This article first appeared on LinkedIn
dog·ma / ˈdôɡmə / noun - a principle or set of principles laid down by an authority as incontrovertibly true.
Nutritionally Mediated - Dilated Cardiomyopathy (NM-DCM) is a very real and scary condition. Dogs can exhibit no outward signs until they are in the late stages. Pet owners, understandably, assume everything is fine with their dog. They don't expose them to blood draws, radiographic imaging, electrocardiograms (EKG) and the like when they are symptom free. The FDA Announcement on Friday is what has prompted me to write this article. For the sake of our pets, action is required by pet food manufacturers, pet owners, veterinarians and the regulatory agencies.
WHAT IS DCM?
From PetMD.com, "Dilated cardiomyopathy (DCM) is a disease of the heart muscle that is characterized by an enlarged heart that does not function properly. With DCM, both the upper and lower chambers of the heart become enlarged, with one side being more severely affected than the other. When the ventricle, or lower chamber, becomes enlarged, its ability to pump blood out into the lungs and body deteriorates. When the heart’s ventricle does not pump enough blood into the lungs, fluid begins to accumulate in the lungs. An enlarged heart soon becomes overloaded, and this often leads to congestive heart failure (CHF)."
The slide to the left can be a little misleading on several fronts. The enormous spike from 2017 to 2018 is a direct response to the FDA's announcement in 2018 that they were looking into DCM after veterinarians at UC-Davis had reported a possible correlation between diet and the disease. Before that, there was no need for a pet owner to report DCM to the FDA. A second point that makes the chart misleading is that it only shows cases reported to the FDA, NOT cases in total! In general, the cases of DCM are most likely significantly understated. Many people will simply be told their beloved pet had "a bad heart". Those that pay for an autopsy most likely haven't reported it to the FDA. They have soldiered on, dealing with the pain of their loss.
HOW IS DIET RELATED TO DCM?
From the UC-Davis website, "Taurine is an amino acid that is not nutritionally essential for dogs and is not required to be in dog foods. However, there are dietary factors (such as protein source, fiber type and concentration, and cooking or processing methods) and individual dog characteristics (such as breed and calorie needs) that impact how efficiently taurine may be made by the body." By definition, Taurine is a non-essential amino acid. It is not "required" as it can be processed/synthesized by the body using sulfur amino acids (e.g. methionine and cysteine). The taurine, in conjunction with Vitamin C, Vitamin E and polyphenols allows the liver to synthesize bile salts and regulate the flow of calcium into and out of cells. It is also a precursor for the synthesis of complex skin lipids. It is a wonderful anti-oxidant and "fighter of free radicals"! The increased prevalence of DCM in dogs that are NOT genetically predisposed to the disease raised the question of diet. The prevailing thought is that something is happening with diets that is impeding the absorption and/or synthesis required for taurine. This could be anything from lower levels of precursor amino acids (methionine, cysteine and carnitine), to the high inclusion levels of grain-free ingredients (pulses and legumes) to the impact manufacturing processes may have on the aforementioned ingredients themselves (high levels of purified starches causing a Maillard reaction). It may be a combination of all three or something totally different!
WHAT ARE "B.E.G." DIETS?
The original concern was that so called "BEG Diets" were to blame because they weren't "properly researched" or WSAVA (World Small Animal Veterinary Association) "compliant". BEG is an acronym for Boutique (where the product is sold), Exotic (the protein source), Grain-Free (substituting peas, potatoes and other legumes and pulses for previously used grains). The chart to the right shows diets that were reported to the FDA that had 10 or more confirmed cases of DCM. You'll notice immediately that many of them are available at a lot of places and not "just" Boutique retailers. Now for the Grain-free portion! A quick search for Grain-Free diets on Chewy.com (under dog food) pulls up 4,890 results! Diets containing peas, potatoes and lentils returned 1790, 1765 and 261 results, respectively. That is a LOT of diets that are NOT showing up on the list so maybe it has something to do with more than just the ingredient.
The last part of the acronym is Exotic. While there are plenty of those ingredients on the chart, the "standard" proteins (chicken, turkey, beef) account for 217 of the reported cases. Lamb is known (through study and analysis) to have lower levels of the precursor amino acids. Maybe it is a numbers game. Hypothetically, 100k people could feed chicken and only 10k feed lamb so while the case numbers are close, the percentages are significantly different.
WHERE DOES DOGMA FIT IN?
Maybe it comes from the news ticker on the bottom of our TV screens or the old 140 character limit on Twitter. Regardless of when and where it started, we have become a society of snippets and soundbites. Using terms like BEG is misleading. Yes it makes a faster impression but it is inaccurate. The traditionally accepted WSAVA compliant companies accounted for 50 of the FDA reported DCM cases. There are hundreds of grain free diets that are not on the list and hundreds more that use the "suspect" ingredients without issue. We cannot allow one dogma to be replaced by another within the pet industry. At a time when consumer confidence is at an all time low in the industry, we need to speak in full, coherent sentences and understand the mechanics of what is at work here with DCM. For veterinarians, CONTINUE to be diligent, get the word out and please insist that owners report cases to the FDA. You are saving lives and preventing literal and figurative heartbreaks! For owners, DEMAND more from the manufacturers that take your money. Don't accept sugar coated, stock answers on how they are dealing with DCM! Ask for inclusion rates of suspect ingredients! Ask for their amino acid profiles. If they don't provide it, take your buying power elsewhere! MOST importantly, while causality hasn't been established, SOMETHING is happening. I know choosing a food for your dog is an emotional decision that carries lots of side baggage. Don't disregard the warnings. If your dog is thriving and has no issues on one of the brands named, FANTASTIC! It doesn't mean that DCM is a hoax, it just means the answer isn't as simple as we'd like it to be. For manufacturers, be forthcoming with your data, your processes and your concerns. Work with the FDA, veterinarians AND YOUR CUSTOMERS! They have literally put the health and well being of their beloved pets lives in your company's hands. Prove to them it isn't misplaced and that you are part of the solution. This means more than adding taurine for God's sake, especially when that has not been identified as the smoking gun. This isn't the first time I've addressed trust and transparency and sadly, it probably won't be the last.
I usually keep my company and industry writings separate but I feel compelled to "walk the talk". This is what needs to be shared by manufacturers. In an effort not to make this a "commercial," if you have any product questions, please go to Guardian Pet Food Company or email me directly. Feel free to post any other comments below!
GUARDIAN PET FOOD
If you follow the current dogma as spouted by "experts," they say to stay away from any brand that has "suspect" ingredients in the Top 10 (Chickpeas #5 and Sweet Potato #6), despite not knowing the inclusion rates (Chickpeas - 3.1%, Sweet Potato - 3.0%), the manufacturing process (freeze-dried not extrusion) or digestibility (93.1% vs industry average of 80%)! Be careful when following dogma and the masses, sometimes the "m" is silent!