Let’s talk about the recent uproar in dog Food and dilated cardiomyopathy. 

Dilated Cardiomyopathy (DCM), Grain-free, Taurine, Amino Acids, Legumes, Potatoes, Peas, Exotic Foods, Genetic Predispositions.  Is your head spinning?

If you’ve been following the news, then you know that starting in July 2018, the FDA announced they had begun investigating a potential link between certain diets and dilated cardiomyopathy(DCM) in dogs.  About one year later, it was reported that that of the roughly 500 cases of canine DCM, 91% were on a grain-free Diet containing a high proportion of peas, lentils, legume seeds, and/or potatoes.  Included in that same report was a list of specific formulations, ingredients, and brands most frequently seen in these cases.

Those buzz words listed above had been bouncing around in my head and driving me bonkers.  I thought grain-free was supposed to be GOOD but now it’s bad?  Before you stomp through Petco and start throwing around 12 lb bags in an ingredient rage, let’s slow our roll and break this down piece by piece.  Since the FDA released these findings, numerous ill-informed articles have cropped up that seem to draw all kinds of scary conclusions.  But don’t let these articles that have been smothered with opinions fool you.  Just like anything that may seem largely complicated at first, we will just take it one step at a time.  In this post, I will explain the theories and present facts from outside research and data I’ve gathered from the 77-page case report released by the FDA.

So let’s dissect each piece together using credible research and logic (and please, can we promise each other not to jump to any outlandish conclusions?)

First, let’s start with some background so we’re all on the same page.

Dilated Cardiomyopathy (DCM)

Dilated cardiomyopathy is a serious, life-threatening type of canine heart disease that affects the heart muscle.  The hearts of dogs with DCM have a decreased ability to pump blood to other regions of the body, which often results in congestive heart failure.

We can’t get by without talking about the diets the FDA have been focusing on.  Say it with me: GRAIN-FREE DIETS!

Background on Grain-free Foods

Allow me to blow your mind with a quick lesson in marketing and consumerism.  Let’s roll back to around 2012 – 2014 when grain-free was just starting to trend.  This type of specialty food was originally intended for pups with a grain allergy.  Well-meaning dog owners started to self-diagnose allergies or mistake unrelated skin conditions for grain allergies and simultaneously, big brands began marketing these specialty diets promising a healthier and happier pup, and BOOM!  Soon enough, majority of dog food products on the shelves were “grain-free” because it’s what consumers wanted (or thought they wanted).  Guess who jumped right on that “grain-free” bandwagon?  This girl!  Grain-free?  Yeah – sounds good to me!  Dogs thrive on a high protein, high fat diet and don’t necessarily need loads of carbs. Plus, the keto diet for humans was popular around this time, which I’m sure didn’t hurt the “grain-free” train.  What I wasn’t thinking about at the time was what the grains were being replaced with in many instances. Since grains were the key binding element for kibble, the grain free dry products needed something else.  In many cases, this meant potatoes and legumes.  What the heck is a legume?  Plain and simple – beans, peas and lentils are part of the legume family. Keep reading – we’ll discuss this more below!

Background on Taurine & Amino Acids

Before we start, if you’re anything like me, I felt like I was guessing every time I said “taurine” so I would try to mumble it softly unless I was around my dogs. The correct pronunciation is tawr-een, or ˈtȯ-ˌrēn.

Numerous studies suggest taurine deficiencies could result in DCM, which is why I think it’s important to understand the role of taurine.  Amino acids, when strung together, make up protein molecules, and proteins are essential for the growth and maintenance of tissues. There are 22 amino acids in total; taurine is one of those 22 amino acids and is essential for the development and function of the heart and heart muscle cells.  However, it is not considered to be one of the ten essential amino acids to dog food products because dogs can manufacture taurine from other amino acids (methionine and cysteine).  This becomes a problem for certain breeds or individual canines that are unable to produce enough taurine on their own or absorb important amino acids effectively due to overall gut health.  We’ll talk more about breeds with these deficiencies below. 

Where would one find taurine you might ask? Protein!  Animal protein to be precise – specifically chicken, turkey, fish, and animal organs.  Where would one NOT find taurine? Well… lots of places… but most importantly… Plant proteins – specifically beans, peas, lentils, and potatoes!  Ring a bell?  And since these cheap plant proteins were replacing the grains in many grain-free food, brands don’t have to use as many quality taurine-rich animal proteins in their products to meet the requirements.  This is certainly not true for all grain-free brands but could be true for some.  So if dogs are unable to manufacture this essential nutrient sufficiently and if they are not getting it from their food… uh.. Mayday.  Mayday.  Come in, Taurine.

Background on Breeds Genetically Predisposed to DCM and Breeds with known Taurine Deficiencies

Dilated cardiomyopathy is recognized as a genetic condition in certain dog breeds such as the Great Dane, Doberman Pinscher, Boxer or German Shepherd (you can read about it in the journal articles cited below).  Similarly, past research and publications have found that taurine responsive DCM has been seen in Golden Retrievers, American Cocker Spaniels, and Newfoundlands.

OK! Time to get down to the nitty gritty!!  This is the fun part… DATA!!

Thanks to the Freedom of Information Act, all DCM related complaints submitted to the FDA between the time frame referenced above can be viewed in a 77 page report.  And since I live and breathe research, data and spreadsheets at work every single day, why not enjoy that at home too in the company of my pups and Netflix?

Click on the image below to be directed to the report.

Quick recap to remember our purpose: The FDA noticed a spike in reports of canine DCM in the recent years so they began an investigation which led to a theory that there is a potential link between certain diets and canine DCM. 

There are two main theories that revolve around diet:

Of the DCM cases reported to the FDA between 1/1/14 through 4/30/19, below are the breeds most frequently reported.  Earlier, we discussed breeds that had known taurine deficiencies and breeds that are genetically predisposed to DCM based on previous literature.  These account for 6/19 most frequently reported breeds. *Important note – there could be more, but those are the breeds I found literature on.

It’s clear Golden Retrievers are the highest represented breed in this dataset.  They make up about 17% of this dataset, which is quite high when you consider the fact that there are 97 total breeds represented.  So we look at possible reasons.  First and foremost, as we mentioned earlier, it is well-documented that Golden Retrievers are likely genetically predisposed to a taurine deficiency.  Additionally, the FDA brings up a possible reporting bias for breeds like the Golden Retriever, suggesting breed-specific social media sites have raised awareness to known issues, which may result in the submission of more reports to the FDA.

To start looking into the “Taurine Theory”, one question we might ask is… do we know the taurine levels of these dogs?

The answer is yes! … a percentage of them.

The Veterinary Laboratory Investigation and Response Network (Vet-LIRN), a key partner in the ongoing investigation, continues to dig deeper into the medical records of the DCM cases.  The team looked at a subset of DCM cases and non-DCM cardiac cases (reported during the same time period) that had both a taurine measurement and an echocardiogram.  The report states “Approximately 64% of dogs with DCM had a taurine measurement.  Of the pets diagnosed with DCM and tested for taurine, approximately 42% had at least one low blood taurine value” For comparison purposes, I added up the number of low, normal, and high taurine readings for each breed in this subset (displayed below).  The dataset is smaller this time but you’ll notice the top three breeds with low taurine readings match the top three breeds with reported DCM cases.

This still doesn’t draw any definitive conclusions about diets, but it seems to provide more evidence to support the theory that taurine levels seem to correlate with canine DCM somehow.

Now the semi-controversial part: the named dog food brands!  With this comes the exploration of Theory 2. To remind you of the brands that were named ten or more times, I’ve included the FDAs graph below.

As of now, there is no causative link between these brands and canine DCM.  I counted a total of 72 brands across the 523 complaints, each brand having a variety of different formulations.   I was curious to see which varieties of the top listed brands were reported most frequently so I plotted the varieties of the top three brands to evaluate ingredients (specifically legumes) and formulations.  As you look through, you will notice each of these three varieties list legumes within the first five ingredients; and the first two contain multiple types. I would just like to point out that a significant amount of grain-free foods (including those not listed) contain a high proportion of legumes, which would suggest that if future research found that legumes are part of the problem, this an industry-wide problem. *Some complaints had multiple brands listed and/or multiple varieties listed. I reported all instances in the graphs below.

#1 ACANA (by Champion Pet Foods – Orijen)

#2 Zignature (by Pets Global)

#3 Taste of the Wild (by Diamond – Professional Plus, Nutra, Diamond Naturals)

What about legumes?

To be perfectly honest, this is where my brain almost imploded because I had no idea this research existed until I really began digging.  Studies performed by Bednar et al. in 2001 and Carciofi et al. in 2008 found that pea and lentil starches present in dog food formulas reduced digestibility for dogs.  The 2008 study compared pea and lentil starches to cassava flour, brewer’s rice, corn, and sorghum. 

“lower digestibilities identified here must be taken into consideration when creating formulations using these ingredients. The lower DM [dry matter] digestibilities of these diets were accompanied by lower protein digestibilities, verifying the results of other studies which demonstrated a reduction in protein digestibility in diets with low‐digestible carbohydrates”

The FDA read the product labels for each case and broke up the data into the following categories. The reason behind creating a category for peas and/or lentils was “because so many products contained peas and/or lentils” – 93% to be exact!

In relation to the overall study, it seems owners are becoming more aware of DCM as a result of these recent investigations and that could be triggering a spike in diagnoses and reports.  And I have proof!  As I was combing through these complaints, especially the recent ones, I’m seeing quite a few descriptions that sound like this: “Due to the recent FDA alert concerning DCM and grain food diet, I decided to have (b)(6) Taurine level tested as well as schedule an ECHO. On 3/27 his first taurine level came back at 244. His second came back at 238. His echo on 4/10/19 performed by Dr. (b)(6), DVM, Cardiologist found early DCM”.  I’m not suggesting that scaring the bajeezus out of people is a good way to get them to pay attention, but I will say that  anytime you can find something positive (like potentially pushing more owners to get their dogs tested) out of something so negative, that is a tiny win in my book.

In Summary

1. In place of grains, many “grain-free” diets began using potatoes, peas, lentils and beans as their key binding ingredients. Some brands used these cheap plant proteins to replace quality animal proteins.
2. Certain breeds are known to be genetically predisposed to DCM. Other breeds have been found to have known taurine deficiencies. The breeds discussed in this post account for 6/19 most frequently reported breeds.
3. Taurine is essential for the development and function of the heart and heart muscle cells; research suggests taurine deficiencies could result in DCM.
4. Of the pets diagnosed with DCM and tested for taurine, approximately 42% had at least one low blood taurine value.
5. Varieties from the top three brands most frequently reported were evaluated and all three contained peas and/or lentils.
6. Past research shows pea and lentil starches reduces digestibility for dogs.

I suspect/hope the FDA is currently exploring the following questions plus more:

91% of dog in this dataset were on a grain-free diet.  What percentage of dogs in the general population are on a grain-free diet?

Could the problem be the ingredients in the foods these brands are producing?  Is it the lack of ingredients?  Or perhaps the combination of ingredients? What role does all of this play in nutrient bioavailability and digestibility?

Does the AAFCO need to update the suggested nutritional requirements for dog food?

What can you do right now?

• Talk with your vet about your current dog food formulas
• Continue to follow updates from the FDA
• If your dog is one the of breeds that is genetically predisposed to DCM or a taurine deficiency, talk with your vet to get the appropriate tests performed
• We love our rescues and our mixed breeds here at DogTiredByMorning but we don’t always know the genetic makeup of these adorable creatures. Embark Veterinary offers comprehensive Dog DNA Test Kits that include breed identification and an analysis of genetic health conditions, one of which includes Dilated Cardiomyopathy. One important note – the gene thought to be associated with DCM is incompletely penetrant, meaning that while having one or two copies of this mutation is thought to confer some increased risk of developing DCM, it is by no means predictive of disease. Learn more about ordering your Embark DNA test at the very bottom of this page.*

About me: Why am I so passionate about dog food?  My sassy little chihuahua recently had an allergic reaction (suspected from medication) that left her gut all out of wack.  It was a change of diet and probiotics that brought her spunk back tenfold.  Now both dogs are on a rotating diet that includes kibble and formulated raw.  It is EASY PEASY – the dogs are happier and WE are even happier (no lie).  I never thought I had the time or money to feed raw but I have been proven wrong! In my blog post next week, I will tell you all about it. SUBSCRIBE NOW so you don’t miss it.

Final food for thought:

The fact that you’ve made it this far down into the post means that you care about what you feed your dog or dog nutrition in general, which I think is an important responsibility (also thank you for reading this far down into the post). Dogs rely 100% on us to advocate for them and provide them with nutritious food. My call to action for you is to keep asking questions, keep learning, and hold our food companies that we trust responsible if and when necessary.

Shoot me a note from the “Contact Us” page if you want more information about any of my sources or the 77-page case document.

Links to FDA Investigation:
https://www.fda.gov/animal-veterinary/news-events/fda-investigation-potential-link-between-certain-diets-and-canine-dilated-cardiomyopathy
Publications
General
Freeman, LM, Stern, JA, Fries, R, Adin, DB, Rush, JE. Diet-associated dilated cardiomyopathy in dogs: what do we know? Journal of the American Veterinary Medical Association 2018; 253(11):1390-1394.
Dilated Cardiomyopathy
Borgarelli M, Santilli, RA, Chiavegato, D, et al.  Prognostic indicators for dogs with dilated cardiomyopathy.  Journal of Veterinary Internal Medicine 2006; 20: 104-110.
Martin, MW, Stafford Johnson, MJ, Celona, B. Canine dilated cardiomyopathy. A retrospective study of signalment, presentation and clinical findings in 369 cases.  Journal of Small Animal Practice 2009; 50: 23-29.
Taurine
Backus, RC, Cohen, G, Pion, PD, Good, KL, Rogers, QR, Fascetti, AJ.  Taurine deficiency in newfoundlands fed commercially available complete and balanced diets. Journal of the American Veterinary Medical Association 2003; 223(8):1130-1136
Kittleson, MD, Keene, B, Pion, PD, Loyer, CG, the MUST Study Investigators.  Results of the multicenter spaniel trust (MUST): traurine- and carnitine-responsive dilated cardiomyopathy in american cocker spaniels with decrease plasma taurine concentration. Journal of Veterinary Internal Medicine 1997; 11(4): 204-211.
Torres, CL, Backus, RC, Fascetti, AJ, Rogers, QR. Taurine status in normal dogs fed a commercial diet associated with taurine deficiency and dilated cardiomyopathy.  Journal of Animal Physiology and Animal Nutrition 2003; 87: 359-372.
Legumes
Bednar, GE, Platil, AR, Murray, SM, Grieshop, CM, Merchen, NR, Fahey, GC. Starch and fiber fractions in selected food and feed ingredients affect their small intestinal digestibility and fermentability and their large bowel fermentability in vitro in a canine model. The Journal of Nutrition 2001; 131: 276– 286.
Carciofi, AC, Takakura, FS, de-Oliveira, LD, Teshima, E, Jeremias, JT, Brunetto, MA, Prada, F. Effects of six carbohydrate sources on dog diet digestibility and post-prandial glucose and insulin response. Journal of Animal Physiology and Animal Nutrition 2008; 92: 326-336.
Murray, SM, Fahey, GC Jr, Merchen, NR, Sunvold, GD, Reinhart, GA. Evaluation of selected high-starch flours as ingredients in canine diets. Journal of Animal Science 1999; 77: 2180–2186.
Twomey, LN, Pethick, DW, Rowe, JB, Choct, M, Pluske, JR, Brown, W, Laviste, MC.The use of sorghum and corn as alternative to rice in dog foods. The Journal of Nutrition 2002; 132: 1704S–1705S.

* If you’d like to get your Embark DNA kit, feel free to click on the “Embark DNA” tab in the ribbon above. Most recent sales and coupon codes are listed here. I receive 10% of sales generated through this link.  All money I receive from my Embark affiliate link will be donated to my trusted local animal shelter, Paws and Claws Humane Society of Rochester, MN.  Thank you!