Learn more about DCM in the September 2018 issue: “DCM in Dogs: Taurine’s Role in the Canine Diet“

A warning from the FDA about a recently reported spike in the number of dogs developing dilated cardiomyopathy (DCM) (linked here again) and a possible connection between DCM and the inclusion of peas, lentils, legumes, and potatoes in the diets of a majority (not all) of the dogs means we are going to be talking about diet a lot for a while.

I read the comments on both my blog from last week and Whole Dog Journal‘s Facebook page (where a link to the blog is posted), and I have also been reading messages and emails sent directly to me, and one thing jumps out: So many people have been feeding grain-free diets with absolutely no reason or justification for their decision. Some people have gone so far as to accuse WDJ of promoting these grain-free dog food diets over diets that contain grain – oh, no you don’t! That is just flat untrue.

The Popularity (Overpopularity?) of Grain-Free Dog Food

When the first few grain-free dry foods began appearing on the market about 10 years ago, we were happy to see products that could be fed to dogs who were allergic to or intolerant of grains. Mind you, these dogs are in the minority. Nevertheless, the fact that some commercial grain-free dog foods were available meant that more people who suspected that their dogs might have an allergy to or intolerance of some grain or another could try one of these foods and see for themselves: Did their dogs improve? Get worse? Or did it make no difference whatsoever? The commercial availability meant they could do a feeding trial that didn’t take a lot of time to research or money (for a home-prepared diet trial).

Lots of people tried grain-free foods and some of them noticed that their dogs’ allergy symptoms or digestive problems went away. When you have been dealing with a chronically itchy dog, or one with persistent diarrhea or gas, and these symptoms cease – well, it’s almost like a religious conversion. These folks often go out and preach.

Between the feeding success of these foods in some dogs, the enthusiasm of the owners of the success-story dogs, and the relentless hype coming from the “bones and raw food” / “biologically appropriate raw food” / “evolutionary diet” people (many of whom have strong anti-grain sentiments), grain-free just took off. I complained in a blog post over a year ago that it has gotten to the point where I was having a difficult time finding a food that did contain grain in pet specialty stores.

It came home again about a month ago, when three different people who were adopting the puppies that I had been fostering for my local shelter each asked about food recommendations and each said, “Should I get a grain-free food?” In each case, I asked them, “Why do you ask?” And not one person had a real answer. “I heard grain-free was better!” seemed to be the consensus. (My answer to that: It’s better for dogs who have problems with grain!)

If pressed about my misgivings about grain-free dry dog foods for any or all dogs, I say this: There is a far shorter history of dogs eating the carbohydrates that are being used in these diets than there was of dogs eating grains. I don’t like putting my dogs on the front wave of anything, whether it is the latest/greatest heartworm prevention medication (when ivermectin works just fine, and has been for decades), or flea treatments, or diets. I tend to want to hold back and see whether an inordinate number of adverse experiences are reported as these things hit the market.

Dogs Need Balance Over Time in Their Diets

But, perhaps more importantly, feeding ANY type of food every day, all year, for years and years, goes against my longest-standing food recommendation. We have always encouraged owners to switch foods frequently – at least several times a year – and switch manufacturers, too. Many food makers use the same vitamin/mineral premix in all their products, making us worry that any nutrient excess, deficiency, or imbalance would become essentially entrenched in the body of a dog fed an exclusive diet of that company’s foods.

Home-prepared diet advocates talk about “balance over time.” The concept is this: If you change the ingredients and recipe of your dog’s diet – exactly as most of us feed ourselves and our human families – as long as you include everything that a dog needs over the span of any, say, week’s worth of meals, the dog will be fine. In other words, every single meal doesn’t have to be “complete and balanced” – you can accomplish this over the course of several meals.

I look at the feeding of commercial diets the same way; I think you can similarly achieve balance over time by feeding different commercial products from different manufacturers, and, in this way, hedge your dog’s nutritional bets, rather than going “all in” on any one manufacturer or set of ingredients.

Whole Dog Journal‘s General Dog Food Recommendations

When I am asked to make diet recommendations, these are the things I say:

1. Feed a variety of products, rotating both among and between several manufacturers of products, for nutritional balance over time, and to avoid problems caused by long-term exposure to any formulation problems or nutritional imbalances/excesses/inadequacies in your dog’s diet.

2. Feed the best food you can afford and that your dog does well on. This doesn’t mean spend the most that’s possible; if your dog does great on mid-range foods, great! But super cheap food should be avoided. The difference in the ingredients of cheap foods versus mid-range foods is staggering.

3. DO READ ingredient labels. You should recognize most of the foods in the food; if things are weird, and only sound sort of food-like, they are likely highly processed food fractions. You don’t want to see a lot of those. If the front of the label says the food is “chicken and rice” you had better see chicken and rice high up on the ingredient label, not buried four ingredients back below chicken by-product meal, corn, wheat, and pea protein.

4.  Feed grain-free foods only for good reason (dog intolerant of/allergic to multiple grains). Feed limited-ingredient foods only for good reason (dog intolerant of/allergic to multiple ingredients). Feed exotic protein sources only for good reason (as a part of a formal food allergy trial, or to a dog intolerant of/allergic to multiple “common” protein sources).

5. Above all: Trust. Your. Dog! If it works for him, it’s okay. If it doesn’t work for him, change!

Learn more about DCM in the September 2018 issue: “DCM in Dogs: Taurine’s Role in the Canine Diet“

Note: read our update on the FDA’s latest report from July 2019 here.

I’ve been getting calls, emails, social media messages, and countless forwarded articles from other websites and publications about the grain-free dog food warning – perhaps even from you! And the first thing I want to tell you is to take a breath!

The FDA issued a warning (linked here) that it is investigating a possible link between diet and dilated cardiomyopathy (DCM) in dogs.

The grain-free dog food warning spread like wildfire through social media channels, but unfortunately, it also rapidly got dumbed down to a ridiculous level; it quickly evolved into something like “grain-free foods cause canine heart disease,” or worse yet, “boutique foods might kill your dog. The FDA characterizes the issue as a “potential association” between diets with very specific attributes (and certainly not ALL grain-free diets) and canine DCM – not a cause.

Please note that the FDA’s headline did not say anything about “grain-free diets” causing heart problems – though almost all the blog posts and articles in other publications have been saying exactly that. If you read the FDA’s statement, you will see that they said there may be a link between some grain-free diets and canine DCM, but there are also many other things going on that may be responsible for an observed rise in cases of canine DCM.

Linda Case, long-time animal nutrition expert and author of Dog Food Logic, has written an in-depth article for WDJ’s September issue that goes into lots of detail about what is known about the dietary causes of DCM, including several issues regarding taurine and the amino acids (cysteine and methionine) that dogs use to produce taurine. Click here to read her article about the connections between diet and DCM in dogs. Hint: It’s not as simple as the possibility that the diets are lacking the amino acid precursors to taurine.

[Whole Dog Journal has covered taurine deficiency in the past, regarding vegetarian diets for dogs, low-fat dog foods, and canine congestive heart failure.]

But for now, hopefully to put your mind at ease, I’m going to briefly discuss some of the pertinent facts that make the story a little more complicated than the “grain-free diets cause heart disease” headlines.

What We Know About Dilated Cardiomyopathy in Dogs

The FDA received a report from Cardiac Care for Pets, a practice that employs 19 veterinary cardiologists in Maryland, Kentucky, Virginia, and Texas, that they had seen a spike in canine DCM cases – and not just in the breeds that have a genetic predisposition to developing DCM, but also in breeds that are not known for an inherited propensity for the condition. Their report also included the fact that all of the cases had something in common: all the dogs had been eating diets heavy in peas, lentils, chickpeas, and potatoes.

Other veterinary cardiologists were noticing the same thing. The FDA received reports recently of about two dozen additional cases, including three dogs that died of the condition. After reviewing the medical records of these dogs, the FDA felt it was prudent to issue a measured warning, in part to alert dog owners and veterinarians to be aware of signs of the condition in potentially affected dogs (which, it is hoped, will elicit more data). Its warning, specifically, stated that vets and dog owners should be alert for signs of DCM in dogs eating foods “containing peas, lentils, other legume seeds, or potatoes as main ingredients.”

That’s our emphasis, but it is repeated in the FDA’s warning:

“Diets in cases reported to the FDA frequently list potatoes or multiple legumes [our emphasis again] such as peas, lentils, other ‘pulses’ (seeds of legumes), and their protein, starch, and fiber derivatives early in the ingredient list, indicating that they are main ingredients.” [Again, our emphasis.]

What is a “main ingredient”? There isn’t a legal definition, but in our book, it’s anything in about the first five ingredients on the list. As you probably know, food ingredients are listed on labels (by law) in order of their weight in the formula before the food is cooked. The first four to six ingredients generally represent the majority of what is in the food.

That said, the FDA’s warning also addressed “multiple legumes.” Our readers should be alert to the fact that food manufacturers sometimes list smaller amounts of several similar ingredients, or several constituent parts or “fractions” of the same ingredient. This not only visually minimizes the seeming presence of those ingredients in the food, but also makes the total of the ingredients ahead of these fractions seem to be present in more significant amounts than they actually are.

For example, it would appear that a food that lists its ingredients as “Chicken, peas, pea protein, pea fiber…” contains more chicken than any other single ingredient. But if you added up the total amount of pea-based ingredients, they would surely outweigh the chicken.  This is what the FDA is getting to with its warning about “multiple legumes” – foods in which the legumes, taken together, might outweigh the animal protein sources.

If You Feel Your Dog’s Food is Connected to DCM:

Based on the FDA’s report, here are our first take-away points:

• No matter what your dog eats, if she has any signs of DCM – including decreased energy, cough, difficulty breathing, and episodes of collapse – you should make an appointment to see your veterinarian ASAP, preferably one who can refer you to a veterinary cardiologist.

• If you feed your dog a food that contains any potatoes, peas, lentils, or other seeds of legumes (such as chickpeas/garbanzo beans, soybeans, other types of beans, and alfalfa seeds), look at the ingredients list. If the food contains one or more of these ingredients high up on the ingredients list, has several of these ingredients, and/or is a limited-ingredient diet – typically, one containing only one animal protein source and one or two carbohydrate sources – the possibility is good that the food is one of the type that is being looked at as possibly causing a higher incidence of DCM.
• In contrast, foods that are not limited-ingredient foods and contain just one of those ingredients, or that have one or two of these ingredients fairly low on the ingredients list (say, as the fifth or sixth or lower-level ingredient/s on the list), are not the kind of diet that has been connected with DCM.
• If you feed your dog a diet that meets the description of the foods that have been described by the FDA as potentially problematic (foods that have potatoes, peas, lentils, or other seeds of legumes as main ingredients), consider these points:

– Are you feeding your dog this food because it’s the only diet you have been able to find that does not trigger other health problems in that dog? If so, continue feeding the diet, but carefully monitor your dog for any hint of signs of DCM. Also, discuss possible alternative diets and/or a blood test for taurine levels, with your veterinarian.
– Are you feeding your dog this food because you like the company, or it was recommended to you, or for no particular reason? Then consider switching to a diet that either contains fewer or none of these ingredients, and read on for more recommendations.

Not All Grain-Free Foods Are Under Suspicion

Within a matter of days of the FDA’s press release, we watched in dismay as the issue was reduced to, in the majority of cases, “grain-free diets cause heart canine heart disease. ”

Please understand that there are grain-free diets that do not contain potatoes, peas, lentils, or other seeds of legumes as main ingredients. For example, there are many raw diets, fresh-cooked/frozen diets, canned diets, and even some dry/kibble diets that are grain-free that do not contain potatoes, peas, lentils or other seeds of legumes.  Not all grain-free diets have been implicated as concerning as regards canine DCM.

But, as we have been saying for some time (most recently here), grain-free diets have gotten inordinately popular for no particular reason. Many dog owners buy these products because they have heard some vague argument that “grains are bad for dogs” – an ill-informed blanket generalization we have fought against for ages. There is no particular advantage – and actually, several disadvantages – to feeding a grain-free diet (of any kind) to a dog who doesn’t have any problems with eating and digesting grain.

Points to Consider About Grain-Free Dog Food

• Grain-free diets are often far higher in fat and calories than many dogs require. In dogs who gain weight easily, there is a very real danger of having to reduce the amount of food that one feeds the dog so much (in order to keep him from gaining too much weight), that he is at risk to become malnourished. In other words, if you cut his portion of a super-high-calorie diet to a reasonable number of calories, he may not get enough of the vitamins and minerals he needs.
• Commercial diets that contain grains have been around longer and have been more thoroughly tested (in clinical settings and through common use) for far longer than diets that use increasingly novel non-grain sources of carbohydrates.
• As Linda Case explains further in her article in the September 2018 issue, certain types of diets (specifically, diets that contain lamb meal and rice diets, soybean-based diets, diets high in rice bran or beet pulp, and high-fiber diets heavy in soybeans), have been previously identified as possible dietary causes of low taurine levels in dogs – something that is known to contribute to the development of DCM.

Our advice has long been to feed a grain-free diet only to dogs who have a problem with digesting multiple grains. (And, if you know which grain is giving your dog problems, you could also find a food that contains different grains, instead.)

However, we would not want to be on the record as saying “all grain-free foods are bad.” That’s another ridiculous overstatement. There are some terrific grain-free foods on the market – and some dogs do far better on these products than any grain-containing foods they have been fed. Owners have to look for products that work well for their individual dogs – and be willing to change as their dogs’ needs change.

Overreaching by Those With an Axe to Grind

It was bad enough to see the FDA’s warning reduced by a combination of poor reporting, poor reader comprehension, and social media hysteria to “grain-free foods cause canine heart disease.” But some media outlets also included statements from an animal nutrition expert whose opinions on diets are consistent with those of the pet food industry corporate giants; she has repeatedly been quoted as implicating “boutique” pet foods in the current rash of reported cases of DCM. What’s a boutique food? She doesn’t define this, but we suspect it’s anything made by any company whose annual sales are less than umpteen million…

This same expert has also implicated foods that contain “exotic ingredients,” which she provided a partial list for in one article: “kangaroo, lentils, duck, pea, fava bean, buffalo, tapioca, salmon, lamb, barley, bison, venison, and chickpeas.” Hmm.

All in all, we have lost track of the number of times she has been quoted as saying that pet owners should avoid “boutique, grain-free, or exotic ingredient diets” – and, unfortunately, this over-broad and ill-defined description is finding its way into more and more discussions of this concerning issue.

We have one more bone to pick with this expert; one of her articles on this topic suggests that dog owners do themselves a favor and “stop reading the ingredient list!” This makes us absolutely see red, as it harkens back to the “bad old days” of pet food. Twenty years ago, the making of pet food was a black box. “You guys, we are the experts here, trust us!” was the message of Big Pet Food. Consumers could no more find out where a food was made or where its ingredients were sourced than find out where the company CEOs ate breakfast. A suggestion that consumers shouldn’t worry their pretty little heads about what is actually in the food they buy for their dogs, and which is listed on the label by law for the protection of consumers and their dogs, is downright insulting.

We’d like to suggest that concerned owners keep reading labels and educating themselves about canine nutrition, and, for now, limit themselves to the facts that are currently known by the FDA about this spate of canine DCM cases (here is that link again!). Also, Linda Case’s excellent article in the September issue of WDJ will also help shed much-needed light on this complex and concerning issue.