Do grain free diets cause heart problems (like DCM or dilated cardiomyopathy) in dogs?
On today's episode of Twin Trees Vet Talk, we welcome our very special guest, Dr. Mark Harmon. Dr. Harmon is a Veterinary Cardiology Specialist at Boundary Bay Veterinary Specialty Hospital in Vancouver, BC (Canada).
We discuss the problem with trendy new diets ( vegan, vegetarian, grain-free), stemming from ingredients like chickpeas, lentils, peas, and dried beans that have been associated with dogs developing heart problems. Since the FDA warning against grain-free dog food, the FDA has halted its investigation but the problem has not gone away. Pet food manufacturers are still making diets with these problematic ingredients, so it is important to read the label on your pet's food and discuss with your veterinarian. If your pet has been fed a diet with these ingredients and there is any indication of heart disease (even a very soft murmur, exercise intolerance, shortness of breath, cardiac arrhythmia, etc.) it very is important to have the heart evaluated. The damage can be reversed in the earlier stages, but in the later stages it is devastating. We hope you enjoy this episode! Please leave your questions and comments below!
-Diet-associated DCM update from Lisa Freeman (Board-Certified Veterinary Nutritionist at Tufts University): https://vetnutrition.tufts.edu/2023/02/diet-associated-dilated-cardiomyopathy-the-cause-is-not-yet-known-but-it-hasnt-gone-away/
-Orthopaedic Foundation for Animals: https://www.ofa.org/
-AKC Guide to Responsible Pet Breeding:
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Certain ingredients- peas and lentils chickpeas and dry beans those are the real problem. It can be devastating. Dilated cardiomyopathy does not often create very loud heart murmurs and so a lot of these murmurs are missed. Unfortunately we were catching these dogs way too late. At that point the damage may be done. Since we started seeing this issue back in 2017, I've easily seen 200 dogs with this. It's a condition that we still see every week to every two weeks, sometimes many more times than that.
Dr. Lopez: Today we have a very special guest Dr Mark Harmon. He is a board certified Veterinary Cardiologist at Boundary Bay Veterinary Specialty Hospital. Let's do this one [question]: Do grain free diets cause heart problems in dogs
Dr. Harmon: So I'm actually going to say no, but there's going to be a very strong asterisk on this answer. It is not the presence or the absence of grain in a diet for a dog that seems to be the problem. What seems to be the problem is that certain ingredients that get included, such as peas and lentils and chickpeas and dry beans, that those are the real problem with these causing a type of heart disease, and we can definitely talk more about that.
The problem is, if we call this a grain free issue then it creates two misconceptions: 1) that sometimes you have a diet that actually is green inclusive but has ingredients that are problematic and could still be a risky diet but 2) I've also seen the situation where people call this a grain-free issue and the owners just feel like well if I just add rice to the diet or if I had some form of a grain to the diet then it's going to be safe, and that's definitely not the case, so those are not protective measures to do.
And so even though we've kind of latched on to it as being in kind of an easier talking point to call it a grain-free issue, it's really an ingredient problem, and it seems to be these peas and lentils and chickpeas and beans that are really the biggest problem.
Now what that leads to, what we've seen since like 2017, is that this will cause their heart muscle and the ventricles of the heart, which are the primary pumping chambers, especially the left side of the heart, will get very big it will get dilated and the pumping strength of the heart becomes very poor. And so if it can't get rid of that blood and get it out to the rest of the body then it will start to back up upstream and animals will start to have congestive heart failure, fluid will build up in their lungs or in the rest of their body, or arrhythmias, because basically the heart's not functioning as well as it can be. It's a really difficult and tricky sort of disease because dilated cardiomyopathy does not often create very loud heart murmurs-these are usually moderately loud at best- and so a lot of these murmurs are missed. If they come in and they're just excited and you're listening to an excited dog that's bouncing around it's hard enough, and you could miss a really really soft heart murmur.
So unfortunately for a while there especially we were catching these dogs way too late and we were catching them once they had developed signs of heart failure or bad arrhythmias, and at that point the damage may be done, it may be a situation where you're trying to stabilize the heart disease as best you can, and that may be the best outcome that you can get in that situation.
However, if you can catch those dogs before they go into heart failure, a lot of times those dogs you can actually reverse their heart disease, It can actually go back to normal, but you just have to catch them before too much damage is done And so that's another thing to say, that if you know your dog has a heart murmur, especially if it's on a diet that can be problematic, then it's a situation where we probably do want to know for sure that there's nothing more worrisome like this going.
Dr. Lopez: Wow that is so interesting. So do we know how those ingredients like chickpeas and lentils are causing the damage?
Dr. Harmon: We don't right now. So there's about 16 peer-reviewed studies that have been put out that keep finding this consistent sort of relationship.
The initial thing that was put out there back in the early papers on golden retrievers was taurine deficiency (taurine being an amino acid or a constituent of proteins). We started with taurine as kind of an easy logical place to look at it because taurine we've known since the 80s could be a problem as far as causing this type of heart disease- actually DCM used to be a very common type of heart disease in cats, and they they figured out that cats are not small dogs, they have very different metabolism, and they reformulated their diets and it actually has become a much less commonly seen issue in cats as well.
So we started with taurine and then what we've subsequently found is actually a lot of these dogs have normal taurine concentrations and they still can get better if we change their diet and can support them with some medication.
So it definitely seems to be a more complicated issue than what we currently know. The other thing I would say is that the U.S Food and Drug Administration was leading some sort of Investigation into it- at least back in 2017/2018 is when they said that they were going to start doing it- and they actually just recently came out and said that they would not be giving any sort of further updates on it, that they basically can't figure out an obvious thing behind it.
That is not to say that the issue has gone away at all and actually Lisa Freeman who is a board certified veterinary nutritionist from Tufts University has been really instrumental at doing some of the research involved at this and figuring out how we can stabilize these animals and help them out, but also how can we try to prevent this from happening with them. She has some really good information on her "pet food-ology" website which I can provide the link.
Dr. Lopez: Oh yeah that would be interesting.
Dr. Harmon: It's got an updated picture. Yes the FDA may be stopping their updates but the problem hasn't gone away. I can also tell you as a conservative number, since we started seeing this issue back in 2017, I've easily seen 200 dogs with this issue. So it's a condition that we still see every week to every two weeks and sometimes many more times than that ,so it's still out there, it's still very present, and it can be a really devastating disease.
So I definitely encourage people to actually look at the ingredient list and try to make sure they are not feeding those sort of ingredients.
Dr. Lopez: So pet food brands are still making foods with these ingredients- like grain free and vegan diets?
Dr. Harmon: Yeah, and actually if you go to these pet food stores it can be a little harrowing. I actually walk up and down the aisles of these pet stores all the time because there's all these new brands out nowadays, and like every single day I'm hearing about a new brand that I've never heard of, and if you just walk up and down the aisles, a good portion of the diets will have problematic ingredients in them when you look at them.
You need to be really careful with it, and you also need to, like pet owners just need to talk to their veterinarians, and also kind of trust their input on things. So it's a tough situation, but you just need to be kind of proactive about making sure you're not putting them at some sort of unnecessary risk.
And I will say, it's not every single dog that's on these diets that develops a problem, that's part of why it's been so difficult to figure out is because some dogs are on these diets for a long time and never have any sort of issues, but when it creates a problem it can be devastating for them.
I would say if you can avoid diets that have peas and lentils and chickpeas and dry beans in them, or if you are going to do some sort of home-formulated diet you should definitely work with a board-certified veterinary nutritionist to make sure that you are formulating a complete diet, because we know that certain nutritional deficiencies can put them at a very high risk for developing heart disease down the road,
Dr. Lopez: Wow, that so helpful and interesting to know. A really good update.
0:43 Intro, Do grain-free diets cause heart problems in dogs?
0:58 Problematic ingredients: peas, lentils, chickpeas, dried beans
2:10 how it damages the heart- DCM ( dilated cardiomyopathy )
2:46 DCM can be missed until the very late stages when it is too late
3:30 early detection is key- you may be able to reverse the damage if caught early enough
3:57 what the research shows, side notes on taurine deficiency in cats
5:56 it's very common even though FDA stopped investigating
6:15 read the pet food label and avoid those ingredients
7:08 not every dog is affected
7:22 how to prevent diet-associated DCM in dogs
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