Feeding Miss Lilly, revised edition: Introduction

Imagine if going to the grocery store to shop for yourself and your family is just a matter of going to the human-food aisle and selecting from the range of different flavors of dry or canned food: beef, chicken, turkey, lamb, fish, and the now-inevitable vegetarian and vegan options.

(Come to think of it, I’ve stood behind people in the checkout line whose shopping carts were piled high with boxes and bags and cans of processed human-food, with no fresh food in their carts at all…)

Even if such foods were “nutritionally complete and balanced,” as is the absurd claim on most dry and canned pet-foods, what are the chances that you’d stay healthy for life on such a diet, processed to have a shelf life of years, and never eating any fresh foods whatsoever? Certainly, one can survive on such a diet; astronauts do. But thrive? No.

Then, what on earth makes us think our dogs and cats can?

The simple truth is that most can’t. I say “most” because you will come across animals who, despite such an unwholesome diet, seem to do OK. But in my experience, these individuals represent a triumph of good genes over bad diet. Or, as is more often the case, they just haven’t lived long enough yet. For the most part, it’s young dogs who still look good on these artificial diets. And when you take a closer look, these dogs are not without diet-related problems after all.

Old too early, gone too soon

In veterinary medicine, 7 or 8 years is commonly accepted as the age at which dogs are considered to be “seniors,” although it varies somewhat with breed, and mostly with size. The large and giant breeds generally have shorter lifespans, so they reach their senior years earlier than the smaller breeds. (And it seems to me that the “senior” threshold has been creeping downward over the years as big corporations have increasingly taken over the petfood and veterinary medical industries…)

For a species whose average lifespan should be 15 or 16 years at least, that’s too early! It’s like saying that humans should be considered seniors in their forties. Perhaps that was true at one time (and it remains true in the minds of teenagers), but now that I’m in my late 50s, I object! I don’t feel old!

At first, I thought that this, to me, premature categorization of senior or geriatric was no more than a marketing ploy by the business experts and corporations who have insinuated themselves into veterinary medicine. Perhaps that’s part of it. It certainly helps a practice’s bottom line to talk owners of older dogs into running a “senior panel” of blood and urine tests every year, whether or not it’s medically indicated. (Seldom do the results of these tests do much more than worry or depress the pet owner.)

But as I thought about it some more and looked more closely, I realized that dogs on the typical dog-food diets are indeed starting to break down and show signs of the customarily age-related diseases by 7 or 8 years of age, often much earlier. And sadly, many are dying before they even make it into their ‘teens.

Diet and disease

The science of aging has revealed some common threads to the conditions we typically think of as age-related, such as arthritis, heart disease, kidney disease, dental and periodontal disease, cataracts, senility, and cancer. Even just “slowing down as we age” is better understood at the molecular level.

Our bodies are designed to be self-maintaining and self-repairing, and thus they’re designed to last us a lifetime. However, two things limit both our lifespan and our ‘healthspan’ (the length of time we remain healthy): our genetic code and the fact that life is messy.

Our genetic code (species and family inheritance) dictates our expected lifespan, but the endpoint (how long we actually live) is really quite ‘elastic’. Here is where the ‘messiness’ of life takes over. Oxidative damage and metabolic debris accumulates over a lifetime, altering cell structure and function such that the efficient maintenance and repair — replacement of cells and renewal of tissues — slows to a crawl or stalls out completely.

This cumulative damage is diet-related, in that a healthy diet of species-appropriate, fresh foods can limit and even counteract it, and an unhealthy diet accelerates it.

But the problem many of us have with making this connection between diet and disease is that the consequences of an unhealthy diet often are insidious. There’s usually a lag between when a dog (or a human) starts on the bad diet and when signs of disease first appear. Sometimes that lag can be years long, so the connection isn’t as obvious as it is with the typical case of food allergy or food poisoning, for example.

Even so, my experience with Miss Lilly and with various domestic animal species in my work as a veterinarian supports the connection between bad diet and poor health — and its opposite, good diet and better health. Often, just improving the diet can be enough to improve the animal’s health and well-being.

Feeding dogs well

Loads of books and articles have been written about feeding dogs, and yet myths and misconceptions about how to feed dogs abound. Perhaps the most pernicious is that it’s beyond the ability of the average person to do it well. I hear this concern often from dog owners who’d like to be making their dog’s food but are too afraid to even try, for fear of getting it wrong. 

Let me relieve you of that notion right now. Feeding dogs well is not rocket science. If it were, then dogs would have died out long ago. You don’t need a degree in nutrition to feed yourself and your family well. The same is true about feeding your dog. You simply need to understand a few essential principles, and go from there.

Given how much information is available already, I thought what might be most useful is for me to tell you how I fed my own dog, Miss Lilly.

Feeding Miss Lilly

Miss Lilly was a bitza (that’s Aussie lingo for a mixed-breed dog: one that’s made up of bitza this and bitza that). She looked like what would happen if you crossed a Greyhound with a Staffordshire bull terrier. She had physical and behavioral characteristics of each, so I think that’s pretty close. As I said in the foreword, I don’t know exactly how old she was when we first met, but she lived with me for about 15 years, having arrived as a young adult.

I love mystery novels, but I don’t like mysteries! When I start a new mystery novel, I read the first chapter or two, get to know the principal characters, and then flip to the end to see ‘who done it’ and why. Only then can I go back to where I’d left off and enjoy the unfolding of the story. In that spirit, I’ll start at the end of Miss Lilly’s life and then go back to the beginning and let the story unfold.


When I published the first edition of this book, Miss Lilly was 13 or 14 years old. While she was clearly a senior dog, she was still bright, energetic, and playful. She would still race around like a puppy — going “crackerdog” as Mrs Pumphrey (of James Herriot fame) would say, or “doing the zoomies” as a friend says of her otherwise very dignified senior dog. At that point, Miss Lilly had been on a fresh meat & veg diet for about 11 years, for reasons I’ll explain in the next section.

But as she continued to age, she slowly faded away. All of her normal processes gradually slowed down and became less efficient, and some of the age-related conditions common in senior dogs began to appear.

The first thing I noticed was that she gradually lost muscle mass and vitality. She went on to develop mild cataracts and eventually had trouble seeing well in the dark, not wanting to go outside on her own after dusk (something she’d really enjoyed as a young dog). She also became quite deaf toward the end, which was a bit of a blessing, as she’d always been very noise-sensitive.

Most problematic (for both of us), she began showing early signs of canine cognitive dysfunction (the canine version of Alzheimer’s disease), notably restlessness, neediness, and anxiety at night. Her sleep/wake cycle became disrupted and she slept more during the day if I didn’t get her moving.

In the last year or so of her life, she developed a cardiac arrhythmia (irregular heartbeat) and she started leaking urine while resting or sleeping, which was something that had been a problem when she was young, right after she’d been spayed, but had not been an issue since. In addition, her skin and coat health gradually deteriorated, and she became more susceptible to parasites, particularly fleas (a persistent vulnerability throughout her life).

But while she did develop arthritis, it was very limited; for example, it was confined to a single joint in a single toe in a single foot, and to a single intervertebral joint in an otherwise normal spine. In other words, her few arthritic joints were probably the result of localised trauma or a specific overuse injury, accumulated over a lifetime. I’ll talk in depth about her teeth in Chapter 2, but I’ll note here that she did not develop periodontal disease.

I was curious to see what would happen if I simply continued to feed her this nature-inspired diet and otherwise provide lots of love and companionship and the varied physical and mental activities of life on a small farm. In her senior years we had goats and chickens on several acres of land, and for both of us our farm ‘chores’ were a daily delight.

What I found was that, while these age-related diseases still developed, they appeared much later in life than is typically seen in dogs her size, and they progressed more slowly. Even more interesting is something I only touched on in the first edition…

When Miss Lilly was 4 or 5 years old, a small, oval-shaped, hairless lump appeared on her left flank fold shortly after we’d made our first cross-country trip to relocate (from Raleigh NC to Seattle WA). It was a stressful time for us both. While it was exciting to plan and open my own practice, it was also one of the most frustrating and discouraging experiences of my life. That move, which felt completely inspired and “meant to be” at the time, prompted what would best be described as a profound spiritual crisis. It led to what I now think of as “the lost decade,” a long period in which I felt utterly lost.

Anyway, back to Miss Lilly’s lump. I always meant to biopsy it, but I never quite got around to it (the cobbler’s child …). To my great surprise, it started to grow rapidly (yikes!) and then it disappeared even more rapidly (phew!), ‘eating’ itself from its center outward and leaving only a small scar at the site where there was once a ‘mesa’ of pink, hairless skin. Based on its behavior, I thought at the time (and still do) that it was probably a mast cell tumor.

The lump slowly regrew a few years later, but it remained fairly static for many years. It would become inflamed and the surrounding area would swell whenever we were chronically stressed, such as when we moved house or moved back across the country (to central NC). It would then settle down again as our stress eased. In effect, her lump was a barometer for our sense of well-being. Given what mast cells do for a living and the fact that they are part of the neuroimmune system, it might be more accurate to say that her lump was a barometer for our sense of safety or security.

Several years after the lump first appeared, and shortly after our second cross-country relocation (refugees of the Great Recession), the nearby lymph nodes and the matching ones on her right side became enlarged. But these too remained fairly static until shortly before her death. In the last few months of her life, the lump began to increase in size, and in her last few weeks it dramatically enlarged and became red and ulcerated. She also developed digestive problems indicative of more systemic spread.

I stood by, ready to euthanise her when the time came, but she managed even her death well. She got to complete her mission on her own terms.

If one needed to pin down her cause-of-death, it was probably this: a mast cell tumor which she managed to keep in check, with no treatment at all, for a dozen years or more, until her aged body couldn’t manage it anymore.

Would she have lived longer if I’d removed it at the start, or treated her at any point along the way? Perhaps. But how interesting that she managed it herself for so long! And what would we have missed by cutting away this part of her body or otherwise suppressing her expression of life’s ups and downs in this way? Might I have forced this expression down another, more destructive or less manageable, path?

Looking back, I think she would have been better served by me attending more to my own physical and mental health. I’ll write about this more in another book, but while I loved her dearly, for many years I struggled with bouts of severe depression that often spawned suicidal thoughts. Miss Lilly was my steadfast companion, my ‘soul friend’, through all that darkness. At what cost to her?

So, it’s all the more remarkable that Miss Lilly was able to manage her own health so well. For all my shortcomings, the way we lived and ate enabled her to keep a commonly lethal tumor from significantly shortening both her lifespan and her healthspan. I remain humbled and awed by that. Miss Lilly continues to teach me the tremendous power of living simply and eating well — and she reminds me of the very great importance of enjoyment! ”More games, more play” is her recurring theme, and one she taught by example.


Miss Lilly arrived as a stray in 2002. Except for her pendulous udder, she was a skin-and-bone life support system for about a million ticks. With her brindle coat and poor condition, she looked like a toast rack. According to her teeth, her behavior with other dogs, and her subsequent development, she was probably 12 to 18 months of age at the time.

I can be as lazy as the next person, so if I could have gotten away with it, I’d probably have fed Miss Lilly some type of dry dog-food for her entire life. I’d already begun my explorations in holistic medicine, but I was still pretty much stuck in the same mindset as most dog owners. If asked “what do dogs eat?” I’d have replied “dog-food, of course.” In fact, in vet school we were warned of the many “dangers” of feeding anything but scientifically formulated dog-food.

Fortunately for my edification and yours, Miss Lilly’s body wouldn’t tolerate either dry or canned dog-food. Not even the “all natural” and “organic” varieties. (And by the way, there’s nothing natural or organic about kibble. Where in nature does such a thing exist? What organ/ism made it? Some man in a white lab coat?!)

Miss Lilly brought with her a spectacular array of what I now know to be symptoms of digestive disorder, each one more colorful or odoriferous than the last: frequent vomiting, diarrhea, gurgly belly, foul-smelling gas from both ends, bad breath, mucky teeth and gums, itchy skin, chronic ear infections, low energy, restlessness, and a “dog smell.” (I’ve since learned that truly healthy dogs don’t smell “doggy” — except perhaps to cat people.)

No matter which of the premium dry or canned dog-foods I tried, her symptoms persisted. On the advice of some colleagues, I  switched her to a grain-free, raw dog-food, and the light finally came on: her symptoms improved dramatically within the first day or two, and they were all resolved by the time we finished that first batch (about 10 days).

(By the way, not knowing any better, I made that transition from kibble to raw food abruptly: all kibble one meal, all raw the next. As I’ll discuss in Chapter 4, that’s not always the best thing to do. It worked out OK, but I attribute that piece of good luck solely to her youth.)

But, lazy bum that I am at times, and needing to stick to a tight budget, after a few weeks I switched her back to dry food. It was cheaper and I could get it at the grocery store when I did my own shopping. However, all of her symptoms returned — some of them with the first or second meal back on kibble. I was convinced! I promptly switched her back to the grain-free raw food and didn’t fed kibble as her basic diet ever again.

(She came to tolerate small amounts of kibble as her health improved.She especially enjoyed it when stolen from someone else’s bowl. On the fresh-food diet, her digestive system, and her body as a whole, became more robust and thus more tolerant — something I’ll discuss later in the book.)

biting the bullet

When we moved across the country 3 years later and I couldn’t find that particular raw food locally, I tried some other commercially made raw dog-foods, but with far less success. Some of them Miss Lilly didn’t care for and refused to eat (they smelled weird to me, too). With others, her symptoms returned or she developed new problems, such as vomiting in the wee, small hours of the morning because the fat content of the food was too high for her.

I finally bit the bullet and started making her food myself — with much of the trepidation I often see in my clients when I recommend that they do the same.

And so began my adventures in home-making food for my dog. In the following chapters, I’ll share what I’ve learned along the way, feeding Miss Lilly and monitoring the transition to home-made diets in my canine patients.

I’ve made many mistakes along the way, including accidentally poisoning Miss Lilly with garlic and nearly killing her with some contaminated chicken. Bless her, she kept on going despite my ineptitude, and forgave most of my mistakes (although she continued to avoid anything with garlic in it).

lessons learned

What I’ve learned along the way can be summed up as this: Miss Lilly did best on a home-made diet of fresh meat & veg, mostly raw but some lightly cooked (particularly the veggies), with lots of variety.

Here are the essential elements, and the book in a nutshell:

1. Dogs are carnivores — but while they are true meat-eaters, they are carnivores of the somewhat more casual (‘facultative’) variety, so dogs do well with some plant material (veggies, seeds, nuts) in their diets. Miss Lilly’s diet had a meat-to-veg ratio of around 60:40 (i.e., animals comprised about 60% of her total diet, and plants the rest). But her daily diet was grain-free, for reasons I’ll discuss in Chapter 1.

2. Carnivores eat the entire animal — they eat most, if not all, of their prey, and dogs are no exception. So, the more body parts we can get into their diets, the better. Along the same lines, bones are an excellent source of calcium for dogs. (Yes, bones… never fear; there’s a whole section on how I feed bones in Chapter 2.)

3. The more variety, the better — facultative carnivores eat a wide variety of foods, and again dogs are no exception. The more variety we get into the dog’s diet, the less we’ll need to supplement and the fewer problems the dog will have with any one food. I fed Miss Lilly as many different beasts, body parts, and products (e.g., eggs, milk, yoghurt, cheese) as I could manage, as well as lots of different vegetables, seeds, nuts, and even some fruits.

4. Carnivores eat their prey raw — and not always fresh. Dogs are well adapted to eating raw meat, even when it has a high bacterial load (although there are limits). I fed most of Miss Lilly’s meat raw, but I was careful about handling and storing raw meat. I fed most of her veggies lightly cooked in order to improve their digestibility and thus their nutrient availability for this carnivorous diner.

5. Carnivores are meal-feeders — dogs have fairly large stomachs for their body size, so they are adapted to eating one or two fairly large meals per day. I fed Miss Lilly (who weighed in at around 50 pounds) roughly 3 to 4 cups of this fresh-food diet each day, divided between a smaller breakfast and a larger dinner.

These are the topics I’ll explore in the following chapters. I hope you find this book helpful and by the end of it you feel well prepared and game to start making your own dog’s food, even if you don’t cook for yourself.