This article presents the results of research that focused on the nutrition and related health issues of medieval and early modern dogs found in the territory of present-day Lithuania. In this study, we present bone collagen carbon (δ13C) and nitrogen (δ15N) isotope ratios for seventy-five dogs recovered from seven sites which were dated back to the between the 12th and 18th C AD. In addition, by studying the remains of almost 200 dogs, we were able to estimate changes in the sizes and morphotypes of canines across over 600 years. On the basis of stable isotope and historical data, as well as the osteometric analysis, we discuss the dietary patterns of different sizes and types of dogs from the sites related to different social strata and time periods. The results of our study demonstrate that the size, type, diet, and health of canines from different time periods and sociocultural environments varied. Overall, carbon isotopic signals indicate that dogs’ diets were based on C3 plant environment foods (cereals and animals), while freshwater fish was more important for some individuals in coastal Klaipėda/Memelburg Castle. The stable isotope analysis supported the historical records, indicating that cereals were highly important in the diet of elite dogs. Meanwhile, urban dogs had a different nutrition. In the Middle Ages, the consumption of plant-based foods was likely higher compared to the early modern period. Our study also revealed that the diets of dogs did not correlate with individual size. Compared to pigs, dogs had a higher intake of animal foods in their diet. In general, the nutrition of the studied canines was similar to that of the rural human population of the same period.