by Morna Pixton, DVM, Guilford Veterinary Hospital
“Annie” is a much beloved, sweet-as-pie, pearl-necklace-wearing bulldog mix owned by our technician, Alexa. She had always been healthy except for allergies, and seemed to do best on a special kangaroo diet. She developed a growth in her mouth in July 2017, when she was 5 years old. I took her to surgery, removed it, and sent it for biopsy. It came back as a potentially serious form of cancer (extramedullary plasmacytoma) and so we performed a series of diagnostic tests to see if it had spread or was indicative of an even worse form of cancer (multiple myeloma). As part of this testing, we took chest xrays, and were surprised to find Annie’s heart was very enlarged. Alexa took her to see Dr deMadron, a board-certified cardiologist, who diagnosed Annie with heart disease, specifically dilatative cardiomyopathy. Her heart was weak, floppy and the muscular walls were stretched out and thinner than they should be. This type of heart disease can develop sometimes if there is not enough taurine in the diet, so we checked a taurine level, but that was normal. Annie started on a combination of medications (including a taurine supplement) right away to help slow the progression of the heart disease. Despite getting the very best treatment and frequent cardiac evaluations, Annie’s heart disease worsened. By the spring of 2018, she was showing signs of heart failure: she tired very easily and even collapsed once. She was developing an arrhythmia and the muscle of her heart was barely able to pump blood. By the summer of 2018, she was being given IV infusions of a medication called dobutamine, to try and improve her failing heart function. We all thought we would lose her at any moment. In September 2018, Annie’s diet was changed from the kangaroo diet to Hill’s h/d (a cardiac diet). She started stabilizing over the fall and winter and came off the dobutamine infusions. She was re-evaluated in March 2019 by her cardiologist – and the findings on her cardiac ultrasound matched what everyone around her was seeing: she had clearly improved. Her heart muscle was working better, and could actually contract to pump blood through her body. Her heart had decreased in size and as no longer nearly as dilated as it had been. While not normal, her heart is remarkably improved and she is no longer in heart failure. The only part of her treatment that can account for this improvement is the diet change: from a grain-free, rare protein diet to a grain-based diet (containing chicken, pork, egg and corn).
Dilated Cardiomyopathy has been associated with genetic predisposition and with taurine deficiency in certain dog breeds. However, since July 2018, reports have been emerging of atypical breeds of dogs who are on grain-free diets being diagnosed with Dilated Cardiomyopathy. Currently there is an FDA alert regarding grain-free diets and canine DCM and an ongoing study at the veterinary school at UC Davis. The current veterinary diet recommendations are to NOT feed grain-free, raw or exotic protein-based diets to dogs or cats, unless there is a specific medical reason to do so. In actuality, veterinarians never really did recommend grain-free, raw or exotic protein-based diets to otherwise healthy dogs and cats. These diets are not considered superior diets by the veterinary community, only by some in the pet food industry. Following are links regarding DCM and diet, and the experience of another CT veterinary hospital: