Review of Canine Dilated Cardiomyopathy in the Wake of Diet-associated Concerns

Sydney R McCauley, Stephanie D Clark, Bradley W Quest, Renee M Streeter, Eva M Oxford

Journal of Animal Science, Volume 98, Issue 6, June 2020, skaa155, https://doi.org/10.1093/jas/skaa155

Published: 15 June 2020

Pet Food Industry

DCM connection to grain-free dog food not found in review

More than 150 published studies didn’t reveal to researchers any firm connection among cases of canine dilated cardiomyopathy (DCM) and grain-free dog food. Veterinarians and others with BSM Partners, a pet industry consulting agency, published their review of existing scientific research on dog nutrition and its relationship to DCM in the Journal of Animal Science.

“This literature review is integral in helping pet food professionals understand what we know about nutritional requirements, as well as the development of DCM,” study co-author Dr. Eva Oxford, DVM, PhD, said. “Our review also points out major gaps in the literature, which offer opportunities for future research.”

For example, Oxford’s team noted that many studies discussing DCM lacked definitive evidence of the disease’s cause, or etiology.

“This is likely because it is so difficult to obtain cardiac tissue for analysis,” she said. “Future issues worth exploring, relating to nutrition and DCM may be measuring concentrations of amino acids in cardiac and skeletal muscle samples, and determining how dogs eating different diet types process and absorb different nutrients.”

Just as academic and private-sector scientists have more work to do to understand DCM, so too do researchers with the government as the investigation continues.

“The FDA does not typically comment on specific studies, but evaluates them as part of the body of evidence to further our understanding about a particular issue and assist in our mission to protect public health. We are continuing to investigate cases of DCM reported to the agency and will communicate publicly about any significant developments.”



Recently, a correlation between diets with specific characteristics, such as, but not limited to, containing legumes, grain-free, novel protein sources and ingredients, and smaller manufactured brands to DCM has come under scrutiny by academic researchers and the FDA. The use of the acronym “BEG” and its association with DCM are without merit because there is no definitive evidence in the literature. At this time, information distributed to the veterinary community and the general public has been abbreviated synopses of case studies, with multiple variables and treatments, incomplete medical information, and conflicting medical data and opinions from veterinary nutrition influencers. Also, in past literature, sampling bias, overrepresentation of subgroups, and confounding variables in the data weaken this hypothesis. Additionally, based on current literature, the incidence of DCM in the overall dog population is estimated to be between 0.5% and 1.3% in the United States. However, the FDA case numbers (560 dogs) are well below the estimated prevalence. Therefore, it is impossible to draw any definitive conclusions, in these cases, linking specific diets or specific ingredients to DCM.

DCM is a multifactorial medical condition with many proven  and potential causes contributing to the development of the disease. Therefore, prospective studies investigating, not only diet, but also infection, metabolism, and genetic involvement, must be conducted. In hopes of better understanding a potential correlation with diets to DCM, more objective data need to be collected and analyzed, without sampling bias and confounding factors. While determining the cause of recently reported cases of cardiac disease is of the utmost importance, based on this review of the current literature, there is no definitive relationship these implicated diet characteristics and DCM.