Grain-Free Dog Food Q & A’s

Due to the overwhelming response we received from our Facebook Live Stream with Dr. Steven Rosenthal, we have compiled these Q & A’s to better help you understand the possible link between grain-free dog foods and heart disease.

Please continue to refer back to this page as we will update it as more questions come in! As always, feel free to reach out to us at and visit our Pet Nutrition Resources Page for further information. 

Q & A’s

How is CVCA interacting with the FDA?
For a while now we have been reporting cases to the FDA in patients that we have had concern about the diet and heart disease relationship.  Currently we are identifying patients with DCM that are being feed grain free diets and working with the FDA to collect both food samples along with samples from the affected patient to analyze blood, urine and fecal samples to try to identify the cause of this relationship.

Does grain-free food really cause heart-disease?
What we can say is that we have seen this many times as have other veterinary cardiologists around the country. It is real, it’s concerning and a life-threatening cardiac condition. There may be multiple factors involved and certain brands of foods or formulations that may pose a greater risk.  We have seen it with raw diets, dry kibble and vegetarian diets. We are working to determine what the specific issues are so we can avoid having pets affected with this heart disease.  


What about cats?  Is the grain-free safe for any pets?
We have not identified the link in cats at this point in time although the composition of the diets in cats are different from dogs. They have a higher protein content along with taurine, a required nutrient in the diet.  In the 1980s it was identified that taurine deficiency will lead to dilated cardiomyopathy in cats. After this discovery, commercial cat foods were adjusted to reflect this unique nutritional requirement for cats.

What are the ingredients we should be concerned about and to what quantity?  I understand peas, chickpeas and lentils but what about white or sweet potatoes?
We are unsure about the relationship of white and sweet potatoes. They have been brought up as a concern and we are still in the process of investigating this with the FDA.

Why are the nontraditional
 meats suspected to be the cause? 
Please refer to a veterinary nutritionist. There can be some differences in nutrient content of certain meats. Of the dogs we are seeing that are affected with Nutritional DCM, some of the most common diets we are concerned with are kangaroo and pork based. We are just trying to be safe until we elucidate the cause of the disorder in making this recommendation.

What tools should we use when analyzing dog food to avoid these issues?
Make sure that the diet has gone through AAFCO testing to confirm nutritional adequacy. 

Is there a certain dog food you recommend?
There are many brands of dogs foods that are excellent and we try not to recommend a specific brand as each pet and each pet family have diets that work best for them.  At this point, the best recommendation we can make is to make sure the diet has gone through the AAFCO testing and is found to be complete.

Do you recommend dehydrated or freeze dried foods?
As long as these diets have gone through feed testing that can prove nutritional adequacy than those diets should be fine.  

Any diet advice for my dog that suffers from several food allergies?
As with all dogs we would recommend a diet that meets the AAFCO standards and is feed-tested to meet nutritional adequacy.  Currently with the issue with grain free foods, we would suggest if there are grain sensitivities that you choose a diet that uses more traditional protein sources like poultry, lamb, beef and avoid some of the unusual proteins like kangaroo, rabbit, bison, etc. and choose a diet that legumes (peas, chickpeas, lentils or beans) are not within the first 5 ingredients.  A consideration also may be to use more than one diet from different established food companies that do feed-testing for your feeding regimen.

How do you know if the dog’s food has created heart problems and if so, can it be reversed changing feed?
The clinical signs of heart disease are slowing down, less tolerance to exercise, more rapid breathing, coughing, weakness and collapse episodes.  Routine physical examinations with your primary care veterinarian can also help find underlying cardiac issues if signs of a heart murmur, other abnormal heart sounds or an irregular heart rhythm are present.  If signs of heart disease are noted and are related to nutritional issues we have found, some of the dogs will have a reversal of their cardiac changes with changes in the diet and taurine supplementation.

What are the daily recommendations for taurine supplements?
In a well-balanced diet that is well absorbed, these supplements should not need to be added to dog food.

Can you recommend a taurine supplement?
There is not a specific supplement that we recommend but we would suggest that it is a supplement that is certified by Consumer Lab which is an independent group that tests supplements.

Is a taurine supplement a good idea for all dogs?
Dogs should not require taurine supplementation although there is some concern that certain breeds like Golden Retrievers, Cocker Spaniels and Newfoundlands may have a predisposition to low taurine levels.  Dogs should be able to synthesize their own taurine if there are adequate precursors to taurine in the diet (the amino acids cysteine and methionine). If the diet is well balanced, has adequate digestible protein and no other factors that may affect absorption of protein (possibly high fiber or maybe certain bacteria in the gut or other causes), taurine should not be needed.  It is a safe supplement though and can be added to the diet.  

Is it okay to add taurine so I can continue feeding my dog grain-free food?
Since we are unsure if taurine is the only factor in the issues with grain-free diets, we cannot tell you that is the only preventative measure.  Taurine supplementation is safe and well tolerated. Close monitoring of a dog’s physical examination, and working with your local cardiologist to screen for disease with echocardiography and Holter monitoring is recommended. Early detection of disease can dramatically slow down the progression of this devastating disease.

Should we consider supplementing with meat protein as opposed to taurine directly?
Since we have seen dogs with this suspected nutritionally mediated dilated cardiomyopathy with normal taurine levels, we are unsure if taurine is the only factor involved in this disorder.  With a high-quality protein that is adequately absorbed into the body through the gut, taurine deficiency should not develop; therefore, use of a high-quality diet (that terminology can be used too often) that has been tested for nutritional adequacy is recommended.  Too much protein in the diet can lead to kidney issues so we have to be careful with adding too much protein to the diet.

My dog had bloodwork done and the echo stated no DCM, but mild mitral valve insufficiency.  If his blood work comes back under 250 should he be supplemented with taurine, even though he is not diagnosed with DCM?
We have seen dogs with low taurine levels and normal hearts.  But, if the taurine level on whole blood is below 250 and the plasma is less than 60, I would consider adding a taurine supplement to the diet.  Taurine should be safe. Make sure the supplement is tested and certified by an independent company like Consumer Lab.