Dilated Cardiomyopathy and BEG Diets Update


We’ve discussed the suspected link between BEG (boutique, exotic-ingredient, and grain-free) diets and taurine deficiency induced dilated cardiomyopathy (DCM) here on our blog several times. The first update {https://biglickvet.com/taurine-deficiency-induced-dilated-cardiomyopathy-golden-retrievers-grain-free-diets/} we shared with you detailed the initial memo from veterinary cardiologists who were beginning to see an increase in cases of DCM in dogs fed grain-free diets. The second update {https://biglickvet.com/grain-free-diets-taurine-deficiency-induced-dilated-cardiomyopathy-update/} we shared detailed the FDA’s decision to open an investigation into the suspected link between certain diets and DCM. In July 2019, the FDA released the most comprehensive information we have on this topic to date, which is what we’d like to discuss with you today.

The Backstory

In July 2018, the FDA announced {https://www.fda.gov/animal-veterinary/cvm-updates/fda-investigating-potential-connection-between-diet-and-cases-canine-heart-disease} that it had begun investigating reports of dilated cardiomyopathy (DCM) in dogs eating certain pet foods, many labeled as “grain-free,” which contained a high proportion of peas, lentils, other legume seeds (pulses), and/or potatoes in various forms (whole, flour, protein, etc.) as main ingredients (listed within the first 10 ingredients in the ingredient list, before vitamins and minerals).

Many of these case reports included breeds of dogs not previously known to have a genetic predisposition to the disease. Although the FDA first received a few sporadic reports of DCM as early as 2014, the vast majority of the reports were submitted after the agency notified the public about the potential DCM/diet issue in July 2018.

By April 30, 2019 the FDA had received 515 reports of DCM in dogs but the FDA suspects that “cases are underreported because animals are typically treated symptomatically, and diagnostic testing and treatment can be complex and costly to owners.”

The Most Recent FDA Update

In July 2019, the FDA released an update {https://www.fda.gov/animal-veterinary/news-events/fda-investigation-potential-link-between-certain-diets-and-canine-dilated-cardiomyopathy} with the most comprehensive information we have on this topic to date. It included breakdowns of the dog food brands most frequently named in reported DCM cases, the breeds most frequently reported to the FDA, the formulations of the dog foods in DCM reports, and the ingredients/characteristics of reported diets.

Dog Food Brands

When examining the most commonly reported pet food brands named in DCM reports submitted to the FDA, it is important to note that the graph above is based on reports that included brand information and that some reports named multiple brands. Brands that were named ten or more times are featured above.

Dog Breeds

DCM is recognized as a genetic condition in dogs, typically in large or giant breeds, such as the Doberman Pinscher, Great Dane, or the Irish Wolfhound and genetic forms of DCM tend to affect male large and giant breed dogs beginning in middle to older age. However, the DCM cases reported to FDA have involved a wide range of dog breeds, sexes, ages and weights. Unlike genetic forms of DCM, many dogs’ conditions have greatly improved after diet changes.

Dog Food Formulation

The vast majority of reported cases have involved dogs fed dry dog food formulations, but raw food, semi-moist food, and wet foods were also represented.

Dog Food Ingredients/Characteristics

To better characterize diets reported in DCM cases, product labels were examined to determine whether the product was grain-free (did not contain corn, soy, wheat, rice, barley or other grains), and whether the products contained peas, other lentils including chickpeas and beans, or potatoes (including sweet potatoes).  Because so many products contained peas and/or lentils, a category was created for “peas and/or lentils”. More than 90 percent of products were “grain-free” and 93 percent of reported products had peas and/or lentils.  A far smaller proportion contained potatoes.

Animal protein sources in the reported diets varied widely, and many diets contained more than one protein source.  The most common proteins in the reported diets were chicken lamb and fish; however, some diets contain atypical protein sources such as kangaroo, bison or duck. No one animal protein source was predominant.

What Now?

We are advising our clients not to feed BEG diets {https://taurinedcm.org/wp-content/uploads/2018/10/vetnutrition.tufts_.edu-A-broken-heart-Risk-of-heart-disease-in-boutique-or-grain-free-diets-and-exotic-ingredients.pdf} at this time. Many pet owners began feeding grain-free diets due to a belief that grain-free foods are easier to digest and provide pets with better nutrition than foods containing grain, however this is a myth {https://taurinedcm.org/wp-content/uploads/2018/10/Myth-Grain-Free.pdf}.


If you are currently feeding your pet a grain-free diet, we recommend slowly transitioning {https://www.hillspet.com/content/dam/cp-sites/hills/hills-pet/en_us/exported/dog-care/nutrition-feeding/images/transitioning-foods_366_en.jpg} them to a diet that meets the World Small Animal Veterinary Association (WSAVA) Guidelines {https://www.wsava.org/WSAVA/media/Arpita-and-Emma-editorial/Selecting-the-Best-Food-for-your-Pet.pdf?fbclid=IwAR3poiQMEmnpecSIEJoclOfmT2APZk39DZub6u4Nu_xrOnz8sADyr8yhVRY} The FDA alert called attention to several dietary ingredients that should be considered when evaluating whether your pet is at risk (for example: legumes like peas and lentils and white or sweet potatoes). UC Davis, who first discovered this potential link, considers these ingredients to be of greatest concern when present within the first 5 listed ingredients on the dog food bag.


Additionally, it has been noted that a high percentage of diets used protein sources other than chicken or beef and were labeled as grain-free. We recommend choosing a food that does not have the ingredients of concern in the first 5 ingredients listed. Most importantly though, we recommend choosing a diet that meets the WSAVA Global Nutrition Guidelines {https://www.wsava.org/WSAVA/media/Arpita-and-Emma-editorial/Selecting-the-Best-Food-for-your-Pet.pdf?fbclid=IwAR3poiQMEmnpecSIEJoclOfmT2APZk39DZub6u4Nu_xrOnz8sADyr8yhVRY} published as consensus by veterinary nutritionists from around the world. They advise that pet food diets and the companies that produce them should meet certain requirements to be deemed safe and nutritionally appropriate.


At this time, we know that Royal Canin, Purina, Hills, and Eukanuba/Iams diets all meet the WSAVA Global Nutrition Assessment Guidelines {https://www.wsava.org/WSAVA/media/Arpita-and-Emma-editorial/Selecting-the-Best-Food-for-your-Pet.pdf?fbclid=IwAR3poiQMEmnpecSIEJoclOfmT2APZk39DZub6u4Nu_xrOnz8sADyr8yhVRY}. These brands all have Board Certified Veterinary Nutritionists on staff as well as PhD Animal Scientists and PhD Nutritionists that work throughout various levels of the companies.

As pet owners, we know you only want to do and feed what is best for your pet and we would be happy to discuss transitioning your pet to one of the diets that meet WSAVA Guidelines. Please call our office at 540-776-0700 to discuss your pet’s diet.