IMPORTANT: All the information below is taken from folks who have had (or still do have) ME dogs. This is what has worked for them, but always err on extreme caution when changing anything for your ME dog. ALWAYS check and discuss with your veterinarian first as each one of our ME dogs is different from the others. What works for one won’t necessarily work for another.

General Info:
ME can be managed but it does require vigilance on your part. Perhaps you need to experiment with his food consistency….maybe a bit more liquid — or a bit more firm, how often he is eating, or what type of food, but sometimes that needs to be changed. In the years since Olivia has been diagnosed, we have switched several times….from milkshake to meatballs, to cubes of canned food, back to milkshake, to gruel, back to meatballs, etc. Sometimes certain things just work better than others. Maybe consider smaller meals more often if he is regurging more frequently.

Try not to switch her foods too often as that will only make her finicky or cause addition problems.

If trouble keeping food down or regurging: Try less volume of food, make sure it is either meatball format or soupy blended in electric blender, and keep him upright at least 20 minutes with minimum of 2 hours in between meals, no more than three if he’s fed soupy. add mashed potatoes and baby oatmeal.

Refusing to eat with pneumonia, sometimes I can tempt her with Gerber baby food…stage 2 which is very creamy; we have used cream of chicken soup when our girl doesn’t want to eat or after surgeries (PRAA and spaying). Picked out all chunks and very smooth.

Most use either a thin, watery gruel, a thicker milkshake consistency or meatballs. Use a good high quality canned food and mix with water in the blender…..add baby oatmeal flakes or oat bran if needed to add calories and thicken if the consistency doesn’t work. If it is watery, they can just lap it up while seated. If it is thicker, you can feed them bite by bite on a baby spoon or rubber spatula. We feed meatballs made from kibble soaked in water and put through a food mill combined with canned food also put through the mill…..then I add some fish oil, molasses, baby oatmeal and Knox gelatin powder dissolved in water so that when I chill it, it makes nice firm meatballs that I can just cut into little cubes and feed by hand. You want it to be as smooth as possible so there are no little bits to get stuck and irritate the esophagus.

High fat content affecting our dogs. It tends to increase the acid reflux and then regurgitation. Since the esophagus has no muscle tone (or little) acid reflux doesn’t just head back “down” as it does in humans who have the problem; The problem w/ fat in these dogs, is that it empties from the stomach more slowly than protein or carbs, EVEN in normal animals. In dogs w/ ME, that creates a problem as it does promote reflux.

Spoke to the vet about the reasons why we with ME dogs try and keep the fat and protein content in our dogs’ diets lower – i.e. to get food to leave the stomach sooner rather than later – she told me that when protein enters the stomach, it stimulates the lower esophageal sphincter to contract.
So in a dog with a normal LES it is beneficial to maintain normal protein content in the diet. Obviously with LES problems merely having protein in the stomach won’t be enough for contraction, but it is a good fact to bear in mind.

I’ll be making a week’s worth of meals. Would it be best to have him freeze half of the meals to maintain freshness or would they be ok in the fridge for 6 days? the short answer to your question is that I would refrigerate a couple of days supply and freeze the rest. IF you have a vacuum machine for making the storage bags airtight, great. IF not, try this: I have removed the air from freezer/storage bags with a soda straw. Simply insert the straw at one side and close the zip bag nearly all the way, right up to the straw. Suck out all the air, then quickly pull out the straw and close the zipper the rest of the way.

What’s the best dog food:
The answer is the one that works best for your dog.
Good link to find out best dog foods: https://www.dogfoodadvisor.com/
Dog food analysis link: http://www.dogfoodanalysis.com/dog_food_reviews/index.php

Soaked kibble:
How long do you soak the dried kibble to make sure it will blend  smoothly? soak the kibble in very hot, almost boiling water for at least two hours. The water should cover the kibble and the kibble should be all swollen.

I mix 1 cup dry food with 1 1/3 cup hot water. I let it soak for about 10-15min,then I blend in the blender and spoon feed it to her. It turns out to be pretty thick if you give it a 50/50 mix; regular kibble that has been soaked in water that is 2x the amount of the food. It absorbs better if it is boiling water and then I wait 30 minutes or more to feed him.

Meatballs:
Approximate recommended diameter of a meatball (I assume it scales by weigh/size) – varies pending size of dog.

when making meatballs: You’re right, meatballs are time consuming! I did find a couple of things that helped a little. I would chill the dog food in the refrigerator first, and then either let it warm up or microwave it for just a few seconds before Stella ate. Also, I got a small scoop that has a metal blade. The food would stick in a melon baller without the blade. I never did find one just the right size, but it did help.

I also buy baby food to “dip” his meatballs b/c (in my mind) I think it coats them & helps them to slide down better. He has a pocket so I worry about it. I make sure not buy baby food w/ onion powder in it (green beans, sweet potatoes, chicken noodle & country vegetables are it). I think it adds extra calories, too.
took dog off all commercial food and began feeding him a rice/ricotta cheese/ground chicken/egg white gruel. I pureed the food in a food processor and the consistency of the diet seemed to work well. The regurgitating of food stopped and he was able to drink water without choking or gagging. In fact, he was doing so well that he was able to walk downstairs without regurgitating.

Meatballs with canned dog food (5 cans), molasses (1/3 cup for calories & taste appeal), wheat germ and finely crushed Total cereal (1/4 bag of Total and 1/2 cup of wheatgerm), 3-4 egg yolks and 3-4 envelopes of gelatin powder. It also helped to chill for an hour before rolling the balls….or put in the freezer for a while. I would freeze the meatballs and partially thaw them prior to serving. The gelatin powder helps keep the meatballs together too.

Meatball recipe, we grind her CA Natural Lamb and Rice with a coffee grinder. Add some oatmeal already made with water. Then add water slowly until the food is the consistency we want…rollable. We then roll it into balls which is very time consuming as her balls are very small. Since your dog sounds like a bigger dog, you could use one of the utensils I’ve read about like a spring loaded scoop which I believe cuts down on the work quite a bit. Those are available online through Sur La Table or other types of kitchen stores and are not very expensive. They come in different sizes. Oh, another important thing that we discovered with Rosie’s balls that helps a whole lot is that before we feed them to her, we put them in the freezer for about 15 minutes so they are very hard and keeps it all totally stuck together so there’s no flaking pieces. She also swallows them whole with more efficiency when frozen and if my aim is off and she accidentally clamps down on one, it doesn’t get crushed in her mouth as it’s frozen.

Grandma Lucy’s Artisan. I just went on their website http://www.grandmalucys.com/ and I see they have meatballs as well. I am not sure if they are soft or hard, but it might be something to check out. The Artisan foods are freeze-dried and are all-natural and grain free. You just add water to reconstitute. This is perfect for our dogs because it is so easy to adjust the consistency. can be made ahead and refrigerated for up to 48 hours. If you can’t find it in your store, you can buy it online (from Amazon).

Mine aren’t oatmeal consistency either. I use Biljac frozen dog food, which is the perfect consistency to make meatballs out of once it has defrosted. I put a piece of diced boiled chicken breast inside each meatball. Takes about 2 minutes to make her 22 meatballs per meal, each about 3/4″ – 1″ diameter. I put them in a bowl with a tablespoon of canola oil and roll them around to coat them all lightly and feed.

Meatball recipe one owner used:
2lbs of fatty Ground Round
1 8 oz of Cream Cheese
1 1/2 cup of Wheat Germ
1 cup of whole oats soaked in 1 pint of heavy cream
1 cup of peanut butter ( Organic with NO salt or sugar)
6 boiled eggs, whites and yolks
1 jar of baby food carrots ( organic just pureed carrots)
1 jar of Baby food Chicken & vegetables
1 jar of Baby food Pureed green beans
1 jar of Baby food Sweet potatoes
6 table spoons of Dinovite Canine Nutritional Supplement for dogs ( read about this on www.k9healthsolutions.com )
1 Cup of Whole Grain Brown Rice
Mix all together and roll into Meatballs. Separate into small containers or Ziplocs and freeze the individual servings. I take out two packages a day to thaw and feed one in morning and one at early evening. They are smooth and he really loves them!!!

Slurry:
recipe (slurry) – A can of California Natural blended with a can of water or low sodium chicken broth, with 1/4 cup of raw oat bran and an equal amount of water for the added oat bran. Blend smoothly. It should make 5-6 servings for a Boston Terrorist (grin), with 2-3 hours in between meals. Lots of exercise to build up muscles too. Don’t try to put weight on too fast. It takes time, anyway. Cal. Nat. is about 100 calories per can more than many of the other quality, premium foods. Can’t go too high in protein and/or fat because it tends to increase reflux and acidity.

canned food with my dog, mixed about half and half with water, and also added a spoonful of canned pumpkin, a teaspoon of plain yogurt, and baby rice cereal to make a milkshake consistency. I eventually switched to a dry food – Flint River Ranch food, which crumbles easily anyway. I ground it up in the blender and then added warm water, baby rice cereal, and the rest. I think the key is to avoid chunks that might get stuck in the esophagus.

Milkshake:
For an older dog: baby oatmeal flakes/powder to her milkshake consistency of canned Hill’s I/D. The I/D is low fat.
Regular oatmeal cooked is sticky and if it doesn’t make it to their stomach/regurgitation increases.

Food brands:
The following is the list of food recommended by Dr. Kathy, that we’d use as a base list for a survey monkey. If your preferred dog food isn’t on the list, please let us know and we’ll be sure to include it.
Wellness, Nutro, Evanger, California Natural, Blue Buffalo, Flint River Ranch, Canidae, Old Mother Hubbard, Merrick, Pinnacle, Natural Balance, Iams, Eukanuba, Science Diet, Solid Gold, Innova. And, yes, even some of the Purina Products (Purina O.N.E. or Pro Plan – some of the others are not as good, in my
personal opinion) – Purina is the ONLY food manufacturer we found that owned its own methods of production. For what it is worth, I put a lot of trust in a company that owns its factories and makes its own food, rather than subcontracting them.
Iams Max Cal for Tasha (diluted for use via PEG Tube) This food is by prescription only.

Merrick – Before Grain which is grain free; they also have a venison canned food and a chicken turkey (Senior Medley). Merrick is good because it is natural with no artificial colors, flavors or preservatives. Merrick is chunky so it will need blended and some water added. Can get Merrick food at Agway and at Petco
Science Diet Light Adult – mixed with water

For a pup that doesn’t want to eat some boil chicken livers until extremely soft than mush them up into a pate, the smell alone will usually trigger them to eat. Have also found Wellness brand dog food has a single formula of venison which is very appealing. It does not contain all of the necessary nutrients of a blended formula but it is food that is very good for them and may get the eating started again. It is usually sold only at vet’s offices. It is all human grade food no additives or grains it is a very good food and very palatable. Natural Balance contains all of the same ingredients but not sure they are human-grade. Venison is a very mild and tasty meat and is very good if your pup has food allergies. If you are feeding dry food you really should switch to canned only, dry food and Mega E do not go well together some pups can handle dry but eventually it will cause more problems then it is worth risking.

Scout Natural Balance Sweet Potato and Herring canned food – 6oz per meal – mixed with 1/4 cup of organic whole grain baby oatmeal cereal. We tried this for a couple reasons: gain weight, more filling and the meatballs stay together better. Chose the organic because of sensitive stomach. the word “by products” should never appear in the ingredients list. All fat sources should be identified. “Animal fat” is a low quality ingredient. It should say, “poultry fat” or “chicken fat”.

Flint River Ranch food. It’s a dry food that looks more like flakes instead of kibble. I tried it with my dog, Piper, after initially using canned food, and I thought it worked well. It’s a higher quality of food than the canned food I was using. The reason I used it was that I had heard that it crumbled easily, which may not be what you want when feeding dry. I put it in the blender dry though and found that it ground to a powder really easily. I’d pulverize it in the blender and then add warm water, canned pumpkin, and baby rice cereal to make a good milkshake consistency. It was a smoother, more milkshake like consistency than the canned food. I was buying it from a holistic vet. I think it’s a little harder to find to buy. But it’s just a suggestion since it might be a little cheaper than canned. The main thing is finding something that works.

I buy Bear and Wolf wild Alaskan pink salmon at Costco. It comes in a 6 can ‘roll’ for just under $11.I then throw a couple of cans into the blender along with some water and puree it down. I then add instant potato flakes to add calories, carbs and to get it to the “school paste” consistency that works for her. It also rolls into pretty good meatballs if I ever need to return to the meatball method. Sometimes, I will cook up fresh sweet potatoes, acorn or butternut squash to add to the mix. This is currently Kali’s meal plan. She gets all of her water, broth, coconut or goats milk w/ Thick It added.

Blue Buffalo Co. blue Wilderness. It has 586 cal per cup but only 16% fat. And I am seriously thinking of ditching the goat’s milk. It is 40% fat.

California Natural Lamb and Brown Rice. It has 577 calories per can blended smooth.

Know Innova is kind of expensive, but you might compare prices on California Natural and Canidae. One good thing about the quality foods is that you don’t have to feed as much. Within some of those brands, such as Wellness and maybe Canidae and California Natural or Natural Balance, they do have foods that have just one protein and one carb. As Julie said, you can soak dry food and then grind it in the blender. Add some canned food and baby rice cereal or baby oatmeal.

We use canned food and Chill or put in freezer to get firm before giving it to him – can try Hill’s Science Diet Gourmet Turkey as very smooth right out of can.

Adding extras to the food:
Pumpkin can be added to help with loose stool or diarrhea – when canned pumpkin is refrigerated it can become a “clump,” whereas pureed sweet potatoes, which have the same therapeutic effect, remains creamy.

Generally, raw oat bran is used for that purpose (adding calories). You must add water or very low sodium broth to keep your dog hydrated – add more when you pour the oat bran in the blender – and blend smooth

Since coconut milk has been mentioned here, so much, of late, I thought it best to look into it’s nutritive value. Coconut milk is not the juice found inside a coconut, but the diluted cream pressed out from the thick, white flesh of a well-matured coconut. To make coconut milk, finely grated coconut meat is steeped in hot water until it is cool enough to handle. It is then squeezed until dry; the white fluid is strained to remove all the pulp. When allowed to sit for a while, the coconut cream (hua gkati) rises to the top. Commercially, coconut cream is obtained by pressing grated coconut flesh by itself without water, using a specialized,
heavy piece of machinery. More hot water is added to the pulp and the process is repeated to yield a lighter fluid, or coconut milk (nahm gkati). Frequently, a third pressing is done to obtain a light coconut milk (hahng gkati), which is used for stewing meats or for thinning coconut milk to make a coconut soup or a light curry. An average mature coconut yields about one cup of coconut cream and one to two cups of coconut milk depending on how light a milk is desired. Coconut milk nutrition facts vary depending on whether you are talking about the actual milk squeezed from the fruit or the water that is left behind when the
fruit hardens (ie. the slightly milky juice within the coconut when opened). The water makes a refreshing beverage which is rich in electrolytes and so is naturally rehydrating. It is low in fat, relatively low in calories and has no cholesterol. It makes a great sports drink because it replenishes several essential vitamins that are lost when we sweat, like potassium and chloride. It also contains lauric acid, a nutrient found in natural mother’s milk. Not all brands of canned coconut milk are good. Some actually can be downright foul-tasting. So try a number of different brands to find the one most to your liking. Good coconut milk has a clean, white color and tastes rich, creamy and mildly sweet with the essence of coconut. As is true with other kinds of natural cream that has not been artificially homogenized, natural coconut cream will rise to the top and separate from the heavier water component. Good brands of coconut milk will have the thicker cream floating on top of the can while the milk on the bottom will be much more watery. The cream usually separates to the top more readily in cool weather, or when refrigerated. Brands with milk that looks homogenized tend to have an artificial taste because of additives introduced to make the cream homogenize, or excess processing which changes the nature of the cream. Two good brands are Chao Koh in 14 oz. cans and Mae Ploy in 19 oz. cans. of look-alike cans of inferior brands. Both are carried by most Southeast Asian markets.

Coconut milk? Very high in calories and other nutrients and most of the ME dogs who’ve tried it are doing well.

Thai Kitchen coconut milk is extremely smooth. It is probably the major brand, because I see it in all grocery stores. It does not need blending. It is even thick enough that a little water can be added. Whole Foods sells a great smooth organic coconut milk too.

Baby Rice Cereal. It is easily digested and contains about 250 calories per cup. I have been mixing it in with my EVO, Wellness (canned) and Wellness 5 in 1 Dry Puppy Food +Wellness Adult Dry food.

If you are unsure of adding the puppy food…many add instant potatoes, baby rice cereal, yogurt to get some extra calories in and get the food to the right consistency for their dogs…..Also pureeing a can of Salmon (800 cals per can) and adding that to the food may also help put some weight back on….some also give add coconut milk (also high in calories) to the dogs food blend.

In the UK we have now reached the end of all canned pumpkin supplies, so I have been surfing the supermarket shelves looking for an alternative. I have discovered, after a lot of label reading! canned marrowfat peas. I don’t know if you have an equivalent in the US, but they are slightly higher in fiber than pumpkin, and also higher in carbohydrate and protein. These are the large, rather unattractive looking peas – a bit greyish in color – good for thickening soups etc. They are also about a quarter of the price of pumpkin. They blend to a really smooth consistency so, for us with the tube-feeding, they work very well.

Tried the oatmeal fakes and baby sweet potato. Will buy potato flakes next.

Hungry Jack Instant Mashed Potatoes. It thickens up my pureed dry dog food and water when I use my blender and by mistake I have too much water in it. It takes such a little amount. Just the sitting time in fridge it set up thick.

Powder that is called Showstopper along with a scoop of protein powder.

Supplements:
High calories dog supplements I’ve been recommending are all liquids – Stat, Dyne, and one other – the name of which escapes me at the moment. There ARE some pastes, but they are not something to use regularly, or even sometimes with certain mega-e cases. These are recommended – but should be mixed in with the diet sparingly at first and then increased if tolerated well.

Blended:
Soak 3 cups of “Taste of the Wild,” grain-free salmon kibble in water overnight. Blend/chop to a “dough” in the a.m. using a Cuisinart. Add 1 can of either 1) Natural Balance or 3) IAMS vet prescribed and mix in. I feed this to Spock over a period of 3 feedings per day, giving him 1/2 of the mixture in the a.m., 1/4 at about 1:00 p.m. and the remaining 1/4 about 6:00 pm.

Try chicken livers; they cook very fast and are tender. When not cooked too long, you can mash them with a fork. Beef liver tends to be more solid when cooked, and needs blended.

One can of dog food and mix with 1 cup of water. I blend it and then measure out 2 cups of the mixture. I then mix in baby oatmeal flakes to thicken it (about one cup).

What kind of blenders do you use? Kitchen Aid food processor, black & Decker blender from Walmart, Vitamix blender, thicken the milkshake with either infant rice cereal, oat bran or mash potato flakes until it could not drop off the spoon if held up.

Purina Pro Plan. We use the dry formula and soak it over night in equal amounts of water. So five cups of water to five cups of dry dog food. Then we blend and let set. I am always one day ahead so the food a little time to set.

Homemade:
Fed fresh food, a mixture of cooked meat, cooked squash and sweet potatoes, and some uncooked foods such as cabbage, carrots, apples, and celery. I had been using about 70% meat, but recently decreased the percentage of meat and added pasta in an attempt to put some weight on. This mix is run through the food processor until it is almost like pudding. He gets about 8 oz. of this mix each meal. Before feeding, I add baby oatmeal and some more water to get the right “mush”.