My small dog was diagnosed with Cushing's at only 6 years old. I ordered this food with high hopes. Food is the size and consistency of dry mini marshmallows and does not absorb much water to increase volume no matter how long I soak it. My dog ate it well when mixed with his old food, but only eats a few bites when given only the new food. (And he normally loves to eat!) I will continue to feed it mixed with a little canned food, and hope it will help him feel better. I don't see how the tiny volume of this food could hold all the nutrients prescribed, but if he improves I will surely give a better review.