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It was only by chance that vets discovered that Sophie, Martha Martin’s beloved black lab, had developed life-threatening heart disease.

The dog was being treated for a snake bite when the vet detected an abnormal heartbeat and ordered an echocardiogram.

“I’ll never forget when the vet turned to me and asked if Sophie was getting grain-free dog food,” Martin recalls. “I felt like someone was punching me.”

The 7-year-old had been consuming the same brand of grain-free dog food since she was a puppy – just like Martin’s other dog, Bailey. An echocardiogram showed that Bailey, 9, also had the beginnings of dilated cardiomyopathy, or DCM.

Black Lab Sophie and Bailey developed life-threatening heart disease, but eventually recovered.Courtesy of Martha Martin

Martin changed the two dogs to different food, one that contained grain, hoping it might help heal their hearts.

In the more than two years since the Food and Drug Administration first warned dog owners of their pets’ heart failure that could be associated with grain-free pet foods, more than 200 dogs would have died of this disease and scientists are still trying to figure it out. Why.

Research has suggested that ingredients used in place of grains in dog food may be involved in the development of DCM, a disease in which the heart gets bigger, leaving it weaker. Certain breeds of large dogs are genetically susceptible to DCM, including Great Danes, German Shepherds and Doberman Pinschers, according to VCA Animal Hospitals.

“Most of the diets associated with reports of non-hereditary DCM contain ingredients from legume seeds, also known as ‘legumes’ – peas and lentils, for example – prominently in their ingredient lists,” the door said. word of the FDA, Monique Richards. “Although soy is a legume, we haven’t seen a signal associated with this ingredient.”

The problem may be the amount of ingredients used in non-traditional dog food.

“Pulses, including legume-based ingredients, have been used in pet foods for many years with no evidence that they are inherently dangerous, but analysis of data reported to [the FDA] indicates that the legume-based ingredients are used in many “grain-free” diets in greater proportions than in most formulas containing grains, ”Richards said in an email to NBC News. “The FDA has asked pet food manufacturers to provide dietary formulations so that we can better understand the proportions of ingredients in commercially available diets and possible relationships with non-hereditary DCM.”

However, it’s not clear if it’s just the amount of these ingredients in foods, said Dr Bruce Kornreich, a veterinary cardiologist in the Department of Clinical Sciences at Cornell University College of Veterinary Medicine.

“It might not just be what the diet is in,” he said. “It could be where it comes from or how it is treated.”

A recent study showed that dogs with DCM who ate non-traditional dog food were more likely to show improvement in their condition and live longer if, with their heart medication, they switched to dog food. traditional.

“Our study was a retrospective look at 75 dogs with DCM over a period of just under five years,” said study co-author Dr Lisa Freeman, veterinary nutritionist and professor at the Cummings School. of Veterinary Medicine. at Tufts University. “One of the new findings from our study is that we have had a significant increase over time in the number of dogs with DCM. This increase began even before the FDA’s first alert. “

To date, the FDA has not recommended the recall of grain-free products or declared specific pet food products unsafe.

The Pet Food Institute responded in a statement to NBC News: “PFI member nutritionists, veterinarians and product safety specialists have closely studied dilated cardiomyopathy (DCM) to better understand whether there is a relationship between DCM and diet in dogs not genetically predisposed to the disease. Drawing on our review of historical and recent scientific analyzes and published articles, PFI members dedicate thousands of hours to improving our understanding of DCM and its causes, all with the goal of advancing the good. – be pets. “

Millions of dogs in the United States regularly consume grain-free foods with no reported problems, said Dana Brooks, CEO and President of the Pet Food Institute, via email.

“Current research suggests that a variety of factors may influence the development of DCM in dogs,” she wrote. “The number of DCM reports submitted suggests that while diet is a factor, it may be among several elements involved such as the dog’s individual physiology.”

Normally, in pets with DCM, the heart gets bigger and its contractions weaken over time, said Freeman of Tufts University. But the hearts of dogs switched to traditional dog food has shown improvements.

“They lived much longer than those without regime change,” she said.

Martin’s dog experience echoes this. She changed Sophie and Bailey to a food containing grains. Bailey immediately began to improve and quickly had normal ECGs. But Sophie was not so lucky. “Each visit with the cardiologist showed it was getting worse,” Martin said. “The cardiologist told me she didn’t think she could recover. I was crushed.

Martin had noticed that Sophie seemed to have digestive issues as well and, on a hunch, changed her pet to food made by the same manufacturer for dogs with intestinal issues.

“She thrived,” Martin said. “Several months later, we went to the cardiologist hoping to hear more bad news. And there she was, she had turned around and was going the other way. Our vet was delighted.

The number of DCM cases reported to the FDA has been on the rise since it issued its warnings in 2018. As of July 31, 2020, the agency had received more than 1,100 reports of DCM in dogs, including 280 of them dying. . There have also been reports of DCM in cats. Of the 20 cases in cats, about 13 have died.

The FDA, along with experts from academia, industry and veterinary medicine, came together virtually in September in a science forum hosted by Kansas State University to explore the potential causes of non-hereditary DCM in dogs.

In November, Dr. Steven Solomon, director of the FDA’s Center for Veterinary Medicine, reflected on the Kansas State forum on the FDA website.

“The best thing you can do as a pet owner is to talk to your vet about your dog’s dietary needs based on their health and medical history,” he wrote.

Kornreich of Cornell University has sympathy for owners whose pets suffer from DCM.

“It’s sad,” he said. “You have to tell people that the decision they made to take care of their baby affected their health. They were trying to do the right thing.

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