Keep Your Pet’s Heart Healthy. Without Changing Their Food

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When your pet is diagnosed with a heart dysfunction or heart disease, you want to take immediate action to support your pet’s health and well-being. In addition to specific recommendations from your veterinarian, here are some tips to help keep your dog or cat’s heart healthy — without modifying their main diet.  

Maintain a Healthy Weight

Your pet’s weight plays an important role in heart health. One of the main contributors to heart problems is obesity. Being overweight adds unnecessary stress to your pet’s joints, muscles, internal organs, but also to the heart itself. 

Help your pet maintain a healthy weight by giving him the right amount of food for his size, breed, age, and reproductive status. 

In combination with a proper diet, daily exercise is vital. Walks, runs, and active playtime improve the strength and endurance of the heart’s ability to circulate blood, but also burn excess calories that can lead to obesity.

If your pet has been diagnosed with heart disease, please consult your veterinarian before starting any exercise program with your pet.  Certain heart conditions dictate no exercise while others allow for lower-intensity exercise sessions that include monitoring duration, intensity, and external temperature. 

Feed the Beneficial Treats

When searching for heart-healthy treats, look for single-ingredient, nutritionally dense, minimally processed products.  These types of treats are typically lower in sodium and other unhealthy preservatives that may aggravate a heart condition. My favorites are freeze-dried hearts, any fish treat (since fish is high in omega 3’s), or any treat containing no or low-salt additives.

Additional Supplements

Supplements can be an important part of your pet’s heart health plan. Although supplements should never replace a well-balanced diet, they can provide a nutritional boost that can help reduce the risk of heart disease, reduce inflammation, improve circulation, manage weight and improve overall well-being. 

Organotherapy

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If you haven’t heard of organotherapy, you’re not alone. This ancient therapy is defined as the practice of using whole animal tissues to support or promote the healthy functioning of a body’s internal organs.¹ It is also known as glandular therapy, cell therapy or tissue therapy. 

Why Organotherapy Works

Organ meat is high in a plethora of vitamins and minerals that may offer benefits for your pet. The cells within a particular organ or tissue contain the amino acids, nutrients, lipids, and glandular secretions (insulin, enzymes, and nucleic acids) needed to benefit that same organ within your pet. In other words, organotherapy may benefit your pet’s body on a cellular level by stimulating the function of that organ. For example, feed your pet liver (which contains amino acids and vitamins) to improve liver health.¹

Where to Find Organ Nutrients

Organ and tissue are plentiful in commercially prepared fresh and minimally processed diets where they have not been heat treated and therefore have the most bioavailable nutrients. Most of these diets contain at least 80% meat, organ, and bone, so they are rich in the essential nutrients, omega fatty acids, amino acids, vitamins and minerals that may support healthy organ function. Feeding organs doesn’t have to be complicated or difficult to incorporate into a healthy pet’s diet. For example, many commercially prepared options such as Instinct include amino acid levels like taurine as part of the guaranteed analysis. These can even be added to kibble diets as a fresh topper.

Some dietary supplements, like taurine, are derived directly from beef and pork heart. Digestive enzymes–primarily used to improve pancreatic function–are commonly sourced from pork pancreas. 

Freeze-dried organ treats also offer an excellent source of nutrition for your pet’s organ health, particularly single-ingredient options.² Freeze-dried liver, heart, lung and kidney make extremely healthy treats. Liver is perhaps the most popular as it’s frequently used and recommended by dog trainers due to its rich flavor and palatability. Liver is also considered one of the highest value rewards you can offer your pet. Freeze-dried treats are perfect for both cats and dogs. 

Organ benefits:

Heart: Taurine, carnitine, CoQ10

Lung: Iron, Vitamins A, D, E and B12

Kidney: Vitamin A, B, and iron

Liver*: Vitamin A, glycogen, potassium, copper, B vitamins, and vitamin D, K and E

Pancreas: digestive enzymes, manganese, insulin and glucagon

Spleen: Vitamins D, K, A, E, plus iron and zinc.

Brain: DHA and EPA, other omega-3 fatty acids

*It’s important to note that liver should be fed in moderation. Excessive amounts can induce vitamin A toxicity.³

Every pet is different and has unique nutritional needs. Supplementing with organ meat for various reasons should be considered on an individual basis. Stop in to speak with us about what options may be best suited for your pet. 

This information is provided for educational purposes only, and should not be taken as medical advice. Always consult a qualified veterinarian for treatment options for your pet. We recommend consulting a board certified veterinary nutritionist for disease-specific nutrition information.

REFERENCES:

  1. Cameron, T. “Glandular Therapy.” Foundation for Alternative and Integrative Medicine. Integrative Veterinary Care Journal. 2012.
  2. Gaylord, L. Raditic, D. “Glandular therapies for pets.” Integrative Veterinary Care. August 6, 2022 https://ivcjournal.com/glandular-therapies-for-pets/
  3. Cho DY, Frey RA, Guffy MM, Leipold HW. Hypervitaminosis A in the dog. Am J Vet Res. 1975;36(11):1597-1603.

What Should I Do If My Pet Is Overweight?

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While our initial reaction to an overweight pet may be to call out how cute and cuddly they look, the reality is that their health is suffering. Obesity has quickly become one of the most common nutritional disorders and could be the most significant health threat to your pet. 

According to a survey performed by the Association for Pet Obesity Prevention (APOP), 56% of dogs and 60% of cats were classified as obese or overweight by their veterinarian, making it one of the most common health concerns in the veterinary world today. 

That means over half of household pets are unhealthy. 

Overweight pets have become normalized in society. There is a disconnect between what we view as a healthy weight and what is actually a healthy weight in pets.

In fact, many pet owners don’t even realize their pets are overweight. A few extra pounds might not sound like a big deal, but realistically it is. Our pets are much smaller, and a few extra pounds make a big difference. For example, a dog with an additional 5-6 pounds is equivalent to a human having an extra 30 pounds. 

A Few Extra Pounds Can Mean Big Consequences

Obesity isn’t just a concern for vanity. It goes much deeper than the surface and has an impact on many facets of your pet’s health. Obese pets are at a much higher risk for many ailments, including:

–       Heart disease/ failure

–       Diabetes

–       Metabolic and endocrine disorders

–       Osteoarthritis

–       Hypertension

–       Renal dysfunction or urinary tract disease

–       Respiratory disorders

–       Shorter life expectancy (on average, obese pets have a two-year shorter life span)

–       Arthritis

–       Kidney Disease

–       Cancer 

–       Inflammation

–       Liver disease

–       High blood pressure

–       Decreased immune function

Lastly, an overweight pet can be costly to your wallet. The expenses of veterinary care and medications rise with the increased likelihood of diseases and injuries associated with obesity. 

Tips to be Proactive and Preventative

As with many aspects of your pet’s health, being proactive is key. If you’re worried about an overweight pet, there are steps you can take to take back control of your pet’s health. 

  1. Work with a veterinarian to assess the pet’s body condition, muscle condition, lifestyle, and any medical conditions. 
  2. Avoid “eyeballing” the measurement of food you feed your pet. Always use a labeled measuring cup or utensil to know exactly how much food goes into their bowl. This will make adjusting the diet much simpler if necessary. 
  3. Understanding the amount of food to feed your pet depends on age, weight, activity level, and other health factors. Since diet and nutrition is not one-size-fits-all, feeding guidelines on your pet food bag are often misleading. Instead, consult a nutritionist for feeding recommendations suited for your pet’s individual needs. 
  4. While the actual measurement of food plays a role, simply reducing the volume of food you feed your pet could lead to malnutrition. The secret is to get good quality – ideally fresh –  food that is nutrient-dense and highly digestible to your pet.
  5. Keeping your pet active with regular exercise can help release pent up energy (and stress), increase their metabolic rate, and retain lean body mass. A little exercise is always better than none. If exercise is new to your pet, start in small increments at 5-10 minutes a day and work your way up. 
  6. Remember to ease your pet into any lifestyle changes slowly. Small, incremental changes are best. 

Other Tips to Prevent Obesity

–       Know the difference between boredom begging vs. hunger in your pet

–       Replace processed food and treats with fresh, minimally processed                   foods

–       Limit treats and table scraps

–       Avoid crash diets

–       Avoid free feeding (allowing your pet to “graze” throughout the day)

The Perks of Pumpkin for Pets

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Pumpkin is a commonly recommended supplement for dogs and cats for everything from loose stool to constipation to an occasional bowl topper or a regular supplement. But what is it about pumpkin that makes it so great for your pet? Let’s find out what makes this sweet treat a favorite among vets and nutritionists! 

Reasons You Should Consider Adding Pumpkin to Your Dog’s Diet

#1 RICH IN FIBER

Pumpkin is rich in dietary fiber – both soluble and insoluble. 

  • Soluble fiber helps with weight management, lowering fat absorption, stabilizing glucose levels, reducing the risk of cardiovascular disease, and feeding healthy gut bacteria. 
  • Insoluble fiber assists in preventing constipation and lowers the risk of diverticular disease. 

Because pumpkin contains both soluble and insoluble fiber, it can essentially help to normalize your pet’s stool, whether it’s too loose or too firm. It’s a win-win situation! 

As a preventative, pumpkin is an excellent source of prebiotics that feed the good gut bacteria- probiotics. This is a wonderful addition for any pet with a sensitive stomach as it can aid in the digestive process. Also, since roughly 80% of your pet’s immune system resides in their gut, a happy belly can mean a healthier pet!

#2 ESSENTIAL VITAMINS

Pets need food that allows them to consume all their vitamins and minerals. Pumpkin is packed with essential vitamins and minerals:

  • Vitamin A and Zinc help strengthen your pet’s immune health, promote clearer skin and a healthier coat, and improve overall eye health. 
  • Vitamin D helps to grow and maintain strong bones by regulating and balancing the retention of calcium and phosphorus. It also works to reduce inflammation. 
  • Potassium is vital to pet health! It assists in the functioning of the heart, nerves, and muscles by aiding in transferring energy from the nutrients. 

Not only is pumpkin a great source of vitamins and minerals your pet needs, but it also assists with the absorption of these nutrients to improve many functions of their body.

#3 ADDED MOISTURE

Kibble-fed pets often live in a mild state of dehydration, as the body pulls moisture from itself to digest the dry food. Therefore, adding moisture to your pet’s kibble is essential. Adding moisture-rich pumpkin can help to keep your pet well hydrated. Added moisture is crucial for not only the digestive process but also… 

  • Weight control – Pumpkin is high in moisture and fiber, which helps your pet feel full. As a result, your pet is less likely to overeat and will be satisfied longer!  
  • Hairballs– Lack of moisture can lead to more frequent hairballs. An addition of pumpkin to your pet’s kibble will keep them well-hydrated, which means fewer hairballs for them and less clean-up for you. 
  • Low in glycemic index– Glycemic index is a measurement of the blood glucose response to carbohydrates. Low GI foods (such as pumpkin) contain carbs that are digested slowly, so energy is sustained for an extended period of time. 

Pumpkin is super versatile for your furry friends. You can include it as a treat, bowl topper, or toy filler. Pumpkin is worth the hype! With the holidays right around the corner, include your pet in the holiday festivities and try incorporating more pumpkin into your pet’s diet! 

*This article is for informational purposes only. It is not meant to provide medical advice or replace the advice of a qualified veterinarian.

We Can Put ‘Grain-Free’ Concerns to Bed!

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2020 surely had it’s fair share of problems – however the pet industry has also still been fighting off a fair amount of bad press, and misrepresentation of data and information surrounding grain-free and grain-inclusive pet foods. So what’s the verdict? In September of 2020 the FDA determined that there was no inherent danger to feeding grain-free pet foods. In fact, heart disease, specifically Dilated Cardiomyopathy (DCM) is a multifactorial issue that will be studied for years to come. For more on the real science and story behind this multi-year story please read the update from Dr. Ryan Yamka below:

Learn More

 

ABOUT THE AUTHOR:

Ryan Yamka, PhD, MS, MBA, FACN, PAS, Dipl. ACAS is founder and an independent consultant with Luna Science and Nutrition, and co-Founder of Guardian Pet Food Company. He is board certified in companion animal nutrition by the American College of Animal Sciences and a fellow with the American College of Nutrition. Yamka calls on his extensive background in pet nutrition, and 20+ years developing, formulating and launching dog and cat foods as a senior executive with leading pet food companies. Yamka has received the 2020 Rogue Pet Science Pet Industry Disruptor Award, the 2019 Pet Age ICON Award and the 2011 ASAS Corbin Companion Animal Biology Award. Dr. Yamka writes a series of blogs Debunking Pet Food Myths and Misconceptions for Pet Food Industry and has been featured in numerous podcasts and seminars.

To learn more about Ryan, check his background credentials on LinkedIn (www.linkedin.com/in/ryanyamka)

FDA Finds No Evidence that Grain-Free Diets Are Causing Canine Dilated Cardiomyopathy (DCM)

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Evidence shows that risk factors for DCM is multi-faceted and is not related to a grain-free diet.

 

INTRODUCTION:

Since 2018, Canine dilated cardiomyopathy (DCM) has been a hot topic in the pet food industry, the veterinary community, the press and among pet owners. Although some veterinarians hypothesized there may be a potential association, there has never been a proven direct link (i.e., cause and effect) to grain-free foods (both over the counter or therapeutic) causing DCM in dogs including the FDA investigation. Unfortunately, the FDA’s original request was for cases involving grain-free pet food only, and that is what people keep sending in (which has resulted in a biased and polluted data pool). Perhaps if the FDA asked veterinarians and the public to send in all cases, regardless of diet, we may have seen something else, like the whole picture or a specific nutrient or lack thereof could be the issue.

 

FDA 2020 DCM UPDATE:

In late September 2020, the Food and Drug Administration (FDA) quietly issued an update on the grain-free pet food and canine dilated cardiomyopathy (DCM) investigation that was a far cry from – and far less publicized than – the initial FDA reports and updates back in 2018 and 2019. In other words, the FDA walked back their initial reports implying a causation between grain-free foods and DCM. Unfortunately, this did not make the headlines.

Since the initial reports, Vet-LIRN (the veterinary laboratory network that FDA partnered with for the investigation) closely examined a subset of approximately 150 dogs diagnosed with DCM to identify potential causative and recovery factors. The results show that DCM is indeed a multifactorial issue with potential variables including, but not limited to, breed, age, weight, gastrointestinal disease, atopy, infection (Lyme and Chagas disease) and more. These results are not surprising. Recently, McCauley et al (2020) reviewed over 150 studies which found no cause-and-effect link of grain-free food to DCM (see figure below). In fact, their review found similar variables related to DCM like infections and concurrent diseases.

Dr. Steven Solomon, director of the FDA’s Center for Veterinary Medicine, acknowledged that the “complex scientific messaging” on DCM and diet has contributed to misinterpretation about the safety of a grain-free diet. Dr. Solomon encouraged dog owners to select the diet that works best for their pet’s nutritional needs and previewed more multidisciplinary, scientific collaboration between the industry, veterinarians, scientists, and other researchers that will further the understanding of DCM.

Solomon also acknowledged:

“This is one of our ongoing struggles: choosing terminology that is scientifically accurate, understandable to pet owners and that does not cast a shadow over products that are otherwise known to be healthful and safe. I appreciate the fact that FDA’s voice is the voice veterinarians and pet owners listen to, yet too often our messages have been repeated inaccurately by third parties. The result is that in the internet age of phenomenally fast sound bites, complex scientific messaging is often lost in translation. We have tried to be careful in our messaging, and we recognize going forward not to speak on this topic publicly unless we are clarifying information or have something substantive to share.”

In addition to acknowledging the lack of connection of grain-free foods with DCM and the miscommunication because of oversimplified sound bites, the FDA provided and a new Question and Answer page on November 3rd which reinforced that grain-free diets were not inherently dangerous and that there has been no link between DCM and grain-free diets established. The FDA still recognizes the incidence of DCM and will continue their investigation into non-hereditary factors to better understand the disease. The FDA also acknowledges that they have received reports of non-hereditary DCM associated with BOTH grain-free and grain-containing diets (Q&A #8).

 

SO, WHAT DO I DO?

If your veterinarian wants to convert you from your current food to their recommended food, it is important to discuss the science behind the “why?”. In fact, the field of nutrition is evolving and advancing, and consumers and veterinarians can benefit from these conversations and by asking questions that help evaluate true quality of pet foods. The truth is that much of the information available for ALL pet foods revolves around marketing rather than nutrient inclusion and availability, but the good news is that you can help change that. Asking the following questions about the food(s) veterinarians recommend and all pet foods in the marketplace can help raise standards and encourage knowledge sharing based on science rather than marketing:

  1. Who formulated the food you are recommending in the marketplace?
  2. Do they perform 3rd party nutrient analysis, and do you have a copy of the data?
  3. Do they perform 3rd party digestibility studies, and do you have a copy of the results?
  4. Does their manufacturing facility (owned or not) have a third certification for quality control and food safety?
  5. Where do the calories in their food come from?

Asking the veterinarian these key questions, will challenge them to think differently about the food they are recommending and come to the realization that the foods they are recommending may be missing this key critical information. Knowing the answers to these questions will enable you to have an open dialogue and make a more informed decision for your pet. This is no different than human medicine. Keep in mind the DCM debacle was started by lack of information tied to nutrient content and availability of the nutrients. Therefore, asking questions #2 and #3 are critical when choosing the right food for your pet. Additionally, when veterinarians started recommending and moving people to Hill’s, likely they were embarrassed, angry and lost credibility with their clients following one of largest recalls in history tied to Vitamin D toxicity which killed and sickened hundreds of pets (question #4).

 

KEY TAKE AWAY:

DCM is not caused by grain-free foods, regardless what a news headline says – as the data does not support this statement. Rather than blaming an ingredient or set of ingredients for any health concern we should instead be focusing on the nutrient analysis and digestibility of all foods in the marketplace to prevent future problems (including grains and ancient grains). For many of us that have studied nutrition, we know that the nutrient content and availability of those nutrients can be significantly impacted by processing conditions.

Using these questions when choosing a food for your pet you should be able to get answers from the manufacturer or from the veterinarian recommending that food. This will enable both of you to have an open discussion about the nutrition of your pet and more importantly help you become an advocate for what you feed your pet. As always if your pet has any health-related issues you should seek veterinary medical advice immediately.

 

RESOURCES:

Dr. Solomon’s Full Statement

https://www.fda.gov/animal-veterinary/cvm-updates/interdisciplinary-scientific-cooperation-will-lead-way-understanding-non-hereditary-dcm

Questions and Answers: FDA’s Work on Potential Causes of Non-Hereditary DCM in Dogs

https://www.fda.gov/animal-veterinary/animal-health-literacy/questions-answers-fdas-work-potential-causes-non-hereditary-dcm-dogs

DCM and grain-free pet food: September 2020 FDA update

https://www.petfoodindustry.com/blogs/10-debunking-pet-food-myths-and-misconceptions/post/9729-dcm-and-grain-free-pet-food-september-2020-fda-update

‘BEG’ pet food and DCM, part 2: Is veterinary bias at play?

https://www.petfoodindustry.com/blogs/10-debunking-pet-food-myths-and-misconceptions/post/8475-beg-pet-food-and-dcm-part-2-is-veterinary-bias-at-play

‘BEG’ pet food does not equal DCM

https://www.petfoodindustry.com/blogs/10-debunking-pet-food-myths-and-misconceptions/post/8369-beg-pet-food-does-not-equal-dcm

McCauley et al. 2020: Review of canine dilated cardiomyopathy in the wake of diet-associated concerns

https://academic.oup.com/jas/article/98/6/skaa155/5857674

Weird science: Published pet food studies not always sound

https://www.petfoodindustry.com/blogs/10-debunking-pet-food-myths-and-misconceptions/post/9339-weird-science-published-pet-food-studies-not-always-sound

WSAVA pet food recommendations: Useful or useless?

https://www.petfoodindustry.com/blogs/10-debunking-pet-food-myths-and-misconceptions/post/9654-wsava-pet-food-recommendations-useful-or-useless

Pet Nutrition Alliance provides false sense of security

https://www.petfoodindustry.com/blogs/10-debunking-pet-food-myths-and-misconceptions/post/8190-pet-nutrition-alliance-provides-false-sense-of-security

 

Evidence shows that risk factors for DCM is multi-faceted and is not related to a grain-free diet.

McCauley et al., 2020. Review of canine dilated cardiomyopathy in the wake of diet-associated concerns. Journal of Animal Science. 98, No. 6: 1-20

Link: https://academic.oup.com/jas/article/98/6/skaa155/5857674

 

ABOUT THE AUTHOR:

Ryan Yamka, PhD, MS, MBA, FACN, PAS, Dipl. ACAS is founder and an independent consultant with Luna Science and Nutrition, and co-Founder of Guardian Pet Food Company. He is board certified in companion animal nutrition by the American College of Animal Sciences and a fellow with the American College of Nutrition. Yamka calls on his extensive background in pet nutrition, and 20+ years developing, formulating and launching dog and cat foods as a senior executive with leading pet food companies. Yamka has received the 2020 Rogue Pet Science Pet Industry Disruptor Award, the 2019 Pet Age ICON Award and the 2011 ASAS Corbin Companion Animal Biology Award. Dr. Yamka writes a series of blogs Debunking Pet Food Myths and Misconceptions for Pet Food Industry and has been featured in numerous podcasts and seminars.

To learn more about Ryan, check his background credentials on LinkedIn (www.linkedin.com/in/ryanyamka)

Science of ‘Sense’ – how does your pet see the world?

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There has always been debate about how and what dogs and cats can see. The reality? Dogs & cats don’t see as clearly as humans, and they’re lacking in the color department. However, they can see movement better than we can.

Learn Something New

Grain-Free Pet Food Diets | What to Know Before Switching

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The benefit and necessity of grain-free pet food have come under scrutiny in recent years due to an FDA investigation due to a potential association with a canine heart disease known as dilated cardiomyopathy (DCM). As a result of this potential association, many have been told there is no scientific evidence to support the use of grain-free foods in canines and felines, or that these foods do not provide any benefit over grain-inclusive foods. For the most part, grain-free refers to kibble, although some have also categorized various canned, freeze-dried, and raw diets under the ‘grain-free’ umbrella. But are these claims accurate? Let’s find out:

 

Grain-free foods don’t provide benefits?grain free dog food kible

The pet food industry’s switch to grain-free was not fueled by a problem with the grains themselves or grain allergies like most believe. The largest pet food recalls in history was due to melamine and cyanuric acid contamination of ingredients coming from China. The short version of the 2007 recall is that wheat gluten and rice protein were intentionally combined with melamine for its high nitrogen content. Higher amounts of nitrogen can cause the protein content of an ingredient to test higher than it actually is. Since cyanuric acid was present, and the combination of melamine and cyanuric acid is likely the reason the recall was so deadly – not the melamine on its own. This series of events fueled the consumer trend of wanting grain-free pet food.

Other Concerns

Another major factor absent from the discussion on grain-free vs. grain inclusive diets for people – and pets – is the contamination of grains with herbicides, pesticides, mycotoxins, and fertilizers. This has become an increasingly large concern since the mid-’90s in both the human and animal food supply. Numerous peer-reviewed articles are detailing the disruption many of these agricultural contaminants have on normal gut bacteria function.1,2 In fact, available literature suggests that humans are becoming increasingly intolerant to grain and grain products for exactly these reasons (e.g. wheat & gluten sensitivity & celiac disease in humans).

We are learning that disruption of vital gut bacteria balance can have devastating effects on the health of the host, including diabetes, obesity, autoimmune disease, cancers, GI issues, and even DCM.3–5 Could the contamination of grains in pet food be one reason why many pets experience improvement of various issues with the change from grain-inclusive to grain-free? Could be.

Ultimately the phrase ‘there is no evidence to support the use of grain-free foods’ doesn’t mean there is not a benefit. It simply means that we have a major gap in research into companion animal nutrition and that we easily forget our recent history. On the contrary, we don’t have evidence to support that feeding grains to canines or felines are any more healthful than feeding grain-free diets. Evidence only shows that it meets minimal (known) nutritional standards, not that pets thrive on these processed diets. In short, canine and feline nutrition fields are far behind the knowledge we have in livestock and human nutrition.

 

Are ALL grain-free foods the same?

Many veterinarians and pet owners automatically lump grain-free cans, fresh food, raw food, and freeze-dried products as ‘grain-free’. While this is technically correct – there are stark differences that make these foods different from their kibble counterparts.

Regardless of whether we are feeding grain-free or not, we need to consider the high temps kibble and canned foods are heated to during the manufacturing process. This high heat creates Maillard Reaction Products (MRP) which is the name for a series of reactions that is the product of sugar (carbohydrate) and protein when heated. These are also known as AGE’s or Advanced Glycation End Products.

MRP’s are responsible for the nutrient loss and associated with diseases like diabetes, cardiovascular disease, kidney disease, loss of cognitive function, allergies, periodontal disease, and chronic inflammation.6–12 This can mean things like arthritis, skin, and ear issues, an old injury that keeps resurfacing, bloating, IBS, etc. Also, there is a large amount of research to suggest that they are carcinogenic and accelerate aging.13,14

  • Heterocyclic amines are MRPs from cooking protein that increases with elevated cooking temperature. This phenomenon is more pronounced in meat than fish – and these increase with temperature and dryness of meat or meat products15.
  • Acrylamides are a chemical that forms naturally from starchy foods during high-temperature cooking. According to the European Food Safety Authority evidence from animal studies shows that acrylamides are genotoxic and carcinogenic: they damage DNA and cause cancer. And since we know so little about animal nutrition is it possible that much of the disease we’re seeing – including DCM – has at least something to do with the MRP’s that are in dry and/or canned pet food? Is it a coincidence that freeze-dried, fresh, and raw options do not have as many associated issues as their processed counterparts? Maybe.

 

Allergic to Grains? Probably Not (sorry, not sorry)

Pet food can be made of everything from rendered unfit foods for human consumption to ingredients that are 100% organic and probably better than the food we feed ourselves. I’m not necessarily here to split hairs on ingredients and in the types of ingredients that are in our pet’s food. Because is it these ingredients that are causing the problem? Or is it something else? – These are the questions that the experts seem to avoid entirely. When a dog experiences issues related to food, we are quick as a society to turn over the bag and blame an ingredient or set of ingredients. However, those ingredients as listed are likely not the problem – rather the quality, processing agents, AGE’s and contamination of these ingredients (e.g. herbicides, pesticides, etc.); something you will never find listed on a label.

 

More Important: Nutrient Availability & Digestibility

The digestibility of food is altered as it is processed, mixed with other ingredients, and heated. That said, canned and kibble foods by definition will have varying levels of nutrient availability and digestibility than their lesser processed counterparts. The ingredients (or set of ingredients) that make up a food could be the most nutrient-dense food available – but if they are not digestible by the cat or dog then those ingredients are irrelevant. In short, this means that it is important to ask your pet food company for their digestibility and nutrient analysis to determine if their food is adequate for your pet. Learn more about what questions to ask and why here.

 

About the author: Nicole Cammack

Nicci is the owner of award-winning NorthPoint Pets & Company, in Connecticut. She is also the Founder & CEO of Undogmatic Inc. Her undergraduate and graduate education includes biology, chemistry, business, and nutrition. She has worked in the pharmaceutical industry on multiple R&D projects and has had the privilege to learn from leading international figures in the human and pet health industry. She regularly lectures at national conferences, including federal, state, and municipal K9 events. Her current research involves identifying pathogenic risk factors and transmission among raw fed pets through a comprehensive worldwide survey.

www.northpointpets.com

www.undogmaticinc.com

 

References:

  1. Van Bruggen AHC, He MM, Shin K, et al. Environmental and health effects of the herbicide glyphosate. Sci Total Environ. 2018;616-617:255-268. doi:10.1016/j.scitotenv.2017.10.309
  2. Aitbali Y, Ba-M’hamed S, Elhidar N, Nafis A, Soraa N, Bennis M. Glyphosate based- herbicide exposure affects gut microbiota, anxiety and depression-like behaviors in mice. Neurotoxicol Teratol. 2018;67:44-49. doi:10.1016/j.ntt.2018.04.002
  3. DeGruttola AK, Low D, Mizoguchi A, Mizoguchi E. Current Understanding of Dysbiosis in Disease in Human and Animal Models. Inflamm Bowel Dis. 2016;22(5):1137-1150. doi:10.1097/MIB.0000000000000750
  4. Galland L. The Gut Microbiome and the Brain. J Med Food. 2014;17(12):1261-1272. doi:10.1089/jmf.2014.7000
  5. Yoshida N, Yamashita T, Hirata K. Gut Microbiome and Cardiovascular Diseases. Diseases. 2018;6(3). doi:10.3390/diseases6030056
  6. Jandeleit-Dahm K, Cooper ME. The Role of AGEs in Cardiovascular Disease. doi:info:doi/10.2174/138161208784139684
  7. Pion PD, Kittleson MD, Thomas WP, Skiles ML, Rogers QR. Clinical findings in cats with dilated cardiomyopathy and relationship of findings to taurine deficiency. J Am Vet Med Assoc. 1992;201(2):267-274.
  8. DCM: add taurine to grain-free dog foods, say scientists. Accessed May 15, 2019. https://www.petfoodindustry.com/articles/8162-dcm-add-taurine-to-grain-free-dog-foods-say-scientists?v=preview
  9. DACVIM CDSBM. Breed-specific variations of cardiomyopathy in dogs. dvm360.com. Accessed May 15, 2019. https://veterinarynews.dvm360.com/breed-specific-variations-cardiomyopathy-dogs
  10. Dilated Cardiomyopathy in Dogs. vca_corporate. Accessed May 15, 2019. vcahospitals.com/know-your-pet/dilated-cardiomyopathy-dcm-in-dogs–indepth
  11. Medicine C for V. FDA Investigation into Potential Link between Certain Diets and Canine Dilated Cardiomyopathy. FDA. Published online June 27, 2019. Accessed June 29, 2019. https://www.fda.gov/animal-veterinary/news-events/fda-investigation-potential-link-between-certain-diets-and-canine-dilated-cardiomyopathy
  12. Freeman LM, Stern JA, Fries R, Adin DB, Rush JE. Diet-associated dilated cardiomyopathy in dogs: what do we know? J Am Vet Med Assoc. 2018;253(11):1390-1394. doi:10.2460/javma.253.11.1390
  13. Prasad C, Imrhan V, Marotta F, Juma S, Vijayagopal P. Lifestyle and Advanced Glycation End Products (AGEs) Burden: Its Relevance to Healthy Aging. Aging Dis. 2014;5(3):212-217. doi:10.14336/AD.2014.0500212
  14. Turner DP. Advanced glycation end-products: a biological consequence of lifestyle contributing to cancer disparity. Cancer Res. 2015;75(10):1925-1929. doi:10.1158/0008-5472.CAN-15-0169
  15. Jägerstad M, Skog K, Arvidsson P, Solyakov A. Chemistry, formation and occurrence of genotoxic heterocyclic amines identified in model systems and cooked foods. Z Für Leb -Forsch A. 1998;207(6):419-427. doi:10.1007/s002170050355

Concerned about grain-free diets? The FDA report tells a different story.

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Summary:

Recent reports discussing the potential relationship between grain-free pet foods and Dilated Cardiomyopathy (DCM) have given pet owners and veterinarians alike a cause for concern. Pet owners and the veterinary community have been led to believe that some pet foods – particularly grain-free pet foods – are causing heart disease in dogs. However, the data buried within the FDA report tells a different story, one that is complex, without evidence showing a causative relationship between grain-free diets and heart disease. Multiple factors surround this issue – and none of them are simple. The fact is, little research and data are available surrounding this potential relationship, and some within the industry have failed to recognize a greater problem. DCM is just one of many concerns pet owners have to face, along with cancer, diabetes, kidney disease, and allergies to name a few. For owners and veterinarians concerned about grain-inclusive or grain free, they are likely concerned about the wrong risk; instead, the concern should be centered around the significant gaps in the field of animal nutrition. These gaps include but are not limited to formulation guidelines that are narrowly researched, outdated research, and foods full of toxic chemicals and byproducts of food processing. The DCM events have highlighted these gaps and the complexity of the field of nutrition, for those simplifying it to a set of ingredients are doing pets & the scientific community a disservice. In this review, we examine the scientific evidence that highlights the complexity of nutrition & DCM.

Timeline of FDA Investigation & Reports

  • In June of 2018, Lisa Freeman, a board-certified veterinary nutritionist from Tufts University published a blog titled “A broken heart: Risk of heart disease in boutique or grain-free diets and exotic ingredients.” This blog warned pet owners and veterinarians that ‘BEG’ (boutique, exotic, grain free) diets were causing heart disease in dogs.
  • July 2018, FDA announces an investigation into the potential association of canine DCM and grain-free foods. On the heels of this press release, the New York Times published an article creating a media storm.
  • In November of 2018, Dr. Freeman published another blog on the Tuft’s Petfoodology website titled, “It’s Not Just Grain Free: An Update on Diet-Associated Dilated Cardiomyopathy.” This reiterated their warning about BEG diets and their association with DCM. This article also was circulated as if it was peer-reviewed when it indeed was another opinion piece.
  • In December of 2018 Freeman et. al. authored a commentary article in JAVMA titled, “Diet-associated dilated cardiomyopathy in dogs: what do we know?” It’s important to note that this paper also was not peer-reviewed, and the AVMA (American Veterinary Medical Association) disseminated it as gospel. This is unfortunate considering 80% of veterinarians believe or look at AVMA as a source of truth even if a commentary article does not contain true or accurate scientific content.
  • Also, in December 2018 there was a paper published in PLOS ONE by Kaplan et al. titled, “Taurine deficiency and dilated cardiomyopathy in golden retrievers fed commercial diets.” The major complicating variable (and there were many) was that golden retrievers are well known to have a genetic predisposition to DCM, as well as have a higher requirement for taurine. Simply, this means that this study cannot be easily applied to the entire canine population.
  • February of 2019 –  The FDA published an update showing a few hundred reported cases in the prior 7 months. It also revealed that the majority of pets were eating dry food, were golden retrievers, and that ingredients like peas, sweet potatoes, lentils, chickpeas, and potatoes were potentially associated with DCM. They also revealed that all diets implicated did appear to be nutritionally adequate based on testing.
  • June 2019  – the FDA released another update naming the most common 16 brands of dog food reported alongside DCM cases. This report along with the accompanying graphs was taken out of context leading the general public and veterinary community to believe that they had made a connection to specific brands and disease when in fact the FDA report states that they believe it to be a complex scientific issue.
  • In May of 2020 a paper titled, “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” was published in PLOS ONE. The article contained multiple inaccuracies, failure to disclose conflicts of interest, and issues that are currently being reviewed. In the meantime, the journal has issued an expression of concern. Regardless, this paper also taken out of context has led the public and veterinary community to believe that the issue is a simple relation to ingredients instead of the complex issue that it is.
  • In June of 2020, an article published in Journal of Animal Science highlighted just how complex DCM and various nutritional and non-nutritional etiologies are. The authors state, “based on this review of the current literature, there is no definitive relationship between these implicated diet characteristics and DCM.” While the public and veterinary associated communities made several further conclusions upon the release of the article, it is important to realize that this paper largely identifies the numerous knowledge gaps within the field of canine nutrition rather than drawing concrete conclusions. While no link between ‘BEG’ (boutique, exotic, grain free) pet foods were found, this does not mean that nutrition and other considerations are not at play.1 You can read our full summary of that article here.

What is DCM? pouring dry dog food into bowl

Dilated Cardiomyopathy (DCM) is defined as a condition where the heart becomes enlarged and is unable to adequately pump blood. DCM can include mechanical dysfunction and/or electrical dysfunction which leads to sudden collapse and death.2 As DCM progresses signs include lethargy, loss of appetite, shallow breathing, intolerance to exercise, and shortness of breath. This disease is known to occur in dogs and cats, at varying levels of severity and has multiple causes.1,3

Further complicating matters DCM has causation that is likely multivariable such as genetics, environmental, nutritional, infections, heavy metal exposure, dysbiosis, and even other unknown causes1,3.

A large issue is that the true prevalence of DCM in canines is unknown. One of the reasons is that there is no central reporting agency that tracks diseases for companion animals. Literature estimates the prevalence of DCM in dogs, prior to grain-free foods being widely available, to be 0.5 to 1.1% of the overall dog population.4 Based on the current data it would appear that the prevalence of DCM is still within the same parameters even with increased reports made to the FDA. That said, it is unclear if cases have been underreported, and continue to be underreported or if there is a significant spike in cases as a result of these diets, or multiple other variables.

DCM is not a ‘new’ concern for dogs or cats. In fact, it has been around for a long time. In the 1970’s -1980’s, DCM was prevalent in cats and it was eventually determined that this was due to low concentrations of taurine and animal protein within the commercialized foods.5 Pet food companies responded by adding taurine through supplementation and additional meat protein which has since seemed to remedy this issue for cats.6  Since dogs and cats are nutritionally different it is unlikely that adding taurine to any canine diet will be sufficient to solve the current issue in dogs, especially since diet-related canine DCM is likely far more complex. Further complicating matters, the only definitive diagnosis for DCM is an echocardiogram, which the majority of “cases” highlighted within the FDA report lack. Other methods of screening for potential cardiac disease are whole blood taurine, plasma taurine, auscultation, and chest x-ray, although these methods are not reliable in diagnosing DCM.

Genetics at Play

We know that certain breeds are genetically predisposed to DCM and those include (but are not limited to) Doberman Pinschers, Boxers, Great Danes, Labrador Retrievers, St. Bernards, Irish Wolfhounds, Golden Retrievers, Newfoundlands, English, and American Cocker Spaniels5,7. There is no cure for genetic DCM, and conventional treatment provides limited relief for a generally short period of time.8

Not Just Grain Free

Not all dogs diagnosed with DCM were consuming a grain free diet.9. Most dogs were also eating dry food, which raises the question grain free not being a problem per se – instead showing evidence of a knowledge gap in the formulation.9 As the report notes, some improved after a diet change from one grain-free diet to another, and this along with differences identified between dogs fed various grain-free diets, suggests that DCM is not necessarily tied to the grain-free status of the diet.2,10 In addition, many dogs diagnosed with DCM were initially thought to be taurine-deficient, and we’ve since learned that this problem is far more complex than the presence or digestibility of taurine within dry pet food. We’re now realizing the presence of significant knowledge gaps regarding small animal nutrition.

Context: Few Pets are Healthy

In examining the whole picture, we know that dogs and cats are not “healthy” – a reality that most of us either ignore or don’t believe to be true. Common problems like skin conditions, “dog smell”, and GI issues are not – and should not be considered healthy; even though we’ve come to accept them as normal. Some of the causality behind “common” problems is that our pets have been, and still are, subject to many detrimental variables over generations and the consequences of such have impacted the overall wellbeing and susceptibility of varying types of disease. These variables include but are not limited to: toxins and pollution in the air, water, soil, and food supply, overuse of antibiotics and other medication, over vaccination, static diets, poor breeding practices, poor nutrition, lack of exercise, and radiation. Some, or more likely, each of these factors may have contributed to our pet’s susceptibility to a variety of diseases, including DCM. In fact, obesity, diabetes, and other issues have known relationships to DCM.11 All factors that complicate the scientific investigation.

Understanding Risk Factors

For the sake of context, the good news is that just because an individual is “predisposed” to a particular disease does not mean that they are going to “develop” that disease as the expression of a “bad gene” can be altered by a healthful diet and limiting exposure to toxins and stress.12 Let’s imagine for a second that an individual was predisposed to any type of heart disease, but they took care of themselves by consuming a diet consisting of fresh foods, including antioxidants along with moderate fat, and sodium, avoided excess use of vaccinations, limited unnecessary medications, consumed clean water and exercised to maintain strong cardiac function. These individuals most likely have a lesser chance of developing heart disease. The point is that multiple variables influence the expression of disease in any human or animal.

Nutritional Knowledge Gap

Pet food formulation comes from generalized minimal recommendations by the Association of American Feed Control Officials (AAFCO) and the National Research Council (NRC). It’s clear that these minimal benchmarks are not complete with adequate scientific evidence. For example, we do not have optimal levels for many nutrients and do not account for breed-specific requirements in most cases. These minimum nutrient recommendations have been established with research on Beagles as a proxy for all canines regardless of size or breed.2 These same recommendations also place pregnant bitches in the same category as growing animals – even though we know that nutritional requirements are different. Additionally, recommendations made by AAFCO correspond to a total nutrient content within the formulation and do not consider the true digestibility of ingredients leading to the potential of a variety of nutrient deficiencies across multiple breeds.13

Not All Diets Metabolized the Same

Some within the veterinary community have illogically lumped home-cooked, canned and raw diets into the “grain free” category, however, per the FDA report, the vast majority of DCM cases that were reported were for dogs consuming dry foods – not “grain-free” raw or “grain-free” cans, causing unnecessary panic at the expense of pet owners canned and raw foods. These diets are entirely different in formulation, composition, and differ in the way they are metabolized in comparison to dry diets. Fresh and unprocessed diets, like raw, will have abundant taurine and natural nutrients which may limit risks of malabsorption and nutrient deficiencies that are common in kibble and other processed diets. Oversimplifying this issue to “grain-free” raw, canned, and home-cooked diets is irresponsible and likely causing more harm than good.

Disproportionate Levels of Macronutrients & Micronutrient Deficiency

DCM aside, all grain-in and grain-free dry foods have a carbohydrate content of at least 30%, most being significantly higher. This can be a problem for several reasons that most haven’t recognized:

  • Ingredients such as potatoes, peas, and other legumes and pulses have been used in grain-inclusive and grain-free dog food for nearly 25 years to provide dietary fiber and protein.14 Use of these ingredients at higher than 15% inclusion on a dry matter basis can decrease crude protein digestibility. Since some foods on the market have greater than 40%, and even up to 60%, inclusion could facilitate a higher risk of nutritional deficiencies, especially if the final product is not validated.2 This can also yield an inadequate amount of animal protein which may lead to an imbalance or not enough of various nutrients – one of which can be taurine, and too little taurine (taurine deficiency) can result in DCM.
  • Some plant-based proteins, like pea or potato protein, can cause malabsorption and inflammatory conditions in humans.15 While insufficient research is available to suggest the same in pets, it is certainly a reasonable theory to explore. More institutions are exploring the similarities in humans and canines and while some still refute these similarities, the stark similarities in types and rates of disease are intriguing.16–18 Logically, these similarities are not surprising considering humans eat a highly-processed diet full of chemicals, lack exercise, overuse medication, and live exposed to environmental toxins and pollution, just like pets.
  • The recent article by McCauley et al. highlighted the various nutritional considerations that may influence dietary DCM including choline, methionine, cysteine, taurine, carnitine, thiamine, copper, vitamin E, selenium among others.1

Before assigning blame to a particular ingredient, set of ingredients, or formulation it is prudent to first identify knowledge gaps – especially before establishing any causation to a particular disease. Further investigation into these inclusion percentages and relationship to canine health and risk factors is needed to understand these relationships. We cannot allow the industry to tunnel vision focus in the way that it has, as it will not yield useful results or a better understanding of the problem at hand.

Why Grain Free?

The pet food industry’s switch to grain free was not fueled by a problem with the grains themselves or grain allergies like most believe. In 2007, the largest pet food recalls in history was due to melamine and cyanuric acid contamination of wheat and rice ingredients coming from China. Also absent from the discussion on grain consumption for pets – and people – is the contamination of grains with herbicides, pesticides, mycotoxins, and fertilizers. Numerous peer-reviewed articles are detailing the disruption that many of these contaminants have on normal gut bacteria function. These are the largest reasons more animals and humans are becoming increasingly intolerant to grain and grain products.19,20 We are also learning that disruption of vital gut bacteria balance can have devastating effects on the health of the host including diabetes, obesity, autoimmune disease, cancers, GI issues, and even DCM.21–23 Said simply, the contamination of grains in pet food is likely why many pets experienced improvement of various symptoms with the change from grain-inclusive to grain-free.

Pet Food Processing & Chemical Factors to Consider

All kibble is heated to high temps which creates a chemical change. A Maillard Reaction Product (MRP) is the name for a series of reactions that is the product of sugar (carbohydrate) and protein when heated. These are also known as AGE’s or Advanced Glycated End Products. MRP’s are responsible for nutrient loss and associated with diseases like diabetes, cardiovascular disease, kidney disease, loss of cognitive function, allergies, periodontal disease, and chronic inflammation.24–29 This can mean things like arthritis, skin, and ear issues, an old injury that keeps resurfacing, bloating, IBS, etc. In addition, there is a large amount of research to suggest that they are carcinogenic and accelerate aging.29,30

Since we know so little about animal nutrition is it possible that much of the disease we’re seeing – including DCM has at least something to do with the MRP’s that are in pet food? Possibly.

Closing Discussion

The considerations surrounding DCM challenges are extremely complicated, with many unknowns. It will likely be many years before any formal answers are reached. Currently, there are no formal dietary recommendations for pet owners from the FDA as of the latest report. If your dog is in a risk group (breed, genetic, or other underlying condition) it is best to seek advice from your veterinarian on the health status of your pet.

Our canines are largely suffering from man-made diseases and conditions such as obesity, type II diabetes, and nutritional deficiency – among others. Most of these can be linked back to feeding low-moisture, high soluble carbohydrate, low meat protein, and ultra-processed dry food with high levels of contaminants. While there is a knowledge gap in the nutrition of both ultra-processed and raw, one cannot deny the association between ultra-processed foods and disease prevalence and progression.

It is imperative to understand and practice methods that recognize each animal as different, having unique needs. Not any one diet is complete – and no feeding regimen will be successful for all pets and this very practice is what has been detrimental to our pets and brought us to this point. As always, all diet changes and additions should always be introduced slowly and carefully. It is always helpful to keep a food journal that can help experts determine potential foods or feeding patterns that may be problematic.

 

 

*This article is for informational purposes only. It is not meant to provide medical advice or replace the advice of a qualified veterinarian. If you think your pet has DCM, or any medical condition please seek the advice of a qualified veterinarian.

About the Author: Nicole Cammack

Nicci is the owner of national award-winning NorthPoint Pets & Company and Undogmatic Inc, in Connecticut. Her undergraduate and graduate education includes biology, chemistry, business, and nutrition. She has worked in the pharmaceutical industry on multiple R&D projects and has had the privilege to learn from leading international figures in the human and pet health industry. She regularly lectures at national conferences, including federal, state, and municipal K9 events. Her current research involves identifying pathogenic risk factors and transmission among raw fed pets through a comprehensive worldwide survey.
www.northpointpets.com
www.undogmaticinc.com

References:

  1. McCauley SR, Clark SD, Quest BW, Streeter RM, Oxford EM. Review of canine dilated cardiomyopathy in the wake of diet-associated concerns. J Anim Sci. 2020;98(6):skaa155. doi:10.1093/jas/skaa155
  2. Mansilla WD, Marinangeli CPF, Ekenstedt KJ, et al. Special topic: The association between pulse ingredients and canine dilated cardiomyopathy: addressing the knowledge gaps before establishing causation. J Anim Sci. 2019;97(3):983-997. doi:10.1093/jas/sky488
  3. Canine Dilated Cardiomyopathy (DCM). Cornell University College of Veterinary Medicine. Published December 13, 2017. Accessed May 15, 2019. https://www.vet.cornell.edu/hospitals/companion-animal-hospital/cardiology/canine-dilated-cardiomyopathy-dcm
  4. Sanderson SL. Taurine and carnitine in canine cardiomyopathy. Vet Clin North Am Small Anim Pract. 2006;36(6):1325-1343, vii-viii. doi:10.1016/j.cvsm.2006.08.010
  5. Pion PD, Kittleson MD, Thomas WP, Skiles ML, Rogers QR. Clinical findings in cats with dilated cardiomyopathy and relationship of findings to taurine deficiency. J Am Vet Med Assoc. 1992;201(2):267-274.
  6. DCM: add taurine to grain-free dog foods, say scientists | PetfoodIndustry.com. Accessed May 15, 2019. https://www.petfoodindustry.com/articles/8162-dcm-add-taurine-to-grain-free-dog-foods-say-scientists?v=preview
  7. DACVIM CDSBM. Breed-specific variations of cardiomyopathy in dogs. dvm360.com. Accessed May 15, 2019. https://veterinarynews.dvm360.com/breed-specific-variations-cardiomyopathy-dogs
  8. Dilated Cardiomyopathy in Dogs. vca_corporate. Accessed May 15, 2019. vcahospitals.com/know-your-pet/dilated-cardiomyopathy-dcm-in-dogs–indepth
  9. Medicine C for V. FDA Investigation into Potential Link between Certain Diets and Canine Dilated Cardiomyopathy. FDA. Published online June 27, 2019. Accessed June 29, 2019. https://www.fda.gov/animal-veterinary/news-events/fda-investigation-potential-link-between-certain-diets-and-canine-dilated-cardiomyopathy
  10. Freeman LM, Stern JA, Fries R, Adin DB, Rush JE. Diet-associated dilated cardiomyopathy in dogs: what do we know? J Am Vet Med Assoc. 2018;253(11):1390-1394. doi:10.2460/javma.253.11.1390
  11. Alpert MA. Obesity Cardiomyopathy: Pathophysiology and Evolution of the Clinical Syndrome. Am J Med Sci. 2001;321(4):225-236. doi:10.1097/00000441-200104000-00003
  12. Hunter P. We are what we eat. The link between diet, evolution and non-genetic inheritance. EMBO Rep. 2008;9(5):413-415. doi:10.1038/embor.2008.61
  13. Columbus D, de Lange CFM. Evidence for validity of ileal digestibility coefficients in monogastrics. Br J Nutr. 2012;108 Suppl 2:S264-272. doi:10.1017/S0007114512002334
  14. Butterwick R, J Markwell P, J Thorne C. Effect of Level and Source of Dietary Fiber on Food Intake in the Dog. J Nutr. 1995;124:2695S-2700S. doi:10.1093/jn/124.suppl_12.2695S
  15. Freed DLJ. Do dietary lectins cause disease? BMJ. 1999;318(7190):1023-1024.
  16. Research by DogRisk. University of Helsinki. Published June 26, 2018. Accessed May 15, 2019. https://www.helsinki.fi/en/researchgroups/dogrisk-health-via-nutrition-epidemiology-and-cancer-detection-dogs/research-by-dogrisk
  17. Dog Disease Mapping Project (DogDNA). Broad Institute. Published June 9, 2011. Accessed May 15, 2019. https://www.broadinstitute.org/project-spotlight/dog-disease-mapping-project-dogdna
  18. Treviño J. A Surprising Way Dogs Are Similar to Humans. Smithsonian. Accessed May 15, 2019. https://www.smithsonianmag.com/smart-news/new-study-suggests-dogs-may-be-better-subjects-research-human-nutrition-180968842/
  19. Van Bruggen AHC, He MM, Shin K, et al. Environmental and health effects of the herbicide glyphosate. Sci Total Environ. 2018;616-617:255-268. doi:10.1016/j.scitotenv.2017.10.309
  20. Aitbali Y, Ba-M’hamed S, Elhidar N, Nafis A, Soraa N, Bennis M. Glyphosate based- herbicide exposure affects gut microbiota, anxiety and depression-like behaviors in mice. Neurotoxicol Teratol. 2018;67:44-49. doi:10.1016/j.ntt.2018.04.002
  21. DeGruttola AK, Low D, Mizoguchi A, Mizoguchi E. Current Understanding of Dysbiosis in Disease in Human and Animal Models. Inflamm Bowel Dis. 2016;22(5):1137-1150. doi:10.1097/MIB.0000000000000750
  22. Galland L. The Gut Microbiome and the Brain. J Med Food. 2014;17(12):1261-1272. doi:10.1089/jmf.2014.7000
  23. Yoshida N, Yamashita T, Hirata K. Gut Microbiome and Cardiovascular Diseases. Diseases. 2018;6(3). doi:10.3390/diseases6030056
  24. Jandeleit-Dahm K, Cooper ME. The Role of AGEs in Cardiovascular Disease. doi:info:doi/10.2174/138161208784139684
  25. OLENIUC M, SECARA I, ONOFRIESCU M, et al. Consequences of Advanced Glycation End Products Accumulation in Chronic Kidney Disease and Clinical Usefulness of Their Assessment Using a Non-invasive Technique – Skin Autofluorescence. Mædica. 2011;6(4):298-307.
  26. West R, Moshier E, Lubitz I, et al. Dietary advanced glycation end products are associated with decline in memory in young elderly. Mech Ageing Dev. 2014;140:10-12. doi:10.1016/j.mad.2014.07.001
  27. Smith PK, Masilamani M, Li X-M, Sampson HA. The false alarm hypothesis: Food allergy is associated with high dietary advanced glycation end-products and proglycating dietary sugars that mimic alarmins. J Allergy Clin Immunol. 2017;139(2):429-437. doi:10.1016/j.jaci.2016.05.040
  28. Advanced glycation endproducts (AGEs) induce oxidant stress in the gingiva: a potential mechanism underlying accelerated periodontal disease associated with diabetes – Schmidt – 1996 – Journal of Periodontal Research – Wiley Online Library. Accessed May 15, 2019. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1600-0765.1996.tb01417.x
  29. Prasad C, Imrhan V, Marotta F, Juma S, Vijayagopal P. Lifestyle and Advanced Glycation End Products (AGEs) Burden: Its Relevance to Healthy Aging. Aging Dis. 2014;5(3):212-217. doi:10.14336/AD.2014.0500212
  30. Turner DP. Advanced glycation end-products: a biological consequence of lifestyle contributing to cancer disparity. Cancer Res. 2015;75(10):1925-1929. doi:10.1158/0008-5472.CAN-15-0169
  31. Jägerstad M, Skog K, Arvidsson P, Solyakov A. Chemistry, formation and occurrence of genotoxic heterocyclic amines identified in model systems and cooked foods. Z Für Leb -Forsch A. 1998;207(6):419-427. doi:10.1007/s002170050355

June 2020: Journal of Animal Sciences Grain Free & Heart Disease Summary

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Background & History of DCM Investigation

In June of 2018 a blog titled “A broken heart: Risk of heart disease in boutique or grain-free diets and exotic ingredients” was published on the Tuft’s University blog ‘Petfoodology’. This blog was followed by a commentary article in JAVMA causing increased media and public attention. It’s important to note that neither of these papers were peer reviewed, and the AVMA (American Veterinary Medical Association) disseminated it as gospel.  This is unfortunate considering 80% of veterinarians believe or look at AVMA as a source of truth even if an article does not contain true or accurate science content.

These articles were composed by Lisa Freeman, a board-certified veterinary nutritionist from Tufts University in order to warn the public and veterinary community about the imminent danger from ‘BEG’ foods. This blog caught the media by storm followed by the FDA launching an investigation into the matter. As a result, the FDA launched an investigation which was complicated by sampling bias, overrepresentation of subgroups and confounding variables. For the past two years, despite additional commentary articles, scarce and vague scientific data and inconclusive FDA reports, information regarding DCM has been incomplete at best. Lack of information has been accompanied by abbreviated synopses of case studies with multiple variables and treatments, incomplete medical information and conflicting medical data and opinions from veterinary nutrition influencers.1  

The reality is that there are many variables that may, or may not, impact the onset, disease process and outcome of DCM. Available studies lack evaluation of isolated variables in a controlled environment free from sampling bias. For example, many unknowns exist surrounding numerous nutrients, genetics, hypothyroidism, myocarditis, arrhythmias and other diet-related etiologies.1

Critical Part of the Conversation: DCM Disease Process & Role of Nutrition

One of the largest points of contention within this investigation is that pet owners and even some within the veterinary community are unaware of the multiple etiologies and the complex relation of nutrition to DCM. Causative factors behind DCM have been oversimplified to blame grain-free foods – which is fundamentally incorrect and is a disservice to the field of nutrition and the health and wellbeing of pets. 

Any self-respecting nutritionist knows that nutrients, not ingredients, make up a well-formulated diet. Nutrition is far more complex than this 2-year conversation has given credit to – and this review acknowledged that. At the same time, this paper also cited the importance of having a general knowledge of the incidence, clinical manifestations, diagnostics and potential treatments required before digging into the rest of the DCM conversation. Let’s have a look:

Incidence & Genetics

The most common cardiovascular disease in canines is chronic degenerative valve disease (approx. 75%), followed by DCM as the second most common. The incidence of DCM appears to be 0.5 and 1.3% of the population, with the majority of cases being an inherited, genetically linked condition.1  In context, the estimated population of dogs in the United States equals 77,000,000 which suggests a minimum of 308,000 to 1,001,000 dogs in the United States have DCM at any given time. Certain breeds and male dogs are often reported to have a higher incidence of DCM – with most cases appearing in middle age to older dogs.1  It was thought that mixed breed dogs had a greater protection against developing genetically linked types of DCM, however statistics show this is not the case. The authors highlight the need for more research in both purebred and mixed breed dogs and the genetic relationship to DCM.

Manifestation & Diagnostics

Clinical manifestation, or presentation of the disease is elusive in many cases. Most dogs have no outward symptoms in the beginning stages of the disease. If undiagnosed DCM progresses on to include decreased efficiency and effectiveness of the heart muscle leading to exercise intolerance, congestive heart failure (CHF), syncope (passing out), and even sudden death. Unfortunately, sometimes there are no outward symptoms, and sudden death is the only sign, especially in Doberman Pinschers1.

The smallest section of the paper titled “Histopathological Manifestation” has one of the most interesting facts in the entire review: “Histopathological changes vary from myocardial samples in dogs with DCM, reflecting the numerous underlying etiologies.” Simply put, biopsies, or samples of heart muscle from various dogs are showing multiple and variable changes to the cardiac tissue that indicate differing causative factors. These factors could include arrythmia, genetics, hypothyroid disease, doxorubicin (chemotherapy), myocarditis, digestive impairment, low protein diets, high fiber diets and deficiencies of l-carnitine, taurine, sulfur amino acids – among many others.1

While the gold standard of diagnostics in humans, cardiac muscle biopsy is rarely conducted in canines due to the invasive nature and high cost of the procedure.  Traditional diagnostics used to rule out other diseases and arrive at a DCM diagnosis include, but are not limited to radiograph(x-ray), echocardiogram, electrocardiogram (EKG), 24-Holter monitoring, and cardiac biomarkers (blood testing). Often, many of these options are limited due to accessibility due to location and the cost prohibitive nature of some of these tests.

Presumptive Diagnosis & Misdiagnosis

As a result of limited access to testing for various reasons, presumptive diagnosis and misdiagnosis are of concern. For example, both left and right sided valve disease may lead to characteristics that could lead to pathologies that resemble DCM. In addition, neoplasia, CHF, pericarditis and left atrial rupture can all cause pericardial effusion which leads to increased silhouette of the heart.1 Ignoring these other potential disease pathologies could lead to misdiagnosis and result in inadequate treatment.

Treatment of DCM

As we’ve learned within the past two years treatment of cases of DCM vary widely, and are complicated by accompanying disease states, age and nutritional status – among other factors. In general, treatment of DCM depends largely on the severity of disease. Treatment for primary DCM can involve use of pharmaceutical drugs, management of arrythmias, l-carnitine supplementation, taurine supplementation, and diet change. Management of secondary DCM may focus on treating the underlying condition in addition to the treatments listed above.1

Nutrition Considerations:

Choline – an abundant nutrient having several important roles within the body and potentially several that may influence DCM in different ways. In humans, choline is important for the regeneration from methionine from homocysteine. When choline is deficient elevated homocysteine elevations occur which likely increases risk of cardiovascular disease. Additional risks related to choline may be indicated by its involvement in the production of trimethylamine N-oxide (TMAO) which promotes inflammation and cardiovascular disease development in humans.1

This review states that choline is deserving of more research to determine if there is a relationship to DCM in canines. It’s important to call out that much of the information in the discussion on choline is from human data highlighting the knowledge gap in this area.

Methionine and Cysteine – These are sulfur containing amino acids which are involved in the synthesis of taurine. There are multiple factors that influence the synthesis of taurine from these two precursors. These influences include low bioavailability, thermal processing of food, diet formulation, deficiency of methionine which is a limiting amino acid – among others. In addition, sulfur amino acid requirements may vary between breed and size of dogs.1

Again, we need more research to determine breed, size and potentially age specific requirements for these nutrients.1 It’s also important to note that we lack the ability to measure functional adequacy of these nutrients highlighting another knowledge gap.

Taurine – Another sulfur containing amino acid, is not considered essential in dogs. This is because canines can synthesize taurine on their own. Taurine is an essential amino acid for cardiovascular function, skeletal muscle, nervous system function and as a component bile acids. Since the initial DCM investigation taurine has been questioned as being essential, however insufficient data exist to make any conclusions.1  That being said, canines with various cardiovascular diseases have been found to have low taurine levels. Further research is needed to determine if low bioavailability of taurine, low taurine synthesis and/or increased requirement of taurine are factors in these pathologies.

Taurine status is also deserving of more research. It is likely that various breeds, and disease states have different taurine requirements. In addition, several factors may influence bioavailability and synthesis of this amino acid. Variables affecting these factors need to be studied in a controlled environment.

Carnitine – Another nutrient that has been given attention is carnitine. This is because carnitine is beta-oxidized to generate continued energy, and 60% of cardiac energy production is through beta-oxidation. Therefore, deficiency or increased need of carnitine may cause cardiac dysfunction leading to cardiac disease such as DCM.1  Like other nutrition considerations discussed, functional assessments for carnitine status are lacking through blood testing. In order to accurately measure carnitine, biopsy of the heart muscle is required. 

Taurine, carnitine and a variety of other nutrients and amino acids require specific balances of vitamins and minerals in bioavailable forms for proper function. Examples include, but are not limited to zinc, iron, selenium and niacin. This means that adequate levels of carnitine or taurine could be present but be unable to be utilized properly by the body.

Thiamine – Insufficient evidence exists regarding thiamine deficiency and cardiac function in canines. However, thiamine does play a role in the metabolism of carbohydrates, fats and specific amino acids. Thiamine can also be rendered unavailable by the presence of certain enzymes in some foods. In short, more research is needed to determine if thiamine deficiency, or lack of bioavailability, potentially contributes to the disease process of DCM in dogs. 

Copper – Copper is known to play an important role of many enzyme functions, hemoglobin synthesis, nerve structure and function, blood vessels and various tissues. Copper deficiency on cardiac health has been studied in other species, but not dogs. While copper is routinely supplemented, it’s status could be negatively impacted by excess zinc and/or iron.1 This again indicates another knowledge gap in the area of canine nutrition and DCM. 

Vitamin E – Vitamin E is a potent antioxidant which has links to cardioprotective mechanisms. Dogs with DCM have been found to have lower vitamin E in comparison to healthy dogs.

Selenium – Selenium deficiency may be related to reduced ability for cysteine synthesis. In addition, selenium deficiency results in increased oxidative stress, and decreases other antioxidant activity. Further, decreased bioavailability of selenium may inhibit the absorption of other metabolic constituents creating further complications. Additional research is needed to determine the involvement of selenium in the pathology of DCM.

Heavy Metals & Other Toxin Considerations:

Heavy metals and various toxins have well documented roles of nutrient interference in humans, canines and other species:

  • Cyanide can increase the sulfur amino acid requirement
  • Certain raw foods (fruits/vegetables) can inhibit iodine function and increase risk of hypothyroid disease
  • Heavy metals such as arsenic, cadmium and mercury increase taurine requirements since taurine detoxifies these metals

Limitations in Current Available Data:

We know that DCM in dogs is not a new concern. Given that, we also know there are significant limitations to research studies currently available due to small sample sizes, sample bias, sample parameter inconsistencies, lack of complete data and known genetic predisposition. Extrapolating data from a small sample size to a large population can be highly inaccurate because subsets of populations are likely to skew results. 

In addition, confounding variables and lack of control for independent variables can infer correlation when none exists. 

The FDA Reports & Sample:

The sample population from the FDA reports resulted from a call for submission of DCM cases in dogs eating suspect (boutique, exotic, grain-free) diets. This resulted in a polluted data set for multiple reasons, including breed reporting, media attention, lack of all confirmed and suspect DCM cases reported, and other confounding factors such as health status of the dog. These confounding factors include obesity and other underlying conditions and diseases.

Summary:

As discussed, DCM has many etiologies, and many variables affecting disease manifestation. Considerable research is needed into these etiologies, and this paper largely serves as a call to action. While researchers state no definitive link can be found between DCM and ‘BEG’ diets, the largest points are that all etiologies of DCM need more investigation and science of nutrition is complex, and oversimplifying suspicions can lead to misguided and incorrect conclusions.

Nicole Cammack

Nicci is the owner of award-winning NorthPoint Pets & Company, in Connecticut. She is also the Founder & CEO of Undogmatic Inc. Her undergraduate and graduate education includes biology, chemistry, business, and nutrition. She has worked in the pharmaceutical industry on multiple R&D projects and has had the privilege to learn from leading international figures in the human and pet health industry. She regularly lectures at national conferences, including federal, state, and municipal K9 events. Her current research involves identifying pathogenic risk factors and transmission among raw fed pets through a comprehensive worldwide survey.

www.northpointpets.com
www.undogmaticinc.com

Link to article: https://academic.oup.com/jas/article/98/6/skaa155/5857674?fbclid=IwAR3A8FdX_DBMbEsi8CGh3tyBgNmSoy712FQf-sUkt4k2n2Ch_larxBQ0aJw

1.         McCauley SR, Clark SD, Quest BW, Streeter RM, Oxford EM. Review of canine dilated cardiomyopathy in the wake of diet-associated concerns. J Anim Sci. 2020;98(6). doi:10.1093/jas/skaa155