DCM Research List

Dilated cardiomyopathy (DCM) is a disease of the heart that has historically affected predisposed breeds (like the Doberman and Great Dane) as well as, occasionally, larger breed dogs. In 2018, the FDA announced an investigation into DCM occurring in unusual breeds, many of them fed similar diets. Since then, thirteen different peer-reviewed research endeavors have suggested a link between diet and atypical, reversible DCM or early cardiac changes.

The current bottom line: Grain free diets, diets high in legumes or peas, and diets containing exotic ingredients are disproportionately associated with unexplained, atypical, and reversible DCM across dogs of numerous breeds, ages, sizes, and geographical locations and we do not know why. Dogs may begin to experience subclinical cardiac changes or damage at a low level as early as 30 days after starting these diets. Evidence continues to suggest that diet is the most likely inciting cause.

Until we know more, pet owners should consider avoiding grain-free or legume-rich diets, and if possible, stick to brands that are going above and beyond with formulation and manufacturing processes.

Research Showing Link Between Diet & DCM:

“Effects of a 28-day feeding trial of grain-containing versus pulse-based diets on cardiac function, taurine levels and digestibility in domestic dogs” Quilliam C, Reis LG, Ren Y, Ai Y, Weber LP., PLoS One. 2023 May 25

https://doi.org/10.1371/journal.pone.0285381

Key takeaway: Beagles fed high-pea, high-amylose diets developed DCM-like changes on echocardiogram after only 28 days of feeding. These changes were not observed in the control-diet, rice-diet, or lentil-diet groups.

Funding: Alberta Pulse Growers, Manitoba Pulse and Soybean Growers, Ontario Bean Growers, Saskatchewan Pulse Growers, Pulse Canada, Natural Sciences and Engineering Research Council (NSERC), Alliance Grain Traders (Saskatoon, SK Canada), Horizon Pet Foods (Rosthern, SK Canada) and Dr. Tom Warkentin (University of Saskatchewan, SK).

"Metabolomic profiling in dogs with dilated cardiomyopathy eating non-traditional or traditional diets and in healthy controls." Smith, C.E., Parnell, L.D., Lai, CQ. et al. Sci Rep 12, 22585 (2022).

https://doi.org/10.1038/s41598-022-26322-8

Key takeaway: "Seventeen metabolites differed significantly in dogs with DCM eating NT versus traditional diets (e.g., fatty acids, amino acids, legume biomarkers), suggesting different mechanisms for primary versus diet-associated DCM." (Article Abstract)
Funding: Nestlé Purina PetCare, Tufts Springboard, Barkley Fund, United States Department of Agriculture Project Number 8050-51000-107-00D

"Comparison of echocardiographic measurements and cardiac biomarkers in healthy dogs eating nontraditional or traditional diets. " Owens, EJ, LeBlanc, NL, Freeman, LM, Scollan, KF. J Vet Intern Med. 2022; 1- 10.

https://doi.org/10.1111/jvim.16606

Key takeaway: When compared between diet groups, healthy adult dogs eating diets containing pulse legumes (peas, lentils, chickpeas, beans) as main ingredients have lower cardiac function and higher ventricular volume than dogs eating grain-inclusive diets without potatoes or pulses in the first 10 ingredients.
Funding: American College of Veterinary Internal Medicine and Department of Clinical Sciences at Oregon State University.

"Untargeted global metabolomic profiling of healthy dogs grouped on the basis of grain inclusivity of their diet and of dogs with subclinical cardiac abnormalities that underwent a diet change," Adin, D. B., Haimovitz, D., Freeman, L. M., & Rush, J. E. (2022). American Journal of Veterinary Research, 83(9)

https://doi.org/10.2460/ajvr.22.03.0054

Key takeaway: Dogs eating grain-free diets have different serum levels of compounds associated with different arms of metabolism when compared to dogs on grain-inclusive diets. The clinical importance of these compounds and their potential relationship to the development of DCM requires further investigation. An unnamed metabolite, X-25419, was ~6.5x higher in dogs eating GF foods, and in a previous study (Smith et al 2021), this compound was 7x higher in DCM-associated diets compared to non-DCM-associated diets. Further speculation on the importance of this compound requires structural characterization.
Funding: American Kennel Club Canine Health Foundation (grant No. 02661)

"Responses in randomised groups of healthy, adult Labrador retrievers fed grain-free diets with high legume inclusion for 30 days display commonalities with dogs with suspected dilated cardiomyopathy." Bakke, A.M., Wood, J., Salt, C. et al. BMC Vet Res 18, 157 (2022).

https://doi.org/10.1186/s12917-022-03264-x

Randomized feeding trial in Labradors supports link between DCM and diet

Key Takeaway: Dogs eating a grain-free, legume-rich diet developed changes to their blood parameters after 30 days which are similar to changes seen in dogs diagnosed with DCM, which provides early evidence of potential pathology.
Funding: Mars Petcare

"Effect of diet change in healthy dogs with subclinical cardiac biomarker or echocardiographic abnormalities” Haimovitz D, Vereb M, Freeman L, Goldberg R, Lessard D, Rush J, Adin D. J Vet Intern Med. 2022 Apr 14.

https://doi.org/10.1111/jvim.16416

Change of diet reduces measurement of heart damage marker in dogs fed grain-free

Key Takeaway: Heart abnormalities in otherwise healthy dogs eating grain-free diets can be resolved/reversed with a change of diet. This is consistent with the findings of multiple previous studies as well as clinical observations.
Funding: American Kennel Club Canine Health Foundation (Grants 02661 and 02947-E).

"Prospective study of dilated cardiomyopathy in dogs eating nontraditional or traditional diets and in dogs with subclinical cardiac abnormalities." Freeman, L, Rush, J, Adin, D, et al. J Vet Intern Med. 2022; 36( 2): 451- 463.

https://doi.org/10.1111/jvim.16397

Another DCM study (2022) shows improved cardiac parameters when changing from non-traditional diet

Key takeaway: Authors write “Dogs with DCM or SCA [subclinical cardiac abnormalities] previously eating NTDs [non-traditional diets] had small, yet significant improvements in echocardiographic parameters after diet changes.”
Funding: Nestle Purina PetCare and The Barkley Fund (Barkley was a Great Dane. From the Tuft's website, "Barkley's owners established the Barkley Fund to foster ongoing innovation in cardiology and emergency/critical care medicine. The fund provides resources for activities that promote scientific inquiry, collaboration, and training.")

"Investigation of diets associated with dilated cardiomyopathy in dogs using foodomics analysis" Smith et al., Scientific Reports volume 11, Article number: 15881 (2021)

https://doi.org/10.1038/s41598-021-94464-2

Biochemical Analysis of Dog Foods Provides New Clues On Causes of Diet-Associated DCM

Key Takeaway: Unique, unnamed compounds were present in high pulse/potato diets named in the FDA case reports (3P-FDA) that were not found in "non-3P/FDA" diets. Additionally, 3P/FDA diets were found to have certain nutrients in deficiency or excess relative to non-3P/FDA diets. Those specific nutrients have previously been associated with physiologic processes that may contribute to DCM development.
Funding: Nestle Purina PetCare and The Barkley Fund (Barkley was a Great Dane. From the Tuft's website, "Barkley's owners established the Barkley Fund to foster ongoing innovation in cardiology and emergency/critical care medicine. The fund provides resources for activities that promote scientific inquiry, collaboration, and training.")

"Effect of type of diet on blood and plasma taurine concentrations, cardiac biomarkers, and echocardiograms in 4 dog breeds." Adin, D, Freeman, L, Stepien, R, et al. J Vet Intern Med. 2021; 35: 771– 779.

https://doi.org/10.1111/jvim.16075

Key Takeaway: Among healthy dogs, consumption of grain-free/high-pea/high-lentil diets is associated with increased levels of Cardiac Troponin I, a biomarker associated with cardiac damage.

Funding: American Kennel Club Canine Health Foundation, grant 02661

"Association of diet with clinical outcomes in dogs with dilated cardiomyopathy and congestive heart failure," A.L. Walker, T.C. DeFrancesco, J.D. Bonagura, B.W. Keene, K.M. Meurs, S.P. Tou, K. Kurtz, B. Aona, L. Barron, A. McManamey, J. Robertson, D.B. Adin, Journal of Veterinary Cardiology, Volume 40, 2022, Pages 99-109, ISSN 1760-2734,

https://doi.org/10.1016/j.jvc.2021.02.001

Key Takeaway: Among dogs in congestive heart failure diagnosed with DCM, the length of time a dog was on a grain-free diet was correlated with worse outcomes. In those dogs that survived at least one week, changing diet was associated with improved outcomes and reverse remodeling of cardiac changes.
Funding: No specific funding disclosed. Study conducted with data from clinical cases at North Carolina State University College of Veterinary Medicine

"Retrospective study of dilated cardiomyopathy in dogs." Freid, KJ, Freeman, LM, Rush, JE, et al. J Vet Intern Med. 2021; 35: 58– 67.

https://doi.org/10.1111/jvim.15972

Key Takeaway: Changing diet in dogs diagnosed with DCM while eating a non-traditional diet is associated with a significant increase in mean survival time following diagnosis, including reversal of disease in some patients.
Funding: The Barkley Fund (Barkley was a Great Dane. From the Tuft's website, "Barkley's owners established the Barkley Fund to foster ongoing innovation in cardiology and emergency/critical care medicine. The fund provides resources for activities that promote scientific inquiry, collaboration, and training.")

"Development of plasma and whole blood taurine reference ranges and identification of dietary features associated with taurine deficiency and dilated cardiomyopathy in golden retrievers: A prospective, observational study." Ontiveros ES, Whelchel BD, Yu J, Kaplan JL, Sharpe AN, Fousse SL, et al. (2020) PLoS ONE 15(5):

https://doi.org/10.1371/journal.pone.0233206

Key Takeaway: There is an association between consumption of non-traditional diets and low taurine and echocardiographic abnormalities in Golden Retrievers.
Funding: Center For Companion Animal Health (CCAH), the Maxine Adler Graduate Student Fellowship, The NIH T35 OD010956 Students Training in Advanced Research Fellowship, and the Amino Acid Laboratory at the University of California Davis.

"Echocardiographic phenotype of canine dilated cardiomyopathy differs based on diet type." Adin D, DeFrancesco TC, Keene B, Tou S, Meurs K, Atkins C, Aona B, Kurtz K, Barron L, Saker K. J Vet Cardiol. 2019 Feb;21:1-9. Epub 2018 Dec 5. PMID: 30797439.

https://doi.org/10.1016/j.jvc.2018.11.002

Key Takeaway: There is an association between grain-free diets and DCM in dogs; the data suggests that a change of diet and taurine supplementation can lead to reversal of disease
Funding: No specific funding disclosed. Study conducted with data from clinical cases at North Carolina State University College of Veterinary Medicine

"Taurine deficiency and dilated cardiomyopathy in golden retrievers fed commercial diets." Kaplan JL, Stern JA, Fascetti AJ, Larsen JA, Skolnik H, Peddle GD, et al. (2018). PLoS ONE 13(12): e0209112.

https://doi.org/10.1371/journal.pone.0209112

Key Takeaway: There is an association between grain-free diets, taurine deficiency, and dilated cardiomyopathy in Golden Retrievers.
Funding: No specific funding declared

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Other Relevant Research on Diet-Associated DCM and Pulses in Pet Food:

"The Pulse of It: Dietary Inclusion of Up to 45% Whole Pulse Ingredients with Chicken Meal and Pea Starch in a Complete and Balanced Diet Does Not Affect Cardiac Function, Fasted Sulfur Amino Acid Status, or Other Gross Measures of Health in Adult Dogs" Pawanpreet Singh, Sydney Banton, Shari Raheb, James R. Templeman, Jennifer Saunders-Blades, Darcia Kostiuk, Janelle Kelly, Journal of Animal Science (2023).

https://doi.org/10.1016/j.tjnut.2023.03.027

Key takeaway: Carefully formulated experimental diets that exceed AAFCO requirements of Cysteine and Methionine by >60% and contain up to 15% each equal parts of three pulse legumes do not induce cardiac changes in Huskies during 20 weeks of feeding.
Funding: Champion Petfoods.

"Incidence of canine dilated cardiomyopathy diagnosed at referral institutes and grain-free pet food store sales: A retrospective survey." Quest BW, Leach SB, Garimella S, Konie A, Clark SD. Front Anim Sci 2022.