Thursday, April 28, 2022

Randomized feeding trial in Labradors supports link between DCM and diet

Literature Discussed: "Responses in randomised groups of healthy, adult Labrador retrievers fed grain-free diets with high legume inclusion for 30 days display commonalities with dogs with suspected dilated cardiomyopathy." Bakke, A.M., Wood, J., Salt, C. et al. BMC Vet Res 18, 157 (2022). https://doi.org/10.1186/s12917-022-03264-x

Key Takeaway: Dogs eating a grain-free, legume-rich diet developed changes to their blood parameters after 30 days which are similar to changes seen in dogs diagnosed with DCM, which provides early evidence of potential pathology. 

Summary: In light of ongoing concerns of diet-associated/non-hereditary DCM noted in the US among dogs eating grain-free and legume-rich diets, researchers conducted a short-term (30 days) feeding trial on a small group of Labrador retrievers. These dogs were selected from a colony at the Waltham Petcare Science Institute. Prior to inclusion, all dogs had baseline blood parameters measured as well as cardiac clearance via echocardiogram with a boarded cardiologist. 5 dogs were fed a grain-inclusive, no-pulse legume diet, and 6 dogs were fed a grain-free, pulse legume-rich (60% inclusion) diet. These were experimental diets formulated for the purposes of the study. Blood work was checked on days 0, 3, 14, and 28. Additionally, urine taurine was measured. The dogs were scheduled to receive end-of-trial echocardiograms, but due to the cardiologist falling ill, only six dogs were scanned. 

For a mode of comparison for the findings, an 'electronic health record interrogation' was also performed. Records were pulled from Banfield database between 2018 and 2019, and DCM records were matched to records from healthy pets undergoing routine wellness exams. Blood work was compared and analyzed. 

Over the course of the feeding trial, the test group (legume-rich diet) showed a decreased in red blood cell (RBC) counts, an increase in blood phosphate, no significant changes to pro-BNP, and no significant changes on final echocardiogram. They also showed a reduction in urine taurine excretion from baseline by day 30. 

These changes, particularly decreased RBC counts and elevated phosphorous, were also seen in the medical records of DCM-diagnosed dogs when compared to the records of healthy dogs. The authors note a number of limitations, including the use of historical medical records in the absence of certain data (how the dog was diagnosed, what other co-morbitities may be present, etc). However, they also note that the mirroring of changes in blood parameters by dogs eating the test diet are compelling. They note the relative under-representation of DCM-typical breeds in their data-set, potentially indicating dietary etiology of those cases as well. The authors discuss a number of other limitations and nutrition/pathology considerations in the discussion portion of the paper, which is open access. 

The conclusion reads: "The data from the 30-day, longitudinal feeding study, indicate that the Test diet containing kangaroo, 60% of the legumes peas (20%) and lentils (40%), and flaxseed (7%) may cause reduced RBC and hyperphosphatemia, as well as possible disturbances in taurine status. EHR interrogation of dogs with DCM in their diagnosis largely corroborated the hematology and clinical biochemistry findings from the feeding study, suggesting these data may be clinically relevant. Further studies are needed to increase our understanding of the relevance of the findings and further details regarding the pathophysiology associated with the development of diet-associated DCM in dogs."

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Diet-Associated Timeline (Routinely updated)

 
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