een heel verhaal. stond op de fb pagina van Valerie Bavegems, hart-echo specialiste.
zij waarschuwde mij 2 jaar geleden al voor graanvrij voer.
A sad milestone has arrived in the diet associated dilated cardiomyopathy (DCM) investigation, and I am asking for help amplifying this message. We have now passed two years since the FDA has made a substantive update on their investigation, with the FDA making only non committal comments when pressed for further information. In those two years there have been multiple quality research publications demonstrating a likely causative relationship between certain pulse ingredients and an unusual reversible form of DCM. Others more knowledgeable than myself have created resources summarizing the diet associated DCM issue and the continued research on the topic. Instead I would like to focus on the flat out false claims made about what the FDA has said, which the FDA has spent years refusing to correct.
The FDA has never retracted their statements or otherwise said that dog foods with high inclusion of pulse ingredients are safe. After meetings between the FDA and pulse industry representatives led the USA Dry Pea and Lentil Council to say that they “convinced the FDA to clarify their language about their concern and minimize the damage to the industry”, the FDA did release a much more subdued update than their previous data heavy statement. Despite the industry concern after seeing a reduction in sales after specific brands and ingredients were named, the FDA CVM still was acknowledging the potential for danger to consumers peppered in with their bland assurances they had not established a clear explanation for exactly how these foods were resulting in illness and death in hundreds of dogs.
In his statements at the September 2020 Kansas State University forum on diet associated DCM, Director for the FDA’s Center for Veterinary Medicine (CVM) Dr. Stephen Solomon outlined the FDA’s approach to the investigation on the reports of atypical DCM occurring in dogs eating certain diets. His focus was not on safety, but on the FDA’s regulatory role. He provided an updated case count of 1100 dogs with DCM reported as adverse events to food. This was approximately half of all cardiac related reports they received, which was startling considering DCM was previously almost entirely seen in dogs of breeds with known genetic forms of the disease. Dr Solomon outlined that their multidisciplinary team of epidemiologists, nutritionists, and veterinarians had developed a definition and approach to processing and reviewing these reports to examine the factors potentially at play. They collected medical records, environmental histories, and tissue samples and examined samples of food for nutritional components “including protein, fat, moisture, fiber, starch, vitamins and minerals, and metals”. This paints a picture of a thorough investigation of many potential causes of these atypical DCM cases, which makes sense as the FDA is largely tasked with regulations around contaminants and not nutritional formulations of products. They found that 93% of the reported foods had a high amount of peas, lentils, or both.
Dr. Solomon stated, “It is important to note that pulse ingredients have been used in pet food for a long time, and we have no evidence to indicate that they are inherently dangerous. However, CVM’s data show that they are used in these “grain-free” diets in greater proportion than in grain-containing formulas, which means there is an area to investigate further.” He did not state that diet was not determined to be an issue, just that the issue appeared to be multifactorial which aligns with the suspicions of the veterinary cardiologists and nutritionists that had been sounding the alarm bells as their offices filled with these cases. While multiple factors were suspected by these experts, the reversible nature of these cases contrasted drastically with the typical genetic forms of the disease which are not reversible with the same standard medications. This put the issue in a regulatory gray zone compared to the typical food related health concerns around contaminants that the FDA has been specifically tasked with responding to. Dr Solomon told industry representatives and scientists, “CVM does not review or declare any particular type of pet food as “safe” the way we do with animal drugs. I believe that our approach to date speaks to the fact that, based off the adverse event reports we have received, we have observed an association between certain diets and DCM.”
At the same forum, Dr. Jennifer Jones presented more specific data related to their investigation. In their first subset of selected cases follow, 88% of the followed cases demonstrated partial or full recovery. All of the dogs that experienced full recovery had changed diets. In group one, 91.5% of diets prior to diagnosis had peas in the top ingredients. Their second subset of dogs was limited to dogs post diet change, and 87% of dogs had partially or fully recovered.
Following these presentations, Dr. Solomon and the FDA released some updated statements and summaries and have not seen fit to update the public since. While these statements make clear they have not identified a distinct cause and effect relationship, they have not claimed these foods are safe and actually made clear the FDA was continuing to investigate the observed association. Regardless, people continue to represent the FDA’s position as having cleared these ingredients and foods as safe. The information vacuum of the past two years has reduced the discussion around this issue largely to arguing semantics about whether an “association” is close enough to a demonstrated causal relationship to switch dogs to more well researched diets. As reporting rates seem to be influenced by FDA attention to the issue, it is difficult to say how many dogs may have potentially been impacted since the 2020 KSU forum and subsequent update. DCM requires advanced diagnostics to identify, and there may have been cases of dogs on suspect diets that experienced sudden death without their owners realizing their purchases may have been related to their beloved pets death.
Despite the FDA’s insistence otherwise, it is clearly critical to provide a status update even if they cannot provide a clear causative link, a target which may never be reached to the satisfaction of industry and influencer critics. It is unclear what the future of the investigation may be, or what can be done to convince the FDA CVM that consumers have a continued need for credible information regarding the status of this issue. Multiple Freedom of Information Act requests for a simple updated number of reports have languished for months. What is clear is that silence is not working, and I urge the FDA CVM to provide a much awaited update on the status of this investigation.
This post is public and shareable. You can visit Doc of All Trades or Diet-Associated Dilated Cardiomyopathy (DCM) in Dogs for more information. This timeline shows details about the investigation and research in more detail:
https://www.alltradesdvm.com/.../diet.../dcm-timeline
