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 about patients for which we have had concerns about the diet and heart disease relationship.  Currently, we are identifying patients with dilated cardiomyopathy (DCM) that are being fed grain-free diets and working with the FDA to collect food samples. We are also submitting 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 correlation many times, as have other veterinary cardiologists around the country. It is real, it’s concerning, and it’s 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 the specific issues, so we can avoid having pets affected with this related heart disease.


Do we know approximately how long dogs with DCM have been fed a grain-free diet?
Not specifically, but in many cases, the dog has been eating the food for 1-2 years. 


How are the dogs presenting? 
Dogs of all shapes and sizes are presenting with different signs and symptoms. Congestive heart-failure, murmurs and low taurine-levels are a few of the more common symptoms we’ve seen thus far.


What about cats?  Is 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 is different from dogs. Cats have a higher protein content along with taurine, a required nutrient in the diet.  In the 1980s it was identified that taurine deficiency would lead to dilated cardiomyopathy in cats. After this discovery, commercial cat foods were adjusted to reflect this unique nutritional requirement for cats.


What do dog owners believe are the advantages of feeding a grain-free diet? 
Most owners want what’s healthiest for their dog and when looking at the list of ingredients on a grain-free dog food, it looks healthy. Humans are going grain-free/gluten free, so the perception is that they can feed their dog something similar to what they are eating, because it’s the healthy thing to do. Also, the public has a negative perception of big brand dog foods like Purina, Hills and Royal Canin when in reality, these foods are okay to feed your dog.


My dog has been eating a grain-free diet. Should I get testing done? 
If the dog is pre-clinical and showing no signs or symptoms, we recommend changing the dog’s diet to a food that has been feed-tested for nutritional adequacy. No specific cardiac testing is necessary; however, if you are concerned and/or you have a dog that may be of potential higher risk, like a golden retriever, we can consider having testing of the taurine levels and/or an echocardiogram done to evaluate for signs of heart enlargement or dysfunction.  


I don’t want to feed my dog anything other than grain-free. Is that okay? 
We recommend that you buy a food that has been feed-tested and does not just “claim” that they meet AAFCO standards.  At this point until we have more information, we would suggest a diet from a reputable manufacturer that has been producing, researching and testing  high quality dog foods for many years. For more information on feed-testing, click here.


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 between 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 consult with a veterinary nutritionist who may be able to provide more information about this topic as there can be some differences in the nutrient content of certain meats. Of the dogs we see 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 have more information about 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 the Association of American Feed Control Officials (AAFCO) testing to confirm nutritional adequacy. This organization regulates the sale and distribution of animal foods, and animal drug remedies, to safeguard the health of animals and humans.


Is there a certain dog food you recommend?
There are many brands of dog foods that are excellent. We try not to recommend a specific brand as each pet and pet family, have diets that work best for them.  At this point, our best recommendation 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, those diets should be fine. 


Do you recommend a raw food diet?
The AVMA does not recommend a raw food diet due to the potential public health hazard of using raw foods.  Many pets have done well on raw diets but to our knowledge, no controlled research has demonstrated the benefit of raw foods over cooked or prepared veterinary diets.


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.  With the issue with grain-free foods, we would suggest that if there are grain sensitivities, you choose a diet that uses more traditional protein sources like poultry, lamb, and beef, as well as avoid some of the unusual proteins like kangaroo, rabbit, bison, etc. It is also important to choose a diet where legumes (peas, chickpeas, lentils or beans) are not within the first five ingredients.  Another consideration would 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 include: noticing that your dog is slowing down, having 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 dogs will have a reversal of their cardiac changes with adjustments 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 issue with grain-free diets, we cannot tell you that adding it is the only preventative measure.  Taurine supplementation is safe and well tolerated. Close monitoring, including a thorough physical examination of your dog, working with your local cardiologist to screen for disease with echocardiography, as well as Holter monitoring, is recommended. Early detection 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.  However, if the taurine level on whole blood is below 250 and the plasma is less than 60, we 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.