![]() ![]() In a European study, 1.1% of the dog population seen at veterinary hospitals were diagnosed with DCM ( Fioretti and Delli, 1988). Interestingly, a subset of dogs from the same study that only included dogs with an inherited disease (27,254 cases) observed an incidence rate of 1.3% in this specific group ( Bellumori et al., 2013). veterinary teaching hospital study that included all dogs evaluated in that hospital between 19 (90,004) reported a DCM incidence rate of 0.4%. referral-hospitals were diagnosed with DCM. According to the Veterinary Medical Database ( Sisson et al., 2000) from 1986 to 1991, 0.5% of the dogs evaluated at U.S. The second most common heart disease (and most common primary myocardial disease) in the dog is reported to be DCM. Up to 75% of all cardiovascular disease in the dog is chronic degenerative valve disease ( Kvart and Häggström, 2000 Kahn, 2005). Information regarding the incidence of DCM in the dog population is limited. ![]() It also includes other potential diet-associated etiologies that have been recently suggested ( Santilli et al., 2017). This review covers the various etiologies known to cause DCM in dogs, including genetics, hypothyroidism, myocarditis, chronic tachycardia, and certain known dietary deficiencies ( Phillips and Harkin, 2003 Sanderson, 2006 Wess et al., 2010b Beier et al., 2015 Hallman et al., 2019 Vollmar et al., 2019). Additionally, robust statistical designs that look at the effect of single dietary components, in controlled environments, with robust outcomes related to metabolism will allow for an understanding of potential disease etiology. Research studies must be carried out evaluating one variable at a time, while mitigating sampling bias of data collected, to effectively identify potential new causes of DCM ( Simundić, 2013). In order to better understand the disease process, a knowledge of the incidence, clinical manifestations, diagnostics, and potential treatments is required. Recently, there has been concern regarding the relationship of 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 ( Freeman et al., 2018) however, no definitive link has been established at this time. However, other causes of DCM include specific nutrient deficiencies ( Freeman et al., 2001 Backus et al., 2003) and concurrent diseases, such as endocrine ( Karlapudi et al., 2012 Janus et al., 2014), myocarditis, and chronic tachycardia ( Calvert et al., 1997). Historically, dilated cardiomyopathy ( DCM) has been considered to be primarily an inherited disease, with higher prevalence in specific dog breeds ( Dukes-McEwan et al., 2003 Sammarco, 2008). ![]() 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. 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. 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. Future studies are needed to evaluate one variable at a time and to minimize confounding variables and speculation. In addition, current literature limitations are addressed, in order to ascertain multiple variables leading to the development of DCM. 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. ![]() 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. DCM is commonly associated with a genetic predisposition in certain dog breeds and can also occur secondary to other diseases and nutritional deficiencies. Dilated cardiomyopathy (DCM) has been in the literature and news because of the recent opinion-based journal articles and public releases by regulatory agencies. ![]()
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