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DCM Due to Diet - FDA UPDATE 6/27/19

Discussion in 'Doberman Nutritional Care' started by Rits, Jun 21, 2017.

  1. strykerdobe

    strykerdobe Hot Topics Subscriber

    Just out from U.C. Davis January 28, 2019

    Dogs Fed Some Popular Diets Could Be at Risk of Heart Disease Study Finds Spike in Deadly Heart Disease Linked to Trendy Dog Diets
    By Amy Quinton on January 28, 2019 in Human & Animal Health
    [​IMG]
    Fiji, a female golden retriever, had taurine-deficient dilated cardiomyopathy. The DCM was reversed with diet change and taurine supplementation. (Jamie Warren)

    University of California, Davis, veterinarians led a team that has found a link between some popular grain-free, legume-rich dog diets and a type of nutritional deficiency and canine heart disease known as taurine-deficient dilated cardiomyopathy. The study was recently published in the journal PLOS ONE.

    Researchers found dogs eating some of these boutique diets are not making or maintaining enough taurine, an amino acid important for heart health. Taurine deficiency has been known for many years to lead to dilated cardiomyopathy, or DCM, a heart muscle disorder that can lead to congestive heart failure and death.

    “Given this recent surge in cases, we need to pay close attention to what we are feeding dogs,” said lead author Joshua Stern, a veterinary cardiologist and geneticist at the UC Davis School of Veterinary Medicine. “Choosing a well-researched dog food that has a healthy nutrient profile backed by expert formulation and research is of paramount importance.”


    Stern said while some dog breeds are more genetically prone to a traditional form of DCM, the disease is now showing up unexpectedly in other breeds, such as the golden retriever. The common link unifying these cases is their diets. He began noticing the trend two years ago and is now treating many dogs with nutritionally mediated DCM that were all eating quite similar diets. Last year, the U.S. Food and Drug Administration issued an alert to pet owners and veterinarians about the potential association between the diets and DCM. The FDA continues to research this issue in an effort to help identify the exact dietary factor causing the problem.

    Study looked at golden retrievers
    [​IMG]
    Suva, a female golden retriever, was treated at UC Davis. She came out of heart failure after switching diets. (Jamie Warren)
    Stern’s research involved 24 golden retrievers with dilated cardiomyopathy and a documented taurine deficiency, representing the largest collection of cases with this condition that has been published. Twenty-three of the 24 dogs diagnosed with DCM had also been fed diets that were either grain-free, legume-rich or a combination.

    Stern then prescribed the dogs a diet change and taurine supplementation. As a result, all but one dog improved. Nine of 11 dogs in this group with the most advanced stage of the disease, congestive heart failure, also showed dramatic improvements or no longer had congestion.

    “This study helped us confirm that this condition is treatable and avoidable, something that traditional DCM of genetic origins is not,” said Stern.

    Stern said consumers who are concerned about their dog’s health, should not naively switch their dog’s diet or simply add a taurine supplement. Instead, consult with your vet as dogs can develop DCM from nutritional origins and not be taurine-deficient. Taurine supplements can also mask the problem and lead to a delay of an important diagnosis.

    DCM cases involve different dog food brands and formulas
    Stern urged pet owners to take a second look at their dog’s diet. Cases of DCM have been reported in dogs eating multiple different brands and formulas of food.

    The problem may not be that the diet is “grain-free” or “legume-heavy” but that ingredients are interacting to reduce availability of taurine or that other nutrients are missing or interacting in the formulation.

    For example, while a lot of pet owners may not want to see “byproducts” in their dog’s food, often the byproducts contain organ meat like heart and kidney, which are good sources of taurine.

    “Pet owners should ask themselves if they’re buying the food because it sounds good to them, or whether it’s right based on veterinary research and evidence,” said Stern. “Staying away from some of the most common marketing gimmicks may help to protect your pet.”

    For more information on selecting foods for your pet, Stern recommends that clients consider using the recommendations set by the World Small Animal Veterinary Association for selecting a healthy dog food.

    Click here for more information on dilated cardiomyopathy and dog food.
    Nutritionally-mediated DCM
    Give now to the Cardiac Genetics and Pharmacogenetics Laboratory

    Dec. 2018 JAVMA Article for veterinarians: Diet-associated dilated cardiomyopathy

    Dog Food & Dilated Cardiomyopathy

    Golden Retriever Taurine Deficiency and Dilated Cardiomyopathy

    Taurine-Deficient DCM in Golden Retriever Article 2018


    Co-authors of the study include Andrea Fascetti and Jennifer Larsen, veterinary nutritionists with the UC Davis School of Veterinary Medicine, and Joanna Kaplan, a veterinary cardiology resident in the UC Davis Veterinary Medical Teaching Hospital.

    Media contact(s)
    Amy Quinton, News and Media Relations, 530-752-9843, cell 530-601-8077, amquinton@ucdavis.edu
     
    • Informative Informative x 4
    • Appreciation Appreciation x 1
  2. strykerdobe

    strykerdobe Hot Topics Subscriber

    I still think finding out what the cause is will take a year or two.
     
    • Agree Agree x 2
  3. strykerdobe

    strykerdobe Hot Topics Subscriber

    [​IMG]
    Index
    [​IMG]
    Debbie Phillips-Donaldson
    By Debbie Phillips-Donaldson
    on February 14, 2019
    FDA asks pet food industry for DCM-related information
    FDA needs pet food producers to report on any changes in ingredients, processing or formulation.
    In its ongoing investigation into atypical cases of canine dilated cardiomyopathy (DCM) possibly related to grain-free pet food ingredients, the Food and Drug Administration (FDA) is asking the industry for information related to changes in ingredients, processing or formulation.

    David Edwards, Ph.D., an officer with FDA’s Center for Veterinary Medicine (CVM)’s Office of Surveillance and Compliance, presented an updated on the agency’s DCM investigation during the American Feed Industry Association’s 12th Annual Pet Food Conference, held February 12 in conjunction with the International Production and Processing Expo in Atlanta, Georgia, USA.

    What FDA needs from pet food industry
    Specifically, Edwards said, CVM needs information from pet food producers relative to the timeframe when most of the new cases of DCM were reported over the past few years, but mainly during 2018. He asked for input on changes in ingredients used, sourcing of ingredients, processing or formulation.

    He also asked that pet food companies, academic programs and organizations such as the Pet Food Institute continue their own investigations on any potential issues with formulas and ingredients possibly related to this DCM situation.

    Wide range of dogs reported among DCM cases
    Through November 30, 2018, CVM had recorded 290 cases of DCM involving 325 dogs (plus a few cats) and 74 pet deaths, Edwards reported. The cases occurred from 2014 through 2018, but most were in 2018. He also presented demographic information showing a wide range of affected pets. For example, the most frequently reported dog breed was Golden Retrievers, with 61 dogs affected, while another 27 were mixed-breed and 25 were Labrador Retrievers. Other breeds with numbers in the double digits included Great Danes at 16 and Australian Shepherds at 11; Edwards listed 15 other breeds with three to nine dogs affected each.

    Related to the variety of breeds affected, the dogs’ weight ranged from 8 to 212 pounds, with a mean of 68 pounds. They ranged in age from 0.42 to 16 years, with a mean of 6.5 years; 59 percent were male, 41 percent female.

    Among the cats affected, ages ranged from 0.4 to 12 years; the mean was 5.5 years old. Their weight ranged from 7 to 13 pounds, with a mean of 11 pounds. The cats were 60 percent male, 40 percent female.

    Dog foods and ingredients in DCM reports
    Edwards also presented data on the types of dog foods and their ingredients in the reported DCM cases. The foods were predominantly dry (269 of the reports), with four raw and one each of wet and semi-moist. In 14 reports, multiple formulations were named; in five others, the foods were unknown.

    Then Edwards provided a deeper dive into the formulations and ingredients for 196 of the reports, in which the affected dogs were fed a single, primary dog food:

    • About 90 percent of the diets were labeled grain free;
    • Of the other 10 percent of the foods, some were labeled vegan or vegetarian, while some contained brown rice;
    • A large proportion of the foods contained peas or lentils high on the ingredients list. In fact, peas appeared in 180 of the dog foods named in these 196 reports and lentils in 104 of the foods. Other ingredients presented by Edwards included potatoes, in 63 of the diets, plus sweet potatoes and chickpeas, each in 55 of the diets.
    Edwards said that, before FDA issued its alert about these cases of DCM in July 2018, the agency had investigated for contaminants such as metals or improper levels of minerals and other nutrients in the cases reported to date. After the alert came out, FDA then bought some of the products named in the reports and tested them specifically for those same factors, among other things. All the tests before and after the alert were negative.

    FDA is continuing its investigation, working with scientists and nutritionists in the Veterinary Laboratory and Investigation Response Network (Vet-LIRN), and also with veterinary cardiologists. The investigation has included nutritional and amino acid analyses of the foods reported and complete health histories of many of the dogs, Edwards said.
     
  4. strykerdobe

    strykerdobe Hot Topics Subscriber

    [​IMG]

    [​IMG]
    photo by MicrostockStudio, shutterstock.com
    By Tim Wall
    on September 17, 2018
    5 usage rates of dog food ingredients in FDA DCM warning
    Dog foods formulated with high percentages of these ingredients may correlate to increased risk of a certain heart disease.

    Pet food ingredients, such as potatoes, peas and lentils, appear with different frequency in dog foods in the United States. Dog foods formulated with high percentages of these ingredients may correlate to increased risk of a certain heart disease, warned the US Food and Drug Administration (FDA) Center for Veterinary Medicine on July 2. FDA notified the public that some canine dilated cardiomyopathy (DCM) cases were correlated to dogs eating diets containing large amounts of potatoes and legume seeds, also known as pulses, such as peas and lentils.

    Grain-free dog food formulas
    Although it is no longer operational, the Dog and Cat Food Ingredient Center database contained data on usage rates of various ingredients related to the FDA announcement.

    In dry dog food, 44 percent of the recipes in the database do not contain grains. These grains include all forms of corn, wheat, rice, soybeans, oats, millet, flax, barley and sorghum. Of these grain-free recipes, 28 percent have grain-free in their product name or in the formula name. Some brands are more heavily invested in grain-free than others, but 78 percent of the brands producing dry dog food have at least one grain-free formula.

    Of grain-free dry dog food recipes:

    • 50 percent contain peas,
    • 23 percent use chickpeas and
    • 14 percent include lentils.
    Use of ingredients mentioned in FDA report
    Outside of the realm of grain-free dog foods, various legumes and potatoes appeared at lower rates. Nevertheless, chickpeas, lentils and peas make up a large percentage of the dry recipes they are in, often showing up in the top 3 to 6 spots in the ingredient deck.

    Of all dry dog food recipes:

    1. Potatoes (not sweet) - 28 percent
    2. Soybeans - 13 percent
    3. Chickpeas - 12 percent
    4. Lentils - 8 percent
    5. Peas - 5 percent
    Webinar with FDA on dog diet and heart disease
    WATT Global Media regularly presents hour-long webinars on topics of interest to pet food industry professionals and leaders throughout the year. These webinars are free to attend and for in-demand playback.

    FDA: possible dog food link to canine dilated cardiomyopathy

    Find out the latest information on the U.S. Food and Drug Administration’s (FDA) investigation into a potential correlation between certain pet food ingredients and canine dilated cardiomyopathy (DCM), and what it means for pet food formulations. Speakers include Martine Hartogensis, D.V.M., deputy director of FDA's Center for Veterinary Medicine's Office of Surveillance and Compliance; Greg Aldrich, Ph.D., associate research associate professor and coordinator for the pet food program at Kansas State University, president of Pet Food Ingredients & Technology and author of the Ingredient Issues column; and Lisa Freeman, D.V.M., Ph.D., D.A.C.V.N., professor at Cummings School of Veterinary School at Tufts University and board-certified veterinary nutritionist.
     
    • Informative Informative x 2
  5. strykerdobe

    strykerdobe Hot Topics Subscriber

    New info!

    FDA Updates on Heart Disease in Dogs
    In July 2018, the U.S. Food and Drug Administration (FDA) caused quite the stir when it announced a potential link between grain-free diets and dilated cardiomyopathy (a form of heart disease) in dogs. On February 19, 2019, the FDA released its latest report and findings, which Dr. Dodds reviews.

    FDA Updates on Heart Disease in Dogs
    By W. Jean Dodds, DVM on February 24, 2019
    The Food and Drug Administration (FDA) issued an updated announcement on February 19, 2019 about the possible link between certain diets and dilated cardiomyopathy (DCM; a form of heart disease) in dogs.

    DCM can be associated with a deficiency of the amino acid, taurine. At this time, it is believed that dogs do not need to be given additional taurine, beyond what is provided in a balanced meat-based diet, because dogs synthesize two other amino acids, cystine and methionine, which are precursors of taurine. Certain dog breeds are predisposed to DCM, and if the condition progresses, it could result in congestive heart failure.

    Hemopet reviews those findings here in comparison to what was initially hypothesized, provides insights into the causes of the initial uproar, and offers suggestions.

    FDA Announcement on July 12, 2018
    “The U.S. Food and Drug Administration is alerting pet owners and veterinary professionals about reports of canine dilated cardiomyopathy (DCM) in dogs eating certain pet foods containing peas, lentils, other legume seeds, or potatoes as main ingredients. These reports are unusual because DCM is occurring in breeds not typically genetically prone to the disease.

    The underlying cause of DCM is not truly known, but is thought to have a genetic component. Breeds that are typically more frequently affected by DCM include large and giant breed dogs, such as Great Danes, Boxers, Newfoundlands, Irish Wolfhounds, Saint Bernards and Doberman Pinschers. It is less common in small and medium breed dogs, except American and English Cocker Spaniels. However, the cases that have been reported to the FDA have included Golden and Labrador Retrievers, Whippets, a Shih Tzu, a Bulldog and Miniature Schnauzers, as well as mixed breeds.”

    FDA Updates on February 19, 2019
    We summarized the statements below taken straight from the FDA’s latest announcement and have added a few notations.

    Based on the data collected and analyzed thus far, the agency believes that the potential association between diet and DCM in dogs is a complex scientific issue that may involve multiple factors.

    Author’s Note: The FDA does not know the cause of DCM in dogs after collecting evidence, and admits more is going on than meets the eye.

    Between January 1, 2014 and November 30, 2018, the FDA received 300 reports of DCM (294 canine reports, 6 feline reports). Approximately 276 of these were reported after the July public notification about FDA’s investigation.

    Author’s Note: Only 24 cases were reported during four and one-half years, or 55 months, compared to 276 cases reported during the last five months.

    Past publications and research suggest that Golden Retrievers may be genetically predisposed to taurine deficiency, which is well-documented as potentially leading to DCM.

    Author’s Note: In the FDA report, Golden Retrievers were disproportionately represented: 61 Golden Retrievers out of the approximately 294 dogs with breeds identified.

    Based on analysis of the 196 DCM reports sent to FDA in which dogs were fed only a single, primary diet (i.e., didn’t eat multiple food products, excluding treats), approximately 90 percent of the foods were reported to be labeled “grain-free” (or labeled as zero-grain) and approximately 10 percent ate diets containing grains, some of which were vegan or vegetarian. A large proportion of the reported diets in DCM cases contained peas and/or lentils.

    Author’s Note: 269 out of the 294 foods were dry (kibble) diets.

    Animal protein sources in the reported diets varied widely. Of the 191 reports with a single primary diet that contained animal protein (rather than being vegan/vegetarian), 31 percent contained more than one animal protein source. The majority of diets containing animal protein included fish, eggs, lamb or chicken. No one animal protein source was predominant.

    The average percent protein and fat, as well as total taurine, cystine, methionine, and methionine-cystine, and the resistant starch content on a dry matter basis (in other words, after removing all moisture content), were similar for both grain-free labeled and grain-containing products.

    Nearly all of the grain-free products had methionine-cystine values above the minimum nutritional requirement of 0.65 percent for adult maintenance dog foods published in the Association of American Feed Control Officers (AAFCO) Official Publication.

    Past publications and research suggested that Golden Retrievers may be genetically predisposed to taurine deficiency, which is well-documented as potentially leading to DCM.

    Author’s Note: DCM in Golden Retrievers has been studied since 1995. Please note that the initial FDA announcement intimated that cases of DCM in Golden Retrievers were novel.

    Veterinary cardiologist Dr. Joshua Stern from the University of California at Davis and his colleagues have been studying the rise in cases of DCM in Golden Retrievers, including a potential dietary link. Many cases of DCM occur in Golden Retrievers that are taurine-deficient. Pet owners who suspect their Golden Retrievers may be affected may wish to consult their veterinarian to discuss checking taurine levels or conducting an echocardiogram.

    Hemopet’s Views
    Dr. Dodds and Hemopet have always urged caution about jumping to conclusions, when preliminary information is released and then spreads over social and other media to create a frenzy of misleading assumptions. We referenced previous studies that demonstrated lower taurine concentrations in the blood from dogs eating formulations that contained combinations of grains and proteins such as barley and turkey or lamb and rice, and one that showed beet pulp as a possible contributor by binding taurine.

    One reason in particular is the presence of food sensitivities or intolerances to specific grains. According to the FDA DCM report, “104 dogs and 2 cats were DCM cases with heart changes characteristic of DCM on cardiac ultrasound – including decreased ventricular systolic function and dilation…Approximately 42% (n=45) of dogs with DCM had a history of allergies or sensitivities to an environmental allergen and/or food that was manifested as dermatitis, otitis, or gastrointestinal disease.”

    Commentary
    The framing of a possible connection between grain-free diets and DCM in dogs was premature and set off alarm bells across the veterinary and dog world communities.

    The veterinary group mentioned above has now veered away from their initial opinions to speculating that the animal protein source is to blame. Specifically, they point to “exotic” animal protein sources such as kangaroo, duck, buffalo, salmon, rabbit, venison, lamb and bison.

    Even though this group of researchers acknowledges prior research, lack of knowledge, the complexity of food interaction, that processing and heat can affect amino acids, that bioavailability varies between animal muscle proteins, that taurine deficiency may be related to cardiotoxic ingredients in the diet, and a host of other potential causes, they remain focused on what they have coined as boutique-exotic-grain-free ( aka “BEG”) diets.

    The FDA’s reports are not in line with this hypothesis as 31% contained more than one animal protein source. The majority of diets containing animal protein included fish, eggs, lamb or chicken. No one animal protein source was predominant.

    Hypotheses About the Cause of DCM in Dogs
    At this point in time, we have ideas about the causes of and contributors to DCM in dogs, and you likely do too. However, speculation on such a serious disease may cause radical shifts in feeding practices that are not based on scientific evidence and may do more harm than good. As the FDA said, “DCM in dogs is a complex scientific issue that may involve multiple factors.”

    References

    Dodds, W. Jean. “Dilated Cardiomyopathy (Heart Disease) in Dogs and Why Some Dogs Eat “Exotic” Ingredients.” Hemopet, 6 Jan. 2019, Dilated Cardiomyopathy (heart disease) in Dogs and Why Some Dogs Eat “Exotic” Ingredients.

    Dodds, W. Jean. “Dodds Responds to FDA Statement on Canine Heart Disease, Taurine Deficiency and Potential Dietary Causes.” Hemopet, 29 July 2018, Dodds Responds to FDA Statement on Canine Heart Disease, Taurine Deficiency and Potential Dietary Causes.

    “FDA Investigating Potential Connection Between Diet and Cases of Canine Heart Disease.” U.S. Food and Drug Administration, Center for Biologics Evaluation and Research, 12 July 2018, FDA Investigating Potential Connection Between Diet and Cases of Canine Heart Disease.

    “FDA Investigation into Potential Link between Certain Diets and Canine Dilated Cardiomyopathy.” U.S. Food and Drug Administration Home Page, 19 Feb. 2019, FDA Investigation into Potential Link between Certain Diets and Canine Dilated Cardiomyopathy.

    Freeman, Lisa M., et al. “Diet-Associated Dilated Cardiomyopathy in Dogs: What Do We Know?” Journal of the American Veterinary Medical Association, vol. 253, no. 11, 1 Dec. 2018, pp.1390–1394., doi:10.2460/javma.253.11.1390. An Error Occurred Setting Your User Cookie.

    Kramer GA, Kittleson MD, Fox PR, et al. “Plasma taurine concentrations in normal dogs and in dogs with heart disease.” J Vet Intern Med 1995; 9: 253–258.

    “Vet-LIRN Update on Investigation into Dilated Cardiomyopathy.” U.S. Food and Drug Administration, Feb. 2019, Vet-LIRN Update on Investigation into Dilated Cardiomyopathy.

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  6. strykerdobe

    strykerdobe Hot Topics Subscriber

    Lots of good info here.

    Grain-Free Dog (and Cat) Food, Taurine, and Heart Disease ...

    Grain-Free Dog (and Cat) Food, Taurine, and Heart Disease – Little Big Catdog-food-taurine-and...
    Remember that dogs make cysteine from methionine, and taurine from cysteine. Any weak link in the chain of methionine, cysteine or taurine could be problematic. Because of this dependency, only methionine has a minimum level in dog food according to current AAFCO standards; there is also a minimum for the combination of methionine + cysteine.

    Dogs, Nutrition
    Grain-Free Dog (and Cat) Food, Taurine, and Heart Disease
    by Jean Hofve DVM • August 3, 2018 • Comments Off on Grain-Free Dog (and Cat) Food, Taurine, and Heart Disease


    NOTE: This is a very fluid situation right now, with a lot of conflicting interpretations and ongoing research. I will update this article as needed. This already involves hundreds of dogs. FDA now admits that cats have also been affected, even though AAFCO standards require taurine supplementation in cat foods. SCROLL DOWN to see details on all updates.

    A couple of weeks ago (July 2018), the FDA released a warning about grain-free dog foods and their possible connection to the development of a serious heart disease in dogs. Is this warning justified, based on science? Let’s take a look.

    What is Taurine?

    Taurine is an amino acid produced by the pancreas, and almost exclusively found in meat. It is abundant in the brain, the eye (especially the retina), muscle tissue, and many organs. It is an essential component of bile acids, which are produced in the liver, stored in the gallbladder, and used to break down fats from food.

    Most mammals produce their own taurine in the pancreas from amino acid precursors. (Notable exceptions are cats and weasels–including ferrets–who must consume taurine in their diet.) The first step involves the sulfur-containing essential amino acid methionine, which is used to make another amino acid, cysteine (also spelled “cystine”). Finally, taurine is made from cysteine. Taurine production naturally decreases with age.

    Taurine plays many roles in the body. It is crucial for muscles, especially the heart muscle. Taurine is utilized in every area of the brain, as well as the retina of the eyes. It is essential for immune system function. Taurine acts as a potent antioxidant and anti-inflammatory agent. More specifically, it has been shown to improve periodontal disease in humans. It also helps regulate blood pressure, and is an extremely important cellular protector. It is used to treat hepatic lipidosis (fatty liver) in cats as well as people; and it may be helpful in kidney disease. Being made in the pancreas, it is no surprise that taurine has a profound effect on the development and course of both Type 1 and Type 2 diabetes.

    History

    Before WWII, more than 90% of commercial pet food came in cans, and contained mostly if not only meat. However, metal was needed for the military, and by the time the war ended, 85% of pet food was dry kibble. It still contained a large amount of meat, and this prevented taurine deficiencies from occurring.

    The primary machinery for producing what we now know as dry food is called an extruder; it was introduced in the 1950s. To get the correct consistency of dough for the extruder, a minimum amount of starch is needed. This started the trend of ever-increasing quantities of cereal grain, such as corn, in dry foods. At the same time, meat processors were getting more proficient at getting more meat from livestock carcasses; so pet food makers substituted other leftover animal tissues or “by-products.” Over time, the result was a high-grain, low-meat dry food, for which the profit margin was—conveniently—much higher than for canned food.

    In the late 1970s, cats were going blind or dying of congestive heart failure due to a condition called dilated cardiomyopathy (DCM). Many of those cats were eating the same food (Hill’s Science Diet); and this was noticed by researchers at UC Davis. In the mid-1980s, they published the results of their research showing that taurine deficiency was the issue. Pet food manufacturers hastened to supplement taurine in their feline diets. Since then, DCM (dilated cardiomyopathy) dramatically decreased in cats eating commercial, “balanced” cat food. (Cats can spontaneously develop DCM unrelated to taurine, and a genetic form exists in Maine coon cats and a few other breeds and lines.)

    Taurine and Dogs

    Dogs make their own taurine from sulfur-containing amino acids, primarily cysteine, but also methionine. It was thought that, because they could produce it themselves, dogs didn’t need supplemental taurine.

    However, it is also known that that big dogs produce taurine at a slower rate than small dogs, putting them at risk for a deficiency. Genetics also play a significant role, with certain breeds and family lines being predisposed to developing DCM.

    The existence of a link between taurine deficiency and DCM in dogs has been known at least since1997—some dogs can’t supply their own taurine needs. Certain lines of spaniels, retrievers (notably Golden Retrievers), and particularly Newfoundlands, are known to develop the same taurine-dependent form of DCM that had killed thousands of cats.

    DCM is a common form of heart disease in dogs, especially in large and giant breeds. Diet is a likely factor in about 20-30% of dogs with DCM, for which supplementing taurine may reverse the disease. Symptoms of DCM include tiring easily, shortness of breath, and coughing.

    However, it may not be a specific taurine deficiency in the food that is a contributing factor in DCM. Some research suggests it may be insufficient cysteine that limits the dog’s ability to produce taurine. Remember that dogs make cysteine from methionine, and taurine from cysteine. Any weak link in the chain of methionine, cysteine or taurine could be problematic.

    Because of this dependency, only methionine has a minimum level in dog food according to current AAFCO standards; there is also a minimum for the combination of methionine + cysteine.

    L-carnitine, another amino acid found primarily in meat, may also play a role in the development of DCM in a small percentage of dogs. L-carnitine becomes unavailable in pet food through processing, and is generally not added back due to its high cost.

    In early studies, most of the dogs with DCM were eating lamb and rice dog foods. Lamb has a relatively low level of sulfur-containing amino acids compared to chicken and other poultry. Another study found that dogs eating foods containing beet pulp had lower blood taurine levels.

    Possible reasons for low blood taurine levels in dogs fed an otherwise “complete and balanced food” that have been suggested include:

    • Differences in protein digestibility and bioavailability may limit available precursors
    • Interference with reabsorption of taurine-containing bile acids in the gut so that more taurine is excreted
    • Interaction of food and/or food form (canned vs. dry) with gut bacteria
    • Type of processing that limits taurine bioavailability
    The Current Situation

    The FDA reported a link between DCM and “grain-free” dog foods that rely heavily on potatoes, legumes, and exotic proteins. Vegan and homemade diets were also reportedly involved. This caught FDA’s attention because some of the dogs were not the breeds that are known to develop DCM due to taurine deficiency; these dogs included Labrador Retrievers, Whippets, Miniature Schnauzers, one Shih Tzu, one Bulldog, and an unspecified number of mixed-breed dogs.

    Specifically, the FDA stated that “potatoes or multiple legumes such as peas, lentils, other “pulses” (seeds of legumes), and their protein, starch and fiber” were main ingredients of the food in several cases of DCM reported to the agency. Note the careful language used in its statement: potatoes are singled out, but with regard to legumes, multiple legumes and their isolated components were main ingredients in implicated diets.

    Subsequently, FDA has emphasized that people should “not tak[e] intuitive leaps beyond what is explicitly stated in our public notice.” That is, don’t assume that all legumes are problematic—just the ones specifically noted. (However, other research greatly widens this array.)

    Unfortunately, FDA failed to indicate whether the associated foods were dry, canned, or both. It’s probably safe to assume that most or all were dry foods, since that is what the vast majority of dogs are fed in the U.S. But it is worth noting that, in the case of cats, canned foods need supplemental taurine at a much higher level than dry foods, because cats’ gut bacteria interact differently with those food forms.

    Based on FDA’s statement and previous research, ingredients that may be correlated with DCM in dogs and are (more or less commonly) used in dog foods include:

    Animal Products Plant Products
    Bison Barley
    Duck Beet pulp*
    Lamb Chickpeas
    Kangaroo Fava beans
    Salmon Lentils
    Venison Peas
    Potatoes
    Rice/rice bran**
    Sweet Potatoes
    Tapioca
    * While it was not named by FDA in this situation, beet pulp is known to decrease taurine status in dogs under some conditions.

    ** Previous studies found taurine deficiency in dogs (and cats) eating diets containing rice or rice bran.

    FDA also suggested that food made by small “boutique” manufacturers were more likely to be problematic. Indeed, some foods that appear to be overloading plant proteins are from smaller manufacturers. However, FDA definitely did not exclude products from big manufacturers.

    It seems odd that this problem should occur now, even though potatoes have been used in dog food—particularly “hypoallergenic” formulas—for decades. Many such foods also included, and continue to include, lamb or other listed animal-source ingredients as the primary or sole animal protein.

    For example, Hill’s Science Diet d/d lists potatoes, potato starch, [venison, salmon, or duck], and potato protein as its first four ingredients. One would think such a would be particularly dangerous, except that Hill’s also adds taurine to these foods. Most vegetarian and vegan dog foods also include both taurine and carnitine. Evidently, this issue was not hard to anticipate in low- or zero-meat diets.

    Of course, correlation does not equal causation, and there are likely to be other factors involved. There are dozens of grain-free dog foods on the market, and without knowing which brands were involved, it’s impossible to know for certain which ingredients or other factors may be at fault. FDA and UC Davis are actively looking into the issue to try to understand what’s really happening.

    Unfortunately, some media reports have focused on legumes, even though potatoes are a far more common pet food ingredient. Legumes are very nutritious, and used properly, can be a very healthy dog food ingredient.

    Many “boutique” grain-free diets contain two or more of the ingredients noted by FDA and other researchers. For example, several salmon-based foods also contain potatoes and/or beet pulp. Several other foods list up to five legumes/derivatives, sometimes in addition to potatoes or a listed lower-taurine meat like venison or lamb, as major ingredients.

    As with many cat products, some dog foods are inordinately high in plant-based products with not so much meat. Certainly, plant proteins are often used to increase total protein and decrease cost in many dog foods.

    Ingredients are listed by weight on the label; using multiple legumes, potatoes, or fractions thereof (a practice referred to as “splitting”) allows a company to include far more plant protein than meat protein, while allowing the named meat to remain at the top of the ingredient panel. So, it may not be potatoes or legumes that are the problem; rather, it may be an overwhelming amount of potatoes or legumes.

    Most small-manufacturer and grain-free diets are relatively high in protein, but the proportion of plant to animal sources may be a crucial factor for those foods implicated by the FDA.

    There are several other factors that could affect dogs’ blood taurine levels that have not been considered:

    • Perhaps there is some intrinsic factor in legumes and potatoes that is acting as an “anti-nutrient” and binding or otherwise interfering with taurine metabolism.
    • Something is happening during processing that is causing taurine in these foods to become unavailable. (We know, for instance, that taurine from fish is diminished by heat processing; the loss is about 30%.)
    • Disruption of the microbiome (gut bacteria population) alters taurine bioavailability in cats through the action of gut bacteria; perhaps this is true for certain dogs as well.
    • Affected dogs may have altered pancreatic function, such as subclinical pancreatitis, that prevents nutrient absorption and/or adequate taurine synthesis.
    To my knowledge, these possibilities have not been explored at all.

    Conclusions

    At this time, FDA is not recommending a diet change for any dog, as their investigation is in the very early stages. They have found DCM in dogs eating all kinds of foods, from those with a simple ingredient list to very complex foods. And while all the above ingredients have at some time been associated with DCM in dogs, at this time FDA is only correlating potatoes and legumes.

    FDA further clarified to me that “foods containing multiple pulses that appear near the top of the product’s ingredient list have appeared more frequently in the reports we have received thus far.” (Emphasis added.)

    It is very important to note that not all dogs with DCM—and not even all dogs who also had very low blood levels of taurine—responded to taurine supplementation. This implies that it isn’t taurine itself that’s the problem (at least in those cases); but as noted, it certainly could be lack of methionine and/or cysteine. Conversely, many of the sick dogs had perfectly normal blood taurine levels. An earlier study concluded that “there was no clear relationship between low [whole blood taurine] and presence of DCM.”

    The association between diet and DCM is far more complicated than simply blaming the problem on one or two ingredients. It seems clear that the interplay between genetics and one or several of ingredients, and perhaps the food’s overall content of methionine, cysteine, l-carnitine, and taurine, that is at the root of DCM in these cases. But at this point, no one–FDA or otherwise–has any idea which factors are actually problematic, or in what amounts or combinations.

    It does seem likely that in a product containing sufficient animal protein, taurine levels will be adequate. If a food has an animal protein at the top of the ingredient list, but also contains four or five plant proteins that—in reality—constitute the majority of total protein, thus diluting and short-changing the taurine, then that may be the real problem.

    One thing that is clear from all this is that AAFCO needs to revisit its Nutrient Profiles (which are based on research published prior to 2003) and either (1) increase the minimum for methionine, (2) increase the minimum for methionine-cystine (sic), and/or (3) add a notation that cysteine and taurine are at least conditionally essential amino acids for dogs. Taurine minimums for cat food also need re-examining, as cats have also been affected. (See 8/10/18 Update below.)

    Most importantly, of the tens or perhaps hundreds of thousands of dogs eating “boutique” and grain-free foods, only a handful have been linked to the problem. It is not time to press the panic button yet, despite the media frenzy.

    However, it would be helpful if pet food manufacturers would test for the four key amino acids to ensure that levels are sufficient for all dogs, or simply supplement taurine in food for dogs, as they already do for cats.

    If you’ve been feeding a potentially taurine-deficient food, you may want to give your dog supplemental taurine, about 250 mg per day for every 40 pounds of the dog’s body weight. Fortunately, taurine is very safe, even at extremely high doses.

    at extremely high doses.

    UPDATE 8/5/18: NBC did a report (1:53 minutes long and somewhat misleading). The veterinarian they filmed specifically said dogs need a GRAIN-based dog food. Sadly, people are being scared off ALL grain-free foods and back to GMO, pesticide-soaked, corn-based foods.

    We’ve never advocated grain-free food, since most of it simply replaces grains with high-carb starchy vegetables, like potatoes, peas, sweet potatoes, and legumes–and carbs are the problem. Make sure your dog’s food contains mostly meat and not half a dozen vegetables or fractions (potato starch, pea fiber, etc.) that add up to the largest proportion of the food.

    UPDATE 8/8/18: The FDA’s characterization of “boutique” foods is apparently way off the mark. Major pet food companies (including but not limited to Champion, Mars, and Purina) are involved: they either make grain-free diets themselves, or they’ve bought out small manufacturers (and not changed the brand name –most consumers are unaware of these acquisitions). Specific brands that have been implicated include (in alphabetical order): Acana (made by Champion), California Natural (owned but discontinued by Mars), Merrick (owned by Purina), Nutrisource (owned by co-packer Tuffy). (Sources: American College of Veterinary Internal Medicine, Veterinary Information Network)

    UPDATE 8/10/18 The FDA has released a “Questions and Answers” post for consumers. They revealed that their initial report involved 30 dogs and 7 cats. They never mentioned cats before. They now have 150 confirmed reports of affected dogs, and an unknown number that are being examined. With growing public awareness, there are undoubtedly hundreds of reports pending, but not all will be confirmed as taurine-deficiency DCM. It is possible for a dog to have DCM with completely normal taurine levels, and some dogs with low taurine levels will not develop DCM.

    UPDATE 8/10/18 More brands involved–to find out which ones, join the Facebook group “Taurine-Deficient Dilated Cardiomyopathy.” The data is confidential and may not be shared outside the group, but it’s extremely valuable information!!

    If your veterinarian wants to to do a blood test for taurine, the lab at UC Davis is doing the tests. Normally their turnaround time is 48 hours, but as you might expect, they are swamped, and processing time is now at least a week. Please be patient!

    References

    AAFCO (Association of American Feed Control Officials). Official Publication. 2018 (revised 4/1/18). (Available at http://www.aafco.org/Publications)

    Backus RC, Ko KS, Fascetti AJ, et al., Low plasma taurine concentration in Newfoundland dogs is associated with low plasma methionine and cyst(e)ine concentrations and low taurine synthesis. Journal of Nutrition. 2006; 136:2525-2533.

    Basili M, Pedro B, Hodgkiss-Geere X. Taurine deficiency in English cocker spaniels diagnosed with dilated cardiomyopathy. Research Communications of the 26th ECVIM‐CA Congress. 2017. https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.14600

    Delaney SJ, Kass PH, Rogers QR, et al. Plasma and whole blood taurine in normal dogs of varying size fed commercially prepared food. Journal of Animal Physiology and Animal Nutrition (Berl). 2003 Jun;87(5-6):236-44.

    Fascetti AJ, Reed JR, Rogers QR, Backus RC. Taurine deficiency in dogs with dilated cardiomyopathy: 12 cases (1997-2001). Journal of the America Veterinary Medical Association. 2003 Oct 15;223(8):1137-41.

    Freeman LM, Rush JE. Nutrition and cardiomyopathy: lessons from spontaneous animal models. Current Heart Failure Reports. 2007 Jun;4(2):84-90.

    Ko SK, Backus RCC, Berg JR, et al. Differences in Taurine Synthesis Rate among Dogs Relate to Differences in Their Maintenance Energy Requirement. Journal of Nutrition. 2007 May; 137(5):1171-5

    Ko SK, Fascetti AJ. Dietary beet pulp decreases taurine status in dogs fed low protein diet. Journal of Animal Science and Technology. 2016;58:29.

    Kramer GA, Kittleson MD, Fox PR, Lewis J, Pion PD. Plasma taurine concentrations in normal dogs and in dogs with heart disease. Journal of Veterinary Internal Medicine. 1995 Jul-Aug;9(4):253-8.

    Lakshmi Sree S, Sethupathy S. Evaluation of the efficacy of taurine as an antioxidant in the management of patients with chronic periodontitis. Dental Research Journal. (Isfahan) 2014 Mar-Apr; 11(2): 228–233.

    Marcinkiewicz J, Kontny E. Taurine and inflammatory diseases. Amino Acids. 2014; 46(1):7–20.

    NRC (National Research Council). Nutrient Requirements of Dogs and Cats. The National Academies Press. 2006.

    Ripps H, Shen W. Taurine: a “very essential” amino acid. Molecular Vision. 2012; 18:2673-2686.

    Sanderson SL. Taurine and carnitine in canine cardiomyopathy. Veterinary Clinics of North America: Small Animal Practice. 2006 Nov;36(6):1325-43, vii-viii.

    Sanderson SL, Gross KL, Ogburn PN, et al. Effects of dietary fat and L-carnitine on plasma and whole blood taurine concentrations and cardiac function in healthy dogs fed protein-restricted diets. American Journal of Veterinary Research. 2001 Oct; 62(10): 1616-1623.

    Simpson S, Rutland P, Rutland CS. Genomic Insights into Cardiomyopathies: A Comparative Cross-Species Review. Veterinary Sciences. 2017; 4:19 (26 pages).

    Spitze AR, Wong DL, Rogers QR, Fascetti AJ. Taurine concentrations in animal feed ingredients; cooking influences taurine content. Journal of Animal Physiology and Animal Nutrition. 2003; 87:251–262.

    Tôrres CL, Backus RC, Fascetti AJ, Rogers QR. Taurine status in normal dogs fed a commercial diet associated with taurinerine deficiency and dilated cardiomyopathy. Journal of Animal Physiology and Animal Nutrition (Berl). 2003 Oct;87(9-10):359-72.

    Vollmar AC, Fox PR, Servet E, Biourge V. Determination of the prevalence of whole blood taurine in Irish wolfhound dogs with and without echocardiographic evidence of dilated cardiomyopathy. Journal of Veterinary Cardiology. 2013 Aug 22; 15(3):189-196]

    Wall T. Do peas and potatoes really cause heart disease in dogs? Petfood Industry. 2018 Jul 19; online bulletin.
     
  7. LifeofRubie

    LifeofRubie Active Member

    Has there been anything new out since the above article?
     
  8. strykerdobe

    strykerdobe Hot Topics Subscriber

    [​IMG]
    Pet Food News / Pet Food Ingredients / Cat and dog food infographics / Pet Food Safety
    Infographic: Official data on grain-free dog food and DCM

    Diets in cases reported to the FDA frequently listed potatoes or multiple legumes such as peas, lentils, other pulses.
    [​IMG]

    By Tim Wall
    on March 20, 2019
    Infographic: Official data on grain-free dog food and DCM
    Diets in cases reported to the FDA frequently listed potatoes or multiple legumes such as peas, lentils, other pulses.

    Since launching their investigation more than half a year ago, the U.S. Food and Drug Administration has compiled statistics about cases of canine dilated cardiomyopathy correlated to certain grain-free dog diets. [see infographic below] The data came from David Edwards, Ph.D., an officer with FDA’s Center for Veterinary Medicine (CVM)’s Office of Surveillance and Compliance, during the American Feed Industry Association’s 12th Annual Pet Food Conference.

    Background of dilated canine cardiomyopathy investigation
    In July, the U. S. Food and Drug Administration alerted pet owners and veterinary professionals about reports of canine dilated cardiomyopathy (DCM) in dog breeds without genetic predispositions to the disease. Although not associated by heredity, the dogs did share a common factor. They frequently ate dog foods containing peas, lentils, other legume seeds, or potatoes as main ingredients.

    High levels of legumes or potatoes appear in diets labeled as grain-free, which the FDA pointed out in their warning, but it remains unknown how these ingredients are linked to cases of DCM.

    Findings from federal investigation of dog heart disease and diet
    The FDA’s Center for Veterinary Medicine and the Veterinary Laboratory Investigation and Response Network, a collaboration of government and veterinary diagnostic laboratories, continue investigating this potential association.

    Diets in cases reported to the FDA frequently listed potatoes or multiple legumes such as peas, lentils, other pulses (seeds of legumes), and their protein, starch and fiber derivatives early in the ingredient list, indicating that they are main ingredients. Early reports from the veterinary cardiology community indicate that the dogs consistently ate these foods as their primary source of nutrition for months to years.

    In the reports the FDA has received, some of the dogs showed signs of heart disease, including decreased energy, cough, difficulty breathing and episodes of collapse. Medical records for four atypical DCM cases, three Golden Retrievers and one Labrador Retriever, show that these dogs had low whole blood levels of the amino acid taurine. Taurine deficiency is documented as potentially leading to DCM.
    [​IMG]

    Tim Wall is a staff reporter at WATT Global Media. Contact Wall via email at twall@wattglobal.com.
     
    • Like Like x 2
  9. strykerdobe

    strykerdobe Hot Topics Subscriber

    This was older info from last year.


    Robin Loreth
    October 1 at 11:26 PM

    An update for you, courtesy of the board-certified veterinary cardiologist that presented to the Mt. Hood DPCA/DDP/Embark summit last March.
    Dr. Atkinson wanted to share this information created by a group of board-certified cardiologists through UC DAVIS and the Veterinary Information Network. She agrees with their recommendations.
    Diet-Related Myocardial Failure in Dogs
    July 23, 2018 (published on-line at VIN)
    Mark Rishniw; Paul Pion; Mark Kittleson
    Introduction
    In 2018, anecdotal reports emerged that some grain-free diets, or diets containing legumes as the main non-meat component, were resulting in taurine deficiency and potentially contributing to dilated cardiomyopathy (DCM)
    Clinical Use Information
    What is the latest information about myocardial failure and grain-free diets? Which diets have been implicated? What should I do if a client is feeding grain-free diets to their dog(s)? How much taurine should I supplement? Can I overdose with taurine? What resources are available for me and my clients?
    What is the latest information about myocardial failure and grain-free 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).
    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. They issued an update to the original warning on 8/10/2018.
    Which diets have been implicated?
    Multiple diets have been implicated. One of the most common implicated diets is the Acana Pork and Squash Singles diet, although Nutrisource grain-free food has been mentioned as well. 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). In one study, Kangaroo and Red Lentil diet was implicated (Adin et al 2018). Therefore, rather than focusing on specific brands, clinicians should focus on the main ingredients in any "grain-free" diet. Clinicians should note that several companies manufacturing such diets have started to address the concerns by producing marketing literature and possibly changing diet composition, but this does not mean that a particular diet is "OK". If it's grain-free and legume-based, then it is considered a suspect diet.
    What should I do if a client is feeding grain-free diets to their dog(s)?
    There are several options that clinicians can consider, depending on the clinical presentation.
    1. For dogs without cardiac clinical signs that appear healthy, changing the diet is the simplest and most conservative action until more definitive information relating to this emerging pattern is discerned.
    2. If the owners do not wish to change the diet as a preventive measure without more information, consider an echocardiogram and testing taurine concentration in plasma and whole blood (see this link for sampling methods and submission requirements).
    3. If myocardial failure is identified, change the diet and consider taurine supplementation regardless.
    4. If taurine concentration is low, change the diet and initiate taurine supplementation
    5. Repeat the echocardiogram in 4 to 6 months to assess resolution of the myocardial failure.
    6. Report your findings to the FDA.
    7. If the owners do not wish to change the diet or perform an echocardiogram, test the dog’s taurine concentration (plasma and/or whole blood).
      1. If low, supplement with taurine and strongly encourage changing diets to one not implicated in the problem.
      2. If normal, encourage the owners to keep abreast of evolving information on this issue.
    8. If the owners are unwilling to change the diet and are unwilling or unable to afford an echocardiogram and taurine analysis, strongly encourage the owners to supplement the diet with taurine, which is safe and inexpensive
    How much taurine should I supplement? Can I overdose with taurine?
    Safe doses of taurine are in the range of 250 mg per day for long-term supplementation. Acute dosing, in situations where a rapid correction is required are in the 500 mg to 1 gm per day range for most dogs (approximately 50 mg/kg/day). Whether large doses of taurine can cause problems is not well understood, but some researchers have raised concerns that long-term overdosing can cause problems. Therefore, high doses of taurine should be used only in cases where myocardial failure has been documented and only for 2-3 months, which myocardial function is being restored.
    What resources are available for me and my clients?
    • You can refer your clients to Lisa Freeman’s blog that discusses this issue in detail.
    • The UC Davis website also has a page discussing the issue and the studies that are currently under way.
    References
    Proceedings
    1. 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.
    Rounds and Other Resources
    1. Olsen J. Taurine Deficiency Induced Dilated Cardiomyopathy in Golden Retrievers. 2018
    2. Morris Animal Foundation. Researchers getting closer to understanding dietary taurine and heart disease in dogs. 2017
    3. Measuring Taurine — VIN Medical FAQ
    4. How to report a pet food complaint to the FDA.
     
  10. Rits

    Rits Admin Administrative Staff Moderator Hot Topics Subscriber

    Update from FDA today

    FDA Investigates Potential Link Between Diet & Heart Disease in Dogs



    FDA Investigation into Potential Link between Certain Diets and Canine Dilated Cardiomyopathy
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    • announced that it had begun investigating reports of canine dilated cardiomyopathy (DCM) in dogs eating certain pet foods, many labeled as "grain-free," which contained a high proportion of peas, lentils, other legume seeds (pulses), and/or potatoes in various forms (whole, flour, protein, etc.) as main ingredients (listed within the first 10 ingredients in the ingredient list, before vitamins and minerals). Many of these case reports included breeds of dogs not previously known to have a genetic predisposition to the disease. The FDA’s Center for Veterinary Medicine (CVM) and the Veterinary Laboratory Investigation and Response Network (Vet-LIRN), a collaboration of government and veterinary diagnostic laboratories, continue to investigate this potential association. Based on the data collected and analyzed thus far, the agency believes that the potential association between diet and DCM in dogs is a complex scientific issue that may involve multiple factors.

      We understand the concern that pet owners have about these reports: the illnesses can be severe, even fatal, and many cases report eating “grain-free” labeled pet food. The FDA is using a range of science-based investigative tools as it strives to learn more about this emergence of DCM and its potential link to certain diets or ingredients.

      Following an update in February 2019 that covered investigative activities through November 30, 2018, this is the FDA’s third public report on the status of this investigation.

      On this page:
      Cases Reported to FDA
      Diet Information from Reported Cases
      Product Testing
      Taurine & Amino Acids
      Diagnostic Testing – Vet-LIRN
      Collaboration
      What you can do
      What’s Next
      Additional Information

      Cases Reported to FDA
      For the purposes of this investigation, the FDA defines a “case” as an illness reported to FDA involving a dog or cat that includes a diagnosis of DCM. Many of the reports submitted to the FDA included extensive clinical information, including echocardiogram results, cardiology/veterinary records, and detailed diet histories. The numbers below only include reports in which the dog or cat was diagnosed with DCM by a veterinarian and/or veterinary cardiologist. We did not include in these numbers the many general cardiac reports submitted to the FDA that did not have a DCM diagnosis. However, this case information is still valuable, as it may show heart changes that occur before a dog develops symptomatic DCM. (Please see the Vet-LIRN DCM Investigative Update for more technical information on the reported cases, including those without a formal diagnosis of DCM). Although the FDA first received a few sporadic reports of DCM as early as 2014, the vast majority of the reports were submitted after the agency notified the public about the potential DCM/diet issue in July 2018.

      [​IMG]
      Between January 1, 2014 and April 30, 2019, the FDA received 524 reports of DCM (515 canine reports, 9 feline reports). Approximately 222 of these were reported between December 1, 2018 and April 30, 2019 (219 canine reports, 3 feline reports). Some of these reports involved more than one affected animal from the same household. The breakdown of reported illnesses below reflects the number of individual animals affected. The American Veterinary Medical Association estimates that there are 77 million pet dogs in the United States. Most dogs in the U.S. have been eating pet food without apparently developing DCM. It’s not known how commonly dogs develop DCM, but the increase in reports to FDA signal a potential increase in cases of DCM in dogs not genetically predisposed.

      Animal numbers in DCM Reports received between January 1, 2014 and April 30, 2019
      Number of reports Number of animals affected Number of deaths
      Dogs
      515 560 119
      Cats* 9 14 5
      *Cats are generally more likely to develop hypertrophic cardiomyopathy (a heart disease)

      Dilated cardiomyopathy is recognized as a genetic condition in dogs, typically in large or giant breeds, such as the Doberman Pinscher, Great Dane, or the Irish Wolfhound. It is also seen in Cocker Spaniels associated with taurine deficiency. It is believed to be less common in small and medium breed dogs. We suspect that cases are underreported because animals are typically treated symptomatically, and diagnostic testing and treatment can be complex and costly to owners. FDA has observed a reporting bias for breeds like Golden Retrievers due to breed-specific social media groups and activities that have raised awareness of the issue in these communities and urged owners and vets to submit reports to FDA. Because the occurrence of different diseases in dogs and cats is not routinely tracked and there is no widespread surveillance system like the Centers for Disease Control and Prevention have for human health, we do not have a measure of the typical rate of occurrence of disease apart from what is reported to the FDA.

      [​IMG]
      Additional breeds with more than one report include Afghan Hound, Australian Cattle Dog, Beagle, Belgian Tervueren, Border Collie, Boston Terrier, Bull Terrier, Chihuahua, Dalmatian, English Cocker Spaniel, English Springer Spaniel, Flat-coated Retriever, French Bulldog, Gordon Setter, Hound (unspecified), Irish Setter, Irish Soft-Coated Wheaten Terrier, Jack Russel Terrier, Maltese, Miniature Schnauzer, Old English Sheepdog, Pomeranian, Portuguese Water Dog, Pug, Retriever (unspecified), Rhodesian Ridgeback, Rottweiler, Rough-haired Collie, Saluki, Samoyed, Schnauzer (unspecified), Shepherd (unspecified), Staffordshire Bull Terrier, Standard Long-haired Dachschund, Vizsla, Whippet, and Yorkshire Terrier.

      Genetic forms of DCM tend to affect male large and giant breed dogs beginning in middle to older age. DCM cases reported to FDA CVM have involved a wide range of dog breeds, ages and weights. There have been a greater proportion of males than females, consistent with what is seen in genetic forms. The significance of this is unknown, but it may be that some cases are genetic in origin or a combination of diet and genetic tendencies.

      Table 1: Mean Age and Weight - DCM Cases in Dogs Reported to FDA-CVM
      Dogs Mean Range
      Age (years) 6.6 0.4-16
      Weight (lbs) 67.8 4-212
      Table 2: Mean Age and Weight - DCM Cases in Cats Reported to FDA-CVM
      Cats Mean Range
      Age (years) 6 0.4-17
      Weight (lbs) 10.7 7-13
      Table 3: Sex of DCM cases reported to FDA-CVM by species (%)
      Sex (%of cases) Male Female
      Dogs 58.7 41.3
      Cats 62.5 37.5
      Back to the top

      Diet Information from Reported Cases
      Review of the canine reports shows that most reports were for dry dog food formulations, but raw food, semi-moist food, and wet foods were also represented.

      [​IMG]
      When examining the most commonly reported pet food brands named in DCM reports submitted to the FDA, it is important to note that the graph below is based on reports that included brand information and that some reports named multiple brands. Brands that were named ten or more times are featured below. For a granular, case-by-case breakdown of DCM reports submitted to the FDA, see Canine Dilated Cardiomyopathy Complaints Submitted to FDA-CVM Through April 30, 2019. FDA urges pet owners to work with their veterinarians, who may consult a board-certified veterinary nutritionist, to obtain the most appropriate dietary advice for their pet's specific needs prior to making diet changes.

      [​IMG]
      To better characterize diets reported in DCM cases, product labels were examined to determine whether the product was grain-free (did not contain corn, soy, wheat, rice, barley or other grains), and whether the products contained peas, other lentils including chickpeas and beans, or potatoes (including sweet potatoes). Because so many products contained peas and/or lentils, a category was created for “peas and/or lentils”. More than 90 percent of products were “grain-free”, and 93 percent of reported products had peas and/or lentils. A far smaller proportion contained potatoes.

      [​IMG]
      Animal protein sources in the reported diets varied widely, and many diets contained more than one protein source. The most common proteins in the reported diets were chicken lamb and fish; however, some diets contain atypical protein sources such as kangaroo, bison or duck. No one animal protein source was predominant.

      [​IMG]
      Back to the top

      Product Testing
      Before the July 2018 DCM Update, FDA/Vet-LIRN had tested multiple products for minerals and metals (calcium, magnesium, phosphorus, iron, cobalt, copper, zinc, selenium, iodine) and amino acids including taurine, cysteine, and methionine. That product testing did not reveal any abnormalities.

      Since the July 2018 DCM Update, Vet-LIRN tested both products labeled as "grain-free" and those containing grain for the following:
      • protein, fat, moisture
      • crude fiber, total dietary fiber, soluble fiber, insoluble fiber
      • total starch, resistant starch
      • cystine, methionine, and taurine
      The average percent protein, fat, total taurine, total cystine, total methionine, total methionine-cystine, and resistant starch content on a dry matter basis (in other words, after removing all moisture content) were similar for both grain-free labeled and grain-containing products. For more details, please see the Vet-LIRN DCM Update.

      Additional food testing is in progress.

      Back to the top

      Taurine & Amino Acids
      Nutritional research indicates that taurine is generally not considered an essential amino acid for dogs, because these animals can synthesize taurine from cysteine and methionine. Nearly all the grain-free products had methionine-cystine values above the minimum nutritional requirement of 0.65 percent for adult maintenance food for dogs published in the AAFCO Official Publication (OP).

      The FDA is still gathering information to better understand if (and how) taurine metabolism (both absorption and excretion) may have a role in these reports of canine dilated cardiomyopathy.

      Back to the top

      Diagnostic Testing – Vet-LIRN
      Vet-LIRN has interviewed 95 owners of affected dogs and cats to document the pets’ complete dietary history and to explore any other factors that could have potentially contributed to development of DCM, such as environmental factors like heavy metal exposure or poisonous plant ingestion.

      In addition, Vet-LIRN has contracted with a network lab to collect blood (whole blood and plasma), urine, feces, and DNA from dogs without a known breed predisposition to DCM (as a point of comparison) to send to Vet-LIRN for testing.

      As of April 30, 2019, Vet-LIRN has reviewed results of 19 gross necropsies from dogs with suspected heart disease, including 13 necropsies that Vet-LIRN coordinated from cases reported through the FDA Safety Reporting Portal. There is one additional necropsy pending evaluation. The gross necropsies were performed by either veterinarians or veterinary pathologists, and Vet-LIRN is currently processing tissues for histopathology. A board-certified veterinary pathologist will review the histopathology slides.

      Vet-LIRN has been collaborating with Chesapeake Veterinary Cardiology Associates (CVCA) to collect medical records, an owner interview, and diagnostic samples from pets with DCM that were diagnosed by a board-certified veterinary cardiologist by echocardiogram. These cases are included in the overall number of DCM cases, but were selected for further study because their ongoing program of care with the practice will be comprehensively documented and provided in full to Vet-LIRN.

      Upon confirmation of a DCM diagnosis, CVCA collects blood (whole blood and plasma), urine, feces, DNA swabs, and food, if the pet is not receiving any supplements (e.g. taurine, cystine, or methionine) and is still eating a diet labeled “grain-free.” Vet-LIRN will test the blood and urine for taurine, cystine, methionine, and other amino acids. Vet-LIRN is archiving feces and DNA from these cases for possible future testing.

      CVCA will repeat collection of urine, blood, and feces at 1 to 2 months, and at 6 months after the initial diagnosis and document any treatment or dietary changes, if any, that were recommended by the cardiologist. The repeat urine and blood samples will be tested for amino acid content and the feces archived. At the 6-month recheck, CVCA will also conduct a repeat echocardiogram to assess any changes to the heart. As of April 30, 2019, CVCA and Vet-LIRN have collected initial samples from 14 dogs, and 1 to 2-month samples from 10 dogs. CVCA is currently collecting the 6-month samples.

      Of the original 14 dogs in this cohort, five dogs have been lost to follow-up at various points after the initial sample collection, including 4 deaths, and will not complete the sample collection. Vet-LIRN is currently evaluating the heart histopathology for two of the deceased dogs. The initial and 1 to 2-month blood and urine samples for 14 and 10 dogs, respectively, have been tested and are being evaluated.

      Vet-LIRN is also collecting food associated with each CVCA case and will test each diet for:
      • protein, fat, moisture
      • crude fiber, total dietary fiber, soluble fiber, insoluble fiber
      • total starch, resistant starch
      • free and total cystine, methionine, and taurine
      Golden Retrievers
      Past publications and research suggest that Golden Retrievers may be genetically predisposed to taurine deficiency, which is well-documented as potentially leading to DCM.

      Veterinary cardiologist Dr. Joshua Stern from the University of California at Davis has been studying the rise in cases of DCM in Golden Retrievers, including a potential dietary link. Many cases of DCM in Golden Retrievers are taurine-deficient. Pet owners who suspect their Golden Retrievers may be affected may wish to consult their veterinarian to discuss checking taurine levels or conducting an echocardiogram.

      Back to the top

      Collaboration
      When unprecedented events such as these occur, the FDA often consults with stakeholders across the animal health community to help fill any knowledge gaps that may help inform its investigation. These collaborations can help provide pieces to complete the puzzle and allow us to gain a better understanding of what happened.

      Veterinary Community
      FDA veterinarians have been working with the veterinary community to exchange information about existing cases and the type of clinical information that is most helpful to the investigation. We are also consulting with a cadre of board-certified veterinary cardiologists and nutritionists to learn more about the presentation of these cases and how they respond to treatment.

      Chesapeake Veterinary Cardiology Associates (CVCA), a multi-location veterinary cardiology practice based predominantly in the Mid-Atlantic states, has provided comprehensive records for some DCM cases (including medical records, owner interviews, and diagnostic samples from pets with DCM diagnosed with an echocardiogram by a board-certified cardiologist) to the Vet-LIRN network for further testing. These case records include imaging studies of the animal’s hearts, comprehensive dietary histories, diagnostic and treatment records, as well as outcomes of the cases.

      FDA veterinarians have been working with Drs. Lisa Freeman of Tufts University, Joshua Stern of UC Davis and Darcy Adin of the University of Florida to learn more about their research findings and the cases they’ve encountered. The three were contributing authors to a paper published in Journal of American Veterinary Medical Association in December 2018, “Diet-associated dilated cardiomyopathy in dogs: what do we know?External Link Disclaimer"

      Pet Owners
      As animal lovers and pet owners, FDA employees understand that the sudden onset of a life-threatening disease in a previously healthy pet can be devastating. The FDA is incredibly grateful to those pet owners who have agreed to be interviewed and given permission for their veterinarians to share medical records and diagnostic samples, including blood, serum and tissue. The agency is especially appreciative when pet owners make the difficult decision to provide tissues for analysis when a beloved pet passes away. The FDA believes that the information gained will help the FDA to understand the specific changes that are happening in the cardiovascular system and how they may relate to diet.

      Industry
      Another puzzling aspect of the recent spike in DCM cases is that they have occurred just in the last few years. The FDA is working with the pet food industry to better understand whether changes in ingredients, ingredient sourcing, processing or formulation may have contributed to the development of DCM.

      Back to the top

      What you can do
      The FDA is open to additional opportunities for collaboration and welcomes the submission of any information that may aid in our investigation. Detailed instructions for submitting case information can be found on “How to Report a Pet Food Complaint."

      Pet Owners
      If a dog is showing possible signs of DCM or other heart conditions, including decreased energy, cough, difficulty breathing and episodes of collapse, you should contact your veterinarian as soon as possible. If the symptoms are severe and your veterinarian is not available, you may need to seek emergency veterinary care. Your veterinarian may ask you for a thorough dietary history, including all the foods (including treats) the dog has eaten.

      Veterinarians
      CVM encourages veterinary professionals to report well-documented cases of DCM in dogs suspected of having a link to diet by using the electronic Safety Reporting Portal or calling their state’s FDA Consumer Complaint Coordinators. The more information you are able to provide, particularly about feeding history, medical records, and diagnostic testing, the better. Detailed instructions can be found on “How to Report a Pet Food Complaint." Technical veterinary information that may aid veterinarians can be found in our Vet-LIRN Update.

      Industry
      The FDA looks to industry organizations and pet food manufacturers to contribute to the FDA's investigation while continuing their own investigations to help shed light on potential issues with formulas or ingredients.

      Back to the top

      What’s Next
      The FDA is continuing to investigate and gather more information in an effort to identify whether there is a specific dietary link to development of DCM and will provide updates to the public as information develops.
     
    • Informative Informative x 3
  11. Ddski5

    Ddski5 Hot Topics Subscriber $ Forum Donor $

    Take this for what it’s worth....I just found it interesting that they posted names of dog food brands.


    Your dog may be at risk for developing heart disease based on their food, FDA says

    Your dog may be at risk for developing heart disease based on their food, FDA says

    What’s in your dogs’ diets could be a factor in whether they develop heart disease, according to a new FDA report.

    The Food and Drug Administration announced Thursday that it is continuing to investigate a potential connection between certain diets and cases of dilated cardiomyopathy, known as DCM or canine heart disease, which can result in congestive heart failure.

    The agency first announced the investigation in July 2018. Thursday’s announcement named 16 pet food brands most frequently identified in the more than 500 reported cases.

    “We know it can be devastating to suddenly learn that your previously healthy pet has a potentially life-threatening disease like DCM,” Steven M. Solomon, director of the FDA’s Center for Veterinary Medicine, said in a statement. “That’s why the FDA is committed to continuing our collaborative scientific investigation into the possible link between DCM and certain pet foods.”

    The report says large and giant breed dogs are most typically affected, with cases being most prevalent in golden retrievers, mixed breeds and Labrador retrievers. However, there have been cases of smaller breeds, too, suggesting “a lack of a genetic connection,” the report notes.

    In most of the cases, the dogs ate dry food formulations.

    The investigation also looked into the ingredients or characteristics of the dogs’ diets. More than 90% of diets were “grain-free” and 93% had peas and/or lentils.

    Identified brands
    The report notes that the FDA doesn’t yet know how certain diets may be associated with the disease.

    “However, the FDA is first and foremost a public health agency, and takes seriously its responsibility to protect human and animal health,” the agency said in the statement. “In the case of DCM, the agency has an obligation to be transparent with the pet-owning public regarding the frequency with which certain brands have been reported.”

    Here are the brands and how many cases were reported to the FDA for each:

    Acana: 67
    Zignature: 64
    Taste of the Wild: 53
    4Health: 32
    Earthborn Holistic: 32
    Blue Buffalo: 31
    Nature’s Domain: 29
    Fromm: 24
    Merrick: 16
    California Natural: 15
    Natural Balance: 15
    Orijen: 12
    Nature’s Variety: 11
    NutriSource: 10
    Nutro: 10
    Rachael Ray Nutrish: 10

    What’s next
    The FDA is encouraging veterinarians to report cases by using its electronic Safety Reporting Portal or by calling their state’s FDA Consumer Complaint Coordinator.

    Pet owners are advised to contact their veterinarian as soon as possible if “a dog is showing possible signs of DCM or other heart conditions, including decreased energy, cough, difficulty breathing and episodes of collapse,” the report said.

    Learn more at www.fda.gov.
     
    • Informative Informative x 1
  12. My2Girls

    My2Girls Notable member

    Thanks for sharing. So sad. We were on 2 of the brands listed. (Zignatures and Earthborn Holistic).

    I’m sure the dog food companies will be scrambling to re-formulate.

    My vet send out an email informing owners of the FDA finding and what to look for about 2 months ago.
     
  13. Rits

    Rits Admin Administrative Staff Moderator Hot Topics Subscriber

    @Ddski5
    Im going to move this to the DCM thread since I posted an update on this FDA post yesterday and to keep it all in one place.
     
  14. MyBuddy

    MyBuddy Moderator Hot Topics Subscriber

    Wow, I was really surprised to see this on the news just now! Looks like people are starting to take this seriously! :thumbsup2::thumbsup2:

     
    • Like Like x 1
  15. Lizbeli

    Lizbeli Hot Topics Subscriber

    Wow I love how they called out Blue Buffalo on the news. There are so many people who believe that its a great brand to begin with. Im just happy I researched all these foods and came across this DCM issue before I got Jasper. Otherwise I may have had him on Orijen if I found one with lower protein.
     
    • Agree Agree x 1
  16. My2Girls

    My2Girls Notable member

    USA Today also had a write up- calling out many brands that had DCM related deaths. It’s in the Taurine deficiency tread - on the last page.
     
    • Appreciation Appreciation x 1
  17. BushyCow

    BushyCow Notable member

  18. My2Girls

    My2Girls Notable member

    We fed Earthborn Holistic for about 4 yrs and Zignatures about 1 yr and switched after this study came out. My vet also sent out an email linking the study and offered taurine testing.
     
  19. Rits

    Rits Admin Administrative Staff Moderator Hot Topics Subscriber

    @MyBuddy
    I'm going to move these posts to the big thread we have to keep it all in one place since the FDA update was posted there already.
     
    • Appreciation Appreciation x 1
  20. MyBuddy

    MyBuddy Moderator Hot Topics Subscriber

    Thank you! I debated where to put it! I didnt see this one. :thumbsup2:
     
    • Like Like x 1

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