English Setters, Taurine, and Dilated Cardiomyopathy

I’ve been receiving a lot of inquiries regarding the news about reports of possible diet related Dilated Cardiomyopathy (DCM). The reports are pretty scary and people are justifiably wondering what they should do. So, I’ve spent some time reading up on it.

Useful Info

First, here is a veterinarian oriented paper on the subject that I found to be informative. It mentions a number a variables that complicate determining what, if anything, is wrong.
https://avmajournals.avma.org/doi/full/10.2460/javma.253.11.1390

These are recent releases from the FDA. If you just want a quick read that tells you a lot, go through the questions and answers.
FDA June Update
Vet-LIRN Investigation
FDA Questions and Answers

Download all of the reports:
https://www.fda.gov/media/128303/download

This article covers a number of things pretty well.  1472_001-1
Thanks to Sue for sending this.

I consider Monica Segal to be an especially knowledgeable and rational person in regards to dog nutrition and diet formulation.
Don’t Panic – Thoughts on the FDA Report re DCM

Whole Dog Journal has some good tips about reading dog food labels and picking a formula. The commentary near the end regarding the way the news has been presented is worth pointing out.
Please Don’t Panic About the Grain-Free Thing

My Reactions

I think the sentiment that there is no need to panic just yet is correct. There is “a potential increase in cases of DCM in dogs not genetically predisposed”, and an “apparent” link between certain types of dog food, but nothing is conclusive at this point.

To put this in perspective, out of the estimated 77 million pet dogs in the US there are currently 515 suspected cases of diet related DCM reported, or 0.0006688%. Roughly one case per 150,000 dogs. Not all of these cases have been proven to be diet related, so the real number is likely less than 515.

Worst case this could be the tip of an iceberg, but at this point there isn’t enough data to determine if that’s the case, and there are too many variables in what they do have to draw any definitive conclusions. Hopefully the FDA will find some answers before too long. In the mean time the safe approach is to assume the increase is real, and that it has something to do with kibble formulas.

I think it’s the Legumes

There are good reasons to suspect that legumes could be causing problems. 93% of the reported foods contain them. Legumes have not been used in significant quantities for very long, they have high levels of anti-nutrients that aren’t neutralized in the kibble making process, and the protein is deficient in multiple amino acids. Plus the amount used has increased recently in order to address a high ash problem in meat meals- meals were reduced and legumes increased. Our dog food supplier has been warning me about the use of legumes for the last several years, and he is not at all surprised to see a rise in DCM.

I could be wrong, but I am skeptical that potatoes and some of the other so-called “exotic” ingredients are a problem. Some may be, but potatoes and tapioca for instance have been used for 20+ years with no issues, including no problems with the earlier grain-free foods that relied heavily on them.

Whole potatoes don’t provide much protein, so companies can’t substitute them for animal ingredients and still claim high protein levels like they’re doing with legumes. Legumes also happen to be far less expensive, especially compared to sweet potatoes, which cost more than meat meals.

Out of curiosity I searched through the FDA reported cases for “potato” and then looked at the ingredients for each food mentioned. This search only reinforced my doubts. With very few exceptions all of the foods that contain potatoes have legumes as a primary ingredient, usually more than the potatoes, and many of those are also low in animal protein. I only found 2 straight up formulas that use potatoes as the main starch. There are also 2 reported that have only tiny amounts of potato in them, and 4 that have extremely low or zero animal protein (2 are vegetarian). I question why they are even looking at potatoes.

Diet Recommendations

I am not a nutritionist, so keep that in mind. I am a breeder who is interested in nutrition and cares about it’s effects on the dogs. In a nutshell here is what I am going to do, and recommend, until the FDA figures out what is going on.

• Don’t feed foods that are heavy in legumes.
• Do feed formulas that have plenty of animal protein in them.
• I doubt potatoes or grains matter at all, but if it makes you more comfortable limit potatoes and don’t feed grain-free.

One option is to simply use a food that doesn’t have any legumes in it, and no potatoes if you prefer. However, if you are currently using a food you like that does have some legumes, or are considering changing to a different food, here are details on how I read the labels and judge foods. Labels are not perfect or even trustworthy, but they will give you a general idea of what’s in a food.

First, do not rely on the name or the claims on the bag- very often these have little to do with what’s actually in the food.

A rough guide for determining whether an ingredient constitutes a large portion of a food is whether it is listed before or after the added fat, and whether there are multiple ingredients of the same type. The primary ingredients are listed before the first major fat source. Ingredients listed after the added fat are generally minor portions of a formula, as long as there aren’t multiples. Pea starch is used as a binder and is less of a concern than whole legumes, protein powders, or flours.

The FDA highlighted the cases of two Dobermans living in the same house that were diagnosed with diet responsive DCM. Both were eating a formula from the most commonly reported brand. Here are the main ingredients.

• Deboned chicken, deboned turkey, chicken meal, whole green peas, whole red lentils, whole pinto beans, chicken liver, chicken fat, catfish meal, chickpeas, whole green lentils, whole yellow peas, lentil fiber, eggs, pollock oil…

Ingredients in pet foods are listed by weight before cooking. I crossed out the wet ingredients because once the water is cooked out of them it’s unlikely there will be enough dry weight left to qualify as primary ingredients.

Chicken meal is the heaviest dry ingredient, but to be listed first all it has to be is slightly heavier than the next ingredient. 3 out of the 4 heaviest ingredients are legumes, and there are also 4 more legumes after the chicken fat that if added together might constitute another primary ingredient. This food should be presumed to be predominantly legumes, not poultry. A very large percentage of the foods reported to the FDA were like this or worse.

Here are the primary ingredients of formulas from the next four brands with the highest number of reports:

• Kangaroo, Kangaroo Meal, Peas, Chickpeas, Pea Flour, Sunflower Oil…
• Beef, lentils, tomato pomace, sunflower oil…
• Turkey, turkey meal, garbanzo beans, lentils, peas, potatoes, pea flour, chicken fat…
• Turkey Meal, Chicken Meal, Peas, Dried Egg, Pea Starch, Chicken Fat…

Another thing you could do is refer to the the Vet-LIRN study mentioned in the FDA’s press releases as a guide. They are comparing grain-free dogs diagnosed with DCM to healthy grain-fed dogs. The requirement for the grain-fed group is that the foods must contain “no more than 2 legume, pulse, or potato (including sweet potato) ingredients that must appear after the animal and grain ingredients”.

Grain-free Choices

You’re not going to find a grain-free kibble that doesn’t contain potatoes or other “exotic” starch sources (anything other than certain grains has been labeled exotic). There are however a small number of them out there that eliminate or minimize either legumes or potatoes, sometimes both. A few use tapioca (cassava) or coconut for the main starch.

Grains

When considering foods that contain grain (in addition to determining the level of legumes) here are some of the things I consider. I’m not telling you to avoid the ones I avoid, just giving you some ideas to think about.

• Whole corn (not corn gluten meal) is OK as a starch source if processed correctly so dogs can digest it. It has a bad reputation compared to other grains that isn’t really deserved. There are concerns about glyphosate and other chemicals due to GMO varieties.
• Unless grown in California most rice has a significant level of inorganic arsenic in it, especially if the hull is not removed (particularly rice grown in Texas, Arkansas, and Louisiana). Arsenic can be in anything, including meats, but it may be best to avoid formulas that use rice as the primary carb source.
• Millet has some good points, but it is one of the few foods that has goitrogens that aren’t neutralized by cooking (fava beans are worse). Since ES have the highest rate of hypothyroid disease of any breed I avoid this.
• Gluten grains are anecdotally associated with Hashimoto’s disease, the human equivalent of autoimmune thyroiditis in dogs. Cause and effect is not proven, and extrapolating to dogs is not proper, but I’m doing it anyway. Seems prudent to avoid.
• Oats avoid the above problems but whole oats don’t seem to work very well in kibbles because of the husk. Rolled oats in a home prepared diet work fine.
• The kibble we’re using at the time of this writing has sorghum as the main plant ingredient. Brown rice is in there too, but as a minor ingredient so hopefully not too much arsenic: Chicken Meal, Pork Meal, Grain Sorghum, Chicken Fat (Preserved with Mixed Tocopherols), Brown Rice…

Conventional Kibbles

Many of the Golden Retriever people seem to be jumping to the old style of corn gluten meal, brewer’s rice, or soy based formulas that are endorsed by vet schools. These are highly refined foods made mainly from cheap by-product types of ingredients. They rely more heavily on added vitamins, minerals and amino acids to meet AAFCO guidelines. Here is one that claims to be designed specifically for setters.

• Brewers rice, chicken by-product meal, chicken fat, soy protein isolate, corn, natural flavors, dried plain beet pulp, fish oil, pea fiber, rice hulls, vegetable oil…

When we switched away from foods with similar ingredients our vet bills went down and we saw improvements in performance and stamina, so I can’t comfortably recommend them for long term use.  However, if you feel safer going that route until any problems with kibble formulations get worked out, these foods are not going to kill your dog or anything.

Home Prepared Foods

I think this can be the healthiest choice, and is undoubtedly the best way to provide dietary taurine. However, I highly recommend against it unless you are willing to spend many hours of research learning how to do it correctly so you don’t cause harm. Or better yet hire someone who does know how to design a diet that meets the individual dog’s nutrient needs.

English Setters and Taurine

So now to what is probably the most important thing I found in all of this. The first paper in the links above mentions English setters as one of the breeds that might be predisposed to taurine deficiency related DCM (the same author has also written this elsewhere). There is no reference to the original source of that information so I can’t comment on how much data there is, but to be cautious it’s probably best to assume there is something to it. And there is no downside to making sure a dog gets enough dietary taurine.

Taurine is not considered essential for dogs because they synthesize it from other amino acids. If setters really are prone to taurine deficient DCM it is because at least some of them don’t synthesize taurine very well.

Poor taurine synthesis has been proposed as one reason why Golden Retrievers are over-represented in the recent reports of DCM. There are reasons to suspect the numbers could just be due to reporting bias for that breed, but it’s also possible Goldens are more sensitive to taurine deficiency in the diet or anything in the food that interferes with taurine. 

Even normal dogs can’t make enough taurine when they are under stress. Traveling, working in the field, hunting, pregnancy and nursing, etc. are all stressful enough to cause this to happen. So, with our hunting setters we may have a double whammy going on here.

The best way to ensure enough dietary taurine is to feed some extra foods that are good sources. It doesn’t seem like the amount of taurine in various foods is very well established, but a couple of sources consistently mentioned are seafood and raw meat. I’ve seen suggestions like giving a can of sardines once a week.

Using a taurine supplement may be worth considering (and possibly L-carnitine, although I have read mixed information on how useful it is). Taurine is available in bulk powders that are affordable. It would not be a big deal to put a little on top of the food on a hunting trip for instance, and it may be beneficial full time with English setters. That’s something I will be considering for our own dogs. A little canned mackerel or sardines every few days wouldn’t be all that difficult either, and you would get the added benefit of some omega 3 fatty acids.

Giving the dogs a reasonable amount of taurine, either through foods or supplements, can’t do any harm and may help prevent DCM. Maybe learning about doing this for our setters will be a side benefit of the grain-free scare.

Lisa