Royal Canin offers specialized veterinary diets designed to support pets with specific health conditions. Among these, the Royal Canin Liver Diet, also known as Hepatic, is formulated to aid dogs and cats with liver function concerns. This article provides a detailed overview of Royal Canin Liver Diet, its benefits, how it works, and other considerations for its use.
Understanding the Need for a Liver-Specific Diet
The liver plays a crucial role in numerous bodily functions, including metabolism, detoxification, and nutrient storage. When the liver is compromised, these functions can be impaired, leading to various health issues. A specialized diet like Royal Canin Hepatic aims to alleviate the burden on the liver and provide the necessary nutrients for its optimal function. Some dogs require precise protein levels to support healthy liver function.
Royal Canin Veterinary Diet Canine Hepatic Dry Dog Food
Royal Canin Veterinary Diet Canine Hepatic Dry is a highly palatable and digestible dog food, restricted in copper content and formulated with nutrients essential to support liver function. This veterinary exclusive formula requires a prescription.
Benefits:
- LIVER SUPPORT: Royal Canin Hepatic Dry Dog Food helps support healthy liver function in adult dogs with adapted levels of highly digestible vegetable proteins.
- LOW COPPER: Low level of copper helps minimize its accumulation in a dog’s liver cells, and essential nutrients promote liver health.
- ADAPTED ENERGY: Adapted energy content helps reduce meal volume and decrease intestinal load.
- IMMUNE SUPPORT: A precise blend of antioxidants helps support a healthy immune system.
- MICROBIOME SUPPORT: Includes selected prebiotics to help support a healthy gastrointestinal microbiome.
How it Works
The high energy density helps reduce necessary food volume in dogs with poor appetites while this formula contains a precise blend of antioxidants to help support a healthy immune system.
Key Features and Benefits of Royal Canin Hepatic Diets
Royal Canin Hepatic diets are designed with several key features to address the specific needs of pets with liver disease:
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Adapted Protein Levels:
- The diet contains adapted levels of highly digestible vegetable proteins to support healthy liver function.
- Diets containing < 50 g protein/1000 kcal for dogs and < 70 g protein/1000 kcal for cats can be used as first-line options.
Low Copper Content:
- A low level of copper helps minimize its accumulation in a dog’s liver cells, and essential nutrients promote liver health. Copper accumulation can be detrimental to liver health, making its restriction an essential aspect of the diet.
Adapted Energy Content:
- Adapted energy content helps reduce meal volume and decrease intestinal load. This is particularly beneficial for pets with poor appetites or those experiencing digestive issues.
Immune Support:
- A precise blend of antioxidants helps support a healthy immune system. Liver disease can compromise the immune system, making antioxidant support crucial.
Microbiome Support:
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- Includes selected prebiotics to help support a healthy gastrointestinal microbiome. A healthy gut microbiome is vital for overall health and can aid in managing liver conditions.
Royal Canin Canine Hepatic: Description
Some dogs require precise protein levels to support healthy liver function. Royal Canin Canine Hepatic is a highly digestible dry dog food that does just that. It contains restricted copper content and is formulated with essential nutrients to support a dog's liver function. The adapted energy content helps reduce necessary food volume in each meal. A precise blend of antioxidants helps support a healthy immune system. Plus, it contains selected prebiotics to help support intestinal and microbiome health.
Interested in a wet food complement? Ask your veterinarian about pairing this diet with Royal Canin Canine Hepatic Wet Dog Food.
Features & Benefits:
- LIVER SUPPORT: Royal Canin Hepatic Dry Dog Food helps support healthy liver function in adult dogs with adapted levels of highly digestible vegetable proteins.
- LOW COPPER: Low level of copper helps minimize its accumulation in a dog’s liver cells, and essential nutrients promote liver health.
- ADAPTED ENERGY: Adapted energy content helps reduce meal volume and decrease intestinal load.
- IMMUNE SUPPORT: A precise blend of antioxidants helps support a healthy immune system.
Adverse Food Reactions (AFRs) and the Role of Specialized Diets
Adverse food reactions (AFRs) in dogs and cats typically manifest with cutaneous or gastrointestinal clinical signs. Although AFRs can be managed with an appropriate diet, choosing an appropriate diet to use in a diagnostic diet trial can be complicated. "Let food be thy medicine and medicine be thy food.” This saying, attributed to Hippocrates, could also be the answer to managing patients with adverse food reactions (AFRs).
AFRs, which are divided into food allergy or hypersensitivity (immunologic) or food intolerance (nonimmunologic) reactions, are typically characterized by either gastrointestinal (GI) signs such as inappetence, vomiting, bloating, and diarrhea or cutaneous signs such as pruritus, erythema, and altered hair growth in dogs and cats. Diagnosis of an AFR requires a strict elimination diet trial using an appropriate diet.
Such diets typically fall into 3 broad categories: veterinary therapeutic hydrolyzed protein diets, veterinary therapeutic limited-ingredient diets, and complete and balanced home-cooked diets. Each type of diet has benefits and drawbacks; the latter 2 categories require a very thorough diet history to ensure a novel protein and/or novel carbohydrate is used.
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Hydrolyzed Protein Diets
The main goal of hydrolyzing a protein is to break it down to a size that removes existing allergens, thereby avoiding recognition by patients sensitized to the intact protein. Briefly, hydrolysis is a reasonably reliable way to reduce antigenicity of a protein molecule by using proteolytic enzymes to cleave peptide bonds. The degree to which the resultant hydrolysate stimulates a response depends on the site of action within the peptide chain.
In a hydrolyzed protein diet, all intact proteins and larger polypeptides are ideally processed into small peptides, typically < 13 kDa (low-molecular-weight proteins). While some protein sources are obvious (i.e., animal proteins), carbohydrate sources also contain protein (TABLE 3), and protein allergens from 67 to 145 kDA have even been detected in refined vegetable oils. Thus, the fat and carbohydrate sources in hydrolyzed protein diets may also contribute allergens, and all the ingredients in any diet should be considered when assessing clinical response.
Some hydrolyzed diets are extensively hydrolyzed with the goal of ensuring fewer allergens and reduced clinical signs. However, even these diets may retain allergens that cause AFRs in some individuals, at which point a trial using a different diet, often with a different protein source, is recommended.
Selecting an Elimination Trial Diet
In selecting an elimination trial diet, carbohydrate sources should also be considered. The most commonly reported sources of food allergies in dogs and cats include animal proteins and some carbohydrates (TABLE 4); therefore, it is worth noting that some hydrolyzed diets offer only the carbohydrate portion of the carbohydrate source (e.g., corn starch, tapioca starch, potato starch, rice starch).
When selecting a hydrolyzed diet, the author prefers diets that use only hydrolyzed proteins (ideally single source) and either isolated carbohydrate sources or rice, as this limits potential confounding factors in the diagnostic process. Some hydrolyzed formulas include plant proteins, but these proteins should still be hydrolyzed to limit antigenicity; thus, some diet formulations that provide hydrolyzed animal protein sources and isolated (but not hydrolyzed) plant protein sources are less preferred by the author.
Elemental Diets
In an effort to further minimize antigenicity, some diets provide protein in the form of individual amino acids rather than the small polypeptides in hydrolyzed diets (oligomeric) or intact proteins (polymeric) in other diets. The advent of these elemental (monomeric) diets in veterinary medicine stems from elemental diet use in human medicine.
Elemental diets have been used in human nutrition for more than 50 years to manage several disease processes, including eosinophilic esophagitis, eosinophilic gastroenteritis, inflammatory bowel disease, small intestinal bacterial overgrowth, intestinal methanogen overgrowth, chemoradiotherapy-associated mucositis, and celiac disease. In veterinary nutrition, elemental diets have been used to improve clinical signs in chronic enteropathy and cutaneous AFRs and as prophylaxis for dogs undergoing pelvic radiation therapy.
However, elemental diets have been associated with palatability issues in both human and veterinary patients. While human liquid elemental diets may be used in veterinary patients in short-term clinical settings, they are not complete and balanced for dogs and cats, and significant essential nutrient deficiencies could lead to poor and potentially fatal outcomes even with short-term use, depending on the human formulation. Supplementation of human products with at least taurine, arginine, and B vitamins is necessary when used longer term.
Use of a complete and balanced elemental diet appropriate for dogs and cats could help particularly sensitive patients that do not respond to hydrolyzed diets. Trial and error is often required to identify the cause of AFRs in patients with GI or cutaneous signs, and owners must be clearly informed that multiple attempts may be necessary to determine the best diet option. However, diagnosis and treatment can go hand in hand if diet selection is successful.
Clinical Strategies for Selecting Diets
The following sections outline clinical strategies for selecting diets for patients with various conditions. Diet history can help guide hydrolyzed protein choice, as many clinicians prefer to choose proteins that are both novel and hydrolyzed (if possible) for elimination diet trials and long-term management.
Clients should expect diet trials for patients with cutaneous AFRs to run at least 4 weeks and up to 8 to 12 weeks. These patients typically take longer to respond even when the ideal trial diet is selected; thus, clients should be counseled to be consistent and follow through to at least 4 weeks.
- Small Bowel GI AFRs: Hydrolyzed or elemental diets with low total dietary fiber (TDF) content (8 to 20 g/1000 kcal) make good first-line trial options for patients with small bowel GI AFRs. If a diet history is available, a hydrolyzed formula of a protein known to be novel or tolerated should be considered.
- Large Bowel GI AFRs: Hydrolyzed diets with high TDF content (> 25 g/1000 kcal) are good first-line trial options for patients with large bowel GI AFRs. Only 1 currently available commercial diet has very high fiber content (Canine Satiety + Hydrolyzed Protein; Royal Canin, royalcanin.com [110 g TDF/1000 kcal]). If a hydrolyzed diet is adequately tolerated but stool quality remains poor, additional supplementation of fiber (e.g., psyllium husk) may be beneficial (BOX 2). Fiber supplements should be introduced gradually, mixing 1 part fiber with at least 3 parts water. Fresh water should be available to the patient at all times. While specific dosing has not been established, varied inclusion rates have been found to be beneficial. In addition, not all fiber is created equally. Solubility, fermentability, and amount all affect each individual differently; thus, trial and error may be necessary and alternate fiber sources (e.g., insoluble fibers such as cellulose) may be considered as well. It is vital to communicate to clients that gradually increasing fiber supplementation to evaluate tolerance will allow for a more successful outcome.
- Pancreatitis, Hyperlipidemia, or Lymphangiectasia: For patients with pancreatitis, hyperlipidemia, or lymphangiectasia, formulas that are lower in fat compared with current diet/intake should be used. The best low-fat diet options have fat contents < 35 g/1000 kcal for cats and < 25 g/1000 kcal for dogs (although cats are less susceptible to fat content than dogs). Lower-fat hydrolyzed formulas are available in dry and canned formats. The available elemental diet is fat controlled but may not be adequately fat restricted.
- Kidney Disease: Specialized formulas designed to help with management of kidney disease have appropriate phosphorus restriction and controlled protein content. They also have additional renal-supportive nutrients, such as higher levels of anti-inflammatory omega-3 fatty acids (EPA and DHA).
- Urolithiasis: For patients with a history of struvite or calcium oxalate urolithiasis, formulas designed to reduce risk of stone recurrence should be considered.
- Liver Disease with Hepatic Encephalopathy (HE) or Urate Stones: Patients with liver disease with hepatic encephalopathy (HE) or urate stones may benefit from plant-based recipes (e.g., hydrolyzed soy protein isolate) as well as those that are lower in protein (or purine, if indicated). Diets containing < 50 g protein/1000 kcal for dogs and < 70 g protein/1000 kcal for cats can be used as first-line options.
- Weight Loss: Plans for active weight loss in pets require a diet that is appropriately fortified with nutrients and avoids essential nutrient deficiencies during caloric restriction. The goal should be to achieve 1% to 2% body weight loss (kg) per week for dogs, and 0.5% to 2% body weight loss (kg) per week for cats.
Accessibility and Palatability
Distribution and accessibility of specialized diets can influence successful management of AFRs. A diet that helps resolve clinical signs has limited therapeutic benefit if it is on backorder or unavailable, requiring alternative diets to be sourced in the meantime. Hydrolyzed diets are also typically considered more expensive and less palatable than veterinary therapeutic limited-ingredient novel protein diets; however, their cost and palatability are similar or preferable to those of the single currently available amino acid-based diet.