The impact of diets in regards to cardiovascular diseases

07 April 2019

DCM; the secondary myopathy that is often overlooked or forgotten.

Who has not yet heard of exotic ingredient, boutique and grain free diet-induced DCM ? DCM is an important problem which has recently caused concerns, but to which we do not have the complete answer to yet. The goal of this rubric is to inform our readers about the current information we have.

Dilated Cardiomyopathy (DCM) is defined by an impaired myocardium and a systolic dysfunction, which can often cause cardiac insufficiency if they persist. Frequently, when the term DCM was used, the severe genetic disease found in Dobermans come to mind. The reality of the concern is that dilated cardiomyopathy can be either primary or secondary.

One of the most common nutritional causes of dilated cardiomyopathy in dogs is associated with taurine deficiency. We have received a few years’ worth of reported suspected cases of DCM in Golden Retrievers, Cocker Spaniels, Newfoundland Dogs, English Setters, Saint-Bernards and Irish Wolfhounds.Each of these patients had common signs of DCM, as seen through a cardiac ultrasound as well as low taurine levels. After supplementing their diets with taurine, a complete recovery or a favorable improvement was noted. The problem was solved with a simple change! However, recently, many medium and large breed dogs that were not normally affected by the disease were diagnosed with DCM, yet, they did not present with a taurine deficiency.The majority of patients presented were symptom-free; however, some were presented with a cardiac insufficiency. These patients did not have any other cause of secondary DCM. This new concern arose with the popularity of unconventional diets on the market. Here is what we currently know about DCM.

Important points regarding the problem

A large number of dogs in the United-States and Canada are presently affected by DCM.We currently see 2 to 4 cases weekly in our practice (E-Vet Mobile cardiology services).
Clinical signs vary: from a new low-grade systolic heart murmur to cardiac insufficiency.
An individual predisposition seems to be present, because not all patients are affected equally. Even within family members, some dogs are more affected than others.
The period in which the food has been consumed does not necessarily correlate with the severity of the disease. Unlike primary DCM, young patients may be affected.
While large and medium breed dogs represent the majority of cases, small breeds and cats have also been presented with DCM.
Dog breeds predisposed to primary DCM canalso be affected.
Although the term grain-free is frequently used, the problem also occurs with exoticingredients and boutique diets.
The exact cause of the dysfunction is still not determined. Many ingredients such as lentils, chick peas, beans, kangaroo, venison, and many other ingredients are held accountable. An unbalanced nutrition, an inadequate proportion of ingredients, an impact of the ingredients on the absorption of taurine and the inclusion of undesirable ingredients are also part of the investigation.
Very few cases have been reported with animals on a hypoallergenic diet or on a grain free veterinary diet.
Other than Golden Retrievers, no taurine deficiencies have been noted in any of these affected patients. The current recommendations are to evaluate the taurine levels of Golden Retrievers and possibly Cocker Spaniels.

A well informed pet owner has all the tools necessary to make an informed decision concerning their pet ! It is crucial to unravel the myths concerning pet food.

A dog is not a human; they cannot have the same diet as we do.
An exotic ingredient is not more natural.
A diet is not a type of car; a higher price does not signify a higher quality.
Grains are not responsible for allergies in dogs. They are actually used for their great source of protein, essential vitamins and minerals.
A high quality diet cannot be evaluated by their first ingredient. A diet’s composition is complex to evaluate and is based on many different aspects, such as the proportions of each ingredient, the effect of these ingredients towards each other, etc. An extensive evaluation and a quality control are of utmost importance when formulating healthy nutrition. Diet changes in combination with treatments for the cardiac condition shows improvement of cardiac function in many patients and in some cases; the medication can be stopped completely. This improvement has a tendency to be longer than other nutritional causes. Long-term effects are still unknown and we do not know if a point of no return could be present.

Current recommendations for patients on these diets are a cardiac auscultation and evaluation. A cardiac ultrasound is recommended, even if a diet change was performed to determine if cardiac medication is required. The cardiac auscultation with dogs affected by DCM can be perplexing, because the disease often causes low-grade heart murmurs that can sometimes be inaudible.

When changing diets, raw diets, vegetarian diets, vegan diets, grain-free diets or other commercial or boutique diets are not recommended.

Adding grains or taurine to a suspect diet is neither sufficient nor recommended.

A veterinary diet or a diet from a well- established company with a high level of expertise in nutrition, having been subjected to many quality tests and being approved by the WSAVA is recommended.

A patient history is of utmost importance and should be evaluated for each patient.

Food companies under observation:

Acana
Taste of the wild
Orijen
Fromm
Blue Buffalo
Nature’s Domain
Earthborn Holistic
Merrick
California Natural
Natural Balance
Nature’s Variety
NutriSource
Rachael Ray Nurish
4Health

For diet recommendations, we suggest this reference: www.vetmed.tufts.edu/heartsmart/

Dilated Cardiomyopathy in the dog

E-VET MOBILE INFOLETTER

Original article by:
Dr Catherine Bélanger, DMV, DACVIM and Dr Jean-Sébastien Boileau, DMV, DACVIM

Interesting links: www.fda.gov, www.vetnutrition.tufts.edu

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