What’s causing unusual cases of dilated cardiomyopathy in dogs? Dietary ingredients, lack of taurine are potential culprits, but the answer remains elusive

By Kim Campbell Thornton

Andrews McMeel Syndication

For several months, the United States Food and Drug Administration’s Center for Veterinary Medicine, in partnership with independent diagnostic laboratories and veterinary cardiologists and nutritionists, has been investigating reports of a trend that began at least two years ago: Some 150 or more dogs (and at least seven cats) that ate pet foods containing plant-based sources of protein among their main ingredients have developed dilated cardiomyopathy (DCM).

Canine DCM is a disease of the heart muscle that causes the heart to enlarge and decreases its ability to pump blood, often leading to congestive heart failure. It has a number of possible causes, including genetic predisposition, infection or toxins, and diet -- in particular, a lack of taurine. Here’s what is known so far.

The reported cases of DCM are unusual because they are occurring in breeds such as golden and Labrador retrievers, whippets, a Shih Tzu, a bulldog, miniature schnauzers and mixed breeds, none of which are typically prone to the genetic form of the disease. (Breeds genetically predisposed to DCM include Doberman pinschers, Great Danes and boxers. Cases of DCM responsive to taurine supplementation have been reported in cocker spaniels.)

Reported cases are also unusual because many of the dogs consistently ate what are popularly described as “grain-free” foods, with high levels of legumes such as peas, beans and lentils; legume seeds (known as pulses); potatoes; or foods with exotic protein sources such as kangaroo.

Investigators have so far been unable to determine why these ingredients might be linked to cases of DCM. In some cases, dogs had not eaten any other food for months or years before exhibiting signs of DCM.

At least four dogs in reported cases had low blood levels of taurine, an amino acid that helps power “excitable” tissues such as the brain, skeletal muscles, retina and heart. Taurine deficiency is documented as a potential cause of DCM.

That said, in four other cases, the dogs had normal blood taurine levels. In some cases seen by cardiologists, though, dogs who were not taurine deficient improved with taurine supplementation and diet change, according to an article by veterinary nutritionist Lisa M. Freeman, a member of the clinical nutrition service at Cummings Veterinary Medical Center at Tufts University. It may be that individual dogs have different taurine requirements based on breed, size or some unknown factor.

The FDA notes that other factors could include nutritional composition of the main ingredients or how dogs process them, sourcing or processing of primary ingredients, and amount of the ingredients used. Various proteins, including meat proteins, have different nutritional profiles and digestibility. Studies have found that certain large dogs fed commercially available complete and balanced lamb and rice diets may have increased risk of developing taurine deficiency-induced DCM. A 2007 study found that giant dogs took in less taurine than small dogs, possibly because of a slower metabolic rate.

Because it is not yet understood how or if grain-free diets are linked to cases of DCM, the FDA recommends consulting a pet’s veterinarian about whether to change a diet. Dogs or cats with signs of DCM or other heart conditions -- such as low energy, cough, difficulty breathing and collapse -- should be seen by a veterinarian immediately. Guidelines released by veterinary cardiologists and nutritionists advise testing blood taurine levels of dogs diagnosed with DCM and changing the diet based on consultation with a veterinary cardiologist. A taurine supplement may be recommended. Improvement after dietary change and supplementation can take up to six months. Report possible dietary cases of DCM to the FDA.

Q&A

Ways to manage

cat allergies

Q: My cat is allergic to everything: fleas, food, pollen, etc. She has scratched and bitten all the fur off her belly and chews at her legs. How can we manage her condition and help her stay comfortable?

A: That’s a triple-whammy! We often see flea-bite allergies in cats, and environmental allergies aren’t unusual either. Food allergies are less common, but they definitely occur. Signs for all three can be similar: scratching, biting, rubbing and grooming excessively. Other signs include sneezing, watery eyes and ear infections. All of those things add up to one seriously uncomfortable cat!

Treatment is individualized to each cat because they all have different signs. Beyond corticosteroids, your veterinarian may prescribe antihistamines, cyclosporine and allergy shots. All of these may play a role in helping to reduce your cat’s intense itching.

Used with antihistamines, essential fatty acid supplements may contribute to itch relief, too, according to some veterinary dermatologists. In dogs, applying EFAs topically has been found to help improve what’s known as barrier function -- the skin’s ability to repel pathogens that can aggravate atopic dermatitis. We don’t know if that works in cats, but it’s something to ask your veterinarian about.

It can be challenging and time-consuming to determine exactly what your cat is allergic to so you can get her on a program to keep symptoms under control. It may be necessary to restrict her diet -- called an elimination diet -- and then gradually add back specific ingredients to figure out which ones are setting off her allergies. Be prepared for the process to take as long as several months. If possible, enlist the services of a board-certified veterinary dermatologist who can perform allergy testing and recommend other environmental or dietary changes, as well as appropriate medication. Your veterinarian may be able to refer you to someone locally, or you can find one through the American College of Veterinary Dermatology. -- Dr. Marty Becker

Do you have a pet question? Send it to askpetconnection@gmail.com or visit Facebook.com/DrMartyBecker.

THE BUZZ

Dose noise-aversion

drug carefully

-- If your dog is fearful of loud noises such as thunder, fireworks, vacuum cleaners, gunshots or traffic sounds, you may be giving him a medication called Sileo (dexmedetomidine), which is FDA-approved to treat noise aversion. The oromucosal gel is administered to the dog’s gums with a special multidose syringe. The FDA warns that dogs can receive too much of the drug if the syringe isn’t set up properly. To prevent accidental overdoses, be sure you understand how to determine the appropriate dose based on your dog’s weight, lock the syringe in place and deliver the drug so the dog doesn’t swallow it. No deaths have been reported, but possible effects of an overdose include sedation, lethargy, sleepiness, slow heart rate, shallow or slow breathing, difficulty breathing, impaired balance, low blood pressure, muscle tremors and loss of consciousness.

-- Love the look of a longhaired cat with a pointed coat? The Birman may be the breed for you. The sweet social butterflies love following their humans around the house and settling into a lap whenever possible. Their silky coats are easy to groom and don't have an undercoat to form mats and tangles, though they still need daily combing to remove loose hair and prevent hairballs.

-- A new system being tested at the port in Mombasa, Kenya, may allow specially trained dogs to search large shipping containers for contraband ivory, rhino horn and other wildlife products using only a small air sample. Called Remote Air Sampling for Canine Olfaction (RASCO), the system will draw air from specific containers and pass it through filters that are then presented to the dogs, trained to sit if they scent anything illicit. The technique could allow the dogs to check many more containers daily, reducing trade of illegal wildlife items. -- Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker

ABOUT PET CONNECTION

Pet Connection is produced by a team of pet-care experts headed by "The Dr. Oz Show" veterinarian Dr. Marty Becker and award-winning journalist Kim Campbell Thornton. They are affiliated with Vetstreet.com and are the authors of many best-selling pet-care books. Joining them is dog trainer and behavior consultant Mikkel Becker. Dr. Becker can be found at Facebook.com/DrMartyBecker or on Twitter at DrMartyBecker. Kim Campbell Thornton is at Facebook.com/KimCampbellThornton and on Twitter at kkcthornton. Mikkel Becker is at Facebook.com/MikkelBecker and on Twitter at MikkelBecker.

Common-sense care keeps pets healthy and injury-free

Andrews McMeel Syndication

If you’re a parent, you’ve been swamped with back-to-school preparations. If you’re a pet parent, it’s also a good time of year to practice some preventive care to keep your dog or cat healthy.

Inoculations. Pets need vaccinations early in life -- usually a series of “core” vaccines for parvovirus, distemper, adenovirus and rabies for puppies, and feline herpesvirus, feline calicivirus, feline panleukopenia virus, feline leukemia virus and rabies for kittens -- followed by a booster when they are 1 year old. Ideally, puppies should receive the final parvovirus and distemper vaccinations when they are at least 16 weeks old because they may not develop a good response to the vaccine before that age.

After that, booster shots are recommended only every three years. Better yet, ask your veterinarian to “titer” your pet every three years to see if the immunity from the vaccines still holds. The rabies vaccine is an exception: Most states require it triennially for dogs and do not allow exceptions even if a titer shows the dog is still protected.

Talk to your veterinarian about whether your pet needs any “non-core” vaccinations for diseases that may be seen in your area or that are specific to an animal’s lifestyle. For instance, a canine influenza vaccine may be a good idea for dogs who travel frequently to dog shows or other competitions where they are in contact with other dogs, or who are boarded or go to dog parks. Farm dogs or dogs who frequent areas where there are wild mammals may benefit from a vaccination for leptospirosis. In cats, the Bordetella vaccine is not routinely recommended unless they are at high risk of exposure from being in crowded environments.

Injuries. Not every injury is preventable, of course, but taking steps to reduce their likelihood helps. Pet-proofing your home and yard is the most effective way to prevent accidents. Better yet, it doesn’t cost anything.

Indoors, make sure medications are well out of reach. Poisonings from human medications are one of the top reasons for calls to pet poison control hotlines. Just 15 seconds is all it takes for dogs to break into childproof bottles. The same goes for trash and foods that could cause digestive upset.

Outdoors, walk the perimeter of your yard to check for weak spots in fences or gates, and repair them. Pull up mushrooms and toadstools that might attract pets who are willing to down anything that looks edible. If you live with one of those animals, avoid putting out snail bait, rat poison or other toxic substances; it’s not worth the risk of a trip to the ER or, worse, a death. Some owners teach their “I’ll-eat-anything” dogs to wear a basket muzzle when they’re outdoors so they don’t swallow sticks, pine cones, toxic mushrooms or other objects that can cause problems.

Part of pet-proofing includes teaching animals to respond quickly to the cues “come” and “leave it,” which can prevent them from running into the street or nabbing something tasty but toxic.

Internal and external parasites. Get an update from your veterinarian about the latest in parasite prevention. Products are available that repel ticks and fleas and prevent roundworms, heartworms and other internal parasites from getting a toehold in your pet’s gut and causing irritation or disease.

Other preventive tips. Keep ear problems at bay by checking frequently for redness or foul odors and noticing if your pet frequently scratches at ears or shakes his head. Ward off skin problems by brushing the coat to remove dirt, distribute skin oils, and remove dead hair so it doesn’t mat and tangle; thoroughly rinsing the coat with fresh water after swimming in pools, lakes or saltwater; and cleaning and drying loose skin folds regularly to prevent bacteria and yeast growth.

Q&A

Cat swings from

nice to naughty

Q: Our cat seems to have two personalities. She is an 8-year-old rescue that we have had for a few months. She can be sweet when she wants to sit by us or when she jumps up on our bed, but more often, she is on the defensive. When we bend down to pet her, she usually tries to bite. Sometimes she reaches out for passing legs. No one dares pick her up. Any suggestions? Do you think it had something to do with her previous life?

A: Cats are more comfortable when they are the ones doing the “choosing” when it comes to initiating closeness or interaction with a person, especially if they’re fearful. Acting out when being petted could be a defensive response caused by fear. Swatting at legs as people walk by could be a type of predatory play behavior.

A consultation with a Fear Free-certified veterinarian, veterinary behaviorist or certified applied animal behaviorist who can see your cat’s behavior in person could help you get a better picture of why your cat acts the way she does or uncover underlying health issues that may be contributing to her behavior.

What animals learn during early life can forever impact their adult personalities and comfort level with humans and their environment. Animals can still learn throughout life, but their basic resilience in the face of stress is formed early. That said, you can do some training exercises to build your relationship, communication and her confidence. One is to turn petting into a positive by pairing the reach of your hand with a desirable reward, such as a favorite treat or toy. A skilled behaviorist or trainer can offer other suggestions. -- Mikkel Becker

Do you have a pet question? Send it to askpetconnection@gmail.com or visit Facebook.com/DrMartyBecker.

THE BUZZ

Dogs’ noses aid

disease detection

-- Could your doctor have a canine assistant one day? Bio-detection dogs sniff out the scent of diseases such as cancer by checking urine or fecal samples, breath odor or skin swabs. They can be a “second opinion” for cancers that are sometimes difficult to diagnose, such as prostate cancer. Studies are also examining their ability to identify the presence of malaria and Parkinson’s disease. Other canine medical aides are trained to notice minute changes in a person’s odor, alerting them to impending seizures or abnormal blood sugar or hormone levels. These medical-alert dogs primarily work with people who have seizure disorders or diabetes, but some have been trained to help people with Addison’s disease and severe food allergies.

-- Scammers have invaded pet adoptions. Be cautious when adopting through online rescue groups or individual placements. If the organization or person placing the pet asks you to wire money or send a pre-paid debit or gift card to cover the cost of shipping the pet to you, it’s likely a fraudulent transaction. Once they receive payment, you may be hit up for more fees to cover nonexistent emergency vet visits or the cost of a crate or pet health insurance. Or they may claim the animal has been shipped, but the pet never arrives. For more information, check BBB Scam Tracker (bbb.org/scamtracker/us) and IPATA’s (International Pet and Animal Transportation Association) page on pet scams (ipata.org/current-pet-scams).

-- We know Pomeranians as toy breeds, but in the 19th century, they were much larger dogs, weighing 20 to 30 pounds before being bred down in size. Today, they typically weigh 3 to 7 pounds, but oversize ones are not unusual and can be a good choice for families. Poms come in many colors and patterns, including orange, white, black, chocolate, sable, cream, black and tan, brindle, and blue. -- Kim Campbell Thornton

ABOUT PET CONNECTION

Pet Connection is produced by a team of pet-care experts headed by "The Dr. Oz Show" veterinarian Dr. Marty Becker and award-winning journalist Kim Campbell Thornton. They are affiliated with Vetstreet.com and are the authors of many best-selling pet-care books. Joining them is dog trainer and behavior consultant Mikkel Becker. Dr. Becker can be found at Facebook.com/DrMartyBecker or on Twitter at DrMartyBecker. Kim Campbell Thornton is at Facebook.com/KimCampbellThornton and on Twitter at kkcthornton. Mikkel Becker is at Facebook.com/MikkelBecker and on Twitter at MikkelBecker.

Cat lovers know that the right litter can be the key to living with a happy cat

By Kim Campbell Thornton

Andrews McMeel Syndication

Remember when there was just one kind of cat litter? Before 1947, the rare cat who lived indoors might have a box filled with sand, ashes, sawdust or soil, which it then tracked through the house, no doubt to the dismay of fastidious housekeepers. In 1947, businessman Edward Lowe handed a bag of granulated clay to a woman who was complaining that her cat tracked ashes through the house. The clay worked, the woman came back for more and the cat litter industry was born.

Now cat lovers might feel as if they’re in a golden age of cat litter. Beyond granulated clay, which remains popular, there is sandlike clumping litter, silica gel crystals, and litter made from recycled newspaper, recycled pine scraps, corn, wheat, walnut shells and grass. For both humans and cats, there’s a litter type for every concern: low tracking, low dust, attractive scent, no scent, low odor, low price and environmental friendliness. Some litters even indicate that a cat may have a urinary tract infection or other condition.

The anonymous woman who sparked the development of granulated clay litter was concerned about tracking, and that remains an issue for many cat owners. While many litters are marketed as being low-tracking, sometimes a larger litter box can also help to solve the problem. Rosemary George of Falls Church, Virginia, says, “I have four cats, so I use cheap clay litter from the grocery store. There are two really large litter pans out on the enclosed sunporch. I scoop them once a day and change them entirely once a week. Once I got huge litter pans, there stopped being so much litter on the floor.”

Cats like what they like, though, and their preferences can win out over an owner’s desire to not have litter tracked through the house. Tery McConville of Mount Vernon, Washington, uses a clumping pine litter. “It gets everywhere,” she says, “but it’s what Princess likes, and it smells nice.”

Humans and cats with asthma benefit from dust-free or low-dust litter. Dust irritates the respiratory tract and can contribute to coughing, wheezing and difficulty breathing when cats kick it up as they dig in the litter box. Litters made from wheat, recycled paper, wood and silica gel crystals, as well as some clumping litters, tend to be low in dust. Unscented litters are also good choices when a person or pet in the home has asthma. Anna Wright uses a wheat-based litter, saying, “It’s expensive, but my health and happiness are worth it. It doesn’t give me headaches or trigger coughs for me like so many other products do. I think the cats like it for the same reasons.”

Older cats may have special needs when it comes to litter. When her cat Shadow was in renal failure, Gail Parker of Philadelphia found that replacing litter with newspaper helped prevent him from urinating outside the litter box. She believes the paper was softer on his paws and found that her other cats preferred it, too. Parker puts sections of newspaper in the cats’ boxes and removes them as soon as they are used.

No litter can replace a veterinary visit, but some litters are made to indicate the need to visit the vet. Coated with a safe, nontoxic pH detector, porous silica gel granules change color when acid, alkaline or bilirubin levels change, suggesting possible infection or illness.

But whatever you look for in cat litter, what your cat prefers is what counts. Offer an assortment of litters to see which one he likes best, and go with that. Provide an extra-large box, and fill it with three to five inches of litter for your cat’s digging pleasure. Scoop it once or twice a day, clean the box and change the litter every week or two, and you’ll have a happy cat.

Q&A

Spot on eye

is cancerous

Q: I noticed a black dot near the pupil of my dog’s eye, which grew quickly. I took him to the veterinarian, and it was diagnosed as a malignant melanoma. He’s scheduled for laser surgery to destroy the tumor. What can you tell me about this condition?

A: Your dog is lucky to have such an observant owner! We usually think of melanoma as a skin cancer, but it’s a tumor that originates in pigment-producing cells, so the iris of the eye -- the colored circle surrounding the pupil -- is one of the areas at risk. Signs include darkening of the color of the iris, a change in shape of the pupil or a raised area on the iris.

These types of melanomas are usually benign and rarely metastasize, or spread, to other areas of the body. They can, however, continue to grow, leading to such problems as retinal detachment, formation of cataracts and glaucoma, so it’s important to treat them.

Your veterinarian may recognize an ocular melanoma at first glance, but the specialized equipment of a veterinary ophthalmologist is necessary to determine how far advanced it is.

When ocular melanomas are malignant but caught early, as in your dog’s case, they are typically highly treatable with non-invasive laser treatment. Your dog is unlikely to lose any vision. For larger such melanomas, laser treatment can shrink the tumor or slow its growth, but dogs may also need surgical removal of the tumor or even removal of the eye itself.

Cat owners, your pets are at risk, too -- and more so than dogs. Feline ocular melanomas are more likely to spread to other areas of the body. Any time you notice a change in color or appearance of your pet’s eyes, bring it to your veterinarian’s attention. -- Dr. Marty Becker

Do you have a pet question? Send it to askpetconnection@gmail.com or visit Facebook.com/DrMartyBecker.

THE BUZZ

Protect pets from

wildfire smoke

-- Pets in areas with wildfires are at risk from smoke inhalation. Breathing unhealthy air can cause disorientation, fainting, lethargy and confusion, according to veterinarians at DoveLewis Emergency Animal Hospital in Portland, Oregon. Pets at heightened risk include breeds with flat faces such as bulldogs, pugs and Persians; senior pets; young animals; and pets with respiratory conditions such as asthma. Avoid letting pets exercise for long periods in smoky conditions, run air conditioning to filter indoor air, and ensure that pets have plenty of fresh water. Take your pet to the vet if you see signs of distress such as difficulty breathing, unusual coughing or sneezing, swollen eyes or mouth, and open-mouth breathing. If conditions are unusually bad in your area, consider taking pets to stay with a friend or relative or at a boarding kennel in an area with better air quality.

-- September is an important month for pets. Here’s what you can celebrate: Happy Healthy Cat Month and Responsible Dog Ownership Month; National Pet Memorial Day and National Hug Your Hound Day, both on Sept. 9; Puppy Mill Awareness Day on Sept. 15; National Dog Week and Deaf Pet Awareness Week, both starting on Sept. 23; and World Rabies Day on Sept. 28.

-- Love a curly coat? Plenty of pets can suit your fancy. On the dog side, consider the American water spaniel; bichon frise; Boykin spaniel; curly-coated retriever; Irish water spaniel; Kerry blue terrier; lagotto Romagnolo; toy, mini or standard poodle; Portuguese water dog; pumi; and Spanish water dog. Curly-coated cats exist, too: Cornish rex; Devon rex; Selkirk rex; and LaPerm. The good thing about curly-coated pets is that they don’t shed much; the bad news is that they often need daily home grooming and, for dogs, regular professional grooming to keep their coats beautiful and tangle-free. -- Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker

ABOUT PET CONNECTION

Pet Connection is produced by a team of pet-care experts headed by "The Dr. Oz Show" veterinarian Dr. Marty Becker and award-winning journalist Kim Campbell Thornton. They are affiliated with Vetstreet.com and are the authors of many best-selling pet-care books. Joining them is dog trainer and behavior consultant Mikkel Becker. Dr. Becker can be found at Facebook.com/DrMartyBecker or on Twitter at DrMartyBecker. Kim Campbell Thornton is at Facebook.com/KimCampbellThornton and on Twitter at kkcthornton. Mikkel Becker is at Facebook.com/MikkelBecker and on Twitter at MikkelBecker.