Study of correlations between serum taurine, thyroid hormones and echocardiographic parameters of systolic function in clinically healthy Golden retrievers fed with commercial diet

Taurine deficiency predisposes to the development of nutritional dilated cardiomyopathy and is widespread in dogs fed with non-traditional diets. However, Golden retrievers show lower plasma taurine concentration and an impaired systolic function compared to breeds of the same size and morphotype. For these reasons, it can be difficult to classify a subject from a cardiological point of view, with the risk of considering as pathological characteristics that can be completely normal in this breed. This is a cross-sectional multicenter study. The aims were 1) to identify breed-specific range of serum taurine concentration, 2) to describe a correlation between serum taurine concentration and echocardiographic parameters of systolic function in clinically healthy Golden retrievers fed with traditional diet, 3) to identify a correlation between thyroid hormones, serum taurine concentration and echocardiographic indices. Sixty clinically healthy Golden retrievers (33% males, 67% females) were included. Fifty-three dogs were fed with traditional diets and their range of serum taurine concentration was 398.2 (31.8-430) nmol/ml. Serum taurine concentration was found to be negatively correlated to systolic internal diameter of the left ventricle and systolic and diastolic left ventricular indices and volumes obtained with different methods, whereas was positively correlated to the left ventricle ejection and shortening fractions but difference was not statistically significative. A weak but significant correlation between serum taurine and T4 was demonstrated. Serum taurine median values in dogs with normal systolic function were higher than in dogs with impaired systolic function. A cut-off of serum taurine concentration of 140.6 nmol/ml had a moderate sensitivity and specificity in the identification of an impaired left ventricular systolic function (AUC 0.6, Se 78%, Sp 44%). This study showed that the median serum taurine concentration was significantly lower in dogs with impaired systolic function. Therefore, echocardiographic monitoring is recommended in all dogs with serum taurine concentration lower than 140.6 nmol/ml.

Domestic dogs maintain clinical, nutritional, and hematological health outcomes when fed a commercial plant-based diet for a year

Domestic dogs can maintain health on complete and well-balanced canine plant-based nutrition (K9PBN). Novel insight on health outcomes in dogs consuming K9PBN is of relevance to veterinary professionals and consumers given a growing interest in non-traditional dog foods with perceived health benefits, while considering potential safety concerns. We aimed to investigate nutritional equivalence by measuring clinical health outcomes in adult dogs fed K9PBN over twelve months compared to a meat-based diet at baseline. We enrolled fifteen clinically healthy adult dogs living in households in Los Angeles County, California in a prospective cohort study and evaluated clinical, hematological, and nutritional parameters in dogs at 0, 6, and 12 months, including complete blood count (CBC), blood chemistry, cardiac biomarkers, plasma amino acids, and serum vitamin concentrations. The study found that clinically healthy, client-owned, adult dogs maintain health, based on physical exams, complete blood count, serum chemistry, plasma amino acids, serum vitamins, and cardiac biomarkers combined with client-reported observations, when fed commercial K9PBN over a twelve-month period. This study is the most comprehensive and longest known K9PBN investigation to date and provides clinically relevant evidence-based nutrition data and new knowledge on outcomes in clinically healthy dogs who thrive without consumption of animal-derived ingredients. These results also provide a valuable foundation for the future study of K9PBN as a potential nutritional intervention for clinically relevant pathologies in canine medicine. Lastly, it is of major relevance to One Health paradigms since ingredients produced independent of industrial food animal production are both more sustainable and help to circumvent ethical dilemmas for maintenance of health in domestic dogs.

DILATED CARDIOMYOPATHY IN SLENDER-TAILED MEERKATS (SURICATA SURICATTA) UNDER HUMAN CARE

Meerkats (Suricata suricatta) housed at two accredited zoological institutions in the United States were evaluated via echocardiography, thoracic radiography, and blood biomarkers-taurine and feline N-terminal pro-B-type natriuretic peptide-to determine the prevalence and severity of dilated cardiomyopathy (DCM) in both populations. In total, 24 meerkats were evaluated and 7 were diagnosed with DCM based on the following parameters: left ventricular internal diameter at end diastole > 1.30 cm, left ventricular internal diameter at end systole > 1.10 cm, and a fractional shortening of <18%. Echocardiographic parameters were identified and reported for normal and affected meerkats, whereas thoracic radiographs were not useful for screening for DCM. Meerkats with DCM were treated with pimobendan and/or benazepril and furosemide if indicated. Seven meerkats died during the study period, with the majority exhibiting myocardial fibrosis. Of the blood parameters tested, elevated taurine levels were associated with DCM. Further research is necessary to characterize the etiology of DCM in meerkats.

A Retrospective Cohort Evaluation of Left Ventricular Remodeling, Perioperative Complications and Outcome in Medium and Large Size Dogs with Patent Ductus Arteriosus after Percutaneous Closure

This retrospective cohort study included one hundred fifty-seven medium and large-size dogs with the aim of evaluating the effect of signalment and echocardiographic features on complications, outcomes and left ventricular modifications before and after patent ductus arteriosus (PDA) closure. The patients were divided in two groups based on the heart remodeling after closure: Group A included dogs that had a reduction in the end-systolic volume index (ESVI) after closure compared to the ESVI measured before; Group B included dogs without a reduction in ESVI after closure. Body weight, minimal ductal diameter (MDD) of PDA, end-diastolic volume index and presence of arrhythmias at presentation were significantly higher in Group B compared to Group A. The shortening fraction and ejection fraction after closure were reduced in both groups, but in Group B there was a major reduction, and the mean values indicated a possible systolic dysfunction. Complications during the procedure and death due to cardiac reasons were greater in Group B compared to Group A. In conclusion, a higher body weight, a larger MDD, a more severe heart enlargement or arrhythmias at presentation increased the risk of developing a worsening structural and functional condition after ductal closure, and this can be associated with perioperative complications and cardiac death.

The Role of Point-of-Care Ultrasound in Managing Cardiac Emergencies

Point-of-care ultrasound (POCUS) is a useful imaging tool for the diagnosis and monitoring of cardiac emergencies. Unlike complete echocardiography, POCUS is a time-sensitive examination involving a subset of targeted thoracic ultrasound views to identify abnormalities of the heart, lungs, pleural space, and caudal vena cava. When integrated with other clinical information, POCUS can be helpful in the diagnosis of left-sided and right-sided congestive heart failure, pericardial effusion and tamponade, and severe pulmonary hypertension and can help clinicians monitor resolution or recurrence of these conditions.

Possible development and resolution of dilated cardiomyopathy phenotype secondary to atypical hypoadrenocorticism in a dog

OBJECTIVE

To report the possible occurrence of dilated cardiomyopathy phenotype associated with atypical hypoadrenocorticism and subsequent marked improvement with treatment in a mixed breed dog.

CASE SUMMARY

A 4.5-year-old, neutered male mixed breed dog was evaluated for a history and clinicopathological changes consistent with atypical hypoadrenocorticism. The dog was being fed a grain-free diet. While hospitalized for supportive care and diagnostics, the patient developed and was diagnosed with biventricular congestive heart failure secondary to dilated cardiomyopathy phenotype and IV fluid administration. The left-sided congestive heart failure resolved with discontinuation of IV fluid therapy and short-term administration of diuretics. After treatment of atypical hypoadrenocorticism with glucocorticoid supplementation, and while continuing to be fed varying grain-free diets, the patient's dilated cardiomyopathy phenotype largely resolved. The patient fully recovered and did not require any long-term cardiac medications.

NEW OR UNIQUE INFORMATION PROVIDED

Development of dilated cardiomyopathy phenotype has not been described in dogs as a sequela of untreated hypoadrenocorticism but has been reported in human literature. Given the fact that standard management of hypoadrenocorticism typically involves aggressive fluid resuscitation, awareness of this potential sequela is important for patients that fail to respond or develop signs consistent with volume overload.

Impact of blood tube additives and timing of sampling on blood taurine concentrations in clinically healthy dogs

INTRODUCTION

Dilated cardiomyopathy can be associated with taurine deficiency in dogs. Blood taurine concentrations can be analyzed in whole blood (WB) and plasma. The study objectives were to investigate agreement between taurine concentrations measured in WB, heparin plasma, and EDTA plasma, determine intraindividual variation in healthy dogs, and evaluate if time from feeding to sampling impacts concentrations.

ANIMALS

Ten English Cocker spaniels and 10 dogs of various breeds.

MATERIALS AND METHODS

Dogs were fasted 12 h prior to initial blood sampling, and the blood was collected at five occasions over eight h. Food was offered immediately after first and one h after fourth sampling time point.

RESULTS

Agreement between taurine concentrations in EDTA plasma and heparinized plasma was good (mean difference 4.5 nmol/mL, 95% confidence interval (CI) 36.8-45.8 nmol/mL). Whole blood concentrations were systematically higher than EDTA and heparin plasma concentrations (mean difference 132.7 nmol/mL, 95% CI 23.6-241.8 nmol/mL, and 127.6 nmol/mL, 95% CI 28.6-226.6 nmol/mL, respectively, all P < 0.001). Intraindividual daily variations in taurine concentration were seen in all additives, with largest variations in plasma (P < 0.001). Taurine concentration in heparinized plasma was higher at first and fifth sampling time points compared to the fourth (P = 0.014).

DISCUSSION

Agreement was found between taurine concentrations measured in different additives, with expected higher concentration in WB than plasma. Taurine concentrations measured in heparinized plasma varied with sampling time point. Intraindividual daily variations were observed in all additives, but mainly in plasma samples.

CONCLUSION

Taurine concentrations in dogs with suspected deficiency should be interpreted with caution.

Comparison of echocardiographic measurements and cardiac biomarkers in healthy dogs eating nontraditional or traditional diets

BACKGROUND

There has been a recent association between nontraditional diets and development of diet-associated dilated cardiomyopathy (DCM) in dogs.

HYPOTHESIS/OBJECTIVES

To compare echocardiographic measurements and cardiac biomarkers between healthy dogs eating nontraditional vs traditional diets. We hypothesized that dogs eating nontraditional diets would have lower measures of systolic myocardial performance compared to dogs eating traditional diets.

ANIMALS

Forty-six healthy dogs: 23 eating nontraditional diets and 23 eating traditional diets.

METHODS

Prospective, cross-sectional study. Dogs were divided into groups based on diet ingredients. Dogs underwent 2-dimensional (2D), 3-dimensional (3D), and Doppler echocardiographic examinations and analysis of plasma N-terminal prohormone of B-type natriuretic peptide, serum cardiac troponin I, and whole blood and plasma taurine concentrations.

RESULTS

Mean 2D ejection fraction (EF) was lower for dogs eating nontraditional diets (48.65 ± 7.42%) vs dogs eating traditional diets (56.65 ± 4.63%; P < .001; mean difference 8.0% [4.0%-12.0%] 95% confidence interval [CI]). Mean 3D EF was lower for dogs eating nontraditional diets (45.38 ± 7.35%) vs dogs eating traditional diets (57.58 ± 4.84%; P < .001; 12.0% [8.0%-16.0%] 95% CI). Mean 2D left ventricular end-systolic volumes, indexed to body weight, were significantly higher in dogs eating nontraditional diets (1.46 ± 0.08 mL/kg) vs dogs eating traditional diets (1.06 ± 0.08 mL/kg; P = .002; 0.4 mL/kg [0.18-0.62 mL/kg] 95% CI).

CONCLUSIONS AND CLINICAL IMPORTANCE

Healthy dogs eating nontraditional diets had lower indices of systolic function and larger left ventricular volumes compared to dogs eating traditional diets. Screening of apparently healthy dogs eating nontraditional diets might allow for early detection of diet-associated DCM.

Acquired Systolic Dysfunction and Subsequent Congestive Heart Failure Following Treatment of Hypoadrenocorticism in Two Dogs

Acquired cardiomyopathies have been described in human patients with hypoadrenocorticism. Several mechanisms have been described to explain the cardiac effects of primary adrenal insufficiency, but, clinically, these manifestations may be underappreciated in dogs. In humans, there is an infrequently described, reversible dilated cardiomyopathy in patients with hypoadrenocorticism. Two dogs were presented to a single referral center for evaluation of weakness or collapse and were subsequently diagnosed with hypoadrenocorticism after a full diagnostic workup. Following the diagnosis of hypoadrenocorticism and administration of glucocorticoids and desoxycorticosterone pivalate, both dogs developed left-sided congestive heart failure and had systolic dysfunction diagnosed by echocardiogram. Both dogs were euthanized; one because of recurrent congestive heart failure and another because of a concern for poor long-term prognosis and decreased quality of life. The purpose of this case report is to document multiple cases of hypoadrenocorticism-associated systolic dysfunction and subsequent cardiogenic pulmonary edema in dogs.

Survey of Pet Owner Attitudes on Diet Choices and Feeding Practices for Their Pets in Portugal

Feeding practices and perceptions of pet owners determine consumer decisions on pet foods and influence the health of companion animals. The objective of the survey was to study emerging trends on pet food diets in Portugal by conducting a preliminary survey. A survey of 74 pet owners revealed that most fed pets with commercial diets (67.6%) bought in supermarkets (40.3%), spending a monthly average of EUR 30, following healthy practices (e.g., ≥30 min of exercise), which translated to an average self-reported pet body condition score of 3. Information about pet foods mainly originates from the animal's veterinarian (64.9%), followed by the internet (16.2%). A trend for a growing interest in alternative diets (e.g., natural and organic) was identified, being already the second most consumed diet type (19.0%), perceived as being of a higher quality, and as a topic of interest (38.6%). This interest likely originates from a higher weighting of the ingredient list (31.5%) in consumer choices and beliefs that commercial diets should consist of a higher proportion of meat (29.3%) and less carbohydrates (38.7%). Therefore, more research is needed on the nutritional adequacy of alternative diets and uncommon ingredients, the pet food industry will have to adapt to changing consumer behaviors, and veterinarians should be available to discuss and oversee novel dietary practices in companion animals.

Responses in randomised groups of healthy, adult Labrador retrievers fed grain-free diets with high legume inclusion for 30 days display commonalities with dogs with suspected dilated cardiomyopathy

Early responses in healthy adult dogs fed grain-free diets with high inclusion of split peas (20%) and lentils (40%) that may lead to canine diet-induced dilated cardiomyopathy (DCM) were investigated. To help understand the clinical relevance of the findings, a survey of electronic health records (EHR) was conducted of dogs with and without suspected DCM for comparison. Control and Test diets were fed to Labrador retriever dogs for 30 days (n = 5 and 6, respectively). Blood and urine samples collected at baseline and days 3, 14 and 28/30 were analyzed for hematology, clinical biochemistry and taurine concentrations. The EHRs of dogs at Banfield® Pet Hospitals in the 2-year period 2018-2019 were surveyed, revealing 420 dogs diagnosed with DCM, which were compared with 420 breed, gender and age-matched healthy control dogs. Compared to baseline values, feeding the Test diet for 28 days caused progressive, significant (p < 0.001) decreases in red blood cell counts (RBC), hematocrit and total hemoglobin by 7.7, 8.3 and 6.3%, respectively, and a 41.8% increase in plasma inorganic phosphate. Commonalities in these parameters were observed in clinical DCM cases. Regarding taurine status, Test dogs transiently increased whole-blood (23.4%) and plasma (47.7%) concentrations on day 14, while taurine:creatinine ratio in fresh urine and taurine in pooled urine were reduced by 77 and 78%, respectively, on day 28/30. Thus grain-free, legume-rich Test diets caused reduced RBC and hyperphosphatemia, findings also indicated in dogs with suspected DCM. Changes in taurine metabolism were indicated. The data will aid in generating hypotheses for future studies.

Association of diet with clinical outcomes in dogs with dilated cardiomyopathy and congestive heart failure

INTRODUCTION

Dilated cardiomyopathy (DCM) in dogs has been associated with feeding of grain-free (GF), legume-rich diets. Some dogs with presumed diet-associated DCM have shown improved myocardial function and clinical outcomes following a change in diet and standard medical therapy.

HYPOTHESIS

Prior GF (pGF) diet influences reverse cardiac remodeling and clinical outcomes in dogs with DCM and congestive heart failure (CHF).

ANIMALS AND METHODS

A retrospective study was performed with 67 dogs with DCM and CHF for which diet history was known. Dogs were grouped by diet into pGF and grain-inclusive (GI) groups. Dogs in the pGF group were included if diet change was a component of therapy. Survival was analyzed using Kaplan-Meier curves and the Cox proportional-hazards model.

RESULTS

The median survival time was 344 days for pGF dogs vs. 253 days for GI dogs (P = 0.074). Statistically significant differences in median survival were identified when the analysis was limited to dogs surviving longer than one week (P = 0.033). Prior GF dogs had a significantly worse outcome the longer a GF diet was fed prior to diagnosis (P = 0.004) or if they were diagnosed at a younger age (P = 0.017). Prior GF dogs showed significantly greater improvement in normalized left ventricular internal diastolic diameter (P = 0.038) and E-point septal separation (P = 0.031) measurements and significant decreases in their furosemide (P = 0.009) and pimobendan (P < 0.005) dosages over time compared to GI dogs.

CONCLUSIONS

Prior GF dogs that survived at least one week after diagnosis of DCM, treatment of CHF, and diet change had better clinical outcomes and showed reverse ventricular remodeling compared to GI dogs.

Incidence of Canine Dilated Cardiomyopathy Diagnosed at Referral Institutes and Grain-Free Pet Food Store Sales: A Retrospective Survey

Dilated cardiomyopathy (DCM) is considered a predominantly inherited disease in dogs. Recent reports suggest an increased incidence of DCM in atypical breeds eating grain-free and/or legume-rich diets. Emerging communications have noted that there is an apparent increase in the DCM incidence rate in the United States (US). However, little data regarding the incidence of DCM are currently available. To address the gap in the literature, this project examines the DCM incidence rate, over time, by retrospective polling of veterinary cardiologists across the US. Further, grain-free brick-and-mortar pet food market share data from 2011 to 2019 were presented. Fourteen US hospitals, out of 88 that were contacted to participate, provided all cardiology canine cases and of those, which specifically were diagnosed as DCM cases, for as many years as were available (1–20 years, average 8.1 years). This included a total of 68,297 canine patients evaluated by a cardiologist. Of the hospitals that participated, three provided age and breed data. A Poisson regression analysis revealed a statistically significant positive trend in the Mixed Breed group (P = 0.025, RC = 0.082), indicating that this group of dogs had an increased trend of DCM diagnoses over the past 15 years. However, there was no correlation (P = 0.16) for the Mixed Breed group and grain-free pet food sales data. The average incidence rate of DCM, amongst referral cases seen in the participating hospitals, was 3.90% (range 2.53–5.65%), while grain-free diet sales increased from 2011 to 2019. Nationally, the data did not support a significant change in percent DCM over time, from 2000 to 2019. There was no significant correlation between the national DCM incidence rate or the individual breed groups (P&gt;0.05) in relation to the grain-free pet food sales. However, additional studies are necessary to understand whether regional factors contribute to increased DCM incidence rates within smaller cohorts.

Short-term amino acid, clinicopathologic, and echocardiographic findings in healthy dogs fed a commercial plant-based diet

Consumer demand for commercially prepared plant-based (PB) dog food is increasing, but studies evaluating the short- or long-term effects of PB diets on canine health are lacking. The objective of this study was to assess the short-term amino acid (AA), clinicopathologic, and echocardiographic findings in 34 client-owned dogs fed a commercial extruded plant-based diet (PBD) in which pea protein was the primary protein source and 4 control dogs fed a commercial extruded traditional diet (TD). Plasma AA and whole blood taurine concentrations were measured in dogs at baseline and after 4 weeks on the PBD or the TD. Hematologic, serum biochemical, and echocardiographic testing were performed at baseline and after 12 weeks on the PBD or the TD. Four dogs in the PBD group did not complete the study. All essential AAs, except methionine, were higher in dogs after 4 weeks on the PBD compared to baseline. Taurine (plasma and whole blood) was also higher after 4 weeks on the PBD compared to baseline. A meaningful difference was detected in whole blood taurine between the PBD group and the control group at 4 weeks (P = .026) with the PBD group being higher. Median hematologic and biochemical results for the PBD group were within normal limits at baseline and at 12 weeks. In the PBD group, left ventricular internal diastolic dimension (LVIDd, P = < .001) and normalized LVIDd (P = .031) were higher 12 weeks post-PBD compared to baseline. There were no meaningful differences in left ventricular internal systolic dimension (LVIDs), normalized LVIDs, or fractional shortening 12 weeks post-PBD. There was no statistical evidence of difference between the 2 groups of dogs for any of the echocardiographic parameters at baseline or at 12 weeks. Essential AA or taurine deficiency was not observed in this cohort of dogs fed a commercial extruded PBD. Additionally, clinically relevant hematologic, serum biochemical and echocardiographic alterations were not detected. Further research is required to determine if long-term static feeding of PB diets can meet and maintain AA and other nutrient targets in dogs.

Screening for dilated cardiomyopathy in dogs

BACKGROUND

Dilated cardiomyopathy (DCM) is the most common cardiac disease in large breed dogs. The disease can start with arrhythmias or with systolic dysfunction of the myocardium.

OBJECTIVE

To describe screening methods for DCM in various breeds and provide a new, modified staging system.

RECOMMENDATIONS

Screening for occult DCM should start at three years of age and use Holter monitoring in Boxers and Dobermans and might be useful also in other breeds. Single ventricular premature complexes (VPCs) can be detected in many healthy dogs, but healthy animals typically have <50 VPCs in 24 h and demonstrate minimal complexity most often occurring only as single ectopic beats. In general, >100 VPCs in 24 h was recommended as the cut-off value for establishing a diagnosis of DCM. However, there are breed-specific recommendations related to Holter recording diagnosis of DCM in Dobermans and Boxers. Yearly screening over the life of a dog is recommended, as a one-time screening is not sufficient to rule out the future development of DCM. Several echocardiographic methods such as M-mode derived measurements, the measurement of the left ventricular (LV) volume by Simpson's method of discs (SMOD), and E-point to septal separation (EPSS) are recommended for screening purposes. The value of additional tests such as cardiac biomarkers (troponin I and N-terminal pro-B-type natriuretic peptide) as well as a 5-min resting electrocardiogram (ECG) or newer echocardiographic methods such as strain measurements is discussed.

CONCLUSION

This review suggests some guidelines for screening for DCM in various breeds.

Effect of personal, food manufacturer, and pet health statements made by a veterinarian during a pet wellness appointment on a dog or cat owner's decision to consider changing their pet's diet

OBJECTIVE

To investigate the effect of statements made by veterinarians during a pet wellness appointment on a pet owner's decision to consider changing their pet's diet.

SAMPLE

Pet owners who presented their dogs and cats for wellness examinations from December 2018 to February 2019 to a veterinary medical teaching hospital or an affiliated low-cost community clinic.

PROCEDURES

Pet owners completed part 1 of the survey, which included questions on various pet characteristics (eg, signalment and current diet) and pet owner's degree of satisfaction with their pet's diet, after a veterinary medical student obtained the pet's medical history and examined the pet. At the conclusion of the wellness appointment, owners completed part 2, which included pet owner demographics (eg, gender and highest educational level) and statements regarding personal, food manufacturer, and pet health that could be made by a veterinarian regarding a pet's diet to which owners were asked to react.

RESULTS

84 dog and 36 cat owners completed the survey. Statements based on pet health and personal (veterinarian) preferences were the most and least effective, respectively, on owners to consider changing their pet's diet. Pet owner gender and pet species did not alter the findings. Most (93%) pet owners were at least somewhat willing to change their pet's diet on the basis of a veterinarian's recommendation.

CONCLUSIONS AND CLINICAL RELEVANCE

When a pet's diet is discussed in the context of a pet's health, a primary care veterinarian consulting with a pet owner during a wellness appointment may be most persuasive to the owner for changing their pet's diet.

Focused Canine Cardiac Ultrasound

Focused cardiac ultrasound (FCU) is a useful point-of-care imaging tool to assess cardiovascular status in symptomatic dogs in the acute care setting. Unlike complete echocardiography, FCU is a time-sensitive examination involving a subset of targeted ultrasound views to identify severe cardiac abnormalities and is performed as part of an integrated thoracic ultrasound including interrogation of the pleural space and lungs. When integrated with other clinical information, FCU can be helpful in the diagnosis of left-sided and right-sided congestive heart failure, pericardial effusion and tamponade, and severe pulmonary hypertension, and can provide estimates of fluid responsiveness in hypotensive dogs.

Computer-aided ration calculation (Diet Check Munich© ) versus blood profile in raw fed privately owned dogs

Many dog owners create nutritionally imbalanced raw meat-based diets (RMBD) with information from the Internet and pseudo-scientific books, some even use pre-prepared frozen raw feed from online shops, local butchers or other providers. The risk of nutritional imbalances is therefore present. Blood profiles for dogs fed RMBD are promoted by laboratories as a simple tool for the owner to check the nutritional supply situation. Veterinarian nutrition specialists seem to be consulted less frequently and, in most cases, when blood analyses show deviations from reference ranges. The aim of the present study was to evaluate whether a RMBD blood profile reflects possible malnutrition according to a computer-aided ration check and to assess its clinical relevance. Using standardized questionnaires, the average daily rations of 104 dogs, 83 of which were fed raw diets versus 21 commercially fed dogs, were analysed using Diet Check Munich©, based on the National Research Council values. Afterwards, the SYNLAB.vet GmbH 'Barfer-Profil' test including calcium, phosphate, calcium/phosphate ratio, vitamin A, vitamin D, copper, zinc and iodine with additional parameters taurine, urea, uric acid and creatinine was carried out. No significant correlation between nutrient supply and associated blood parameters could be detected. Diet calculation revealed significantly more nutritional imbalances in the RMBD group than in the control group. Low plasma taurine could be detected only in the RMBD group. After participating, 30% of the dog owners (RMBD group) decided to adjust their dogs' diets at the nutrition consultation of the Clinic for Small Animal Internal Medicine of the LMU Munich. Based on these results, for most parameters a RMBD blood profile is not an appropriate tool to monitor a dog's nutrition and computer-aided ration calculation remains the gold standard for detecting nutritional imbalances.

2021 AAHA Nutrition and Weight Management Guidelines for Dogs and Cats

The guidelines discuss the components of a systematic approach to nutritional management of dogs and cats. A nutritional assessment, including a body condition score and muscle condition score, is a screening evaluation that should ideally be performed at every examination. Individualized nutritional recommendations, based on the nutritional assessment, should be designed to achieve and maintain an appropriate body weight and meet nutritional requirements. Communicating nutritional recommendations to clients is a challenging aspect of nutritional management because pet owners may interpret the practice team's guidance as advocacy for a particular pet food brand or a judgment of the client's ability to properly care for the pet or of the owner's own nutritional status. The guidelines discuss approaches for effective, nonjudgmental communication of dietary recommendations to clients and strategies to increase acceptance of and adherence to veterinary nutrition recommendations. Other pet nutrition topics of current interest include recommendations for particular pet life stages, breeds, and disease conditions; risk factors for nutritional deficiencies and obesity; and considerations for home-prepared diets.

Grains on the brain: A survey of dog owner purchasing habits related to grain-free dry dog foods

Grain-free pet food options abound in the pet food market today, representing more than 40% of available dry dog foods in the United States. There is currently a dearth of information about the factors that contribute to a dog owner's choice of a grain-free dry dog food and if those factors are similar among countries. Therefore, the primary objective of the current survey was to identify the variables that are predictive of a dog owner's choice of a grain-free dry food across North America (Canada and the United States) and Europe (France, the United Kingdom and Germany). The survey consisted of 69 questions, took less than 15 minutes to complete and was distributed virtually via Qualtrics (Qualtrics XM, Utah, USA). A total of 3,298 responses were collected, equally distributed between countries. Multinomial logistic regression was performed in SPSS Statistics (Version 26, IBM Corp, North Castle, New York, USA). Male respondents, people from France, people who ranked the importance of ingredients in a pet food in the lower quartiles and people who do not rotate their dog's diet to provide variety were less likely to select 'no grain' when choosing a pet food. In contrast, people who believe that their dog has a food allergy, follow more than 5 specific dietary routines in their own diet, do not try to include grains in their own diet, get their information about pet food from online resources or pet store staff and look for specific claims on pet food (such as 'no fillers'), were all more likely to select 'no grain' when choosing a pet food. This survey provides insight into the similarities and differences in decision making among dog owners in North America and Europe and should be considered when exploring the effects of grain-free dog foods on canine health and well-being.

Cardiac diagnostic test results and outcomes in 44 dogs naturally infected with Trypanosoma cruzi

Background

The protozoal parasite Trypanosoma cruzi causes myocarditis in dogs.

Objectives

To describe the cardiac diagnostic test results and outcomes of dogs naturally infected with T. cruzi.

Animals

Forty‐four client‐owned dogs.

Methods

Medical records were retrospectively reviewed to identify dogs with an indirect fluorescent antibody test result for T. cruzi ≥1 : 80. Data collected included signalment, cardiac diagnostic test results (ECG, echocardiography, cardiac troponin I) and outcome. Outcomes were categorized as alive, dead (cardiac or noncardiac) or lost to follow up.

Results

ECG abnormalities were present in 41 dogs with ventricular arrhythmias (n = 28) and atrioventricular block (AVB) (n = 15) most commonly identified. Echocardiographic chamber enlargement was present in 28 dogs and most often included the right ventricle (RV) (n = 15) and left atrium (n = 12). Troponin was ≥2 times the reference range in 20/36 (56%) dogs. In univariate analysis using nonparametric Kaplan‐Meier, ventricular arrhythmias with a modified Lown score ≥2 (P = .02), presence of AVB (P = .04), and RV enlargement (P = .006) were associated with decreased survival times. Right ventricular enlargement (HR 3.6; 95% confidence interval [CI] 1.4‐9.3; P = .007) and higher body weight at presentation (HR 1.0; 95% CI 1.0‐1.1; P = .04) were associated with decreased time to death in the final explanatory multivariable model.

Conclusions and Clinical Importance

Cardiac abnormalities were common and variable, and RV enlargement was associated with shorter survival time. A diagnostic evaluation that includes screening for arrhythmias, echocardiography, and cTnI can provide useful information related to the characterization of heart disease in dogs seropositive for T. cruzi.

Pros and Cons of Commercial Pet Foods (Including Grain/Grain Free) for Dogs and Cats

Commercial pet food in the United States includes a diverse range of products. There is a tremendous amount of variation among companies regarding the financial resources invested into producing their products, research, and marketing. Commercial pet food is a regulated industry at both the state and federal levels, and many of the same standards applied to the human food industry apply to pet food. Many foods that both pets and people consume are processed; however, the type and extent of processing do not correlate with the nutritional value. Commercial pet food does not meet the needs of every pet.

Clinical Findings in Healthy Dogs Fed With Diets Characterized by Different Carbohydrates Sources

In recent years, pet owners have become more interested in the ingredients, and quality of pet-food, and several studies have demonstrated that feed management could affect healthy status. Recently, some authors indicated that commercial diets formulated without cereals, or using unconventional protein, and starch sources, can cause a reduction in taurine levels in both whole blood, and plasma. Nevertheless, the specific mechanism by means of which nutritional factors determine this reduction is not completely clear. Thirty neutered half-breed dogs were recruited at a kennel in the province of Naples (Italy) to investigate the influence of carbohydrates sources, and dietary density of nutrients on healthy status of dogs in terms of blood count, and biochemical parameters. The dogs were housed in the kennel and divided into three distinct groups. Three iso-energy, and iso-nitrogen commercial kibble diets (named GF1, GF2, and CB) with different protein, and carbohydrates contents, and carbohydrates sources were chosen for the trial. The chemical composition and amino acid profile of each of the three tested diets were analyzed. Moreover, blood samples of each dog were collected to evaluate the hematological and biochemical profiles. The taurine level was determined both on plasma and whole blood. The effect of the diets was analyzed statistically, and all tested diets were compared to the control one. There were significant differences between the three tested diets as regards their chemical composition. The concentrations of all amino acids seem to reflect protein content diets. The hematological profile resulted within the ranges considered physiological for the canine species for all subjects. Compared to the control diet, the three tested diets showed significant differences in blood count for MCHC and platelets. The biochemical profile showed significant differences between the diets, particularly their AST, fructosamine, lipase, and triglycerides values. The diets did not affect the blood and plasma taurine levels. They resulted in higher than optimal reserve levels. Preliminary results showed that the sources of carbohydrates and use of balanced diets affected only some biochemical parameters and did not alter the levels of taurine in healthy adult dogs.

Low plasma taurine levels in English cocker spaniels diagnosed with dilated cardiomyopathy

OBJECTIVES

The aims of this study were to evaluate taurine levels in English cocker spaniels with dilated cardiomyopathy and assess their survival time and natural progression of their disease.

MATERIALS AND METHODS

Retrospective comparison of English cocker spaniels with dilated cardiomyopathy phenotype with and without taurine deficiency at the cardiology department of a UK academic referral centre between 2008 and 2018.

RESULTS

Taurine plasma concentration was available in 16 English cocker spaniels with dilated cardiomyopathy phenotype; 13 of 16 had congestive heart failure and three of 16 did not. Taurine concentration was low (<50 μmol/L) in 13 of 16 and normal in three of 16. Deficient dogs received taurine supplementation in addition to conventional cardiac medications. Eight dogs were still alive at the end of this study and eight were dead. MST for all dogs included in the study was 2800 days. Left ventricular systolic function improved and left ventricular dimensions reduced in English cocker spaniels with taurine deficiency following taurine supplementation and conventional cardiac therapy, although similar results were observed in English cocker spaniels with normal taurine concentration on cardiac therapy alone.

CLINICAL SIGNIFICANCE

Based on laboratory reference intervals, low taurine concentrations were common in English cocker spaniels with dilated cardiomyopathy, showing a possible association between dilated cardiomyopathy in English cocker spaniels and taurine deficiency; supplementation with taurine was not curative.

Blood taurine concentrations in dogs with exocrine pancreatic insufficiency

OBJECTIVE

To determine whether blood taurine concentrations in dogs with exocrine pancreatic insufficiency (EPI) were lower than the reference interval (200 to 350 nmol/mL) or the cutoff used to indicate taurine deficiency (< 150 nmol/mL).

ANIMALS

18 dogs with clinical or presumptive subclinical EPI with residual blood samples available for taurine concentration analysis.

PROCEDURES

Dogs were classified as having clinical EPI if they had a serum trypsin-like immunoreactivity concentration of < 2.0 μg/L and presumptive subclinical EPI if they had a concentration of 2.0 to 5.0 μg/L. Archived, frozen blood samples stored in EDTA were submitted for measurement of taurine concentration with an automated high-performance liquid chromatography amino acid analyzer. Medical record data were examined for associations with blood taurine concentration.

RESULTS

None of the 18 dogs had a blood taurine concentration < 150 nmol/mL. Two dogs had a concentration < 200 nmol/mL. No clinical signs, physical examination findings, or serum biochemical abnormalities were associated with blood taurine concentration. Eleven of the 17 dogs for which diet histories were available were not receiving a diet that met recommendations of the World Small Animal Veterinary Association Global Nutrition Committee.

CONCLUSIONS AND CLINICAL RELEVANCE

A low blood taurine concentration was noted in a small subset of dogs with EPI. Additional research is needed to determine whether EPI was the primary cause of this low concentration. Findings suggested the importance of obtaining complete diet histories and ensuring dietary requirements are sufficiently met in dogs with EPI. (Am J Vet Res 2020;81:958-963).

Species-Spanning Echocardiography: Cardiovascular Insights from Across the Animal Kingdom

PURPOSE OF REVIEW

The objective of this review is to present comparative echocardiography as a source of insights for human cardiovascular medicine.

RECENT FINDINGS

We present echocardiographic examples of high impact human cardiovascular pathologies, including valvular, vascular, conduction, and myocardial disorders, in a wide range of species in varying environments. Unique features associated with comparative echocardiographic assessments are linked to human cardiology, including natural animal models of resistance and vulnerability. The cardiovascular vulnerabilities and strengths of other species can be a source of invaluable insights for human healthcare professionals. Echocardiography is playing a key role in bridging human and veterinary cardiology. Consequently, species-spanning echocardiography can deliver novel insights for human medicine.

Review of canine dilated cardiomyopathy in the wake of diet-associated concerns

Dilated cardiomyopathy (DCM) has been in the literature and news because of the recent opinion-based journal articles and public releases by regulatory agencies. DCM is commonly associated with a genetic predisposition in certain dog breeds and can also occur secondary to other diseases and nutritional deficiencies. Recent communications in veterinary journals have discussed a potential relationship between grain-free and/or novel protein diets to DCM, citing a subjective increase in DCM in dog breeds that are not known to have a genetic predisposition for the disease. This literature review describes clinical presentations of DCM, common sequelae, treatment and preventative measures, histopathologic features, and a discussion of the varied etiological origins of the disease. In addition, current literature limitations are addressed, in order to ascertain multiple variables leading to the development of DCM. Future studies are needed to evaluate one variable at a time and to minimize confounding variables and speculation. Furthermore, to prevent sampling bias with the current FDA reports, the veterinary community should be asked to provide information for all cases of DCM in dogs. This should include cases during the same time period, regardless of the practitioner's proposed etiology, due to no definitive association between diets with specific characteristics, such as, but not limited to, grain-free diets and those containing legumes, novel protein diets, and those produced by small manufacturers to DCM in dogs. In summary, in order to determine if certain ingredients, categories of diets, or manufacturing processes are related to an increased risk of DCM, further studies investigating these variables are necessary.

Development of plasma and whole blood taurine reference ranges and identification of dietary features associated with taurine deficiency and dilated cardiomyopathy in golden retrievers: A prospective, observational study

INTRODUCTION

A surge in Food and Drug Administration (FDA) consumer complaints identified concerns that legume-rich, grain-free diets were associated with nutritionally-mediated dilated cardiomyopathy (DCM). Golden retrievers represent the most reported breed affected by this condition and previous studies documented the disease is responsive to dietary change and taurine supplementation. Although dietary findings across cases are compelling, prospective studies with control groups are lacking. The role of diet in developing taurine deficiency and echocardiographic changes consistent with DCM in healthy dogs is unknown.

OBJECTIVES

We hypothesized that golden retrievers eating non-traditional diets are at a higher risk of having taurine deficiency and nutritionally-mediated DCM compared with those eating traditional commercial diets. We aimed to compare taurine concentrations and echocardiographic indices of systolic function between golden retrievers in each diet group and elucidate associations between diet and these variables. Additionally, we aimed to generate breed-specific reference intervals for whole blood and plasma taurine concentrations.

ANIMALS

86 golden retrievers.

METHODS

Golden retrievers eating traditional or non-traditional diets were evaluated and diet history, taurine concentrations and echocardiographic data were collected. Dietary features, taurine concentrations and echocardiographic findings were compared between diet groups. Relative risks were calculated for the likelihood of echocardiographic abnormalities and taurine deficiency in each diet group. Breed-specific reference intervals were constructed for taurine concentrations in dogs from the traditional diet group.

RESULTS

Golden retrievers eating non-traditional diets had significantly lower taurine concentrations and more frequent systolic dysfunction. Breed specific reference intervals are higher than previously reported across breeds.

CONCLUSIONS

Non-traditional diets, which were typically grain-free and contained legumes in this study, were significantly associated with and have increased relative risk for the identification of taurine deficiency and echocardiographic abnormalities consistent with nutritionally-mediated DCM. These findings were identifiable in the absence of clinical signs and support the findings of multiple previous studies and the ongoing FDA investigation.

Nutritional inadequacies in commercial vegan foods for dogs and cats

The objective of this study was to evaluate the macronutrients composition, fatty acid and amino acid profiles, and essential minerals content of all vegan foods for dogs and cats available in the Brazilian market, and to compare results with FEDIAF (2019) and AAFCO (2019) recommendations. Four vegan pet foods were assessed (three for dogs and one for cats). The comparisons were made in a descriptive manner. All foods met the minimum recommendations for macronutrients. Arachidonic acid was not reported in any food label. Regarding the FEDIAF recommendations, one food for dogs had low calcium, another had low potassium and a third had low sodium. The cat food presented potassium content lower than recommended. The Ca:P ratio did not meet the minimum recommendation of FEDIAF (2019) and AAFCO (2019) in any of the dog’s foods analyzed, and the cat food also did not present the minimum recommendation based on FEDIAF (2019). Copper concentrations exceeded the legal limit in all foods. Zinc concentrations exceeded this limit in two foods (one for dogs and one for cats) and iron levels exceeded the legal limit in one dog food. One of the dog foods did not meet the minimum recommendation for methionine and the cat food did not meet the minimum recommendation for arginine. In addition, when the amount of nutrients consumed by animals with low energy requirements was simulated, in addition to the same non-conformities described above, it was observed that the cat food does not meet the minimum recommended of protein and taurine in unit/Kg^0.67. It was concluded that all foods analyzed had one or more nutrients below the recommended levels and some presented zinc and copper excess, therefore, these foods should not be recommended for dogs and cats, because dietary deficiencies found may lead to health risks for dogs and cats. Furthermore, manufacturers should review their formulations to ensure the nutritional adequacy of these foods.

Special topic: The association between pulse ingredients and canine dilated cardiomyopathy: addressing the knowledge gaps before establishing causation

In July 2018, the Food and Drug Administration warned about a possible relationship between dilated cardiomyopathy (DCM) in dogs and the consumption of dog food formulated with potatoes and pulse ingredients. This issue may impede utilization of pulse ingredients in dog food or consideration of alternative proteins. Pulse ingredients have been used in the pet food industry for over 2 decades and represent a valuable source of protein to compliment animal-based ingredients. Moreover, individual ingredients used in commercial foods do not represent the final nutrient concentration of the complete diet. Thus, nutritionists formulating dog food must balance complementary ingredients to fulfill the animal's nutrient needs in the final diet. There are multiple factors that should be considered, including differences in nutrient digestibility and overall bioavailability, the fermentability and quantity of fiber, and interactions among food constituents that can increase the risk of DCM development. Taurine is a dispensable amino acid that has been linked to DCM in dogs. As such, adequate supply of taurine and/or precursors for taurine synthesis plays an important role in preventing DCM. However, requirements of amino acids in dogs are not well investigated and are presented in total dietary content basis which does not account for bioavailability or digestibility. Similarly, any nutrient (e.g., soluble and fermentable fiber) or physiological condition (e.g., size of the dog, sex, and age) that increases the requirement for taurine will also augment the possibility for DCM development. Dog food formulators should have a deep knowledge of processing methodologies and nutrient interactions beyond meeting the Association of American Feed Control Officials nutrient profiles and should not carelessly follow unsubstantiated market trends. Vegetable ingredients, including pulses, are nutritious and can be used in combination with complementary ingredients to meet the nutritional needs of the dog.