What is the ketogenic diet?

A ketogenic diet is one that is high in fat, adequate in protein, and low in carbohydrates (carbs). When non-fibrous carbs are significantly reduced, protein is moderate, and dietary fat is increased, the body will naturally switch its primary fuel source from carbohydrates to fat. Once a person or dog begins using fat for fuel instead of glucose, the liver breaks down those fats into ketone bodies which are then used for energy by tissues throughout the body. This process induces a healthy metabolic state called ketosis.

Who is a ketogenic diet ideal for?

The ketogenic diet has been used since the 1920s as a therapy for children with drug resistant epilepsy, and is currently being studied as a therapy for cancer, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), traumatic brain injury (TBI), diabetes, and autism. At KetoPet, we consider the ketogenic diet “species appropriate” as it closely mimics how a dog might eat in the wild. It is a nutritional approach that is also used by people interested in improving human health and performance.

What is a 2:1 ketogenic diet ratio?

A 2:1 ketogenic ratio refers to a diet that has twice the amount of calories from fat to the amount of protein and net carbohydrates combined (fat: protein+ carbohydrate). In terms of percentages, this equates to 82% of calories from fat, 17% of calories from protein, and 1% coming from net carbohydrates.

Is this the ratio you give the cancer dogs? What if my dog doesn’t have cancer?

At KetoPet, we give our dogs with cancer a raw ketogenic diet that is made up of 82% of calories coming from fat (2:1 ratio). This ratio allows each dog to easily transition into ketosis with minimal side effects. We monitor every dog’s blood glucose levels, blood ketones, and body composition. It is very important to keep a close eye on all three factors, as blood and weight determine how you will need to adjust the diet. Depending on how a dog responds to the diet, we may increase or decrease the ratio and his or her caloric intake.

For dogs that do not have cancer or have never suffered from disease, we use a raw ketogenic diet that’s comprised of about 69% of calories coming from fat. This is a good “lifestyle” option for dogs. In a dog without disease, you don’t typically need to be as strict in your formulation compared to dogs that do have cancer. However, keep in mind that we do not yet have evidence showing that this diet is disease preventative.

How long should my dog stay on a ketogenic diet?

We are still in the process of validating the ketogenic diet for dogs. As a result, we don’t have any data to show how long a dog should or can remain on the diet. At this point, our answer would be indefinitely, as we do have anecdotal data of cancer returning in dogs who were taken off of their ketogenic meal plan.

What are some of the side effects of a ketogenic meal program?
When transitioning onto a ketogenic diet, the most common side effects are water and fat loss. Caloric intake should always be closely monitored and adjusted to meet the nutritional needs of your dog. Loose stools and/or constipation can also be an initial side effect (issue discussed in further detail below).

The difference between ketosis and ketoacidosis 

Ketosis achieved through nutrition should not be confused with the term ketoacidosis. When a person’s (or dog’s) primary fuel source is carbohydrates, blood glucose levels are typically moderate, and ketones are non-existent. Ketoacidosis, on the other hand, is only seen in patients with diabetes mellitus and is considered an emergency event where ketones are extremely high (usually 20-25 mM) in the presence of extremely high blood glucose. In comparison, nutritional ketosis is where ketones are moderately high (0.2-8 mM) and are in the presence of moderately low glucose (<75 mg/dL). Below you’ll find an example that describes the difference between these two metabolic states.

  • Ketosis: 0.5 mM Ketones, 75 mg/dL Glucose
  • Ketoacidosis: 20.0 mM Ketones, 220mg/dL Glucose

Can my dog eat this diet while on chemo or radiation?

Yes, they can. As a matter of fact, a ketogenic diet can improve the outcome of these treatments as well as mitigate the harsh side effects often associated with standard of care therapies. Please see our “Scientific Articles” section to read journals associated with these findings.

What is 70/30 ground beef?

Meat is typically labeled by percentage of fat. You’ll see 96/4, 90/10, 80/20, and sometimes you’ll even find 75/25. These numbers relate to the percentage of lean meat to fat content. We recommend using 70/30 if you can find it because it is a 2:1 ketogenic ratio by itself, without the addition of fats (82% of calories coming from fat). You can ask your local butcher or meat dept. if they can make you a 70/30 ground beef if you don’t see it at the store. If you’re not able to find anything less than 80/20 or 85/15 meat, you can still use it, but you’ll need to add in additional fat. Please refer to our eBook (see homepage of our website) on how to calculate the specific number of grams of protein, carbs, and fats to give your dog.

Why does KetoPet suggest feeding raw meat?  

Raw food closely replicates what a wild canine might eat in nature. When feeding dogs suffering from cancer, we believe that it’s important to only offer species appropriate nutrition that improves a dog’s metabolism. Cooking dog food can significantly impact the quality and integrity of ingredients. In fact, high heat can damage fats and denature protein through the heating process.

What about bacteria and pathogens in the meat?

Bacteria does not persist in the mouth of a raw-fed canine. Canine saliva contains lysozyme, an enzyme that lyses and destroys bacteria, but more importantly, the absence of plaque means the dog’s mouth is no longer a hospitable place for bacteria to inhabit.

If you are worried about being licked by a raw-fed dog, you have a couple of options. Teach your dog not to lick or avoid being licked. If you are licked, wash your face and hands regularly. Raw meat should be handled with the same safety precautions you use when you prepare burgers or steaks on the grill. Wash your pet bowls after feeding and sanitize eating surfaces regularly. Also make sure your hands are clean when handling all raw meats.

Additionally, only have the raw meat in the bowl for as long as it takes the dog to eat. Deliver the meal and if your dog isn’t interested then make sure to put it back into the fridge right away. This will prevent any chance of bacteria growth. Keep in mind, poultry has a higher risk for salmonella and other bacteria, so we typically feed raw ground beef to help reduce this risk. Overall, if you are healthy, being licked and in contact with a raw-fed dog will not affect you other than potentially boosting your immune system.

What types of meat sources can I feed my dog?

At the sanctuary, our team primarily used fatty sources of beef and chicken. We suggest starting with the fattest cuts of meats possible. Some cuts of chicken, turkey and venison can be very lean and high in protein. If you’re using leaner meats, you’ll need to calculate how much additional fat to add in. Again, if you don’t see fattier meat in the store coolers, ask the butcher if he can prepare it for you (most will).

What fat sources do you use?

In addition to fatty beef, we rotate fat sources often as it is healthy for dogs to get a variety of fats in their diet. Rotation also helps prevent our dogs from developing an aversion to specific fats. We suggest that you rotate fat sources from time to time. The fats sources we suggest are the following:

  • Monounsaturated fat sources: Avocado oil, olive oil, avocado mayo.
  • Saturated fat sources: Coconut oil, red palm oil, ghee, Kerrygold salted butter, or heavy whipping cream.

What about the risk of fatty liver disease associated with high fat consumption?

Developing fatty liver disease from high fat consumption on the ketogenic diet is not likely. Fatty liver disease is often the result of abnormal bile flow in the liver and deficient hepatic function. Significant deterioration of hepatic function can affect the liver’s capacity of detoxifying the bloodstream, and toxins can accumulate in the body causing further complications.

What vegetables can I give my dog?

At KetoPet, we typically use the list of fibrous vegetables below and we serve them to our dogs raw. We suggest dicing the vegetables before mixing them up in your dog’s food before feeding. Please stay away from other vegetable sources due to their high carbohydrate content (like corn, squash, carrots etc.)

  • Fibrous vegetables: Green beans, red cabbage, broccoli, brussel sprouts, asparagus.

Can I use commercial dog food in building a ketogenic meal plan for my dog? 

Many “raw” dog food products are higher in carbohydrates. Even though your dog’s food might be grain free and raw, many products contain sweet potatoes, fruit, carrots and other ingredients that will make it very challenging for your dog to enter into ketosis. If you have a question about specific products or need suggestions, please email us at info@ketopetsanctuary.com.

My vet suggests that I do not feed raw. What do I do?

Most vets are anti-raw diet due to the potential threat of bacteria or salmonella.  If served properly (see above), you will not have an issue with bacteria or salmonella. All of our dogs at the sanctuary were fed raw, even during chemo/radiation treatments.

Can I cook the food?

We do not recommend that you cook the food. Dogs have the proper gut bacteria and enzymes to naturally break down raw food. Cooking animal fats may also lead to pancreatitis (see our Blog).

I received a plan from you after reading your eBook. Why are the food measurements you gave me in grams?

If your dog suffers from cancer, it’s very important to finely tune his or her caloric intake. If you don’t own a food scale, we suggest purchasing one as it will help ensure that you are delivering the exact amount of food suggested. Please weigh out the grams listed on your plan on a food scale.

Are your food measurements correct?  The meal plan doesn’t seem like a lot of food.

Yes, the measurements are correct.  The standard kibble diet is roughly 30 calories per pound. This is the #1 reason that approximately 25-30% of the general canine population is obese in North America. Unless a dog is already extremely lean, we start most at 15 calories per pound. This calorie allotment allows us to get the dog into a metabolic state that will help them fight disease. As weight fluctuates, you can make caloric adjustments as needed.

Please also keep in mind that a diet higher in fat is also more calorically dense. While it may look like a smaller portion on the plate, it’s higher in calories as fat has 9 calories per gram compared to 4 in protein/carbs.

Are the food measurements on the plan you sent me for one meal or for the entire day?

The gram measurements on all KetoPet plans are for the entire day, but can be divided into multiple meals if you prefer feeding two or three times per day.

My dog has very loose stools since starting the ketogenic diet.  How can I fix this?

When transitioning your dog from a kibble-based diet to a ketogenic diet, they may temporarily experience very loose stools.  This is due to the sudden change in their diet, and will eventually go away as they adapt to consuming a higher amount of fat. You can add in a tablespoon of chia seeds (per 40lbs) split between their meals if they continue to have diarrhea. You may also want to consider using a pet digestive enzyme supplement to help them with the transition.

How do I know if the diet is working?

The ketogenic diet is the only diet that you can validate with a simple blood ketone test.  If the blood ketone test shows 0.3mmol or higher, that’s a good indication that the diet is working.

What glucose/ketone reader do you suggest?

We suggest the Precision Xtra blood glucose and blood ketone reader. You can purchase it on Amazon.com. It’s important to note, that you’ll also need to separately buy blood glucose and blood ketone strips.

Where is the ideal location to draw blood to test both glucose and ketones?

To draw blood, you can use the side of your dog’s paw pads or the loose skin on their front elbow. You may also want to try the inside of the ear or lip. We suggest using the needle only (and not the lancet device) as it’s more controlled and the device may scare your dog.

How often do you suggest that I test blood glucose and blood ketones?

We highly suggest in the beginning that you test blood levels every other day. Test your dog on an empty stomach, first thing in the morning and/or before their last meal of the day. Once numbers are consistently where you want them to be, you can reduce testing to twice per week.

What are the numbers we want to hit for blood glucose and blood ketones?

  • Blood Glucose: 75 mg/dL or lower
  • Blood Ketones: 0.3mmol or higher

I recently discovered Ketostix (urine ketone strips). These are much cheaper than the blood ketones strips. Are these ok to use?

Ketone urine test strips will only work for the first few weeks of a ketogenic diet. In the early stages of a ketogenic diet your body will produce a small amount of ketones, and they may not be detectable in your dog’s urine. It takes time for your body to efficiently use those ketones for fuel, and as a result, they are passed and show up as trace amounts of ketones in your urine. Once keto-adapted (glucose is low and the body is efficiently burning fat for fuel), ketones will no longer be present in urine. We do not suggest using urine testing as a method to validate the diet with a dog.

My dog is losing too much weight, what do I do?

Patience is key when transitioning a dog onto any new diet. Keep in mind, when starting the ketogenic diet, water loss can occur as blood glucose/insulin levels drop. If weight loss happens in the first few days of placing your dog on the diet, don’t be alarmed. Some dogs will lose between 1-5 pounds when initially transitioning onto a ketogenic diet. Monitor your dog patiently, and if they continue to drop weight past the first week or two, you may need to re-adjust their meal plan and add in more calories. However, if your dog needs to lose weight, monitor their weight loss until they’ve reached their ideal body condition score. At that point, you can increase their calories a little to prevent further weight loss.

My dog doesn’t want to eat. What do I do?

It is perfectly ok if your dog misses a meal or even a few meals. If they are not interested, place the meal in the fridge and try feeding them at a later time. Your dog will eventually eat when they are hungry. You can try to exercise your dog as activity typically increases appetite. However, if multiple days have passed and they still will not eat, please contact your veterinarian.

Speaking of exercise, how often should I exercise my dog and what exercises do you recommend?

Metabolic conditioning (metcon) was a very important part of our ketogenic diet protocol at KetoPet sanctuary. The goal was to give each dog daily exercise to increase their heart rate, burn calories, and stimulate their mitochondria. This also keeps insulin low, helping them battle cancer. Every dog that was physically able would participate in metcon that typically consisted of two 20 to 30 minute sessions per day. An intense game of fetch or a long jog is a perfect way to enjoy your best friend’s company while getting in daily activity!

What treats can I give my dog?

At KetoPet, we do not feed our dogs treats. All of the calories our dogs get are in the two meals we feed them. We suggest trying to avoid feeding treats as they can easily add a lot of extra calories (and in some cases, carbs) to their diet. Some treats are also full of protein and hidden carbohydrates which may prevent your dog from getting into ketosis. However, it is okay to give your dog a bully stick once a week to help keep his or her teeth clean.

If you must give them a treat, try freezing a tablespoon of coconut oil or salted butter in a hollow bone or Kong. Just make sure you give this to your dog outside or on a hard surface.

Are there any supplements I should give to my dog?

At KetoPet, we used our own a vitamin/mineral/enzyme mix that is not commercially available. When transitioning onto the ketogenic diet, we suggest adding in a mineral supplement that includes potassium and magnesium. You may also want to add in digestive enzymes to help your dog acclimate to a higher fat diet. We also suggest purchasing chia seeds that you can use if your dog experiences loose stool. We typically give our dogs 1 tbsp per day for every 40 lbs. All of these items can be found on Amazon.com. Please also very lightly salt your dog’s meals. Sodium and mineral requirements increase on a ketogenic diet because as glucose/insulin drops the kidneys excrete excess water. Water loss can result in an electrolyte imbalance if minerals and/or salt are not used.

Are there any other supplements that are safe for my dog on a ketogenic diet?

Be careful when selecting additional supplements to give your dog while they are on a ketogenic diet. Some supplements may prevent them from getting into ketosis as they can cause a spike in blood glucose (due to hidden carbohydrates). Before purchasing additional supplements, do your research and/or ask your vet for advice.

My dog has seizures.  Will they benefit from a ketogenic diet?

Yes, we have been able to reduce (and in some cases completely stop) seizure medication in some of the epileptic dogs we’ve worked with using a ketogenic diet.

Will a ketogenic diet help a dog with diabetes?

Yes. If you follow the diet properly and stop feeding your dog food that’s high in carbohydrates, you will be able to lower your dog’s blood glucose numbers significantly. Our dogs at KetoPet typically have blood glucose levels in the mid 50s to low 60s.

Will a ketogenic diet help a dog with arthritis or joint issues?

Yes. A diet full of high glycemic carbohydrates can cause a lot of inflammation in the body, especially in the joints of older dogs. Eliminating these carbs and increasing the consumption of quality fats will often eliminate a lot of the inflammation and joint pain.

What are your thoughts on CBD oil.  Can I give to my dog CBD oil?

We have never used CBD oil with any of our dogs at KetoPet Sanctuary, and because of this we cannot validate its efficacy. If you still feel this is something you want to try with your dog, we highly recommend that you discuss this decision in detail with your vet.