Nutrition Recommendations

What’s the big deal with pet food? And what happened to grain-free diets?

Health & Harmony Animal Hospital’s veterinarians primarily recommend the following brands of pet food: Royal Canin, Hill’s Science Diet, and Purina Pro Plan.

Why?

In recent years, the influx of new types of pet diets has greatly increased the options owners have when choosing the right food for their dog or cat.  With this increase in selection does come an increase in uncertainty.  Royal Canin, Hill’s Science Diet, and Purina Pro Plan have all had extensive scientific studies conducted regarding the quality and safety of their ingredients.  Furthermore, there have been no reported cases of DCM (Dilated Cardiomyopathy) in conjunction with these brands.

In June 2018, nutritionists at Cummings School of Veterinary Medicine at Tufts University published an article and study titled “A broken heart: Risk of heart disease in boutique or grain-free diets and exotic ingredients.” The article focused on the connection between certain diets and DCM (Dilated Cardiomyopathy).

“Dilated cardiomyopathy or DCM occurs in cats where it is associated with a nutritional deficiency (see below).  DCM is a serious disease of the heart muscle which causes the heart to beat more weakly and to enlarge.  DCM can result in abnormal heart rhythms, congestive heart failure (a build-up of fluid in the lungs or abdomen), or sudden death.  In dogs, it typically occurs in large- and giant-breeds, such as Doberman pinschers, Boxers, Irish Wolfhounds, and Great Danes, where it is thought to have a genetic component.  Recently, some veterinary cardiologists have been reporting increased rates of DCM in dogs – in both the typical breeds and in breeds not usually associated with DCM, such as Miniature Schnauzers or French Bulldogs.  There is suspicion that the disease is associated with eating boutique or grain-free diets, with some of the dogs improving when their diets are changed.  The US Food and Drug Administration (FDA) Center for Veterinary Medicine and veterinary cardiologists are currently investigating this issue.”

The article concluded the following:

“If you’re feeding your dog a boutique, grain-free, or exotic ingredient diet, watch for early signs of heart disease – weakness, slowing down, less able to exercise, short of breath, coughing, or fainting. Your veterinarian will listen for a heart murmur or abnormal heart rhythm and may do additional tests (or send you to see a veterinary cardiologist), such as x-rays, blood tests, electrocardiogram, or ultrasound of the heart (echocardiogram).”

Boutique, exotic ingredients, and grain-free diets (known collectively as BEGs) were studied further by Tufts in November 2018 and discussed in an article titled “It’s Not Just Grain-Free: An Update on Diet-Associated Dilated Cardiomyopathy.”  The article stated the following:

  • It’s not just grain-free. This does not appear to be just an issue with grain-free diets.  I am calling the suspected diets, “BEG” diets – boutique companies, exotic ingredients, or grain-free diets.  The apparent link between BEG diets and DCM may be due to ingredients used to replace grains in grain-free diets, such as lentils or chickpeas, but also may be due to other common ingredients commonly found in BEG diets, such as exotic meats, vegetables, and fruits.  In addition, not all pet food manufacturers have the same level of nutritional expertise and quality control, and this variability could introduce potential issues with some products.
  • Most dogs being diagnosed with DCM do not have low taurine levels. Some owners continue to feed a BEG diet but supplement taurine thinking that this will reduce their risk for heart disease.  In our hospital, we currently measure taurine in all dogs with DCM, but more than 90% of our patients with DCM in which taurine has been measured have normal levels (and the majority are eating BEG diets).  Yet some of these dogs with DCM and normal taurine levels improve when their diets are changed.  This suggests that there’s something else playing a role in most cases – either a deficiency of a different nutrient or even toxicity that may be associated with BEG diets.  Giving taurine is unlikely to prevent DCM unless your dog has a taurine deficiency.  And given the lack of quality control for dietary supplements, you can introduce new risks to your dog if you give a supplement without evidence that she needs it.
  • Raw diets and homemade diets are not safe alternatives. Out of concern, some owners are switching from BEG diets to a raw or home-cooked diet.  However, we have diagnosed DCM in dogs eating these diets too.  And raw and home-cooked diets increase your dog’s risk for many other health problems.  So, forego the raw or home-cooked diets and stick with a commercial pet food made by a well-established manufacturer that contains common ingredients, including grains.  If your dog requires a home-prepared diet for a medical condition or you feel strongly about feeding one, I strongly recommend you consult with a Board-Certified Veterinary Nutritionist™ .  However, because home-cooked diets are not tested for safety and nutritional adequacy like good quality commercial diets, deficiencies could still develop.

This article was followed by a paper published in the Journal of the American Veterinary Medical Association titled “Diet-associated dilated cardiomyopathy in dogs: what do we know?”  The paper contained the following summary:

“Pet food marketing has outpaced the science, and owners are not always making healthy, science-based decisions even though they want to do the best for their pets. The recent cases of possible diet-associated DCM are obviously concerning and warrant vigilance within the veterinary and research communities. Importantly, although there appear to be an association between DCM and feeding BEG, vegetarian, vegan, or home-prepared diets in dogs, a cause-and-effect relationship has not been proven, and other factors may be equally or more important. Assessing diet history in all patients can help to identify diet-related cardiac diseases as early as possible and can help identify the cause and, potentially, the best treatment for diet-associated DCM in dogs.”

In June 2019, The FDA concluded their investigation and released a report titled “FDA Investigation into Potential Link between Certain Diets and Canine Dilated Cardiomyopathy.”  Included in the report were the brands of dog food most frequently named in DCM Cases reported to the FDA (below).

“The FDA is continuing to investigate and gather more information in an effort to identify whether there is a specific dietary link to the development of DCM and will provide updates to the public as information develops.”

Based on the recent studies and case reports, Health & Harmony Animal Hospital continues to recommend Royal Canin, Hill’s Science Diet, and Purina ProPlan diets for our patients.  We encourage all pet owners to speak directly with their individual veterinarians about the best diet for your cat or dog as each pet is an individual.

For more information on how to read nutrition labels or guidance on how to mindfully choose your pet’s diet, follow the links below!

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