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Grain-Free Diets Linked to Heart Disease

October 6, 2018

On July 12th the FDA issued an alert about reports of canine dilated cardiomyopathy (DCM) in dogs eating diets labelled as grain-free. The most problematic diets contained peas, lentils, and other legume seeds, potatoes or sweet potatoes as main ingredients.

What is dilated cardiomyopathy (DCM)?

DCM is a disease of a dog's heart muscle and results in an enlarged heart. As the heart and its chambers become dilated, it becomes harder for the heart to pump, and the heart valves may leak, leading to a buildup of fluids in the chest and abdomen. DCM often results in congestive heart failure. Heart function may improve in cases that are not linked to genetics with appropriate veterinary treatment and dietary modification, if caught early.(1)

How are diets causing DCM?

It is not yet completely understood how and why particular diets are causing canine DCM. Some of the dogs diagnosed with diet-related DCM had blood tests confirming low taurine levels. It has been known for some time that low levels of taurine are associated with a potentially reversible form of DCM. Taurine is an amino acid that dogs get naturally in their diets and that is made by the body. Taurine is not required to be in dog foods because dogs can usually make enough of it on their own. 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.(2)(4)

Which diets have been implicated?

A group of veterinary nutritionists and cardiologists has been formed to collect and evaluate cases of diet-related DCM. So far, they have discovered that many of the dogs that developed heart disease were being fed some variety of grain-free,(2) boutique (small manufacture), or exotic ingredient (non-traditional protein sources) diets. The diets frequently list potatoes or multiple legumes 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. High levels of legumes or potatoes appear to be more common in diets labeled as grain-free. Early reports from the veterinary cardiology community indicate that the dogs consistently ate these foods as their primary source of nutrition for time periods ranging from months to years.

What should you do if your dog has been eating one of the implicated diets?

The veterinary cardiologist and nutrition group has pieced together a few brief guidelines to help pet-owners navigate this complex issue:

  1. Reconsider your dog's diet. Consider making an appointment to talk to your veterinarian about the FDA announcement and what diet may be best for your dog. If you're feeding a grain-free, boutique, or exotic ingredient diet, consider changing your pet's food to a diet with more typical ingredients made by a company with a long track record of producing good quality diets. There is no proof that grain-free is better! The fact is that food allergies are uncommon, and meats contribute to more food allergies than grains. Grains are used in pet food as a nutritious source of protein, vitamins, and minerals.(3) Reputable companies that meet the AAFCO and WSAVA standards and have done long-term testing on their diets include Hills/Science Diet, Royal Canin, and Purina brand dog foods. To read more about choosing a diet for your pet see this article by Dr. Lisa M. Freeman at Tufts University: http://vetnutrition.tufts.edu/2016/12/questions-you-should-be-asking-about-your-pets-food/.
  2. Watch closely for signs of heart disease such as weakness, slowing down on walks, coughing, fainting or trouble breathing. Your veterinarian may also recognize early heart disease by hearing a heart murmur or abnormal heart rhythms. If you observe these things or your veterinarian is concerned, additional testing may be indicated such as heart ultrasound (echocardiogram), x-rays, electrocardiogram (EKG) or blood tests.

What to do if your dog is diagnosed with DCM

If your dog is diagnosed with DCM, particularly if eating a diet that meets the criteria listed above:

Additional Resources:

Questions you should be asking about your pet's food, Cummings Veterinary Medical Center at Tuft's University.
Freeman, L. M., DVM, PhD, DACVN. (2016, December 19).


  1. U.S. Food and Drug Administration. (2018, July 12). FDA Investigating Potential Connection Between Diet and Cases of Canine Heart Disease, U.S Department of Health and Human Services. Retrieved September 10, 2018 from https://www.fda.gov/animalveterinary/newsevents/cvmupdates/ucm613305.htm.
  2. Wood, T. (2018, July 19). UC Davis Investigates Link Between Dog Diets and Deadly Heart Disease, UC Davis Veterinary Medicine. Retrieved September 10, 2018 from https://www.vetmed.ucdavis.edu/news/uc-davis-investigates-link-between-dog-diets-and-deadly-heart-disease.
  3. Freeman, L. M., DVM, PhD, DACVN (2018, June 4). Risk of heart disease in boutique or rain-free diets, Cummings Veterinary Medical Center at Tuft?s University. http://vetnutrition.tufts.edu/2018/06/a-broken-heart-risk-of-heart-disease-in-boutique-or-grain-free-diets-and-exotic-ingredients/.
  4. Wood, T. (2018, July 23). Update from Nutritional Services on Concern Between Diets and DCM in Dogs, UC Davis Veterinary Medicine. Retrieved September 10, 2018 from https://www.vetmed.ucdavis.edu/news/update-nutrition-services-concern-between-diets-and-dcm-dogs.

Please don't hesitate to reach out if you have any further questions or concerns.

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