Lymphangiectasia in Dogs: How a Low Fat, Gently-Cooked Diet May Help

Written by Kelly Gredner RVT, VTS (Nutrition) 

Lymphangiectasia is one of the more complex gastrointestinal conditions a dog can face. It affects both the gut and the lymphatic system, causing the body to lose proteins and nutrients through the intestinal wall. While it requires veterinary care, nutrition is one of the most powerful tools available to manage it. 

A low-fat, highly digestible, whole-food diet for dogs can help reduce pressure on the lymphatic system, minimize protein loss, and support your dog's comfort and quality of life throughout treatment.

Dog parents can probably attest to this: gastrointestinal problems are a common occurrence and a concern. They would be right!

Acute and chronic gastrointestinal symptoms are a common issue raised in veterinary clinics with up to 20–30% of veterinary visits in companion animals are related to vomiting or diarrhea or both2. 

These problems can be relatively straightforward like intestinal parasites, or more complex with issues such as Chronic Inflammatory Enteropathy, or CIE. Historically named irritable bowel disease or IBD, current research and experts have renamed, and revisited, how to approach care for these types of conditions. 

Canine CIE describes a group of gastrointestinal disorders with persistent or recurrent GI symptoms and variable mucosal (intestinal lining) inflammation2.

One such disorder is called Lymphangiectasia. 

What Lymphangiectasia Is and How It Affects Dogs

Lymphangiectasia is a complex medical condition involving both the gastrointestinal tract and the lymphatic system. 

• Lymphatic system: An important part of the immune system which helps fight infections, contains lymphocytes, filters blood, drains excess fluid from tissues, and works as a filter and storage center in the body5 

• Lymph: A fluid to circulates the body passively though normal muscle activity

• Lymphocytes: A white blood cell in the body which is included in the lymph fluid

• Lacteals: Vessels along the gastrointestinal tract that absorb nutritional fats (run through the center of microvilli)

• Microvilli: Finger-like projections along the small intestine that absorbs nutrients

• Lymphangiectasia: Dilated lymph vessels

If an inflammatory condition appears, this can increase the pressure within the lacteals causing them to dilate and potentially burst. They can also become blocked, increasing the pressure and risk of rupture. This fluid (proteins, fats, cells) from the lacteals is leaked into the gut, and although some of it can be reabsorbed, unfortunately, not all of it is. 

If the inflammation continues without treatment or has spread throughout the body, then this can mean a recurring loss of nutrients, particularly protein, into the gut. 

Common Signs of Lymphangiectasia in Dogs

There are various signs a pet parent might see if their dog has Lymphangiectasia, and it also depends on the severity of the disease at diagnosis. You might see your dog experience:

• Waxing and waning of symptoms, predominantly gastrointestinal symptoms

• Chronic intermittent vomiting or diarrhea

• Might not see any gastrointestinal signs at all

• Progressive weight loss, even with a strong appetite

• Signs of excessive protein loss

If your dog is experiencing excessive protein loss in the advanced stages, this can accumulate as:

1. Pitting edema: a type of fluid-retention swelling where pressing a finger into the swollen area leaves an indentation (or "pit") that takes several seconds to refill 

2. Ascites: fluid accumulation in the abdominal cavity which will look like bloating and can cause discomfort and pain in the lower abdomen

3. Pleural effusion: fluid accumulation in the chest which can cause difficulty breathing and a cough-like reaction

Treatments for Lymphangiectasia in Dogs 

There are a few medical treatments for Lymphangiectasia. Typically, treatment will focus on targeting inflammation through the use of steroids (e.g., prednisone, cyclosporine), and/or stabilizing nutritional deficiencies caused by lack of absorption like vitamin B12 or D33. 

Sometimes the condition can cause blood clotting issues so anti-coagulants are used (clopidogrel). 

Nutrition is a crucial element to any gastrointestinal problem, but with Lymphangiectasia, it’s even more important! 

89% of dogs with CIE are food responsive. This means that they require no antibiotics, steroids, or medications2 when treated appropriately with nutritional intervention!

Nutrition for Dogs with Lymphangiectasia

Current recommendations focus on following a diet trial to determine the best diet for the individual dog. Typically, this will involve the use of a veterinary exclusive diets as they look for diet options that are:

• Low in fats

• High in digestible, high-quality protein

• Control for the level of fiber

• Are highly digestibility 

Diet trials are done for a minimum of two weeks per diet as improvements should be seen within 10-14 days if the diet is working!

Like with potential food allergic dogs, food trials are to be very strict; this means no: 

• Treats

• Flavored medications

• Toppers or “extras”

• Table scraps

If there is also the need to rule out a food allergen, novel protein or hydrolyzed protein diets are recommended.  This usually means over-the-counter foods cannot be part of the plan due to the risk of cross contamination*2

*Please discuss with your Veterinarian on what would be best for your own dog

Human Grade Advantages - the Tom&Sawyer Difference

However, how Tom&Sawyer differs from many over-the-counter brands is our human grade claims and commitment to our pet’s food safety. 

All of our pet meals are produced in a CFIA-inspected (Canadian Food Inspection Agency), SQF-certified (Safe Quality Food) facility following HACCP (Hazard Analysis and Critical Control Points) food safety protocols. 

This means all of our meals mirror the high standards required for human food consumption and safety, but the end consumer is your beloved pet instead!

Every production batch is individually traceable via a lot number on the package, held and documented with a retained sample stored on-site, and produced using sanitized equipment before and after each batch.

For food allergens specifically, SQF testing is required under environmental monitoring & verification of sanitation effectiveness. This is typically how facilities demonstrate that cleaning between batches prevents cross-contamination and is used to confirm no detectable allergen residue after sanitation.

We also use whole food ingredients, so there are no proteins in our meals that aren’t included on our labels! 

How to Feed a Dog with Lymphangiectasia

The main aspects of nutritional care for a dog with Lymphangiectasia are¹:

• Fat

• Protein

• Fiber

• Digestibility 

Fat: Keeping It Low (Goal: Less Than 15% Dry Matter Basis)¹ 

Fat is the most important factor in deciding what diet to feed a dog with  Lymphangiectasia. We want reduced fat because limiting fat:

• Minimizes lymph flow

• Reduces lacteal and lymphatic distension

• Minimizes protein loss

But we do want to ensure dogs get their essential fatty acids and fats for energy. For dogs with Lymphangiectasia, some resources focus on using Medium Chain Triglycerides (or MCTs).

MCTs can be helpful, but sadly, not too tasty on their own. These fats are rapidly and easily broken down and have less effect on the lymphatic system as opposed to long chain triglycerides likes omega 3 or 6 fatty acids

However, MCTs do not contain essential fatty acids, so if they are to be used they need to be balanced in a meal, and best to be formulated into the meal rather than added to the meal. 

Protein: Meeting and Replacing What's Lost (Goal: 25% or More Dry Matter Basis)¹

With the potential for protein loss in the gut, we want to ensure that the protein levels meet the individual needs of each dog. 

We want:

• High quality animal proteins or proteins with high biological value

• Adult maintenance levels and beyond as we need to replace the protein being lost in intestinal tract, and also for regular bodily maintenance 

As a reminder for this condition:

• No protein restriction (unless this is instructed by a Veterinarian)

Crude Fiber: Lower Is Better (Goal: 5% or Less Dry Matter Basis)¹

Crude fiber is the measure of insoluble fibers in your pet’s food. Of course, fiber is beneficial for gut health, but for Lymphangiectasia, we want to be cautious.

• Avoid diets high in insoluble fiber (or diets with >7% crude fiber on a dry matter basis)

Why do we want to minimize fiber for dogs with Lymphangiectasia?:

• Fiber is not necessarily detrimental*, but we don’t want to interfere with the overall digestibility of the diet 

• We don’t want to negatively affect the caloric density, especially since we have to minimize fats which are the biggest contributors to the calorie content of your dog’s food! 

• We don’t want anything “rough” to harm the already fragile intestinal walls 

*Each dog is different! Please discuss with your Veterinarian on what might be the best fiber levels for them

Diet Digestibility*: Why Every Bite Counts (Goal: Above 80%)

With a compromised gut, digestion and absorption becomes a problem which can lead to malnutrition with subsequent weight and muscle loss. Every bite matters!

Why? Because highly digestible foods are associated with: 

• Reduced diarrhea from poor fat and carbohydrate absorption

• Reduced intestinal gas (with then a reduction of flatulence and cramping) due to poor carbohydrate absorption

• Decreased triggers to the immune system from antigens because there are smaller amounts of protein that are absorbed intact (particularly helpful if there is an underlying allergy, either known or suspected)

*Sometimes these dogs require what’s called an “elemental” diet (a diet that is already “predigested” into simpler forms requiring little to no digestion) and sometimes they require an ultra low fat diet which can not be found in commercial foods. These home cooked meals are formulated by board certified veterinary nutritionists and need to be monitored closely. 

Best Tom&Sawyer Diets for Lymphangiectasia 

If we’re looking for certain levels of protein, fat, fiber, and digestibility, then the diets that fit this nutrition profile are: 

Thai Coconut Chicken & Rice Recipe

Our Thai Coconut Chicken & Rice Recipe+ is low in fat (<25g/1000kcal) but also contains coconut milk which includes MCTs. Cooked chicken and white rice are commonly used, highly digestible ingredients in gastrointestinal upsets. 

Fisherman’s Best Friend

While this recipe is low in fat to meet the low fat needs for a dog with Lymphangiectasia, the Fisherman’s Best Friend recipe also uses a hypoallergenic protein source which might be helpful for dogs who might also have an allergen or food sensitivity. 

Please note: this meal also contains lower protein levels than the rest, but still hits the protein requirements. 

Beef & Broccoli

The Beef & Broccoli* recipe still meets the low fat requirement but while using a highly palatable, lean beef! 

Lean beef is a high-quality animal protein with strong biological value, which matters a lot for dogs losing protein through the gut and needing every meal to count. The addition of broccoli brings whole-food nutrients into the bowl while keeping the fat profile in check. As a gently-cooked, human grade meal, what's on the label is exactly what goes into it.

Kangaroo

Another low fat, novel protein option, our Kangaroo recipe* is a crowd favourite! This is a great option for dogs that just aren’t a fan of fish based meals.

The kangaroo* protein is a novel protein source, making it a particularly strong option for dogs who may also have a food sensitivity or suspected allergen alongside their lymphangiectasia diagnosis. It delivers the high-quality animal protein these dogs need to offset intestinal protein loss, while staying well within the low fat requirements for managing this condition.

Due to the nature of being human grade and gently-cooked, Tom&Sawyer meals are highly digestible4. They are also high in moisture, which is beneficial for overall digestion, and super palatable which for a chronically ill dog, matters a lot for maintaining a healthy body weight. 

Not sure where to start? Build a custom meal plan tailored to your dog's needs.

Feeding Tips for Dogs with Lymphangiectasia 

Helping a pet through progressive, chronic illness is stressful, and management becomes a part of the daily routine. But small changes in feeding can help!

Make Food More Appealing

•  Warming up the meals to enhance the aroma and taste.

• Add variety with safe, appropriate options when possible 

Use Meal Rotation 

If your Veterinarian approves, you can discuss feeding on a rotational basis offering a few different options. This means having 3-4 meals available to help once they "tire" (or become food averse) of one. If your dog gets bored with one, switch to another and rotate back to keep interest high!

Feed Smaller, Frequent Meals

By offering small, frequent meals you can help your pup to:

• Meet calorie needs

• Maintain digestive health

• Improve appetite

Monitor Weight Closely

• Weigh your dog regularly 

• Track changes in weight over time

• Pending the size of your pup, consider purchasing a baby scale to monitor and trend their weight 

This way you can catch weight loss sooner and get them the help they need. 

Supporting Your Dog Through Lymphangiectasia

Caring for a dog with Lymphangiectasia can feel overwhelming. But nutrition is one of the most powerful tools you have to support their health. 

By focusing on:

• The right nutrients

• Managing their weight

• Keeping meal appealing

You can help your dog stay comfortable and enjoy a better quality of life!

If you’re unsure what to feed, talk to your veterinarian. Together, you can build a nutrition plan tailored to your dog’s needs.

 

 

* current available in Canada only

+ US recipe; availalbe in the US

References:

1. Hand M.S. et al. (eds) (2010). Small Animal Clinical Nutrition 5th ed. Mark Morris Institute 

2. Romy M Heilmann, Albert E Jergens, Aarti Kathrani, Karin Allenspach, Silke Salavati Schmitz, Simon L Priestnall, Julien R S Dandrieux, Annette M O’Connor, ACVIM–endorsed statement: consensus statement and systematic review on guidelines for the diagnosis and treatment of chronic inflammatory enteropathy in dogs, Journal of Veterinary Internal Medicine, Volume 40, Issue 1, January-February 2026, aalaf017, https://doi.org/10.1093/jvimsj/aalaf017    

3. Brooks DVM, DABVP, W. (n.d.). Intestinal Lymphangiectasia (Protein-losing Enteropathy) in Dogs. Veterinary Partner. https://veterinarypartner.vin.com/default.aspx?pid=19239&catId=254092&id=4951862 

4. Sungho Do, Thunyaporn Phungviwatnikul, Maria R C de Godoy, Kelly S Swanson, Nutrient digestibility and fecal characteristics, microbiota, and metabolites in dogs fed human-grade foods, Journal of Animal Science, Volume 99, Issue 2, February 2021, skab028, https://doi.org/10.1093/jas/skab028  

5. Dodds DVM, J. (n.d.). Lymphatic system and diseases in dogs. Hemopet. https://hemopet.org/lymphatic-system-diseases-dogs/