Diet-Associated Dilated Cardiomyopathy Research List

Dilated cardiomyopathy (DCM) is a disease of the heart that has historically affected predisposed breeds (like the Doberman and Great Dane) as well as, occasionally, larger breed dogs. In 2018,  the FDA announced an investigation into DCM occurring in unusual breeds, many of them fed similar diets. Since then, 10 different peer-reviewed research endeavors have suggested a link between diet and atypical, reversible DCM.

The current bottom line: Grain free diets, diets high in legumes or peas, and diets containing exotic ingredients are disproportionately associated with unexplained, atypical, and reversible DCM across dogs of numerous breeds, ages, sizes, and geographical locations and we do not know why. Dogs may begin to experience subclinical cardiac changes or damage at a low level as early as 30 days after starting these diets. Evidence continues to suggest that diet is the most likely inciting cause.

Until we know more, pet owners should consider avoiding grain-free or legume-rich diets, and if possible, stick to brands that are going above and beyond with formulation and manufacturing processes.  

Research Showing Link Between Diet & DCM:

"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 

Randomized feeding trial in Labradors supports link between DCM and diet

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.

"Effect of diet change in healthy dogs with subclinical cardiac biomarker or echocardiographic abnormalities” Haimovitz D, Vereb M, Freeman L, Goldberg R, Lessard D, Rush J, Adin D. J Vet Intern Med. 2022 Apr 14.
https://doi.org/10.1111/jvim.16416

Change of diet reduces measurement of heart damage marker in dogs fed grain-free

Key Takeaway: Heart abnormalities in otherwise healthy dogs eating grain-free diets can be resolved/reversed with a change of diet. This is consistent with the findings of multiple previous studies as well as clinical observations.

"Prospective study of dilated cardiomyopathy in dogs eating nontraditional or traditional diets and in dogs with subclinical cardiac abnormalities." Freeman, L, Rush, J, Adin, D, et al. J Vet Intern Med. 2022; 36( 2): 451- 463.
https://doi.org/10.1111/jvim.16397

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

Key takeaway: “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.”

"Investigation of diets associated with dilated cardiomyopathy in dogs using foodomics analysis" Smith et al., Scientific Reports volume 11, Article number: 15881 (2021)
https://doi.org/10.1038/s41598-021-94464-2

Biochemical Analysis of Dog Foods Provides New Clues On Causes of Diet-Associated DCM

Key Takeaway: Unique, unnamed compounds were present in high pulse/potato diets named in the FDA case reports (3P-FDA) that were not found in "non-3P/FDA" diets. Additionally, 3P/FDA diets were found to have certain nutrients in deficiency or excess relative to non-3P/FDA diets. Those specific nutrients have previously been associated with physiologic processes that may contribute to DCM development. 

"Effect of type of diet on blood and plasma taurine concentrations, cardiac biomarkers, and echocardiograms in 4 dog breeds." Adin, D, Freeman, L, Stepien, R, et al.  J Vet Intern Med. 2021; 35: 771779.
https://doi.org/10.1111/jvim.16075

Key Takeaway: Among healthy dogs, consumption of grain-free/high-pea/high-lentil diets is associated with increased levels of Cardiac Troponin I, a biomarker associated with cardiac damage.
 
"Association of diet with clinical outcomes in dogs with dilated cardiomyopathy and congestive heart failure," A.L. Walker, T.C. DeFrancesco, J.D. Bonagura, B.W. Keene, K.M. Meurs, S.P. Tou, K. Kurtz, B. Aona, L. Barron, A. McManamey, J. Robertson, D.B. Adin, Journal of Veterinary Cardiology, Volume 40, 2022, Pages 99-109, ISSN 1760-2734,
https://doi.org/10.1016/j.jvc.2021.02.001.

 Key Takeaway:  Among dogs in congestive heart failure diagnosed with DCM, the length of time a dog was on a grain-free diet was correlated with worse outcomes. In those dogs that survived at least one week, changing diet was associated with improved outcomes and reverse remodeling of cardiac changes.

"Retrospective study of dilated cardiomyopathy in dogs." Freid, KJ, Freeman, LM, Rush, JE, et al. J Vet Intern Med. 2021; 35: 58– 67.
https://doi.org/10.1111/jvim.15972

Key Takeaway: Changing diet in dogs diagnosed with DCM while eating a non-traditional diet is associated with a significant increase in mean survival time following diagnosis, including reversal of disease in some patients.

"Development of plasma and whole blood taurine reference ranges and identification of dietary features associated with taurine deficiency and dilated cardiomyopathy in golden retrievers: A prospective, observational study." Ontiveros ES, Whelchel BD, Yu J, Kaplan JL, Sharpe AN, Fousse SL, et al. (2020) PLoS ONE 15(5):
https://doi.org/10.1371/journal.pone.0233206

Key Takeaway: There is an association between consumption of non-traditional diets and low taurine and echocardiographic abnormalities in Golden Retrievers.

"Echocardiographic phenotype of canine dilated cardiomyopathy differs based on diet type." Adin D, DeFrancesco TC, Keene B, Tou S, Meurs K, Atkins C, Aona B, Kurtz K, Barron L, Saker K.  J Vet Cardiol. 2019 Feb;21:1-9. Epub 2018 Dec 5. PMID: 30797439.
https://doi.org/10.1016/j.jvc.2018.11.002.

Key Takeaway: There is an association between grain-free diets and DCM in dogs; the data suggests that a change of diet and taurine supplementation can lead to reversal of disease

"Taurine deficiency and dilated cardiomyopathy in golden retrievers fed commercial diets." Kaplan JL, Stern JA, Fascetti AJ, Larsen JA, Skolnik H, Peddle GD, et al. (2018).  PLoS ONE 13(12): e0209112.
https://doi.org/10.1371/journal.pone.0209112 

Key Takeaway: There is an association between grain-free diets, taurine deficiency, and dilated cardiomyopathy in Golden Retrievers. 


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