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Dec. 21, 2022

DCM in Dogs 101

DCM (Dilated Cardiomyopathy) took over mainstream headlines beginning in 2018 that suggested a link between DCM and grain-free dog food. How and why did this link happen?

Hosts Dan and Jen break down the scientific cause of DCM, the nutritional side of this disease as well as the diagnosis criteria in dogs. 

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Link to key visuals discussed in this episode 

shorturl.at/enxN2

Have a question or concern about DCM? Email us at hello@feedyourdogfacts.com

Transcript

Jennifer: Well, welcome to another episode of Feed Your Dog Facts. So we are going to be diving into and dedicating a whole episode, which is so exciting to just d c M, which you may or may not have heard the term DCM. Um, I know Dan has. So we will, we'll get to that in a second. But we're gonna be focusing on, we're calling it DC m and Dogs 1 0 1 or DCM 1 0 1, because literally this is the introductory episode that you would need to understand the science and facts behind DC m and what this is and what this heart disease is in dogs. So, it's important to note, and Dan's gonna get into all the details, that this is what I would say a part one or even like an intro to probably three full episodes that we'll do here on the podcast dedicated to just d c m and Dan. I wanna just take like two quick minutes. We have a lot of new listeners too, so this is really important before we dive into all, like the, I guess the meat and bones, pun intended, of today's episode, and it's to reintroduce ourselves because we have a lot of new listeners. Uh, we do have a little intro that plays before every episode too, but I think it's important to kind of note like who we are, who you are, especially, you're the one with all the credentials, but, you know, I'm just the producer, but, uh, my name is Jennifer Wolanik and I am the co-host and producer of Feed Dog Fox, and I'm an avid dog lover, former foster dog, mom. All of the things. So anything dog I loved. And it wasn't until Dan and I crossed paths and I read his book, and I understood all the science that I really knew that I needed to make this into a podcast to make sure that people had like, gotten to people's ears, gotten to people's brains of like really breaking down the science because I am not a science person. I am learning new words. Dan has all these big fancy words. He has all the credentials. But, um, anyway, I will throw it over to my co-host, but also our resident expert. I would like to say, uh, we should probably have a formal title for you, Dan, b

 

Dan: It's, it's like, I mean, I ha I I have, uh, the credentials that I have are, it's like, it's almost like credentials the wrong word, because like, I don't have, it's really important to note, in fact, for this show, I'm not a veterinarian, as you've said. You are not a veterinarian, Yeah. Mm-hmm. And so like, we're gonna be talking for anyone that this is your first show. We're gonna be talking about nutritional science and as it pertains to dogs, so what studies say, how the body works, all that kind of stuff. We are not, and this is, we got a disclaimer you'll hear at the end of every show, but this is an important one, um, episode, I mean to, to like highlight this. Mm-hmm. this is not veterinary medical advice. If you are concerned about your dog and what diseases it may or may not have and how to treat or prevent those diseases, you need to go speak to your vet. This is not meant to displace the importance of vet your personal veterinary medical advice. This is our analysis of important news and events that have to do with veterinary nutrition and D C m, the disease, dilated cardiomyopathy is one of those subjects. It's a disease that dogs experience and it's one that has done the really rare thing which is crossed over into the mainstream of pet food nudes. To the extent that there is such a thing as a big story in pet food. This is it. This is a story that this is a disease that has been discussed in the pages of the New York Times, the Washington Post, and every other major publication over the past few years. And what we're gonna do over the course of these three, uh, in all likelihood it's gonna be three episodes, is we're gonna provide a bunch of information about what's gotten this stuff into the news about this disease and why it's newsworthy. Um, and it's basically, like you said, we're going to break it up into three blocks that cover three distinct aspects of what's important about the disease. Today we're gonna talk about, like you said, DCM 1 0 1. We're gonna talk about as of 2018, which is a key date in all things D C m as of 2018. What did the scientific community understand about this disease? This is a disease that we've known impacts dogs for much since, much earlier than 2018. We've known a lot about it since earlier than 2018. And as of 2018, there was a whole body of literature you could find. It discussed in every major veterinary nutrition textbook, veterinary cardiology, textbooks, that kind of thing. It's a disease that we knew something about. In 2018, a big thing happened that began a process that's still ongoing, and that's gonna be the subject of our second episode. The big thing is that the United States Food and Drug Administration, which governs the regulation of pet food at the federal level in the United States, announced that it was investigating whether a specific class of pet food products was doing something to make D c m more common or worse was de was, was this class of products. And we'll get into like the ways it's been defined, this, this group of products over time, cuz it's changed. Is this class causing dogs to develop this disease? Should we be worried about it as pet owners? Should we not be feeding a specific kind of food? Cause we don't want our dogs to get this truly serious, truly deadly disease. Um, and that investigation that the F D A announced in 2018 is ongoing today. It's much less prominent today, but it hasn't been formally ended. It's spawned all kinds of stuff. This is why this, this event is like news where it's a crossover pet food issue. Usually the world of pet food doesn't get much attention from the lay public. Well, it has on this one issue. The F d A investigation got has been, like I said, covered in all the major news outlets, the biggest ones in the country. It's led to an uptick in interest around this disease in the veterinary community. All sorts of veterinary offices, if you go visit the, the website for your, your vet's office, or if you call them up on the phone and you ask them about D C M, they will talk to you primarily about what's transpired around this disease since 2018, since the F d A investigation began. Um, but it's also spawned an interest in like professional research science around the disease. A bunch of folks, um, animal nutrition, PhDs and veterinary folks alike have leaned into the study of D DCM since the F D A announced this investigation. And so all that, that whole thing, what's taken place, uh, since in the public's understanding of this issue since 2018 is episode two. That's the FDA investigation and related stuff. And that's just us breaking down what's taken place in the public domain and trying to put it all in one place so that everybody can understand it. In a way, those, this episode and the next one are building blocks that are necessary for you to properly understand the significance of episode three. And episode three is where we have legitimately unique stuff to add to the public discourse around DC m it's not just lay public, the professional, the veterinary and the regulatory public needs to understand, I guess that is not really the public, the regulatory public, but like at every level, the stuff we're talking about in episode three is significant to this discussion. To understand its significance, you gotta have the conceptual building blocks in place. Can't teach somebody calculus until you teach 'em, uh, addition. And so like, we gotta talk about what it is as a disease. DC m what happened in the f d A investigation where it currently stands so that we can talk about the unique stuff in episode three. And that unique stuff is basically whistleblower material. I, in addition to having a good level of understanding, professional level understanding of the stuff surrounding this, this FDA investigation, I've been involved with it in one way or another since the beginning, since it was originally announced. I immediately began some professional work pertaining to it. But more importantly, I've been engaged in litigation with the FDA since 2019. And as part of that litigation, what the FDA has done has produced its internal records about the investigation. Okay? These are records that do not go out into the public, typically, they're not available to anyone else. I had to sue the government win on stuff. They agreed to produce it. They have over about three years produced about 20,000 pages of internal documents about the investigation. To me, to my knowledge, the number of other people outside of the F D A that have it are can be counted on one hand. Okay? There's a, at the time this is going to, uh, air, there's a, a science journalist who's had access to them, who's written up a big article about what they show. But generally speaking, these are things that nobody else has. Very few other people. And they are hugely, hugely significant to what, how the public, both veterinary and lay, understands the f d a investigation. They include legitimate smoking gun evidence of real misconduct. That's super important to how anybody understands this issue. That's the exciting aspect of this. That's the novel aspect of this. That's what, you know, we're ACLU or I, I'm somebody that understands the science around DCM reasonably well, you know, professional level well, but not counted on one hand, there are hundreds or thousands of people in the country who could tell you this stuff. I'll tell you in episodes one and two, that's kind of like public stuff, not very much new, very little in terms of opinion, just kind of like covering all the bases. Episode three is truly unique and if you're at all interested in this subject, you gotta listen to it cuz it's, it's, it changes the entire narrative around it in my judgment. So that's the, that's the long intro. Yeah, That's the long thing. Log intro. Well, you talked about the building blocks of the DCM and our little trilogy that we're, well, not really little. I mean, these are gonna be pretty hefty episodes, but let's talk quickly about the building blocks of you and how Dan Schlock intersects the, the Indu pet food industry, the world of pet food. Uh, I mentioned you were an author, but can you kind of, kind of dive into detail? Let's reintroduce you your background and how you got interested in this and, and how you, that professional knowledge. Yep. My name's Dan Schoff. I am, uh, I've worked, uh, as a, um, executive in the pet food industry since 2011. Um, I'm also, uh, trained as a lawyer to practice litigation. Um, I Can't tell at all Dan Yeah, Right. Um, which is not that much. I mean, it, it adds a little bit to why this is like, how this all came to be, but you know, whatever, it's really neither here nor there. But I founded numerous companies, the most significant of which is called Keto Natural Pet Foods. We make low carbohydrate kibble style dog food. Founded it in 2017, I founded a nonprofit that's called the Pet Food Consumer Rights Council. Very first of its kind in terms of a nonprofit organization that's devoted to protecting pet food consumer rights. So if you're somebody that buys pet food for your dog, this is an organization for you. It's functions by taking individual donations. So keto natural pet foods does not donate to organizations like, like this one. It's all, we only accept donations from private individuals, only small dollar donations so that we can reliably be said to represent the interest of pet owners. I don't control it. I founded it. I think it's a good idea. Something like this needed to exist to represent pet owners. I'm not the, uh, somebody that controls the organization. The money comes in, it gets used for the purposes that's described in the, the, the founding documents. Um, but that's another thing I've done. I also wrote a book, the book was published in 2016. The book is called Dogs Dog Food and Dogma. It is an examination kind of on a lot of the same level that we discussed things on this show of the problem of obesity among pets in the western world. It's this weird topic. More than half the dogs and cats in the country are overweight or obese. That's something that, given the way that the public has talked to about obesity in dogs and cats, you'd think wouldn't be the case. You'd think it would be really if, if everything that your vet tells you is accurate about that, that topic, you'd think we'd all have no problem keeping our dogs and cats over, uh, at an appropriate weight. Unfortunately, that's not just not the case. It's far from the case. The majority of people in this country seem to not be able to do it. I wrote this big, a big long book, pardon my French, this big long book that examines why it took me four years. And it puts, it's got a bunch of original, you might even say, groundbreaking stuff in it. So anyway, I've been writing about pet food stuff since about 2013. I do professional level writing where I'm at conferences and in academic journals. I do general interest writing about these subjects like my book, which is for a lay readership, and I founded a bunch of stuff that's, that's tied to it As well. That's great. And we, I promise we're gonna get into it in like literally a couple of minutes of the nuts and bolts of dcm, but I think I might have a working title for your next book, and that's the working title that you were kind of talking with me right before we recorded of like, this third part of the series is going to be diving into the conspiracy ask. And it is, you know, the really the facts behind and the documents behind all of these numbers and data that you came across through a FOIA request. And I think you should kind of talk about that really quickly and yeah. And just the title of it. Yeah. You can see from how long this has taken us that it's a little bit hard to break this down into digestible nuggets. There's so much to talk about, but the, the like scandal, the like controversy aspect of it, the aspect that's like the story that has been reported is different from the story that took place in ways that involves misconduct, wrongdoing, harm, and bad guys is like, how do you describe that by, it's not that the f d a investigation is that Yeah, it's that there is stuff pertaining to that. And so the best, we're not branding experts. The best we can come up with is DCM Gate. Mm-hmm. just like Watergate or whatever the other, you know, Russia Gate, stuff like that. There's a long ongoing sequence of events that involve scandal, misconduct and misinformation people Yeah. Deliberately trying to mislead other people about what the truth is. Yeah. So it's DCM Gate, if you got a better title, you should tell us, uh, because We're, yeah, please write in. We're not confident that that is the one that should stick to describe the, you know, whistleblower materials surrounding This. Yeah. I like it. It, it gets at least across that like instantaneous, like, ooh, there's, there's a little bit of scandal going on. Everybody, everybody loves a little scandal. So, um, okay. This is great. Yes, we, we've taken a little bit more than we usually do for intro, but this is all really good setup to now get into the 1 0 1. DCM 1 0 1, yeah. Dcs. So, uh, yeah, as Dan mentioned, we're really breaking this down as if you are taking maybe like a high school level course or even like an intro college course of understanding the physiology, understanding what it is, how it occurs, you know, we will even get into like breeds and all of the genetics and things like that, but we are focusing on science and facts today. And then we'll be stay tuned for part two. So Dan, let's get into what is D dcm? Let's just kind of start there. DCM is an acronym, and it's an acronym for a disease. And the disease in full is called dilated cardiomyopathy. It is a disease that impacts among other species, dogs and cats. And, um, it has been, uh, known about in some capacity known, defined as a distinct disease for decades, um, is a bad disease if your dog is diagnosed with proper d dcm, not like a warning sign that it might be developing it, but like using the diagnostic criteria. If it's got full-blown dcm your dog's life is legitimately at risk. This is a disease that kills dogs for sure, and it is can be sudden. It can be something where you don't know what's going on and your dog begins exhibiting the symptoms of it. One day you bring it into the vet and it's not soon enough that the dog's life is already at risk and the, and the dog can die, um, because it impacts the heart. And obviously the heart is not something that is, um, you know, that's not an auxiliary, that's something that is central vi very des definition of a vital organ. The heart stops pumping or doesn't do it pumping well. Um, you, you can't live. And so, and that's, that's basically what goes on when a dog, uh, develops d c m. It is typically what's called a degenerative disease. It over time, a properly functioning heart degenerates gets worse and begins to take on the characteristics of a heart showing D c M and begins to function less, uh, appropriately stops doing what it's supposed to do, pump blood around the body, um, more particularly what kind of heart develops with dcm, basically a lar an enlarged one. So you've got, don't you have like images that are just like, let's pull it up. These are just examples. If you're watching this on video, you can see mm-hmm. sort of some context around what I mean. Yeah, Yeah, yeah. I think if, if you were to summarize it, it's an enlarged heart. Like if you were Exactly. Yeah. Mm-hmm. dilated means enlarged. Yep. You get dilated pupils, right? That's when your pupils get super big. When you go have eye work done or something. Dilated, cardiomyopathy, same thing. Aspects of the heart get super big. What happens when they get super big is not that it becomes superpower, it's the opposite. It pumps less effectively. There's less tension I through like the system, right? I'm not, the contractions aren't producing enough force to move the blood where it needs to be moved. So dilated lar enlarged cardio heart myopathy, I believe is just a general like, uh, uh, expression of disease. Um, so basically it's a disease of an enlarged heart. Okay. Um, you can see, yeah, the, the, just to talk everybody through the image that's on the screen right now, there's just like a graphical depiction of a normal heart next to a dcm, uh, afflicted heart. And then there's also an, IM an, an example of an image of a, uh, um, of an enlarged DCM heart inside. I think this is a dog. Mm-hmm. um, using a technology that's like, you know, there's, there's a variety of ways that professional medical providers can look inside your body or your dog's body and determine what the organ looks like without actually taking the, the, the thing out. In the case of a, um, examining the heart of a dog, what's typically the nature of the, uh, ex exam. That examination is called echocardiogram. And so this is an example of an echocardiogram of a, uh, dog's heart. With dcm, you can see the basically like enlarged LV left ventricle in the case of, uh, this dog. Yep. Um, cool. So that's, that's generally what we're talking mm-hmm. About. That's what the disease is. There are characteristics that tend to come, like symptoms that tend to arise when your dog develops gcm. It's beyond the scope of this to talk about why the, like, how, okay, well mm-hmm. there's fluid buildup because the heart's not working well, and that produces, like, that's, that's probably more than anyone needs to know. What's really important to understand is just like, what generally this disease is that We're talking about. Yeah. And so the echo Is deadly. Mm-hmm. deadly, super, super, Oh My gosh, super bad. There's like, you can bring in, uh, depending on how your vet, um, runs their, like their medical opinion, they can conduct something like an echocardiogram and other diagnostic testing. There's kind of blood and plasma tests that are sometimes done. They can give an indication that your dog is either at risk or on the road or in early stages, stuff like that, which is not a, oh my god, immediate diagnosis. It's something for sure to take seriously because it could be lead to something that is a truly, oh wow. We've got an immediate acute life threatening problem on our hands, which is what does Yeah. CM becomes once it gets advanced. Is DCM only occurring in dogs or are there any other breeds that can, DCM can develop in their hearts? Yes. Other species. Other species, yes. Yes. Yes. Um, with regard to listeners of this show, the important ones to note are dogs and cats. Both dogs and cats can get it. Um, it, I, I'm not sure it's fair to say it's been studied more on the feline side than on the canine side. They've both been studied prior, again, all prior to 2018. Like the, what the community was looking at before the f d A investigation was announced, both been studied significantly. And we have the, the community has managed to tease out differences in how, in what causes dilated cardiomyopathy in cats and what causes it in dogs. But both species can get it. It is roughly as bad in both cases, which is to say seriously bad and life threatening. Um, but there are differences that have arisen through experimentation. We've come to understand that some things contribute to DCM and cats in different ways than how they contribute to it in, uh, in dogs. Okay. Very interesting. I never knew that. I had always, always heard the cats get it. Yeah. The cats get it. I had always just heard DCM and dogs DCM and dogs. Well, The investigation, what the reason why is because if you're, you're nine outta 10 listeners of this show knew nothing, probably more than that, knew nothing, uh, about dilated cardiomyopathy mm-hmm. until at least 2018 Yeah. When the FDA announced this investigation mm-hmm. and the investigation is just about dogs. Yeah. But at the risk of doing like a little bit of a tangent, you know, when I, when I told the FDA a, that it's gotta produce its DCM records to me, big part of what it sent me is case reports of DC m So like the part of how the f d A functions is it's got a, an arm that goes, Hey, if your dog gets sick, tell us about it. If you think, think it's tied to some specific product that we regulate mm-hmm. So like, if you think, and they called this out in their 2018 investigations, big part of the investigation we'll get to in, in part two of the series, they said, if your dog has DCM and it's on one of these products, come tell us. We want to know about that. And so it's got this like portal through which you can submit cases. And so when they gave all their documents to me, of course they gave me a bunch of those, but you also have cases in there of cats with T C M and it's like, I don't know if it's people we're looking out for it more cause they heard all the info about dogs. Yeah. Or it's just independent. Like it is definitely a piece the cats get. Yeah. And that really leads into my next question is when I saw, you know, the headlines back in 20, you know, 18, 20 19, and I thought, oh my gosh, since the FDA is investigating this must be very common, but how common is DC m and dogs overall? It depends to some degree who you ask because the, uh, it is not something where we can speak with reasonable confidence about the number of people in the United States who get lung cancer every year. Okay. You know what I mean? Yeah. That's like a, that's, there are enough different professionals studying just that one issue through well-controlled experimentation to be able to tell us, you don't have to count every lung cancer case to develop a reasonably good approximation by sampling. That kind of stuff hasn't been done as well. And again, we're talking about prior to 2018 mm-hmm. in the DCM world, in the veterinary world, generally, that stuff's not nearly as common as it is on the hu in the human medical community, where there are epidemiological studies that are being performed at any given time that are teasing out disease prevalence in various populations, you know, among citizens of the United States or white males over 40. Right. Oh my God, I said that out loud. Um, I'm 40 on dot 40. Okay. I guess White males between 34 and four Right. Um, But it's just not, generally speaking, it's not done as significantly in the doggy world. So it's not like you could publish what's called a meta-analysis of existing standalone papers about DCM prevalence. Okay. There's some in information about it. It was clearly being diagnosed as as old as 30 years ago, standalone, um, like well-recognized disease. Okay. Things that are worth pointing out though is that as of, oh man, what year does she publish it? 20 0 26. Um, there's a chapter in a pretty big, like well-read, um, desk reference compendium for veterinarians that got put together, um, is sponsored by i'd, I'd screw up who's like the official body that put it together, but it's tied to Nestle Purina pet care is kind of like the organization that was at least the moving, moving force behind it, and it deals with a bunch. Mm-hmm. It's a desk reference, so you might use that in, in your job if you listen to this. We certainly had 'em back when I used to practice law, you had like the lawyer's desk reference to technology litigation. Mm-hmm. And it talks about how the law differs state to state within a bunch of different domains there. Right. And it gives you highlights, key issues. So in the version of that that I'm referring to, there's a chapter written by a veterinarian who's a veterinarian nutritionist, um, who at the time was fun was, was credentialed in that way, and at the time was held down the same job that she holds today, which is a professor as big major university, uh, in the northeast called Tufts University, one of the most reputable veterinary schools in the country. And as you're gonna see in episodes two and three, she's central to the F d A investigation and the misconduct pertaining to the investigation. But in 2006, sometime long before the investigation was announced, her perspective on it, and this woman's name, you're gonna hear it a lot in the, in the, you know, weeks that follow or episodes that follow here. Her name is Lisa Freeman. And Dr. Freeman wrote in 2006 that dilated cardiomyopathy is the second most common cardiac disease experienced by dogs in the United States. Um, there are a bunch of different ways the heart can break down. There's an enlarged heart is not the only one, but it's a relatively, with as cardiac diseases go, it's relatively common. It's the second most common she wrote. Um, overall, she also wrote that something like 11% of dogs in the United States suffer from some form of cardiac disease in their lifetime. So what that means is that yeah, there's something like 70 million dogs in the United States, 80 million somewhere in there. So 11%, call it 10%, you're talking about something like six to 8 million dogs getting cardiac disease in the US every year. Hmm. Rough, you know, let's, let's just assume shouldn't get exactly right on mark somewhere in that framework, and that of those six to 8 million dogs, the second most common disease that they get is D dcm. Um, does that mean that it's hundreds of thousands? Does it mean that it's millions? Um, it's certainly not, if it was any pattern, it, it couldn't be less than that, or it wouldn't, you wouldn't see any cases of the, like third most common disease, if that makes sense. Right. Like if you got 7 million total, the number two's gotta be reasonably high, but she didn't give a specific number and there's just not a like good specific number, um, that prior to 2018 anyone had tried to put together. And then the issue of how common is this disease now, how common has it become, became central to the discussion about DC m once the f d a investigation began. So that's like, we'll get to that in episode two, but as of the prior to the d a investigation, something like hundreds of thousands, maybe low millions of dogs in the United States, so maybe one in, in a hundred dogs ish would get this disease. Mm-hmm. so rare ish. Ish, but not unheard of at all. Right. It's important to note that it, it existed. Yeah. That's a vital fact for understanding what's coming up here Yeah. Is that it's not like there was no such thing as D cm and then in 2018, all of a sudden it showed up on the FDA's radar and they're like, what the heck is this? Yeah. Mm-hmm. it's like this is a disease that had been known about and studied. There's a whole body and we're about to get into it Yeah. Of literature around this disease and what pet owners can do about it prior long before 2018. Yeah, absolutely. And when we talk about, like you said, all these numbers of, uh, you know, the, the 10 to 11% of around that time period from that study that dogs were affected, that some breeds are more Yeah. From their pure genetics. Like not even necessarily environmental factors considered, but pure genetics that they're more predisposed to dcm. Is that how I understand it to be? Yes. So something you'll, uh, you'll often hear in introductions to DCM is that you'll, you'll inevitably hear, begin with a bit of a disclaimer where it's like, this is a multi-factorial disease. Nobody knows exactly for sure where it comes from. Mm-hmm. Here's our kind of the best things that we do know after that. You will often hear that there are some breeds that have a pre genetic predisposition to develop this disease. Um, yep. Beautiful. Yeah. You've got a slide made sure that Dan had a reference list here because it's quite a few. I mean, yeah, Some of them are conversational. If you, uh, have anybody in your, uh, family that works as like a vet tech, they could probably, if you told them to name the like five or six most commonly linked with DCM breeds, I bet you they'd rip off Doberman's and boxers. Those are okay. In my experience, at least that's what you hear most commonly. Okay. You, you like folks in terms of like, uh, I'm not talking about the number of boxer owners I know that have said I've got a dog with dcm, but when you talk to folks who are in the community that's associated with diagnosing treating it in veterinary offices, I do think that that's something like when I, I talk to people about DCM controversy all the time and when I'm trying to gauge their existing level of understanding of it, kind of like put it out to them like, yeah, alright, so what do you know about this? And often you'll hear people will say like, well, I know that some breeds are more disposed like Dobermans and boxers. Those are two you hear a lot. And there has been research that could demonstr that could be, you know, logically used to defend the idea that these, these types of dogs have a genetic predisposition to develop this disease. None of that is to say that the majority of these dogs get this disease, but there's at least some amount of evidence that the breeds that you see on this list Doberman's boxers. But in addition, some really large breeds, great Danes Newfoundlands, Irish wolf founds tend to be more likely than other breeds to get this disease. They tend to be overrepresented in the dogs that come in to veterinary clinics to be diagnosed with a and are diagnosed with D C M. Okay. That's very interesting. Yeah, exactly. This is not, this is, you know, important to understand what this list, uh, is not. It is definitely not a list that says these are the only breeds that can get dcm. That is not what this is. Dogs can get DCM under the right conditions. You can make any dog develop that disease over time. There are some that are more likely to get it. The mechanism by which they are more likely to get it is probably outside the scope of our show because it's not something where there's a clear scientific consensus. This is why boxers get it more, it's more of a matter interpretation of the evidence in theory that's reasonably well grounded, but like doesn't really add to this show anyway. You know, some people might say it's like there's something, um, that regardless of how you raise your boxer, it just might have the DCM gene and it's gonna get this, it's just faded to get this disease. There are other folks who might say, if you have a boxer, it's genetic structure is gonna be such that if you do certain things throughout that dog's lifetime, it's going to activate this gene in a way that it's gonna develop dcm. Mm. So again, it's not, this is not a, if you've got a Doberman, your dog, me telling you your dog is gonna get D dcm, it's not necessarily, that's definitely not it. And it is also definitely not the case that anyone is out there making a claim that this is an exhaustive list. This is a what again, pre 2018 best sense of the issue. Like these are the ones that we can say if there's any evidence that there's anyone that's predispose de any breed that's predisposed to this developing this disease mm-hmm. you definitely would include these breeds On it. Yeah, I agree. Yeah. And I think this is a good time to just remind everyone, you are not a vet, Dan. I just wanna, you know, like we really kind of really get into the diagnosis and what vets are looking for or what has been reported to the scientific literature. But it's a really good, you know, I think this is a good reminder for you to, you know, really kind of go into that. This is just representation of the science you know? Yeah. We, we never want to have you interpret this as, oh my dog, this means my dog this, or I should do this for his or her health decisions. Please talk to me. Exactly. Yeah. If you are, yeah. I mean that's, that's the main point there is like, yeah, this is me giving you an overview of public info, not me telling you things about your specific dog. And in addition, I'm not, there's, there are plenty of folks who would say, well, even in that world, I don't care what you have to say unless you're a credentialed veterinarian and I am not that. And if you are one of of those people, then you don't care what I have to say about it. I would submit to you that both, uh, rising veterinarians and myself are trying to achieve the same goal, which is understanding what the scientific literature says about a specific topic. I've done that, uh, for my own professional reasons. Cause I wrote a book about it all and it discusses basically where the various studies, where they came from, what predated them, what got incorporated, and what findings, how the findings, blah, blah, blah, all that kind of stuff. Whereas veterinarians, it's really similar exercise. They wanna understand the reality about a disease. And a disease can be something that's really hard to understand everything you wanna know about it just by looking at one animal. Yeah. You gotta look at it in a systematized way. The professional practice of science is designed to bring that kind of truth to light. And so we're drawing on the same sources. If you think that the only person who can reliably interpret that evidence is a veterinarian. Fair enough. But that's not me. Yeah. Yeah. I Would submit to you that it's not, but Fair enough. Yeah, absolutely. No, I think it's just a, a really good just reminder, uh, we're not here to misrepresent anything or misrepresent you or your, uh, you know, credentials. Yeah. None of this, I mean, like importantly, even if, if you are now going, okay, I'm signing off something you should understand is that nothing I'm saying right here is controversial whatsoever. Yeah. This is like, this is 1 0 1 stuff. This is, we're gonna get to stuff in the course of this series that some people are gonna, it's gonna at the very least provoke an emotional response in, I'm not saying it's a matter of interpretation, cuz it's not mm-hmm. it's just facts. But it is something that's gonna be controversial. This is not okay. This stuff you could take to the bank, this is what you're gonna hear. I promise you, if you go wherever you go, you're gonna hear the same things about here unless somebody doesn't know what they're Talking about. Yeah, absolutely. So let's continue with the facts, So let's continue. So we covered, you know, what D cm is, how it affects the dog's body, which talked about even breeds, but I, you know, we really need to kind of hit the nail on the head of w the cause. Yeah. What is causing, you know, dcm, and I remember when all these headlines came out and it was all these questions around like, like what is, what is, you know, is it what your dog feeding your dog? Is it this, is it that, you know, they were kind of throwing out maybe some other possible leads, but I think the core of it is nutrition. It, how does Nutrition, yeah. I mean mm-hmm. Genetic predisposition is, plays a role in determining an undefined kind of, I can't give you a mathematical equation, but it plays a role in whether any individual dog is gonna get, uh, DCM or not all, all else being equal. If your dog's a doberman, it is more likely to get DCM than if your dog's a labor order retriever. That's the, what the evidence says. That said, the most reliable way you can increase your dog's risk of developing dcm. I'm not saying that you can guarantee every single time a hundred out of a hundred give a dog DCM by doing this, but you can certainly drastically reduce, or excuse me, increase its likelihood of developing this disease through nutrition. This is, again, this is something that was understood by the veterinary community before the f d a investigation. If you walked into a veterinary office in 2015 when there was no such thing as an f fda a, uh, investigation mm-hmm. They weren't even looking at this issue and you said, Hey, outside of genetic predisposition, what can be done to, uh, you know, make a D C M, uh, make D bring about D dcm? Um, your vet would say, well, it depends what you feed the animal. Um, because there are well understood links between nutrition and DCM, both in dogs and in cats, and they're somewhat different because dogs and cats bodies aren't, uh, don't function exactly the same. Um, so basically, uh, I'll give you the rundown. GCM is a disease of the heart. It's a disease of the heart. Muscle. Muscle is composed, uh, cardiac muscle like skeletal muscle. Mm-hmm. is composed of protein, which is primarily, which is to say that it is composed of the building box of protein, which are called amino acids. Amino acids are the little individual or different kinds, and they're the little individual types of molecules that come together to build up to become proteins. Mm-hmm. that are used to develop lean tissues in the body such as cardiac muscle. Um, as anyone that's listening to this Shirley nose, these things are not just, uh, proteins and amino acids. They're not just things to be discussed within the animal's body. They're part of the nutritional makeup of a food product. So when you're feeding your dog something, the most important way to think about what that thing is, is it's nutritional characteristics. You can talk about things like, well, what brand is, uh, behind this product? You can talk about things like, well, what ingredients are in this product? But at the end of the day, when you reduce it down to its most basic fundamentals mm-hmm. both of those things are just vehicles for nutrition. Nutrition is what actually acts on the animal's body, not the brand. You don't, there's no chapter in a textbook that says when a dog eats keto natural food, this, that, and the other thing happens. You might say a dog, if a dog eats keto natural food, it eats a low carbohydrate food and then that interacts with the body in x, y, z ways. But that's because our brand is a vehicle for that nutritional makeup. Carbohydrate is a nutritional turine nutritional phenomenon. And so protein and more basically the building blocks of protein, amino acids are nutritional phenomena. Um, there are two classes of amino acids and, um, they change species to species. They're called, called essential and inessential. Um, in some species, uh, what's an essential nutrient is inessential in another species. The difference is that if a amino acid is inessential for your species, that means that your body can make that amino acid on its own if you give it the right building blocks. So I know we're going like another level of building blocks beyond this, but basically that's what that means is that like if you hit all the essential ones in the nutritional makeup, nutrition, essential amino acid means nutritionally essential. The animal has to eat these nutrients in order to not develop some kind of deficiency disease mm-hmm. Um, whereas if it is inessential, as long as the essential ones are getting met, the inessential ones can be made within the body. Okay. That's kind of a, I know that's a little bit of a conceptually challenging concept. I I probably didn't do my best explaining it. Um, but if, if anyone's still with me, that's the concept. They're essential amino acids in essential amino acids and they change depending on if you're a sloth or a an or or a dog or a cat. It makes me think of like primary colors and complimentary colors. Like you need a Not bad Bad. Yeah. I was kinda, I was trying to think, I'm like, how can I kind of break this down where, you know, the, you need the primary colors to make the complimentary colors to make the tertiary colors. So, but you need the primary colors. That's super good. I love it. Okay. Put that in your next one analogy. Um, put that in your next book and smoke it. Yes. Serious. Yes. I was gonna say sound Like, kinda like a write off. Uh, but no, I, I think this is good. I mean yeah, you're, you're you're going in deeper, but it's, but it's, we gotta go, you gotta go nuts and bolts. Yeah. Well you gotta do this, these specific nuts and bolts to understand a really important point. Yeah. Which is that there is one particularly important amino acid when it comes to the disease of dilated cardiomyopathy. That amino acid is touring. Toine is one of, oh man, on top of my head, not sure. 16 different amino acids. Oh wow. Okay. That exists. Um, and it plays an important role in the development of cardiac muscle tissue. Um, in dogs touring is not considered by the such as to the extent that there's such a thing as scientific authorities. The, the folks who get together form consensus around what the evidence says and make recommendations or regulations grounded in that consensus have come to the conclusion that touring is not an essential amino acid in dogs, but it is an essential amino acid for cats that your dog's body will produce toine if you give it the right primary colors going into it. On the other hand, there's no combination of primary colors you can give your cat that will allow the cat to produce touring. You have to give it to the animal through diet. Really important distinction because the implication of course is that if you don't give a cat enough nutritional toine, it will increase the likelihood that that animal develops D cm. Cuz toine plays an important role in skeletal muscle and a lack of available toine contributes to the development of tcm. Um, this is the primary reason why Toine is considered an essential nutrient in cats. That's the main disease you're worried about without development. Uh, if, if that wasn't a disease, I'm not sure you'd be able to call toine an essential nutrient in, in cats. Like that's, that's a very important function that that nutrient performs. And given the fact that the animal can't produce it in its own, it's essential that it comes in through its nutrition. Um, that reality is baked into how pet food is regulated in the United States. If you wanna sell cat food and get the blessing of the organization that matters, the, uh, what's called afco, the Association of American Feed Control Officials, you need to include a certain amount of touring in your cat. Food must happen with dogs. That is not the case for dogs. The same group has determined that based on the weight of the evidence, toine is not an essential nutrient. And that's because dogs can produce toine on their own if you do give them the right primary colors. Those primary colors are two other kinds of amino acids and they're essential. So if you give them the essential ones, the primary colors your dog will make touring on its own is how the, that's how the logic goes. The two go. Yeah. I was just thinking like, I never remember seeing touring listed on any of the dog food I've ever purchased, which makes Not until the 2018. Yeah. Not until, and then now it's, yeah, now it's like, wait, then something did change because now I, you know, it's like, it's such a different Yeah. It's still not Required by Afco, but it is now because DCM is such a prevalent news item mm-hmm. and because toing clearly plays some aspect of a role in the development of dcm, all of a sudden there are folks who are saying, Hey, we need to reconsider this. Is toing actually an essential nutrient for dogs? Should we be making sure that all of them take it in in some capacity? Do we maybe get this issue wrong? Mm-hmm. and I'm not out here saying that, I'm just giving you an overview. Right. Kinda a Current state of affairs mm-hmm. But what with the state of affairs as is embodied in the regulations right now is if your food con contains enough cistine and methionine, these are two essential nutrients for dogs, essential amino acids for dogs, then the dog will be able to produce toine on its own. Again, using your primary color analogy, it's like cistine and methyine are like red and yellow, and in a dog toine is orange. Give enough if you have red and yellow in there and sufficient quantities, the dog can make the orange within its own body and avoid problems. Yeah. Complications, including dilated cardiomyopathy. Um, that is the main nutritional phenomenon. That's the one thing if you're, if your vet or vet tech or friend who knows about, uh, veterinary nutrition could tell you just one thing about DCM prior to 2018, that's what they would tell you is that a lack of toine is the primary nutritional thing that can, uh, lead to the development of this disease. And that in dogs, what that means is you've gotta make sure you give them enough cistine and methionine mm-hmm. And in cats it's more than that. It's gotta actually give them Tori. Yeah. Last important thing to note, um, about the nutritional, um, side of this disease, again, before anything kicked off in 2018, is that the types of ingredient we, I mentioned before that like nutrients are the actual things that act on your dog's body. There's a reason when you take, uh, nutritional, when you talk about nutritional science and not ingredient science or pet food, brand additional science, the nutrients are what acts on the body. The ingredients do not, the ingredients are composed of nutrients and the in nutrients act on the dog's body. Um, that's said touring like protein generally, but particularly touring is most common in meat products. So it is why cat foods typically contain a higher proportion of meat than dog foods. If you know anything about our show, you know, that we recommend, we believe it is most helpful to feed your dog a product that is composed entirely or as much as possible of meat. And one of the qualities that meat ingredients tend to have skeletal muscle, particularly as opposed to organ or fat components of, of meat products, is they contain the, as the, uh, amino acid toing. And so cats, this is why it's often said that cats are what are called obligate carnivores. Mm-hmm. They have to eat meat. Pe Some people have the perspective that a dog is not an obligate carnivore, and I wouldn't necessarily say they're wrong. Um, this DCM stuff is the closest thing you could say to somebody that, uh, would, would for arguing somebody's wrong, for saying a dog is an obligate carnivore because the dog can synthesize the primary meat-based nutrient. The old, the thing that you can only really find in meat touring dog can make it on its own. So you could get by without feeding your dog meat if you constructed the diet just right. Mm-hmm. they could make that toine on their own. Cat can't do it. So a cat's gotta eat meat. If you try to feed a cat an all vegetarian diet and nothing derived from meat, the cat will die. Hmm. So, wow. Um, Is there anything that, so dogs can make it on their own, so kind of using this primary complimentary analogy, but is there anything that can like, interfere with that? Yep. Okay. That's right. That's exactly right. So that, that is, um, to some degree that's, uh, the, the like, um, the most fertile like ground for ongoing study of nutritional links between, um, uh, nutritional causes of DCM in dogs. Mm-hmm. So like the science that's been spawned and theorizing that's been spawned by the 2018 FDA investigation is largely focused on this is, okay, well look, we know how much cystine and methionine a dog needs to ingest in order to be able to make sufficient amounts of toine. But what if there are some things within the diet, some nutritional qualities of the diet that make it unlikely to absorb enough of that cystine, methyine or otherwise get in the way of the process by which cystine methyine are converted into toine within the body. And that's, you know, you can, you can, you can piece together why that would, in the framework we've already covered, contribute to the development of cm. And so there are folks who are pursuing that as a theory. But even before 2018, a good deal about this was already understood, which was, uh, could be summarized kind of like this. It's like dietary fiber can interfere with the absorption and metabolism of cystine methyine to some degree. So if you ate a very high fiber diet, you will con your dog, excuse me, will consume, will, um, metabolize less of the cystine methionine that's being ingested nutritionally than a dog that has a lower fiber diet. Mm. That's interesting. It is, it is also the case that that science didn't ever, uh, rise to a level that was sufficient. Where Afco said, we gotta get fiber out of fat pet food because it's causing, it's making it so that dogs can't develop, there's no like top cap. And they do that with some d with some types of nutrients. They say, look, the evidence is clear if you feed your dog more than this, it's gonna get, it's more likely to develop this disease. So we're not gonna let any pet food manufacturers do that. That's like meat and potatoes. What Afco does, they haven't done it in this case. Um, fiber is this weird, uh, nutritional thing that passes through the animal without being absorbed like carbohydrate and, uh, you know, amino proteins, amino acids, they get ingested, they're in food products, and then they, then they get absorbed, they get digested and absorbed into the dog's body and become part of the body fiber in indigestible insoluble fiber is not like that. Mm. It passes through the body. It's why, like it's often talked about in the, uh, context of digestion and defecation and like stool quality. Mm-hmm. is like, it plays a role. It passes through the system. And so clearly it's the only thing that it's really touching on in the immediate sense is stuff that's going on within the digestive system. And so the idea here is that too much fiber causes in like binding up of other nutrients that would otherwise be absorbed and used in the process to produce storing within the body. And that you can have that there if there's too much fiber and not quite enough cystine and methyine that the amount of fiber can take the cystine methyine below the levels that are required and therefore reduce the availability of, um, of toine to meet the animal's needs. Wow. Your dog really is what it eats Oh wow. Have you been put on That one since This entire goes right through Like drum roll that In your outline you Just saved, what? Did you have some inkling that I would not Think that that was a sufficiently created That that'll be the singer subtitle for your next book. That Definitely. Wow. Nobody's ever thought of that Oh man. No, it's like so classic that we end with like, and this is how your dogs poop It's just Oh, yeah. Yeah. It's True. But yeah, I, I hope we did cover so many bases, but of course, if you have any further basic dcm we are happy. If any DCM questions, please write into us to the show. It's just hello@feeddogfax.com. And we might do a, a mini part too. We'll see. But if there's any questions that come in, but this is to serve as a so of standing DCM 1 0 1. Um, you've heard about it, you're not quite sure what it is. And, and I know we did it justice and you know, this is, yeah, I Mean, like there's, you can, um, a good way to like always, I think to, um, help someone like understand whether or not what you're telling them is factual and true or not, is to reference a broader third party analysis of the same issue that you've been discussing and say, look, go take a look and if it, if you see anything wrong here, come tell me and we'll talk about why what you're seeing is wrong, if there's anything, and we'll be happy to address it. Yeah. And in the course, in the context of d c M, there have been kind of like, there have been two really good, really big comprehensive peer reviewed evidence review papers that basically cover the terrain that we just covered. What is this disease, how do you explain the links between genetic predisposition, nutrition and disease outcomes in the context of dogs and cats? I'm gonna, I, I'm tempted to put 'em in the show notes because we will absolutely be discussing both of them over the course of this series. But really it's a part two thing because they are, they didn't come out until after like once F D A announced its investigation. Boom. D DCM becomes a big issue. Boom. Scientist are Interested in writing about it. Yeah. They could have written this stuff. 99% of it. Mm-hmm. prior, like one of them came out just like a few months after the investigation was announced. And you could see it's clearly being written in response to the announcement. Like, it's like reference the announce the investigation is referenced in the paper. Yeah. As like, this is why we're writing this. So, but 99% of the material is the same stuff that we're talking about. Perfect. Another reason to listen to part two right there, go's Oh, you can't, if you suffered, there's no way. If you suffered through this, the thes and bolts of it, you've got it, then you're coming back for two. Because Coming back, we hope you'll be, it's good. The whole trilogy, right? We don't give up on our Game of Thrones yet. We have more scandal on its way. No, No, this is not scan. It's like this stuff. Nobody's gonna write an Email To me or come to my house and threaten me over this. Oh yeah. No, this is, we, we have to set the stage right. We're we're saying the, we're building the building blocks. Right. You use that a lot of, like the amino acids and how this operates in the body. Many blocks. So many blocks, so many building blocks, many Blocks in this show, So it's important to note that this is the nutrition as known and published before 2018. So again, please turn into the next part, part two, and Dan will kind of walk, Dan will walk through all the timelines. So he's gonna, all the news story, like he's going to clearly lay out. So we're gonna be doing a very investigative reporter esque of when this came out, what was discussed, all the, the dominoes I would say that had to come into play. And anyway, part two's coming up next and It's just like, sorry, one more like the goal in part two. Yes. For me mm-hmm. is to present that information without, like, interpretation. I'm not, I I really want to try to put something out there that is not me. It is not subject to any kind of serious debate or is gonna release, you know, produ put people on sides of an issue. That's like what you're gonna get in episode two is like in this episode, something that if you take it to anybody, anybody that knows what they're talking about in this, they're gonna be like, yeah, this is all sure. Because it's just gonna be not controversial stuff. It's just a different body of material that we're gonna walk through in this same kind of way. To be clear, controversial stuff is coming and it is like, that will be a part of this, but it's not, part two is not gonna be like that. It's just gonna be current and it's gonna get on an issue that ruffles feathers. Like I unfortunately, believe me when I tell you that the issue of dilated cardiomyopathy in the news since 2018 is an emotionally charged one. Yes. Yes. When this gets discussed in public forums, people retreat to their sides and fight it out. It is like a, you know, information war. Yeah. And so that's very much the thing. I don't think anybody will take that away from, you gotta re, you're gonna have to reach to like, be like, oh, screw this guy over. What's he saying here? It's not gonna be like, it's just basically compiling it all in one place. Yeah. The, the, the existing Facts. Absolutely. And DCM is a very deadly disease. So again, if you feel that your dog is exhibiting so signs and symptoms, please work with your fat. This is show is not to replace any type of veterinarian care. We'll make sure we have our disclaimer everywhere and anywhere. Um, this is purely for educational and scientific purposes only. But thank you again for listening for another episode, first part of our trilogy. So please stay tuned for part two. Head over to listen to part two. To continue on the story of DCM DCM Gate DCM Gate DM Gate. Thanks for listening, guys. All right.