Cardiology Service Update: Dog Food & Dilated Cardiomyopathy

The following handout was forwarded to me by Limoncello’s cardiologist, Dr. Beth Bossbaly. The Direct link can be accessed by clicking HERE.

CARDIOLOGY SERVICE UPDATES: DOG FOOD & DILATED CARDIOMYOPATHY
The Cardiology Service has developed this document in response to the alerts from the FDA. These alerts identify an
associated risk for some grain-free diets containing certain ingredients (legumes like peas, pea components, lentils; white
potatoes, sweet potatoes) and a diagnosis of dilated cardiomyopathy (DCM). The links provided throughout this document
can be copied and pasted to obtain additional information.
FDA Alerts found here:
https://www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ucm613305.htm
https://www.fda.gov/AnimalVeterinary/ResourcesforYou/AnimalHealthLiteracy/ucm616279.htm


What is Dilated Cardiomyopathy (DCM)?
DCM is a heart muscle disorder that results in a weak pump function and heart chamber enlargement. In the early stages of
this disease pets may appear totally healthy with no apparent clinical signs. Later in the course of this disease, dogs may
have a heart murmur, an arrhythmia (irregular heart beat), collapse episodes, weakness or tiredness with exercise, and even
trouble breathing from congestive heart failure. While there are some breeds of dogs (like Dobermans) that have a genetic
predisposition to development of DCM, there are also nutritional factors that may result in this disease.


What should I do?
If you are feeding a diet of concern based upon the FDA alert we recommend that you consult with your veterinarian or
veterinary cardiologist. We provide 4 general points for guidance below:

  1. An initial step is to consider whether you are willing or interested in performing additional testing to assess whether
    your pet is affected with DCM. If you believe your dog is at risk, showing any of the aforementioned clinical signs or would
    prefer to simply rule out any heart disease, we recommend that you first have your pet’s taurine levels tested (both whole
    blood and plasma levels) as well as seek an echocardiogram by a board-certified veterinary cardiologist. Low taurine levels
    are associated with development of DCM in dogs and are sometimes a component of this current issue.
    Information on taurine testing can be found here: https://www.vetmed.ucdavis.edu/labs/amino-acid-laboratory
  2. At this time, diet change is recommended when possible and should be considered regardless of the results obtained
    from any testing. You can consult with your veterinarian in selecting a new diet that avoids the ingredients of concern listed
    by the FDA. When selecting this diet, we recommend that you choose a diet that is manufactured with rigorous quality
    control measures and research behind the formulation. A way to ensure that your diet meets these recommendations is to
    follow the following guidelines that were generated by a large number of the world’s leading experts in veterinary nutrition.
    Food selection guidelines found here:
    https://www.wsava.org/WSAVA/media/Arpita-and-Emma-editorial/Selecting-the-Best-Food-for-your-Pet.pdf
  3. If your pet is identified through testing to have a low blood taurine level or evidence of DCM by echocardiogram, we urge
    you to report this information to the FDA.
    FDA reporting guidelines found here: https://www.fda.gov/AnimalVeterinary/SafetyHealth/ReportaProblem/ucm182403.htm
  4. Work with your veterinarian(s) to determine the best course of action and medical treatments if indicated. In the case of
    a DCM diagnosis, diet change alone may not be sufficient and additional medications may be prescribed.

Please continue to monitor the FDA website and the UC Davis School of Veterinary Medicine Newsfeeds for updates and
recommendations regarding this issue.

How We Discovered That Limoncello Had a Heart Issue

In the middle of the 2017 Dock Diving Season, Limoncello suddenly stopped jumping.   Brian was up on the dock with her at a competition in June 2017, and released her to jump.  Limoncello literally sauntered to the end of the dock and flat-jumped in. She continued to show disinterest at every event after that. We actually stopped jumping her for a little bit and took her to the vet for some testing. Nothing concerning was discovered at that point. She began to jump towards the end of the season again, and at the 2017 World Championship .… But still not showing the same interest and “extreme” tendencies she had before. At that point we resorted to the fact that perhaps she was just tired of a sport she once loved…just like so many German Shorthaired Pointers who are surrendered to rescue or are “dumped” by hunters because they just woke up and decided to stop hunting. Although we did not have an echocardiogram done at the time, there was medically no need to at that point… Cello did not display other symptoms, her bloodwork came back normal, and nothing irregular was heard by stethoscope.

Fast forward to February 2018.  One day in early February, Hooch started licking Cello’s chest as if it was coated in honey! He was exhibiting behaviors of an intact male (Hooch is intact, Limoncello is not) – but instead of being interested in her hind-end , he wouldn’t leave her CHEST alone … turning over on his back to lick her chest, nosing at her chest while whimpering, and did everything in his power to get to Cello if we tried to separate them.  Thinking her hair follicle issue had returned, and we were missing something like a rash or infection on her chest that was peaking Hooch’s interest … we took her back to our primary veterinarian, Dr. Helen Campbell .

This time, while I was sitting in the waiting room at Old York Veterinary Hospital, another dog entered the office waiting room with his owner.  Although Limoncello is extremely human-friendly, she despises most other dogs outside of her pack, and will act on her aggression.  Cello was freaking out at the other dog as the vet tech called us back into the room.  With Cello’s adrenaline still pumping, our veterinarian walked into the room.  She immediately listened to Cello’s heart with her stethoscope…and thought she heard a murmur.  However, as Cello began to calm down, the “noise” went away.  Jokingly I said to Dr. Campbell,  “Walk a dog by her again … that’s what she was freaking out about earlier.”  Surprisingly, she said,  “Yes – let’s do that!” One of the vet techs had their dog at work with them, so they leashed their pup and walked her by the exam room with the door left open.  Dr. Campbell had her stethoscope on Cello’s chest the entire time.   As Cello began to break out into what we call “Cujo mode” as she saw the dog pass by the doorway… bam! …the “noise” was back! 

Although we will never know the answer, we have two thoughts on the discovery of Cello’s heart murmur:

  1. This heart issue could have began to develop during the 2017 dock diving season (our answer to why her performance dropped).  It is likely it could have gone unnoticed because when Cello is at the vet she is usually super calm IF there is no other dog in the waiting room with us.  We usually time our visits so that Cello does not encounter other dogs in the office, so it’s quite possible she was not “excited” enough to display symptoms during other visits.  The murmur was undetectable while she was calm, so Dr. Campbell would not have heard the murmur with her stethoscope at other appointments.
  2. Cello’s 2017 performance was totally unrelated, and the heart murmur began in the beginning of March when  “Dr. Hooch” discovered it! 

Regardless of when the murmur began, it had to be explored to determine if there were any other related cardiac issues.   Dr. Campbell referred us to Dr. Bossbaly, a cardiologist at Veterinary Specialty and Emergency Center (VSEC).