The Food and Drug Administration recently issued an alert about reports of canine dilated cardiomyopathy (DCM) in dogs eating pet foods containing peas, lentils, legume seeds, or potatoes as main ingredients. DCM is a disease of the heart muscle that causes increased heart size and decreased ability to pump blood, which can lead to congestive heart failure or sudden death. Many of these diets are grain-free, boutique (small manufacturers), or contain exotic ingredients.

Many pet owners are being misled by marketing myths that tout grain-free or exotic diets as more natural or healthier.

Unfortunately, many pet owners are being misled by marketing myths that tout grain-free or exotic diets as more natural or healthier for our pets than those with traditional ingredients, while there is no published data to support these claims. In the few pets with true food allergies, most veterinary dermatologists cite proteins as the culprit—not grains. So there is absolutely no advantage to feeding pets grain-free food. According to Cecilia Villaverde, BVSc, PhD, DACVN, DECVCN, Nutrition Support Service, William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, “‘grain free’ means almost nothing nutritionally, nor does it mean ‘hypoallergenic.’ Grain free diets usually include other sources of starch (mostly root vegetables, but also legumes). In an effort to avoid cereal grains, some are also very high in fat.”

To rule out food allergies, novel protein diets (proteins the animal would not have been exposed to in the past) are more helpful than grain-free diets. Some people try a number of over the counter diets in an effort to try to find something which will help their miserable, itchy pets. However, there have been studies which found some over the counter diets to be contaminated with other proteins, thus the prescription veterinary diets are recommended. Many clients express concern about the fact that prescription diets are more expensive and feel veterinarians are just trying to make money by recommending them. In truth, most veterinarians make no money on the prescription foods they sell and merely offer them as a reliable source of balanced nutrition to meet a specific medical need (backed up by numerous studies) as a convenience to their clients. This author tells clients not to spend more money for grain-free, as there is no medical indication for grain-free, nor is it superior to tradition diets, and I will happily write a prescription for therapeutic diets not carried by our clinic.

Alarming New Information

So, back to the alarming new information which has come to light regarding these grain-free, exotic diets. As of July 2018, several cardiologists have examined this issue and have not come to a single conclusion—some have implicated diets and taurine deficiency in specific breeds (e.g. Golden Retrievers) (Olsen 2018) (Morris Animal Foundation 2017), while others have shown a relationship between the implicated diets and DCM but failed to find a strong association with taurine deficiency (Adin et al 2018). Unfortunately, simply supplementing these diets with taurine is not the answer.

In July 2018, the FDA issued a warning that some diets might be associated with DCM. However, the association is far from established or clear. Multiple diets have been implicated. It is important to understand that any of the grain-free diets could be problematic (although there is currently no conclusive evidence that they are causal.)
The UC Davis website has a page discussing this issue and the studies that are currently under way.

There is also a blog by Lisa M. Freeman, DVM, PhD, DACVN at http://vetnutrition.tufts.edu/2018/06/ which discusses the risk of heart disease in boutique or grain-free diets and exotic ingredients.

Clients are urged to check the WSAVA (World Small Animal Veterinary Association) global nutrition guidelines website for help in selecting foods that meet their criteria. Some examples of foods meeting these criteria are: Purina brands, ProPlan, Merrick, Chow, ONE, etc.; Hill’s brands: Science Diet, Healthy Advantage, etc.; Mars brands: Royal Canin, Iams, Eukanuba, Nutro, Pedigree.

References:
UC Davis website
Lisa M. Freeman, DVM, PhD, DACVN at http://vetnutrition.tufts.edu/2018/06/
ELISA testing for soy antigens in dry dog foods used in dietary elimination trials.
J Am Anim Hosp Assoc. 2014 Nov-Dec;50(6):383-9.
DOI: 10.5326/JAAHA-MS-6063
Christine Willis-Mahn 1, Rebecca Remillard, Kathy Tater

Adin D, DeFrancesco T, Keene B, Tou SB, Meurs K, Atkins CB, Aona BB, Kurtz KB, Barron LB. Echocardiographic Phenotype of Canine Dilated Cardiomyopathy Differs Based on Diet. ACVIM Forum 2018.
Cecilia Villaverde, BVSc, PhD, DACVN, DECVCN 
Nutrition Support Service 
William R. Pritchard Veterinary Medical Teaching Hospital 
University of California, Davis
FDA Website: www.fda.gov/animalveterinary/newsevents/cvm

efannondvm@embarqmail.com
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Ellen has been making up stories since before she could write. Ellen is a practicing veterinarian, former missionary, foster parent, pastor’s wife, and church pianist/organist. She originated and wrote a newspaper column on pet care for six years before taking an assignment with the Southern Baptist International Mission Board. She lives in Valparaiso, Florida with her husband, son, and assorted pets.