# Mild Heart Disease and Taurine Deficiency related to grain-free diet?



## TheBigRoo (Dec 3, 2011)

So my spoo Samson is now 10 years old. We recently had him at the vet and they picked up on a mild heart murmur. A subsequent X-ray revealed that although his heart is within the normal size range, it's on the higher end of normal, which could be a sign of heart disease. He's a very happy boy and still has a lot of energy, but the thought of him going into possible heart failure scares the living daylights out of me. I only recently read about some of the possible connections between grain-free dog foods and DCM, but it's enough to make me want to switch to a grain-inclusive diet for all three of our spoos.

The vet's first question was whether we had Samson on a grain-free diet, which we do and are now planning to change. Currently, we have all of our spoos on Taste of the Wild grain-free lamb formula, but we also cook fresh sweet potatoes, which they get at dinner along with greek yogurt. At breakfast, we also mix the Freshpet Vital Chicken, Beef, Salmon, and Egg recipe into this kibble. Furthermore, we also give them freshly-cooked real atlantic salmon at dinner once or twice a week when we visit Costco, which they love. While the vet said there is nothing wrong with feeding them any of this other stuff, she recommended we switch to a grain-inclusive diet. She's also prescribing Pimobendan for Samson to help regulate blood pumping from his heart.The vet also said that it's possible to see a significant improvement in heart function following a change in diet and taking this medicine.

Our vet recommended three brands of grain-inclusive dry kibble: Purina Pro, Hills Science, and/or Royal Canin. But honestly, I'm a little confused now because of all the brands and could really use some advice. My concern is the taurine deficiency, which Taste of the Wild actually has listed as an ingredient, oddly enough, even though the formula is grain-free. I know that taurine comes from tough meats, but I could not find it listed among any of the ingredients in Purina Pro. Royal Canin does include it about halfway down its ingredients list, but its first ingredients are also "meals", which don't thrill me as I prefer to see real protein ingredients like beef, lamb, and/or chicken and not byproduct meal listed first. Royal Canin also costs a fortune compared to some of the other brands, and I'm a little weary of trying a breed-specific formula, which Royal Canin makes. I've also seen some other brands that feature taurine for heart health, but it's like trying to find a rare diamond in a coal mine to determine what's best.

Finally, the vet recommended also adding cooked chicken thighs to our dogs' diets, since thigh meat is rich in taurine. I now understand that potato and legume-based formulas (even if they have real proteins) can still lead to a taurine deficiency.

So I guess my main question to the forum is because we have to now balance grain-inclusive with a consideration of a taurine deficiency, should we simply pick one of the grain-inclusive formulas recommended to us and just add natural sources of taurine to the food? Would that be the most direct way to get more taurine into Sammy's diet? I know that Purina Pro Plan has a pretty good reputation and our vet practice is one of the oldest in San Francisco with a good reputation as well. The Purina just doesn't have taurine listed as an ingredient. I know that some dog food brands provide synthetic forms of it, but obviously even the taurine content in Taste of the Wild wasn't enough to prevent Samson from showing possible signs of heart disease.

Any recommendations?


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## PeggyTheParti (Sep 5, 2019)

The greatest common denominator was not grain-free, but rather:

_"[Contain] 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)."_









Third FDA Status Report on Potential Link Between Diet & Canine DCM


The FDA Center for Veterinary Medicine’s third status report on the investigation into reports of dilated cardiomyopathy (DCM) in dogs eating certain pet food.




www.fda.gov





That's why I chose Farmina for Peggy:









FARMINA N&D Ancestral Grain Chicken & Pomegranate Medium & Maxi Adult Dry Dog Food, 26.5-lb bag - Chewy.com


Buy Farmina N&D Ancestral Grain Chicken & Pomegranate Medium & Maxi Adult Dry Dog Food, 26.5-lb bag at Chewy.com. FREE shipping and the BEST customer service!




www.chewy.com


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## TheBigRoo (Dec 3, 2011)

Thank you for replying so quickly! Yes, Farmina was one of the other brands I looked up. It has a lot of powerful ingredients in it and I've been looking at the lamb and blueberry formula...


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## Liz (Oct 2, 2010)

My vet knows the authors of the study and there are some major issues, one of which was raised by PTP above. For example, the study was funded by Purina, and the authors excluded dogs that developed DCM who were fed Purina. They also didn't control for breeds that have a high incidence of DCM. The study got a lot of headlines but the results have not been duplicated. My point is simply not to jump to any conclusions based on this particular study. I wouldn't rush to blame TOTW.

That said, I have no issues with grain-inclusive diets. Farmina looks great and many top brands have grain inclusive lines. My own dogs get raw, but they also get pork buns and PB&J, so we're hardly 100% grain free, lol.


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## TheBigRoo (Dec 3, 2011)

Liz said:


> My vet knows the authors of the study and there are some major issues, one of which was raised by PTP above. For example, the study was funded by Purina, and the authors excluded dogs that developed DCM who were fed Purina. They also didn't control for breeds that have a high incidence of DCM. The study got a lot of headlines but the results have not been duplicated. My point is simply not to jump to any conclusions based on this particular study. I wouldn't rush to blame TOTW.
> 
> That said, I have no issues with grain-inclusive diets. Farmina looks great and many top brands have grain inclusive lines. My own dogs get raw, but they also get pork buns and PB&J, so we're hardly 100% grain free, lol.


Thanks Liz. Yes, I'm in no way trying to assume that TOTW is responsible, so I apologize if that's how it came across. In fact, our spoos really like TOTW and it has a good reputation. I've honestly had few problems with it. Sammy is also 10 years old, so some of these things are bound to happen anyway given his age, which I understand. I was simply stating that the study itself was a little concerning and that if it helps to switch to a grain-inclusive diet, so be it. TOTW has an ancient grain line that might be worth a shot too.


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## Liz (Oct 2, 2010)

Mia is 10 years old, too. Time goes fast, doesn't it? Being a poodle, she's still a bundle of energy, but she's the only puppy I know with arthritis.


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## Rose n Poos (Sep 22, 2017)

Not knowing what you've run across in your research, I'm going to copy an article with the link to the original source and then a few other links.


Source:Study: Grain-Free Diet for Dogs Leads to Canine Heart Disease
University of California, Davis, veterinarians led a team that has found a link between some popular grain-free, legume-rich dog diets and a type of nutritional deficiency and canine heart disease known as taurine-deficient dilated cardiomyopathy. The study was recently published (Taurine deficiency and dilated cardiomyopathy in golden retrievers fed commercial diets) in the journal _PLOS ONE_.

Researchers found dogs eating some of these “boutique” diets are not making or maintaining enough taurine, an amino acid important for heart health. Taurine deficiency has been known for many years to lead to dilated cardiomyopathy, or DCM, a heart muscle disorder that can lead to congestive heart failure and death.

“I was surprised by how similar the diets being fed to the affected dogs were,” says lead author Joshua Stern, a veterinary cardiologist and geneticist at the UC Davis School of Veterinary Medicine. “I was shocked to see so many cases with this condition in such a short period of time.”

Stern says the research was prompted by the surge in cases at UC Davis. “This is a condition that was previously rarely seen in our busy clinic,” he says. “What we would really like to do is spread awareness of this issue. We have seen a great number of affected animals. Given that this is a reversible form of this devastating disease, we really want to ensure that veterinarians can recognize the risk and treat it expediently when needed.”

Stern says choosing “a well-researched dog food that has a healthy nutrient profile backed by expert formulation and research is of paramount importance.”

*The Culprit: “Boutique” Pet Foods*

Pet foods containing peas, lentils, other legume seeds, or potatoes as main ingredients, are what’s being linked to DCM, which leads to reduced heart pumping function and increased heart size. The alterations in heart function and structure can result in severe consequences such as congestive heart failure or sudden cardiac death. While the most common cause of DCM is genetic, on rare occasions other factors can also result in the condition, particularly in breeds that are not frequently affected.

Stern says the disease is now showing up unexpectedly in other breeds, such as the golden retriever. The common link unifying these cases is their diets. He began noticing the trend two years ago — while treating many dogs with nutritionally mediated DCM he realized that they were all eating similar diets. Last year, the U.S. Food and Drug Administration issued an alert to pet owners and veterinarians about the potential association between the diets, which have become quite trendy, and DCM. The FDA continues to research this issue in an effort to help identify the exact dietary factor causing the problem.

*Study Looked at Golden Retrievers*

Stern’s research involved 24 golden retrievers with dilated cardiomyopathy and a documented taurine deficiency. Twenty-three of the 24 dogs diagnosed with DCM had also been fed diets that were either grain-free, legume-rich or a combination.

“The study was a clinical study looking at affected dogs and their response to therapy,” explains Stern. “The published study included 24 golden retrievers, which represents the largest collection of taurine-deficient DCM cases in the literature.”

Stern prescribed the dogs a diet change and added a taurine supplement to their diet. All but one dog showed improvement. Nine of 11 dogs in this group — including Suva pictured above — had the most advanced stage of the disease, congestive heart failure. These dogs also showed dramatic improvements or no longer had congestion, says Stern.

*Recommendations to Give Clients*

Stern said veterinarians should educate clients about their dogs’ diet. He also cautions that dogs can develop DCM from nutritional origins and not be taurine-deficient. Taurine supplements can also mask the problem and lead to a delay of an important diagnosis.

But when the problem is related to taurine deficiency, says Stern, it may not be that the diet is “grain-free” or “legume-heavy” but that ingredients are interacting to reduce availability of taurine or that other nutrients are missing or interacting in the formulation.

For example, while a lot of pet owners may not want to see “byproducts” in their dog’s food, often the byproducts contain organ meat like heart and kidney, which are good sources of taurine.

For more information on selecting foods for your pet, Stern recommends that clients consider using the recommendations set by the World Small Animal Veterinary Association for selecting a healthy dog food.

Stern says the UC Davis clinic continues to treat patients with DCM. “Since the study, we have collected many many more cases and we continue to diagnose and treat these patients today.”

Co-authors of the study include Andrea Fascetti and Jennifer Larsen, veterinary nutritionists with the UC Davis School of Veterinary Medicine, and Joanna Kaplan, a veterinary cardiology resident in the UC Davis Veterinary Medical Teaching Hospital.



These are reports that the FDA gathered and then used to create their reports:


https://www.fda.gov/media/128303/download





I can't speak to the "politics" of this publication, but the information presented seems pretty even handed.








Update on grain-free diets and DCM cases in dogs - Whole Dog Journal


Whole Dog Journal‘s mission is to provide dog guardians with in-depth information on dog food, training, behavior, health, and more.




www.whole-dog-journal.com





About ingredient lists:








Why you shouldn’t judge a pet food by its ingredient list


Although ingredient lists are commonly used by pet owners and most pet food rating sites to determine the quality of pet foods, this approach has many pitfalls and usually is not a good way to select a food.




vetnutrition.tufts.edu





It's Not Just Grain Free








It’s Not Just Grain-Free: An Update on Diet-Associated Dilated Cardiomyopathy


Dr. Freeman provides an update on diet-associated dilated cardiomyopathy in dogs




vetnutrition.tufts.edu





Questions You Should Be Asking








Questions You Should Be Asking About Your Pet’s Food


How can you tell about the quality and nutritional expertise of a pet food company? Here are some questions savvy owners should ask companies to select the best possible food for their pets.




vetnutrition.tufts.edu





Selecting The Best Food - World Small Animal Veterinary Association


https://wsava.org/wp-content/uploads/2020/01/Selecting-the-Best-Food-for-your-Pet.pdf



AAFCO - Association of American Feed Control Officials





The Role of AAFCO in Pet Food Regulation







talkspetfood.aafco.org





All the above said, there seems to be a connection between grain free and taurine deficient DCM, with some cases being reversed by adding taurine back into the diet. By-products and meal don't sound nutritious but may actually be a better source of some nutrients. Legumes and even certain protein sources are being looked at for their possible connection to this health issue.

My girl Noel was diagnosed with a mild heart murmur at 12 or 13 which slowly progressed to full CHF, which progressed until she went into acute decompensation and we had to let her go, 3 months before her 16th birthday. She was not on grain free food. I don't know if she was taurine deficient.

Not intentionally, I'd had my boys mostly on grain free kibble but have always topped with whatever protein our dinner included as well as sides and veggies appropriate to dogs. To be safe, I've switched to grain inclusive.

At that time, pimobendin wasn't prescribed til CHF had developed. It's now being given much earlier in the course of the condition, with good effect.

It sounds like you're doing the right things for Samson. You're not going to find taurine listed as an ingredient in any food unless it's added as a synthetic. Taurine is found naturally within the meat sources.

I'm throwing a lot of information at you thru these links but it sounds like your vet is keeping up with current studies.


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## Michigan Gal (Jun 4, 2019)

My dog developed a heart murmur in his old age. I'm sure he had plenty of taurine because he had chicken thighs every day. I think your vet may be relying too much on the connection with taurine. If your dog is otherwise healthy I think I would stay with the TOTW and add RAW chicken thigh as a topper. Bone in.


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## Michigan Gal (Jun 4, 2019)

I should also add that he may need vitamin C. Kibble does not have C because it has a short life. You can get Thompson's buffered C to his food. Dogs seem to like it.


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## TheBigRoo (Dec 3, 2011)

Rose n Poos said:


> Not knowing what you've run across in your research, I'm going to copy an article with the link to the original source and then a few other links.
> 
> 
> Source:Study: Grain-Free Diet for Dogs Leads to Canine Heart Disease
> ...


Thank you for all this information, Rose! There is definitely a lot here, but it's all relevant. Interesting that I always though by-product meal wasn't the healthiest thing for canine diets when listed among a brand's first ingredients, but perhaps that's a mistake. We've had our spoos on TOTW (Taste of the Wild) and oddly enough, Taurine is listed as an ingredient, though I imagine it has been synthetically added. While the first ingredient in the TOTW Sierra Mountain blend is lamb, the grain-free variety does have sweet potatoes, peas, and lentils, which have been linked to a potential taurine deficiency based on those studies. I'm hoping that switching to a grain-inclusive diet combined with pimobendan will be a help. I will definitely review all these links, though, so thank you again!

@Michigan Gal: Thanks. My vet did mention adding chicken thighs as a topper, but she didn't recommend adding it raw with bone in; however. I know that cooking the thighs can remove some of the nutritional value, but I worry about them choking on the bones. One of our breeders used to recommend giving puppies raw chicken wings, and our female Zoey did eat several of these as a puppy, but once the breeder told us that one of her litter mates aspirated on one, we hesitated to feed raw. Then again, puppies mouths are smaller. I'll definitely consider adding some vitamin C to their diets as well.


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## Rose n Poos (Sep 22, 2017)

I'm going to link to another thread which is more about choosing a food, and, as usual for me, there's a bunch more links. You can skip to the ones with info about information in the ingredient lists.
I'll drop you in part way thru but feel free to look thru the entire thread.









Royal canine puppy poodle food


I will welcome our newest babyboy, a toy poodle, this sunday. He is currently being fed a royal canine kibbles and from doing severe research, it seems like id have to continue feeding him the same food and slowly move away and introduce new food. question!!!! What is good to feed our toy...




www.poodleforum.com


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## For Want of Poodle (Feb 25, 2019)

Liz said:


> My vet knows the authors of the study and there are some major issues, one of which was raised by PTP above. For example, the study was funded by Purina, and the authors excluded dogs that developed DCM who were fed Purina. They also didn't control for breeds that have a high incidence of DCM. The study got a lot of headlines but the results have not been duplicated. My point is simply not to jump to any conclusions based on this particular study. I wouldn't rush to blame TOTW.
> 
> That said, I have no issues with grain-inclusive diets. Farmina looks great and many top brands have grain inclusive lines. My own dogs get raw, but they also get pork buns and PB&J, so we're hardly 100% grain free, lol.


Liz - I knew about the lack of control issues, do you have source for the Purina link??? Wouldn't surprise me, Purina was losing a lot of market share to the newer brands, but would love to see a source for that.


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## Liz (Oct 2, 2010)

I learned all of this through a conversation with my vet during Mia's annual, so I don't have a written source.


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