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FDA statement regarding the potential link between certain diets and canine dilated cardiomyopathy (DCM)
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On June 27th, 2019 the FDA released a status update about the ongoing investigation of the potential link between boutique/exotic ingredient/grain-free (BEG) diets and DCM. This statement breaks down the 515 canine cases that have been reported in the last several years and lists specific brands that are over-represented (10 or more cases).
View the full FDA report now:
What we know so far:
- There has been an increase in the number of DCM cases that correlates with the increase in popularity of BEG diets.
- Many breeds that are affected are not the standard breeds that typically develop DCM.
- It is not just grain free diets but we have not identified the underlying cause.
- There are many dogs on BEG diets that do not develop DCM so there is likely a genetic component.
- Many of the affected dogs are not taurine deficient. The exception is Golden Retrievers.
- There appear to be three separate groups of DCM cases:
- Diet associated DCM with normal taurine levels.
- Diet associated DCM with taurine deficiency.
- Non-diet related DCM (primary DCM) in breeds that are genetically predisposed to the disease.
- There is no association between diet and chronic degenerative valve disease which is generally associated with a loud heart murmur. Unfortunately, dogs with DCM may not have a heart murmur at all which makes auscultation a poor screening tool.
- Dogs that respond to diet change +/- taurine supplementation show improvement in heart size and muscle function over a several month period (up to 8 months). Some have complete resolution of disease and can stop cardiac medications, while other show improvement but not complete resolution. These cases may need to continue some or all cardiac medications.
Recommendations:
- For asymptomatic dogs on BEG diets:
- Since we do not know the exact cause and what population is at risk, diet change to one with standard ingredients that is manufactured by a company that does feeding trials/has veterinarians on staff is recommended.
- Lamb and rice diets should ideally be avoided as they have been associated with breed specific taurine deficiency in the past.
- For symptomatic dogs on BEG diets:
- Dogs with clinical DCM may present with signs of lethargy, weakness/collapse, exercise intolerance, coughing and/or changes in respiratory rate/effort to name a few.
- Symptomatic dogs should be worked up with thoracic radiographs, bloodwork and blood pressure.
- Referral for cardiac work up is highly recommended.
- Diet change and potentially taurine supplementation should be instituted.
- Screening options for asymptomatic dogs on BEG diets with very concerned owners:
- Whole blood and plasma taurine testing: This can be considered but it is important to note that many affected dogs are not taurine deficient. The exception to this is Golden Retrievers.
- Thoracic radiographs: This is useful in detecting more severely affected dogs but will not detect dogs with heart muscle dysfunction and no significant cardiac enlargement.
- NT-ProBNP: This is a blood test that detects cardiac stretch and can be used for screening severely affected dogs but may not detect more mild cases.
- Echocardiogram: This is considered the gold standard for evaluation of heart muscle function.
Reporting cases:
Cases of suspected diet related DCM should be reported to the FDA. It can be done by clients or veterinary professionals. Cases can be reported here:
Safety Reporting Portal
To schedule an appointment with Dr. Fauske, please call our Glendale location. If you believe your client needs to schedule an appointment right away and Dr. Fauske's schedule is booked, please give her a call to discuss the case and she will do her best to schedule an earlier appointment for your client.
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Meet Our Residency-Trained Cardiologist
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A
vailable advanced diagnostics and treatments include:
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- Ambulatory ECG monitoring (Holter or event recording)
- Blood pressure monitoring
- Cardiac-specific blood tests
- Cardiac catheterization and angiography
- Echocardiography (ultrasound)
- Electrocardiography (ECG or EKG)
- Emergency management (arrhythmias & heart failure)
- Fluoroscopy
- Interventional procedures (PDA occlusion, balloon valvuloplasty for pulmonic stenosis)
- Radiography (X-ray)
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Lakeshore Veterinary Specialists offers collaborative, compassionate and board-certified care.
To make a referral or for additional information, we welcome your call at any of our locations.
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Glendale 2100 W. Silver Spring Dr. | Glendale, WI 53209 | 414.540.6710
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207 W. Seven Hills Rd. | Port Washington, WI 53074 | 262.268.78
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