Friday, March 18, 2022

Another DCM study (2022) shows improved cardiac parameters when changing from non-traditional diet

     Dilated cardiomyopathy is discussed on this site so often, people are often surprised when told I don’t intend to specialize in nutrition or cardiology. My interest in this topic is fueled instead by a passion for countering misinformation and providing education to the pet owning public, as well as enthusiasm for epidemiology and emerging disease science. On that note:

     “Prospective study of dilated cardiomyopathy in dogs eating nontraditional or traditional diets and in dogs with subclinical cardiac abnormalities” was published 03/17/22 in the Journal of Veterinary Internal Medicine, with authors representing both nutrition and cardiology. The paper is open access, meaning anyone can read it without a login, subscription, or fee.  In as few words as possible, the main findings of the paper are summarized at the end of the abstract, “Dogs with DCM or SCA [subclinical cardiac abnormalities] previously eating NTDs [non-traditional diets] had small, yet significant improvements in echocardiographic parameters after diet changes.” 

     The study recruited patients from Tuft’s and University of Florida that had been eating a commercial kibble diet for 6 or more months and were either diagnosed with DCM during the study period or were evaluated during the study period and found to have a combination of decreased fractional shortening and elevated cardiac biomarkers without DCM. Diets were designated traditional and non-traditional on the basis of being grain-inclusive/grain-free or the absence/presence of pulse legumes or potatoes in the first 10 ingredients. 

The final recruited group of dogs included:

- 51 dogs with DCM eating non-traditional diets (NTD)

- 9 dogs with DCM eating traditional diets (TD)

- 16 dogs eating non-traditional diets with subclinical cardiac abnormalities (SCA)

Statistically significant findings included:

- Larger left ventricular measurements in NTD DCM group when compared to TD group DCM

- Increase in Fractional Shortening within NTD groups (DCM & SCA) at 9 month recheck

- Decrease in elevated cardiac measurements within NTD groups (DCM & SCA) at 9 month recheck

- Shorter duration of NT diet use in dogs with subclinical changes when compared to dogs with DCM

Additional findings:

- Dogs with DCM, regardless of diet type, are at high risk of sudden death from arrhythmia 

- Median survival time after diet change was 611 days in NTD vs 161 days in TD. This difference was not statistically significant, potentially owed to the small sample size of the traditional diet group. This contrasts two previous studies that did find significance in the difference between survival times

The authors discuss a myriad of limitations to the study in the discussion portion, a major one of which was the sample size. Other limitations included the use of several different diets for the diet change, the broad scope of definitions for diet types, the relatively short period of follow-up, and the inclusion of potentially predisposed breeds in the NTD group. The potential impact of these limitations are discussed thoroughly in the paper, and should be reviewed by those interested. These limitations may be used to further refine future research into this disease. Even with consideration granted to the limitations, this study adds to the body of work, now consisting of 8 peer reviewed studies, that demonstrates a concerning association between DCM cases and certain diet types. 


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