him with the MVD? I know it got excellent reviews and a lot of Maltese owners buy this food and say their dogs like it. Right now I have some Wellness small breed complete health that I am giving him. I stopped with the Purina Benefuls, although he loved that food. Today I gave him some of the Wellness moistened with warm water, added a few fresh blueberries and later as a snack I gave him a healthy cookie from the Honest Kitchen, Fish & Pumpkin kind. This dog eats anything I put down for him. He is so small and eats like a big dog LOL. He always looks at me like "is that it Mom"? Funny little furrball.


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## NikoDenali (May 19, 2017)

sherry said:


> I'm so sorry to hear about your nephew. What a tragedy for such a young man. Condolences.
> This is what I feed Riley who was diagnosed with MVD 3 years ago. And at the time his body was so polluted with ammonia, he was very sick. But with diet, lactulose, and good food he is thriving. For breakfast and dinner he gets The Honest Kitchen Keen, which is turkey protein. First thing when we get up he gets his denamarin, then we wait an hour before breakfast. He gets lactulose on his breakfast and dinner. For lunch he gets a teaspoon of cottage cheese, and for afternoon snack he gets a chicken and apple cookie. It took a while to get all the ammonia out of his system, and then probably several more months before he started acting normally.
> You are way ahead of the game finding this out before he got sick. It sounds like maybe he could stand to eat a little more, maybe add a scrambled egg or some cottage cheese or ice cream and see if he gains some weight back.
> I really don't have advice on any other foods as this is what works for me and he and Sissy love it. Oh, I forgot to mention I boil chicken thighs and put about a teaspoon on their meals.



*Thanks Sherry. I think I will do that and give him an egg and or cottage cheese in addition to his food. At least until he gains that pound back. Do you buy low fat cottage cheese? Also, what kind of ice cream can you give a dog? Do you mean dog ice cream? They sell that at our local Public grocery. I think it is called Frosty Paws by Purina. I am leaning towards getting him Fromm Four-Star Nutritionals Grain-Free Salmon Tunalini Recipe Dry. I believe the protein is 28%. Do you think that is good for him with the MVD? I know it got excellent reviews and a lot of Maltese owners buy this food and say their dogs like it. Right now I have some Wellness small breed complete health that I am giving him. I stopped with the Purina Benefuls, although he loved that food. Today I gave him some of the Wellness moistened with warm water, added a few fresh blueberries and later as a snack I gave him a healthy cookie from the Honest Kitchen, Fish & Pumpkin kind. This dog eats anything I put down for him. He is so small and eats like a big dog LOL. He always looks at me like "is that it Mom"? Funny little furrball.


*


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## maggieh (Dec 16, 2007)

Why do you want to use dry kibble? Dry food is actually harder for the kidneys and liver to process. If you think you want to use dry, make sure you allow it to soak in warm water for 10 minutes or so before feeding to make it more digestible and to make sure his little body has enough fluids to process the kibble.

What does your vet say about his weight? If you can feel the ribs but they feel like they have a thin layer of fat over them, then the weight is appropriate. If it feels like there is no fat, then he should gain a few ounces, and it you have to work at feeling ribs, then he needs to lose weight. My girls eat about 1/8 cup of food twice a day and Tessa who is a little bigger gets another tablespoon midday.


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## wkomorow (Aug 26, 2011)

Luck gets organic vanilla or blueberry or strawberry ice cream or frozen yogurt - the human kind. Low fat or no-fat. His favorite is coconut milk ice cream that I eat, but it does not have enough protein for him. Just make sure there are no sugar substitutes in it. Sugar and honey are fine, others substitutes may be deadly.


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## maddysmom (Mar 8, 2012)

maggieh said:


> Why do you want to use dry kibble? Dry food is actually harder for the kidneys and liver to process. If you think you want to use dry, make sure you allow it to soak in warm water for 10 minutes or so before feeding to make it more digestible and to make sure his little body has enough fluids to process the kibble.
> 
> What does your vet say about his weight? If you can feel the ribs but they feel like they have a thin layer of fat over them, then the weight is appropriate. If it feels like there is no fat, then he should gain a few ounces, and it you have to work at feeling ribs, then he needs to lose weight. My girls eat about 1/8 cup of food twice a day and Tessa who is a little bigger gets another tablespoon midday.


Maggie, I'm glad you mentioned how hard it is to digest kibble, this is very true, for all breeds.
Also, once a bag of kibble is open, it must be used up within a month otherwise it loses its nutrients, as well as it grows all kinds of mold. Buying a smaller bag at a time would be wise. Storing in the freezer is an option and will help maintain its freshness, if you choose a kibble.

I've noticed you mention that ND eats quite a bit, like a big dog, yet hasn't maintained his weight. I think a pound is a lot of weight to lose in a week. That being said, if it continues, I would have some bloodwork done to see if he has a condition called PLE or EPI. These dogs do not digest the food properly and lose the nutrients needed in a diet, so they tend to waste. They have a hard time gaining or holding on to weight and always being hungry are symptoms.


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## sherry (Jan 4, 2013)

I wish I could advise you on protein percentage. I know that 28% is way too high for Riley. He does it well on the 19% THK that I feed him. As far as cottage cheese, I normally just get the regular cottage cheese. Maybe I should use low fat. I have and they don't know the difference.


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## wkomorow (Aug 26, 2011)

Sherry - 

You should stick with what is doing well. With Luck, he gets dairy with each of his meals and at night, and I am concerned too much fat will lead to pancreatitis. But Riley only gets a spoonful here and there.


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## sherry (Jan 4, 2013)

wkomorow said:


> Sherry -
> 
> You should stick with what is doing well. With Luck, he gets dairy with each of his meals and at night, and I am concerned too much fat will lead to pancreatitis. But Riley only gets a spoonful here and there.


Thanks Walter, I agree if it works, don't fix it!


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## CrystalAndZoe (Jul 11, 2006)

Honestly, the greatest majority of Maltese (and Yorkies) are asymptomatic MVD. They are undiagnosed because most people don't do full blood panels and protein C as young puppies. It makes diagnosing future health issues harder because the first thing a vet sees is a Maltese and elevated ALT's and AST;s and they only think of MVD or liver shunt. There are some great educational past posts on this topic. Do a search for asymptomatic MVD and learn from some very educated people who used to post here. 

How high are his ALT's and AST's and BAT? If they are not alarmingly high and he's asymptomatic, there is no need for a special diet. Your vet is correct in what he is telling you. What Maggie mentioned is key. Lots of moisture is what is needed for healthy kidneys and to help the liver function properly. My Callie is asymptomatic MVD. She's been fed a frozen raw diet from the day I got her. Her blood work is perfect and always has been. The only reason I know is I did a protein C on her when she was spayed when she was a year old. Now if those liver values are high enough to cause some concern, that's a different story. But if they are just slightly elevated, honestly I would add moisture to his food or switch to a wet food and do a liver panel in 3-6 months. If it hasn't changed, keep on doing what you are doing. But I would do a liver panel a couple times a year until you and your vet are confident the liver levels are being maintained and not increasing.


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## NikoDenali (May 19, 2017)

maggieh said:


> Why do you want to use dry kibble? Dry food is actually harder for the kidneys and liver to process. If you think you want to use dry, make sure you allow it to soak in warm water for 10 minutes or so before feeding to make it more digestible and to make sure his little body has enough fluids to process the kibble.
> 
> What does your vet say about his weight? If you can feel the ribs but they feel like they have a thin layer of fat over them, then the weight is appropriate. If it feels like there is no fat, then he should gain a few ounces, and it you have to work at feeling ribs, then he needs to lose weight. My girls eat about 1/8 cup of food twice a day and Tessa who is a little bigger gets another tablespoon midday.



Yes, good advice, I always add some warm water to his dry kibble. I wait about 10 minutes or so and it is soft. He is not a big water drinker so I always add a little water to his food no matter what he eats (except cookies snacks of course). My vet didn't say anything about him being under weight. When he was at the vet he weighed 6 lb. 8 oz. It was a good weight then. It was only after we boarded him for a week did he lose a little weight. 
Now he is gaining some ounces back since we have him back home and on his regular routine. I've been giving him a little extra food and that seems to be working. I know both his parents were around 6 lbs. so I think he is just going to be a small Maltese his whole life. His highest weight was 6 lb.8 oz. He is an active little boy too, loves running around playing. Feeling his ribs today I can feel a thin layer between his skin and bones. He could probably stand to gain a few more ounces.


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## NikoDenali (May 19, 2017)

maddysmom said:


> Maggie, I'm glad you mentioned how hard it is to digest kibble, this is very true, for all breeds.
> Also, once a bag of kibble is open, it must be used up within a month otherwise it loses its nutrients, as well as it grows all kinds of mold. Buying a smaller bag at a time would be wise. Storing in the freezer is an option and will help maintain its freshness, if you choose a kibble.
> 
> I've noticed you mention that ND eats quite a bit, like a big dog, yet hasn't maintained his weight. I think a pound is a lot of weight to lose in a week. That being said, if it continues, I would have some bloodwork done to see if he has a condition called PLE or EPI. These dogs do not digest the food properly and lose the nutrients needed in a diet, so they tend to waste. They have a hard time gaining or holding on to weight and always being hungry are symptoms.



Yes, he is an excellent eater. His weight had been maintained before our trip. The reason I think he lost weight was because he was boarded one week. I think he was more active and running around their 1.5 acres for a week. My pet sitter allows free roaming in the house and yard and I'm sure he burned off some weight keeping up with the other big and small dogs there. I will keep on eye on his weight. He has gained back a few ounces so far since being home. Niko has always been a great eater. Since we've had him at 9 weeks old he has always finished his food and is not picky at all. He likes all kinds of fruits, vegetables, dry food, wet food. I am very lucky in this respect. He easily eats 3/4 cup of food per day, plus a few afternoon training treats. He is a very active boy too during the day time. I was told when we got him that both his parents are free-fed dry food, they are both around 6 lbs. So I think my little guy is always going to be around that range too.


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## NikoDenali (May 19, 2017)

maddysmom said:


> Maggie, I'm glad you mentioned how hard it is to digest kibble, this is very true, for all breeds.
> Also, once a bag of kibble is open, it must be used up within a month otherwise it loses its nutrients, as well as it grows all kinds of mold. Buying a smaller bag at a time would be wise. Storing in the freezer is an option and will help maintain its freshness, if you choose a kibble.
> 
> I've noticed you mention that ND eats quite a bit, like a big dog, yet hasn't maintained his weight. I think a pound is a lot of weight to lose in a week. That being said, if it continues, I would have some bloodwork done to see if he has a condition called PLE or EPI. These dogs do not digest the food properly and lose the nutrients needed in a diet, so they tend to waste. They have a hard time gaining or holding on to weight and always being hungry are symptoms.





Crystal&Zoe said:


> Honestly, the greatest majority of Maltese (and Yorkies) are asymptomatic MVD. They are undiagnosed because most people don't do full blood panels and protein C as young puppies. It makes diagnosing future health issues harder because the first thing a vet sees is a Maltese and elevated ALT's and AST;s and they only think of MVD or liver shunt. There are some great educational past posts on this topic. Do a search for asymptomatic MVD and learn from some very educated people who used to post here.
> 
> How high are his ALT's and AST's and BAT? If they are not alarmingly high and he's asymptomatic, there is no need for a special diet. Your vet is correct in what he is telling you. What Maggie mentioned is key. Lots of moisture is what is needed for healthy kidneys and to help the liver function properly. My Callie is asymptomatic MVD. She's been fed a frozen raw diet from the day I got her. Her blood work is perfect and always has been. The only reason I know is I did a protein C on her when she was spayed when she was a year old. Now if those liver values are high enough to cause some concern, that's a different story. But if they are just slightly elevated, honestly I would add moisture to his food or switch to a wet food and do a liver panel in 3-6 months. If it hasn't changed, keep on doing what you are doing. But I would do a liver panel a couple times a year until you and your vet are confident the liver levels are being maintained and not increasing.



Hi Crystal,
Thank you for your advice. When tested in May 2017, 18 months old, his ALT number was 266 (normal range was (12-118). His Bile Acid Test results were 4 pre meal, 67 post meal. His Protein C test done came back at 79. Doctor told me it is high probability he has MVD. He does not show any signs of MVD. He eats well, very active, no ibs issues, or neuro issues. The vet did say we can recheck his liver enzymes in a year. I will probably not wait that long and bring him back in 6 months. There was no AST result listed on test chemistries results. Only his CBC numbers, and the CMP checked Total protein, Albumin, Globulin, A/G Ratio, ALK Phosphtase, Urea Nitrogen, Creatinine, Glucose, Potassium, BUN/Creatinine Ratio. Not sure why AST was not checked. I will ask for that number next time for sure. Any other chemistry I should be asking for to get a better picture of his liver status? His vet really didn't seem overly concerned. 
I was the one kind of freaking out when I saw his liver ALT number. :w00t: My vet said he has other Maltese that are the same as Niko, asymptomatic MVD. He said most live long healthy lives, did not recommend giving liver supplements or changing his diet. He said I could give him Denamarin if I wanted to, which I did start giving him. He said it wouldn't hurt to give him that. I am also changing his diet to Fromm dry kibble. I will add warm water to it, he isn't a big water drinker, so I've always added some extra water to all his food whether it be wet or dry. 
My vet seems like a very competent vet, very compassionate, and takes a lot of time with us when we are there. He was familiar with liver shunts and MVD, so I was pleased with that. I am Niko's best advocate, so I continue to learn all I can about MVD, I will be researching this more on the site too. I really value everyone's opinions and advice very much. This is all new to us in the past 2 months but I have learned a lot in a short time thanks to this great forum.


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## Aviannah's Mom (Apr 28, 2017)

I am so sorry for you and your family having to go through such a tragic loss! My sincere sympathy for all of you. It looks like you have gotten a lot of good advice for how to help Niko Denali. Hopefully he is feeling better soon!


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## NikoDenali (May 19, 2017)

Aviannah's Mom said:


> I am so sorry for you and your family having to go through such a tragic loss! My sincere sympathy for all of you. It looks like you have gotten a lot of good advice for how to help Niko Denali. Hopefully he is feeling better soon!


Thank you very much. You are very kind. Yes, difficult days, but we have great faith in God to get us through anything and everything that comes our way.

Niko Denali is feeling better. He is a super cute boy, he loves his new treats made by Grandma Lucy, Blueberry little cookies. We got these today for him. He was so excited to see the bag :aktion033:


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