FDA Webinar Discussing Dietary Risk Factors for Dilated Cardiomyopathy

The FDA has recently held a webinar with a representative of the agency, a nutritionist, and a representative of the pet food industry to provide an update on the state of the ongoing investigation of certain diets and possible heart disease risk. Here is the link to the recording along with my summary notes.

Martine Hartogensis– FDA
Cardiologists reported ~ 150 cases dilated cardiomyopathy (DCM) in atypical breeds to FDA

FDA noted ~ 30 case reports had been filed with them with dogs on grain-free and legume/tubers containing diets.

FDA followed up on 30 cases and did not see low taurine in the foods but did find low taurine in some of patients

Now total of 160 dogs reported with DCM (149 case reports), 39 deaths, mostly from 2017-2018

8 cats reported (in 4 cases) with 1 death, these are from 2015-16

90% of dog cases had grain-free/legume/tuber-containing diet history

Prospective study ongoing checking foods and dogs for cysteine/methionine/taurine

Lisa Freeman– Tufts
DCM 2nd most common canine heart disease after valvular disease

A variety of different diets and breeds linked to taurine deficiency/DCM over the years

Dr. Sterns at UC Davis has been looking at taurine-deficient DCM in Golden Retrievers for about 3 years

Some dogs with DCM on grain-free or legume-containing diets are taurine deficient but even those that aren’t sometimes improve on taurine supplementation

Roughly 3 groups of dogs-

  1. Typical breed primary DCM cases (Boxers, Dobermans, etc.)
  2. Taurine-deficiency DCM in both typical and atypical breeds
  3. Diet-associated DCM with normal taurine levels in either typical or atypical breeds. These are not just grain-free but also “boutique” and exotic protein diets (“BEG” diets). The majority of DCM cases on these BEG diets have NOT been taurine deficient.

May be deficient in taurine or precursors, decreased absorption, increased elimination, other variables

All DCM cases should have full diet history, screen for taurine, supplement taurine whether low levels or not, change to more typical diet

Greg Aldrich– KSU/Industry
Lots of manufacturers are now adding taurine to diets even though it is not clear this is the answer

Grain-free diets are ~ 25% of the dog food market, so not going away
Even with a large supply of relevant amino acids in meat meal, if the bioavailability is not high enough there may not be enough on an as-fed basis

Legume seeds/pulses lower in methionine than traditional cereals and lower bioavailability. They also have some soluble fibers in them which can influence bacterial fermentation in the colon which can deplete taurine.

Potatoes don’t really contribute to the protein in a diet, so unclear how any association with taurine levels might work

FDA uses cat taurine levels as guideline since likely to be higher than dogs need, so in foods identified as not deficient this means they meet the cat requirement

Number of reports has, of course, increased since FDA announced it is investigating this, and many do not appear to be genuinely related to this issue; The 160 dogs mentioned are confirmed DCM diagnoses by echocardiogram.

Even though most notable association has been legumes/tubers/boutique diets the FDA is looking at other possible causal factors but so far no other clear signals. No clear pattern related to particular protein source in diets.

BEG Diets= boutique (small manufacturers but not willing to define specifically), exotic ingredient, grain-free diets. Reiterated majority of DCM cases on these diets have not been taurine deficient.

Worth bearing in mind that < 200 animals known to be affected out of ~100 million pet dogs, so scale of the problem does not yet appear very large

Bear in mind taurine may not be the whole story so adding taurine to foods or supplementing individual dogs may not be appropriate if it turns out some of these cases are associated with other risk factors

Recommendation to pet owners is to speak with veterinarian about nutrition since a lot of the information and advice people seek and use to guide feeding comes from marketing, pet food stores, and other sources without necessarily a sound, science-based approach.

Very few reports from countries outside the U.S. at this point.


The Science Dog


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24 Responses to FDA Webinar Discussing Dietary Risk Factors for Dilated Cardiomyopathy

  1. lbz says:

    Interesting! Do you think legumes and potatoes should also be avoided in homemade cooked diets?

  2. skeptvet says:

    I don’t think we know enough at this point to be sure, and the risk is influenced by other aspects of the diet. I do recommend any home-cooked diet be formulated and monitored by a board-certified nutritionist

  3. A MORE Skeptical Vet says:

    There is no evidence this applies to whole potatoes or legumes, or that this is an ingredient issue at all. This will turn out to be an ingredient QUALITY and manufacturing issue. On the call, they mentioned this was exclusively bags of food – BGD boutique, grain free diets. The headline should be “Some kibble’d food causes DCM.” but of course PFI and vets don’t want that headline, so they blame it on “Grain Free” or “Potatoes” so that they can say “I told you so”meanwhile missing the point entirely: extruded diets aren’t as safe as we thought they were. They never have been.

    I’m actually surprised SkeptVet isn’t taking a more ‘skeptical’ approach to this and wondering why the FDA and UC Davis are so quick to blanket ‘grain free diets’ and certain ingredients without addressing the quality of the formulations and/or ingredients or processing. SkeptVet has historically been pretty critical of this type of PR – because that’s what it is – PR. I guess it’s hard to remain skeptical – ahem – neutral – when your friends are involved.

  4. Lbz says:

    Ok, thanks! I’m very curious about the FDA’s conclusions. Unfortunately, there are no certified vet nutritionists in my country, just some of the so-called “holistic vets” who advocate fresh diets, but I don’t really trust someone who believes in homeopathy and other witchcraft. I started cooking for one of my dogs because he was extremely picky and would only eat commercial pet food (dry or wet) when starving. He was miserable, always searching for food, so I started studying a lot about homemade food. I read some books and bought a software (Pet Diet Designer) to help me build recipes with the necessary ingredients to guarantee all the nutrients in the right amounts and proportions. He’s happy now! 🙂

  5. skeptvet says:

    Silly, snide comment without much substance. If you’d like to present some evidence that this particular clinical problem has anything to do with the formulation and extrusion process in general and applies equally to all kibble, feel free. At this point, you’re just making vague insinuations, not providing a testable alternative hypothesis.

  6. skeptvet says:

    You can find nutritionists who will consult regarding diets online. Here are a couple of resources, though there are many others:


  7. Lbz says:

    Thanks! I didn’t know PetDiets, so I will definitely explore it! I knew BalanceIt, but I dislike their methods. They basically give you very few ingredient options, so the recipes are incomplete and you have to buy their own supplements… I find this quite irritating. I like to use food only, like humans do daily. The software I bought uses the USDA food database (nutrient data for each ingredient) and allows you to build recipes according to NRC, AAFCO and FEDIAF guidelines. Everything is monitored (recommended allowances, macro and micro nutrients, Ca:P ratio, etc.), so I feel more comfortable in feeding him only homemade food.

  8. Silverwynde says:

    Were the cats fed grain free diets as well? I’m thinking of getting another cat–ours had to be euthanized back in June–and I’m seeing more and more grain free formulas being manufactured for cats. My Sammy lived on Iams for 17 years, though I’d like to pick a better food for my future kitty.

    If I can avoid a potential problem, I’d like to do so.

  9. skeptvet says:

    The cat cases n the FDA database are likely unrelated to the current issues with DCM and various diets in dogs. Unlike in dogs, taurine is an essential amino acid in cats, and cat foods are all supplemented with it regardless of other ingredients.

  10. Silverwynde says:

    Thanks! Great to hear!

  11. Eric Canham says:

    Is this correct?
    “Cardiologists reported ~ 150 cases dilated cardiomyopathy (DCM) in atypical breeds to FDA.”
    Of those.
    “FDA noted ~ 30 case reports had been filed with them with dogs on grain-free and legume/tubers containing diets.”
    So 30 of the 150 are specifically on a grain- free and Legume / tubers containing diets
    But only some, a not specified amount of the 30 had low taurine in the dog not the food.
    “90% of dog cases had grain-free/legume/tuber-containing diet history”
    So in the original 150 cases 90% of those dogs at some point in life ate legume or something grain-free / tuber-containing diet but are not currently on that type of diet.
    So would this mean that 120 cases of the 150 cases of (DCM) in atypical breeds are eating something else?
    All DCM cases should have full diet history, screen for taurine, supplement taurine whether low levels or not, change to more typical diet”
    I am confused what the typical diet would be?

  12. Frances says:

    In a way I am very reassured by these reports – they show that the early warning reporting system is working, and rapidly disseminating information worldwide. I suspect hundreds if not thousands of cats suffered because of taurine deficient foods back in the ’70s and ’80s before the pattern was observed.

  13. skeptvet says:

    Sorry, I was taking notes while listening to the webinar, so the format of the article is not clear. The 150 cases were those originally reported to the FDA by a group of cardiologists. The 30 cases then mentioned were those the FDA had already been aware of before the 150 that the cardiologists told them about.

    Overall, about 90% of the 160 dog cases now known involve diets that are grain free or contain legumes or tubers. So far, the majority of cases of DCM seen on these diets have NOT been deficient in taurine by the typical measure of how normal taurine levels. The diets themselves are not “taurine deficient,” of course, because taurine is not an essential amino acid that has to be supplied in the diet normally.

    A “typical” diet here refers to the type of diets that have been in common use before the current mania for grain-free diets or those with unusual protein sources (venison, bison, duck, kangaroo, etc). A typical commercial diet can contain a lot of different ingredients, but often they contain common protein sources used in human and pet foods (chicken,beef, pork, etc) and grains of some kind (corn and wheat mostly, though there are others). The diets that MAY be associated with this problem are those that use legumes or tubers to replace grains and some unusual protein source to replace traditionally used meats.

  14. Maria says:

    Hi! I just checked my cat’s dry food (Orijen) and it has no Taurine listed in the ingredient/supplement list… I checked their webpage and this is what I found:

    “TAURINE – ORIJEN contains lots of Taurine. What’s the source?

    ORIJEN cat foods list Taurine in the Guaranteed Analysis but not in the Ingredient Panel. This is because ORIJEN is very rich in meats (in which Taurine is naturally present) and therefore no supplementation is required. Most foods do not contain sufficient Taurine in natural form (from meat) and so must supplement with a Taurine ingredient.”

    Should I trust them or should I worry?

  15. skeptvet says:

    Unlike dogs, cats do require taurine in the diet, so there is an established minimum. Animal protein sources do provide taurine, but cooking lowers the levels some. If the company does not supplement, then they should conduct post-processing analysis to demonstrate adequate taurine levels in the food as fed. If they do not do this kind of analysis, then I would be concerned about the possibility that the levels might be insufficient, though there is no other way to know for sure.

  16. Maria says:

    Thanks! I sent them an e-mail asking this specific question and here is what they replied:

    “All of our diets will contain taurine. We test the taurine content of our diets after the food is made to ensure that the amount of taurine present will meet the minimum requirements for cats.”

  17. mzy says:

    Hi, SkeptVet. After reading these comments about cats, I’m more confused than I was before. If grain-free foods are causing this problem in dogs, why not in cats? I understand that they require taurine, but it happens that foods containing an adequate amount of taurine are also causing the problem, which may be due to low absorption or other unknown interactions. So, basically, the taurine they add to cat foods (if they add any) may be useless if the food contains legumes and/or potatoes, right? Which makes me think the risk for cats is the same even with added taurine. Some light? Thanks!

  18. skeptvet says:

    Because cats need taurine directly in the diet and dogs do not, cat foods are supplemented much more heavily. It is theoretically possible that if legumes or other ingredients interfered with taurine absorption that this could cause a problem, but that hasn’t actually been seen, and since cats are more sensitive to taurine deficiency than dogs, I’m fairly sure this problem would have appeared if it were a real issue.

  19. Mzy says:

    What about cat foods that do not supplement heavily with taurine, but meet the minimum requirement, like the one @Maria shared above? There are many… It’s strange that these foods are not causing the issue in cats, since, like you say, they are more sensitive to taurine deficiency than dogs.

  20. Elisabeth says:

    Have you heard the one where male cats aren’t supposed to eat fish and female cats something else? (I tuned out while the very nice woman was explaining this to me at the pet store today, so I didn’t catch everything she said.) Something about how it affects their behavior. I assumed this was utter bunk.

  21. Aline Yonkman says:

    I am very confused about what kind of dog food to give my beloved Kelpie/Border Collie/Blue healer. We have been feeding him Acana 75% protein (from Canada) but I am now concerned because it is grain free and contains peas and potatoes. As well it contains what is referred to in some studies as exotic meat; salmon, duck, lamb. Should I discontinue using this product entirely. Perhaps I should mix it with a dog food that contains grains such as Iams (Feel free to recommend a brand). We also supplement Oby’s diet with wild salmon and deer meat sourced locally. (The same salmon and deer my husband and I eat). I find all these studies extremely unclear. I would love some specifics as to how I should proceed. The only instructions I’ve been given so far is to not buy a boutique brand of dog food; not sure how to tell if something is a boutique brand. Any information or clarification would be greatly appreciated.

  22. skeptvet says:

    There is no perfect food, and a food that works well for one dog may not work for another, so the best you can do is choose a maintenance diet form an established company (one with veterinary nutritionists on staff to oversee formulation and quality control) and then monitor important signs, such as weight, stool quality, coat quality, etc. There are many good choices and only a few I would recommend against (raw diets, and BEG diets).

  23. Pingback: Diet-Associated Dilated Cardiomyopathy (DCM) in Dogs: What Do We Know So Far? |

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