On July 12, 2018, the US Food and Drug Administration issued a warning to pet owners and veterinary healthcare professionals about reports of heart disease (Dilated Cardiomyopathy) in dogs eating grain free diets.  The diets in question contain peas, lentils, legume seeds or potatoes as main ingredients.  At this time, there may be more questions than answers but here is what we know.

Dilated Cardiomyopathy

Dilated Cardiomyopathy is a disease of the heart muscle that results in an enlarged heart.  When chambers of the heart become enlarged, the muscles become thinner and weaken. As a direct result, the heart has difficulty delivering blood and oxygen to organs.  With the progression of the disease, the valves start leaking which leads to fluid accumulation in the chest and the abdomen.  Symptoms associated with fluid in the chest are lethargy, exercise intolerance, coughing and decreased appetite.  Animals with fluid building up in the abdomen will have a distended abdomen, lethargy, anorexia and sometimes vomiting.  

Causes of Dilated Cardiomyopathy (DCM)

1. Genetics: Breeds that are more typically associated with DCM are large and giant breed dogs, such as Boxers, Dobermans, Irish Wolfhounds and Great Danes.  
2. Taurine deficiency: In the 1980’s it was discovered that Taurine deficiency was the leading cause of DCM in cats. This has largely been resolved by the supplementation of Taurine in their diets.  Two years ago, Dr Stern at US Davis started noticing an increase of DCM in Golden Retrievers that were eating the same grain free diet. These patients also were Taurine deficient.  Additionally, he found that these patients responded favorably to taurine supplementation.  Other breeds that seem to be at risk for taurine deficiency is the Cocker Spaniel, Newfoundland, St. Bernard, English Setter, Portuguese Water Dog and Irish Wolfhound.
3. Grain Free Diets: There is a third group of animals that do not fall into either of the above categories.  They are the patients that are on grain free, boutique or exotic ingredient diets but do not have a Taurine deficiency. At this time, we do not know why this group of animals are developing DCM but it could even be a result of something in the diet that is toxic to the heart. There are several groups of veterinary researchers looking into this now.

A bit about the diets

In the past decade or so, we have seen a rise in grain free, boutique and exotic protein diets.  These diets require the manufacturer to have more expertise in nutrition in order to provide a well balanced meal to your pet.  Exotic ingredients may have different digestibility as well as make other ingredients less bioavailable.  Without the proper research, serious nutritional deficiencies can occur affecting the life of your pet.

Which ingredients have been implicated ?

At this time, the FDA reports that the following are main ingredients in many of the diets: potatoes, multiple legumes including peas, lentils and seeds of legumes.  Exotic ingredients that have been seen include kangaroo, duck, pea, fave beans, buffalo, tapioca, salmon, lamb, barley, venison and chickpeas. 

What should you do?

1. The easiest option for dogs without heart disease is to change the diet to a brand whose manufacturer has nutritional expertise and strict standards.  Lisa Freeman, DVM is a board certified Veterinary Nutritionist at Tufts University with some great advise for choosing a diet.  Check out this link to her website with lots of nutrition information for your pet: Nutrition Information
2. If you do not want to change your pets diet, we recommend having an echocardiogram (ultrasound of the heart) and  test blood Taurine levels.  If the Taurine level is low with or without heart muscle disease,  begin supplementing Taurine based on recommendations by your veterinarian and change the diet. 
3. Remember some dogs are not actually Taurine deficient. and still develop DCM.  Monitoring for symptoms consistent with DCM and yearly cardiac auscultation is imperative if you are not going to change from a grain free or boutique diet. 

As always, we are here to help. Please call us with questions regarding this important issue!