The Big Miss: Is No-Hide® Actually Rawhide?

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A ‘consumer advocate’ recently stirred up drama from July 2017 re-circulating an article (figure 1) claiming that Earth Animal No-Hide® treats were rawhide, again. This was on the heels of the announcement of a class-action lawsuit (figure 2) against Earth Animal Ventures (EAV) questioning the ingredients and sourcing of No-Hide® products. I didn’t think I would have to address this issue, but apparently, I do since misinformation and cherry-picked information from the original chain of events keeps circulating (if it’s on the internet it must be true, right?). Consumers and retailers alike need to see the situation for what it is, so I’ll also write this from both a retailer and consumer standpoint to provide the level of transparency I hold others to. As you read this, you’ll understand that both sides have significant issues. In fact, No-Hide® being (or not being) rawhide is hardly the issue. Instead there is a pervasive lack of transparency and misinformation from both the consumer advocate side and EAV.

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Grain-Free Pet Food Diets | What to Know Before Switching

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The benefit and necessity of grain-free pet food have come under scrutiny in recent years due to an FDA investigation due to a potential association with a canine heart disease known as dilated cardiomyopathy (DCM). As a result of this potential association, many have been told there is no scientific evidence to support the use of grain-free foods in canines and felines, or that these foods do not provide any benefit over grain-inclusive foods. For the most part, grain-free refers to kibble, although some have also categorized various canned, freeze-dried, and raw diets under the ‘grain-free’ umbrella. But are these claims accurate? Let’s find out:

 

Grain-free foods don’t provide benefits?grain free dog food kible

The pet food industry’s switch to grain-free was not fueled by a problem with the grains themselves or grain allergies like most believe. The largest pet food recalls in history was due to melamine and cyanuric acid contamination of ingredients coming from China. The short version of the 2007 recall is that wheat gluten and rice protein were intentionally combined with melamine for its high nitrogen content. Higher amounts of nitrogen can cause the protein content of an ingredient to test higher than it actually is. Since cyanuric acid was present, and the combination of melamine and cyanuric acid is likely the reason the recall was so deadly – not the melamine on its own. This series of events fueled the consumer trend of wanting grain-free pet food.

Other Concerns

Another major factor absent from the discussion on grain-free vs. grain inclusive diets for people – and pets – is the contamination of grains with herbicides, pesticides, mycotoxins, and fertilizers. This has become an increasingly large concern since the mid-’90s in both the human and animal food supply. Numerous peer-reviewed articles are detailing the disruption many of these agricultural contaminants have on normal gut bacteria function.1,2 In fact, available literature suggests that humans are becoming increasingly intolerant to grain and grain products for exactly these reasons (e.g. wheat & gluten sensitivity & celiac disease in humans).

We are learning that disruption of vital gut bacteria balance can have devastating effects on the health of the host, including diabetes, obesity, autoimmune disease, cancers, GI issues, and even DCM.3–5 Could the contamination of grains in pet food be one reason why many pets experience improvement of various issues with the change from grain-inclusive to grain-free? Could be.

Ultimately the phrase ‘there is no evidence to support the use of grain-free foods’ doesn’t mean there is not a benefit. It simply means that we have a major gap in research into companion animal nutrition and that we easily forget our recent history. On the contrary, we don’t have evidence to support that feeding grains to canines or felines are any more healthful than feeding grain-free diets. Evidence only shows that it meets minimal (known) nutritional standards, not that pets thrive on these processed diets. In short, canine and feline nutrition fields are far behind the knowledge we have in livestock and human nutrition.

 

Are ALL grain-free foods the same?

Many veterinarians and pet owners automatically lump grain-free cans, fresh food, raw food, and freeze-dried products as ‘grain-free’. While this is technically correct – there are stark differences that make these foods different from their kibble counterparts.

Regardless of whether we are feeding grain-free or not, we need to consider the high temps kibble and canned foods are heated to during the manufacturing process. This high heat creates Maillard Reaction Products (MRP) which is the name for a series of reactions that is the product of sugar (carbohydrate) and protein when heated. These are also known as AGE’s or Advanced Glycation End Products.

MRP’s are responsible for the nutrient loss and associated with diseases like diabetes, cardiovascular disease, kidney disease, loss of cognitive function, allergies, periodontal disease, and chronic inflammation.6–12 This can mean things like arthritis, skin, and ear issues, an old injury that keeps resurfacing, bloating, IBS, etc. Also, there is a large amount of research to suggest that they are carcinogenic and accelerate aging.13,14

  • Heterocyclic amines are MRPs from cooking protein that increases with elevated cooking temperature. This phenomenon is more pronounced in meat than fish – and these increase with temperature and dryness of meat or meat products15.
  • Acrylamides are a chemical that forms naturally from starchy foods during high-temperature cooking. According to the European Food Safety Authority evidence from animal studies shows that acrylamides are genotoxic and carcinogenic: they damage DNA and cause cancer. And since we know so little about animal nutrition is it possible that much of the disease we’re seeing – including DCM – has at least something to do with the MRP’s that are in dry and/or canned pet food? Is it a coincidence that freeze-dried, fresh, and raw options do not have as many associated issues as their processed counterparts? Maybe.

 

Allergic to Grains? Probably Not (sorry, not sorry)

Pet food can be made of everything from rendered unfit foods for human consumption to ingredients that are 100% organic and probably better than the food we feed ourselves. I’m not necessarily here to split hairs on ingredients and in the types of ingredients that are in our pet’s food. Because is it these ingredients that are causing the problem? Or is it something else? – These are the questions that the experts seem to avoid entirely. When a dog experiences issues related to food, we are quick as a society to turn over the bag and blame an ingredient or set of ingredients. However, those ingredients as listed are likely not the problem – rather the quality, processing agents, AGE’s and contamination of these ingredients (e.g. herbicides, pesticides, etc.); something you will never find listed on a label.

 

More Important: Nutrient Availability & Digestibility

The digestibility of food is altered as it is processed, mixed with other ingredients, and heated. That said, canned and kibble foods by definition will have varying levels of nutrient availability and digestibility than their lesser processed counterparts. The ingredients (or set of ingredients) that make up a food could be the most nutrient-dense food available – but if they are not digestible by the cat or dog then those ingredients are irrelevant. In short, this means that it is important to ask your pet food company for their digestibility and nutrient analysis to determine if their food is adequate for your pet. Learn more about what questions to ask and why here.

 

About the author: Nicole Cammack

Nicci is the owner of award-winning NorthPoint Pets & Company, in Connecticut. She is also the Founder & CEO of Undogmatic Inc. Her undergraduate and graduate education includes biology, chemistry, business, and nutrition. She has worked in the pharmaceutical industry on multiple R&D projects and has had the privilege to learn from leading international figures in the human and pet health industry. She regularly lectures at national conferences, including federal, state, and municipal K9 events. Her current research involves identifying pathogenic risk factors and transmission among raw fed pets through a comprehensive worldwide survey.

www.northpointpets.com

www.undogmaticinc.com

 

References:

  1. Van Bruggen AHC, He MM, Shin K, et al. Environmental and health effects of the herbicide glyphosate. Sci Total Environ. 2018;616-617:255-268. doi:10.1016/j.scitotenv.2017.10.309
  2. Aitbali Y, Ba-M’hamed S, Elhidar N, Nafis A, Soraa N, Bennis M. Glyphosate based- herbicide exposure affects gut microbiota, anxiety and depression-like behaviors in mice. Neurotoxicol Teratol. 2018;67:44-49. doi:10.1016/j.ntt.2018.04.002
  3. DeGruttola AK, Low D, Mizoguchi A, Mizoguchi E. Current Understanding of Dysbiosis in Disease in Human and Animal Models. Inflamm Bowel Dis. 2016;22(5):1137-1150. doi:10.1097/MIB.0000000000000750
  4. Galland L. The Gut Microbiome and the Brain. J Med Food. 2014;17(12):1261-1272. doi:10.1089/jmf.2014.7000
  5. Yoshida N, Yamashita T, Hirata K. Gut Microbiome and Cardiovascular Diseases. Diseases. 2018;6(3). doi:10.3390/diseases6030056
  6. Jandeleit-Dahm K, Cooper ME. The Role of AGEs in Cardiovascular Disease. doi:info:doi/10.2174/138161208784139684
  7. Pion PD, Kittleson MD, Thomas WP, Skiles ML, Rogers QR. Clinical findings in cats with dilated cardiomyopathy and relationship of findings to taurine deficiency. J Am Vet Med Assoc. 1992;201(2):267-274.
  8. DCM: add taurine to grain-free dog foods, say scientists. Accessed May 15, 2019. https://www.petfoodindustry.com/articles/8162-dcm-add-taurine-to-grain-free-dog-foods-say-scientists?v=preview
  9. DACVIM CDSBM. Breed-specific variations of cardiomyopathy in dogs. dvm360.com. Accessed May 15, 2019. https://veterinarynews.dvm360.com/breed-specific-variations-cardiomyopathy-dogs
  10. Dilated Cardiomyopathy in Dogs. vca_corporate. Accessed May 15, 2019. vcahospitals.com/know-your-pet/dilated-cardiomyopathy-dcm-in-dogs–indepth
  11. Medicine C for V. FDA Investigation into Potential Link between Certain Diets and Canine Dilated Cardiomyopathy. FDA. Published online June 27, 2019. Accessed June 29, 2019. https://www.fda.gov/animal-veterinary/news-events/fda-investigation-potential-link-between-certain-diets-and-canine-dilated-cardiomyopathy
  12. Freeman LM, Stern JA, Fries R, Adin DB, Rush JE. Diet-associated dilated cardiomyopathy in dogs: what do we know? J Am Vet Med Assoc. 2018;253(11):1390-1394. doi:10.2460/javma.253.11.1390
  13. Prasad C, Imrhan V, Marotta F, Juma S, Vijayagopal P. Lifestyle and Advanced Glycation End Products (AGEs) Burden: Its Relevance to Healthy Aging. Aging Dis. 2014;5(3):212-217. doi:10.14336/AD.2014.0500212
  14. Turner DP. Advanced glycation end-products: a biological consequence of lifestyle contributing to cancer disparity. Cancer Res. 2015;75(10):1925-1929. doi:10.1158/0008-5472.CAN-15-0169
  15. Jägerstad M, Skog K, Arvidsson P, Solyakov A. Chemistry, formation and occurrence of genotoxic heterocyclic amines identified in model systems and cooked foods. Z Für Leb -Forsch A. 1998;207(6):419-427. doi:10.1007/s002170050355

Hemp & CBD: Not All CBD is “Natural”

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In part II we discussed phytoremediation, and why this is one of the largest hidden risks for those who give CBD to their pets or consume it themselves. To review, cannabis absorbs heavy metals, and many of the agricultural chemicals in the soil such as pesticides, herbicides, and fertilizers. If a company does not have processes and procedures in place that ensure their product is free from contaminants and is actually the concentration that is listed on the label. Don’t believe this is a real issue? Due to a lack of regulation, hemp products have the potential for significant risks.

Consequences Due to Lack of Regulationrisks of hemp products

Unfortunately, due to the phytoremediation properties of hemp, contaminants and formulation errors are common and often go unnoticed. For example, a recent study by Cornell University showed 10 out of 29 CBD products tested were within 10% of the concentration on the label.  That same study also showed that heavy metal contaminants were found in 4 out of 29 products.19 Stop and read that again – because it means that only 34% of the most popular CBD’s were even the correct concentration. Never mind those with contamination issues…Yikes!

Spoiler alert: these are some of the most popular pet CBD supplements on the market today. Most of them are sold locally to Cheshire – so you may want to pay attention.

Lack of regulation for CBD means that companies who are NOT members of the NASC are not required to test raw ingredients or finished products for contaminants or adequacy. Heavy metal contamination, poor sourcing, and/or formulation errors could potentially be a contributing factor to elevated liver function testing and other documented adverse effects relating to hemp & CBD use. This highlights the need to screen companies for adequate product testing and transparency. The reality is that a very small handful of companies can provide verification that their products are contaminant-free, or within concentrations listed on the label.

Ask Questions Verifying Quality

When looking for a CBD product, or any supplement for yourself or your pets you must ask the following questions:

  • Are you a member of the NASC? (pets only)
  • Do you inbound test your raw and concentrated ingredients for contaminants such as heavy metals, fertilizers, and other agricultural chemicals?
  • Do you test your raw ingredients specifically active ingredients to ensure their concentrations are correct?
  • Do you source any ingredients from China?
    • Are you willing to provide certificates of origin?
    • Note that ingredients from China are not necessarily bad if they are responsibly sourced, and they are verifying quality and purity.
  • Do you complete an analysis of your final product to ensure the formulation is correct and ensure there are not any contamination issues? This is important to ensure that active ingredients match the label.

If companies are unwilling to transparently ask these questions or use the excuse of information being proprietary, I would strongly suggest that you find another brand. Not being transparent or testing products when it comes to ensuring safety is unacceptable. Brands that are not meeting these standards could potentially be poisoning the market for other companies who do their due diligence. As consumers, demand better.

Summary

CBD may have its benefits when well-sourced and formulated. While more research is needed, this is a common problem for a lot of supplements and pharmaceuticals on the market. Overall, the risk of adverse effects appears to be low, but consideration should be taken for those pets who may have liver problems.

Some veterinarians are well educated in the CBD landscape and available products, and some simply are not. If your vet is unable to provide information or recommend products it is ok to ask them for someone who can. Many reputable companies do have veterinarians and scientists on-staff that you or your veterinarian may also be able to speak to for more information.

As always, this is a rapidly evolving field. We expect to see changes as the FDA and AVMA begin to release more guidance and information in this area. We also will see more research regarding safety, efficacy, and other applications as time goes on. While it can be frustrating to see both advice and information change, remember this is a good thing and something you should embrace and support!

Did you miss part I, II, III of this series?

About the Author: Nicole Cammack

Nicci is the owner of award-winning NorthPoint Pets & Company, in Connecticut. She is also the Founder & CEO of Undogmatic Inc. Her undergraduate and graduate education includes biology, chemistry, business, and nutrition. She has worked in the pharmaceutical industry on multiple R&D projects and has had the privilege to learn from leading international figures in the human and pet health industry. She regularly lectures at national conferences, including federal, state, and municipal K9 events. Her current research involves identifying pathogenic risk factors and transmission among raw fed pets through a comprehensive worldwide survey.

www.northpointpets.com

www.undogmaticinc.com

References

  1. Sawler J, Stout JM, Gardner KM, et al. The Genetic Structure of Marijuana and Hemp. PLoS ONE. 2015;10(8). doi:10.1371/journal.pone.0133292
  2. Marijuana, the Second Trip. Revised Edition by Bloomquist, Edward R.: Good PAPERBACK | Earthlight Books. Accessed June 3, 2020. https://www.abebooks.com/Marijuana-Second-Trip-Revised-Edition-Bloomquist/22676164305/bd
  3. Kogan L, Schoenfeld-Tacher R, Hellyer P, Rishniw M. US Veterinarians’ Knowledge, Experience, and Perception Regarding the Use of Cannabidiol for Canine Medical Conditions. Front Vet Sci. 2019;5. doi:10.3389/fvets.2018.00338
  4. Fitzgerald KT, Bronstein AC, Newquist KL. Marijuana Poisoning. Top Companion Anim Med. 2013;28(1):8-12. doi:10.1053/j.tcam.2013.03.004
  5. Mackie K. Cannabinoid Receptors: Where They are and What They do. J Neuroendocrinol. 2008;20(s1):10-14. doi:10.1111/j.1365-2826.2008.01671.x
  6. Maroon J, Bost J. Review of the neurological benefits of phytocannabinoids. Surg Neurol Int. 2018;9. doi:10.4103/sni.sni_45_18
  7. Levinsohn EA, Hill KP. Clinical uses of cannabis and cannabinoids in the United States. J Neurol Sci. 2020;411:116717. doi:10.1016/j.jns.2020.116717
  8. Mechanisms of CB1 receptor signaling: endocannabinoid modulation of synaptic strength | International Journal of Obesity. Accessed June 5, 2020. https://www.nature.com/articles/0803273
  9. Commissioner O of the. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). FDA. Published online March 10, 2020. Accessed June 4, 2020. https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd
  10. Commissioner O of the. FDA Warns Companies Illegally Selling CBD Products to Treat Medical Conditions, Opioid Addiction. FDA. Published April 26, 2020. Accessed June 6, 2020. https://www.fda.gov/news-events/press-announcements/fda-warns-companies-illegally-selling-cbd-products-treat-medical-conditions-opioid-addiction
  11. How CBD pet product brands avoid federal warnings. Accessed June 12, 2020. https://www.petfoodindustry.com/articles/8793-how-cbd-pet-product-brands-avoid-federal-warnings
  12. Drug Scheduling. Accessed June 6, 2020. https://www.dea.gov/drug-scheduling
  13. AVMA weighs in at cannabis hearing. American Veterinary Medical Association. Accessed June 17, 2020. https://www.avma.org/javma-news/2019-08-15/avma-weighs-cannabis-hearing
  14. FAQs. NASC LIVE. Accessed June 13, 2020. https://nasc.cc/faqs/
  15. Resnik DB. Beyond post-marketing research and MedWatch: Long-term studies of drug risks. Drug Des Devel Ther. 2007;1:1-5.
  16. Deabold KA, Schwark WS, Wolf L, Wakshlag JJ. Single-Dose Pharmacokinetics and Preliminary Safety Assessment with Use of CBD-Rich Hemp Nutraceutical in Healthy Dogs and Cats. Animals. 2019;9(10):832. doi:10.3390/ani9100832
  17. McGrath S, Bartner LR, Rao S, Kogan LR, Hellyer PW. A Report of Adverse Effects Associated With the Administration of Cannabidiol in Healthy Dogs. :5.
  18. Commissioner O of the. What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD. FDA. Published online March 3, 2020. Accessed June 12, 2020. https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis
  19. Wakshlag JJ, Cital S, Eaton SJ, Prussin R, Hudalla C. Cannabinoid, Terpene, and Heavy Metal Analysis of 29 Over-the-Counter Commercial Veterinary Hemp Supplements. Vet Med Res Rep. 2020;11:45-55. doi:10.2147/VMRR.S248712

CBD & Hemp: Hemp, CBD (and other) Safety Considerations

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In part I and part II we discussed the history of CBD, how it works, and the legality behind CBD for pets & people. While this can all seem a little overwhelming, especially considering the wide availability of CBD – the main take away is that it is important to be safe when choosing any supplement. One of the reasons I decided to put together such a robust series was to explain why it was so important to look for quality and transparency in products. I can tell you all day that quality and transparency are important, but if I don’t explain the reasoning, it just becomes a hollow message.

Part III dives into the clinical data available for CBD use in pets. We’ll also look at what to do if your pet ingests marijuana. Unfortunately, this is a common incident, and THC within marijuana products is an emergency. Finally, we’ll discuss why there is not more available data on dosing, and just why this may be different for each pet.

Hemp & Marijuana: Available Data, Risks & Clinical Information

No established long-term safety data for Hemp/CBD in pets, however, this is not unlike many pharmaceutical medications and supplements already on the market.15 Recent short term data from a recent small study of cats and dogs given 2mg of CBD twice daily for 12 weeks determined that CBD was not detrimental to complete blood counts (CBC) or biochemistry values. It was determined that CBD in cats is metabolized differently than dogs, and needs further evaluation to determine appropriate dosing.4 Additionally, one cat experienced rising levels of ALT, a liver enzyme, which also requires further investigation.16 Additional studies have shown an elevation in ALP, another liver enzyme, further identifying the need for more research.17 This is in line with findings on the human side regarding use of CBD.18

Marijuana itself does have well-documented risks for pets that stem from THC. Even though this is not used or recommended for pets, exposure is common through the ingestion of their owner’s marijuana supply. The minimum lethal oral dose for dogs for THC is more than 3 g/kg, and has been seen most commonly with the ingestion of THC butter.4 Treatment of THC/marijuana ingestion in animals is largely supportive. Meaning that no specific antidote presently exists for THC poisoning. The majority of dogs experiencing intoxication after marijuana ingestion recover completely without long term effects or deficit.4

Clinical effects of toxic levels of THC/marijuana ingestion are generally seen within 60 minutes. Signs of canine intoxication include depression, hyper-salivation, mydriasis, hypermetria, vomiting, urinary incontinence, tremors, hypothermia, and bradycardia. Higher dosages may additionally cause nystagmus, agitation, tachypnea, tachycardia, ataxia, hyper-excitability, and seizures.4 If you suspect your pet has ingested marijuana seek immediate veterinary care.

Toxin Concerns: Phytoremediation

In our last article, we discussed the lack of accountability and product adequacy testing within the human and pet supplement market. When it comes to toxic screening, cannabis in all form are of concern, because it can be a highly toxic plant. This is because it performs a process called phytoremediation and therefore adds another level of concern to the equation. Phytoremediation means that cannabis absorbs heavy metals and many of the agricultural chemicals in the soil such as pesticides, herbicides, and fertilizers. Many CBD companies like to hide behind the word ‘proprietary’ when it comes to analysis or ingredient sourcing. However, this is not an excuse that holds any weight when it comes to the safety of cannabis, period. Fortunately, the National Animal Supplement Council (NASC) works with some CBD companies to help protect against contaminated CBD products and other supplements from entry to the marketplace. In other words, it is wise to avoid pet supplements without the NASC seal. We discussed the NASC in more detail in Article II.

Dosing for CBD Products

A variety of CBD containing products are on the market for people and pets. These include oral oils, pills, capsules & food products like treats and honey.  There are also balms and other transdermal-type products that are designed for use on skin. Products have varying levels of effectiveness that likely have to do with quality, purity, concentration, and dosage. Exact dosing of CBD dosing for pets is still being established and is largely up for debate. Further complicating this issue is that some hypothesize this could be highly individualized.

Fortunately, CBD containing hemp products, by law, are to have 0.3% THC or less on a dry weight basis, so the risk of overdose from THC is quite low.9 This does not however mean that dosing CBD, hemp products in pets should not be measured or monitored. Always follow veterinarian and/or product label instructions.

Summary

We’ve all heard the claims of benefits for CBD for both pets and people, however, we now know that those claims are largely unsupported by science and that companies are likely in violation when making these claims. Regarding safety, it appears that there are few adverse events. For CBD have been reported, however, some studies point to a potential for concerns for liver values. This area needs further research, and we’re sure that more data will be available in the near future. If your pet has had or currently has any liver concerns, it is important to discuss CBD use with your veterinarian prior to using it. In addition, if you decide to use CBD it is paramount to ensure the product is NASC compliant. There are also several questions that you can ask your CBD (or any supplement company) which we will discuss in Part IV! Did you miss part I and part II of the CBD & Hemp series?

About the Author: Nicole Cammack

Nicci is the owner of award-winning NorthPoint Pets & Company, in Connecticut. She is also the Founder & CEO of Undogmatic Inc. Her undergraduate and graduate education includes biology, chemistry, business, and nutrition. She has worked in the pharmaceutical industry on multiple R&D projects and has had the privilege to learn from leading international figures in the human and pet health industry. She regularly lectures at national conferences, including federal, state, and municipal K9 events. Her current research involves identifying pathogenic risk factors and transmission among raw fed pets through a comprehensive worldwide survey.

www.northpointpets.com
www.undogmaticinc.com

References
  1. Sawler J, Stout JM, Gardner KM, et al. The Genetic Structure of Marijuana and Hemp. PLoS ONE. 2015;10(8). doi:10.1371/journal.pone.0133292
  2. Marijuana, the Second Trip. Revised Edition by Bloomquist, Edward R.: Good PAPERBACK | Earthlight Books. Accessed June 3, 2020. https://www.abebooks.com/Marijuana-Second-Trip-Revised-Edition-Bloomquist/22676164305/bd
  3. Kogan L, Schoenfeld-Tacher R, Hellyer P, Rishniw M. US Veterinarians’ Knowledge, Experience, and Perception Regarding the Use of Cannabidiol for Canine Medical Conditions. Front Vet Sci. 2019;5. doi:10.3389/fvets.2018.00338
  4. Fitzgerald KT, Bronstein AC, Newquist KL. Marijuana Poisoning. Top Companion Anim Med. 2013;28(1):8-12. doi:10.1053/j.tcam.2013.03.004
  5. Mackie K. Cannabinoid Receptors: Where They are and What They do. J Neuroendocrinol. 2008;20(s1):10-14. doi:10.1111/j.1365-2826.2008.01671.x
  6. Maroon J, Bost J. Review of the neurological benefits of phytocannabinoids. Surg Neurol Int. 2018;9. doi:10.4103/sni.sni_45_18
  7. Levinsohn EA, Hill KP. Clinical uses of cannabis and cannabinoids in the United States. J Neurol Sci. 2020;411:116717. doi:10.1016/j.jns.2020.116717
  8. Mechanisms of CB1 receptor signaling: endocannabinoid modulation of synaptic strength | International Journal of Obesity. Accessed June 5, 2020. https://www.nature.com/articles/0803273
  9. Commissioner O of the. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). FDA. Published online March 10, 2020. Accessed June 4, 2020. https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd
  10. Commissioner O of the. FDA Warns Companies Illegally Selling CBD Products to Treat Medical Conditions, Opioid Addiction. FDA. Published April 26, 2020. Accessed June 6, 2020. https://www.fda.gov/news-events/press-announcements/fda-warns-companies-illegally-selling-cbd-products-treat-medical-conditions-opioid-addiction
  11. How CBD pet product brands avoid federal warnings. Accessed June 12, 2020. https://www.petfoodindustry.com/articles/8793-how-cbd-pet-product-brands-avoid-federal-warnings
  12. Drug Scheduling. Accessed June 6, 2020. https://www.dea.gov/drug-scheduling
  13. AVMA weighs in at cannabis hearing. American Veterinary Medical Association. Accessed June 17, 2020. https://www.avma.org/javma-news/2019-08-15/avma-weighs-cannabis-hearing
  14. FAQs. NASC LIVE. Accessed June 13, 2020. https://nasc.cc/faqs/
  15. Resnik DB. Beyond post-marketing research and MedWatch: Long-term studies of drug risks. Drug Des Devel Ther. 2007;1:1-5.
  16. Deabold KA, Schwark WS, Wolf L, Wakshlag JJ. Single-Dose Pharmacokinetics and Preliminary Safety Assessment with Use of CBD-Rich Hemp Nutraceutical in Healthy Dogs and Cats. Animals. 2019;9(10):832. doi:10.3390/ani9100832
  17. McGrath S, Bartner LR, Rao S, Kogan LR, Hellyer PW. A Report of Adverse Effects Associated With the Administration of Cannabidiol in Healthy Dogs. :5.
  18. Commissioner O of the. What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD. FDA. Published online March 3, 2020. Accessed June 12, 2020. https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis
  19. Wakshlag JJ, Cital S, Eaton SJ, Prussin R, Hudalla C. Cannabinoid, Terpene, and Heavy Metal Analysis of 29 Over-the-Counter Commercial Veterinary Hemp Supplements. Vet Med Res Rep. 2020;11:45-55. doi:10.2147/VMRR.S248712

CBD & Hemp: What is CBD and How Does It Work?

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Cannabis: An Ancient Crop with Claims of Health Benefits

The use of cannabis dates back to ancient civilizations, with records of its use dating back to 6,000 years ago.1 Claims of health benefits included constipation, gout, rheumatism, and absent-mindedness.2 However, it wasn’t until recent years that numerous potential therapeutic uses of cannabis for pets have surfaced.

While there is more research for human use of CBD, animal research into CBD is lacking. The minimal research that is available needs significant expansion and validation. It’s important to remember that just because something is published, it doesn’t mean it’s entirely accurate or even applicable to the real world. Therefore, it is essential to understand the regulation, safety, and legality surrounding pet supplements.

Today, there is a plethora of CBD supplements available to people and pets. However, with so much misinformation and dangerous information on the market, it can be challenging to determine what is safe and legal. 

In this multi-part series, we will explore the regulation, how CBD works, and the safety and legality surrounding pet supplements. Since this article serves as our opening to the discussion, we’ll cover the basics: the difference between hemp and marijuana, how CBD works, and how it’s absorbed.

Classification & Cannabinoids

Cannabis can be broadly classified as either hemp or marijuana, and that classification depends on the concentration of the cannabinoid Delta 9-tetrahydrocannabinol (more commonly known as THC) and other cannabinoids they contain.3 The plants contain more than 400 chemicals but the cannabinoid THC is the one with the most recognition for its psychotropic “high” effect.4 Because THC is highly lipid-soluble and is distributed in fat, liver, brain, and renal tissue in the body.

The other cannabinoid that has gained attention is cannabidiol (or CBD), which is the focus of this discussion. It was first isolated from the marijuana plant by Roger Adams in the 1940’s, although it wasn’t chemically described until 1964 by Raphael Mechoulam. Today CBD is commonly used in a variety of human and pet supplements and edibles for pets and people. This cannabinoid has a lot of focus due to its potential, not proven, the ability to help manage anxiety, insomnia, and pain in humans. As already discussed, despite many anecdotal reports and claims more research is needed to determine the effectiveness, dosing, and safety of CBD and other cannabinoids in pets. However, as mentioned earlier, this is also true for many other types of supplements for pets – in fact, a lot of human data is used in order to promote the benefits to pets.

How CBD Works

There are three types of cannabinoids. Like neurotransmitters, all types of cannabinoids work by triggering a response from a receptor. Cannabinoids interact with receptors in the endocannabinoid system (ECS). The main function of the ECS is to maintain body homeostasis— which is biological harmony in response to changes in the environment.5  CBD is known as a phytocannabinoid, which comes from plants. For context, several plants beyond cannabis also produce phytocannabinoids, including cacao and echinacea. All mammals also produce their own cannabinoids, called endocannabinoids. The third type of cannabinoids is synthetic cannabinoids which are made in a laboratory. 

Phytocannabinoids, such as CBD work to inhibit the activity of ECS receptors, or in other words; limit activity or turn them off. The endocannabinoid system (ECS) has a role in the regulation of pain, pleasure, digestion, metabolism, inflammation, sleep, movement, neuroprotection, immune function, appetite, body temperature, mood, memory, and cardiovascular function.6,7  

Since CBD influences the ECS, there is potentially a wide range of benefits to the therapeutic use of CBD containing supplements and much of the theory behind CBD comes from this. Many anecdotal and case reports reflect these benefits; however, the problem is that there are few evidence-backed indications of these benefits in the mainstream scientific literature. This is complicated by the fact that many companies and non-scientific blogs continue to make claims of benefit giving the consumer and even retailers the perception of more evidence than there is. This climate has created a lot of trust and transparency issues for medical practitioners and CBD manufacturers.

There are two main cannabinoid receptors in humans and dogs, CB1 found primarily in the central nervous system and CB2 which are peripheral and immune-modulating.4,8 CB1 activity is believed to be responsible for most endocannabinoid clinical effects and benefits. 

Dosing & Absorption

CBD dosing & bioavailability, or the body’s ability to absorb CBD containing products are other factors to consider. There are several different types of products that have varying levels of bioavailability. For example, CBD itself is a fat-soluble cannabinoid, like THC. Since our bodies are mostly water traditional CBD oils not absorbed well in the gut, and therefore only have adequate absorption via the oral mucus membrane. Humans for example would need to hold a traditional CBD oil in their mouth for about 90 seconds for best absorption – not exactly realistic for dogs or cats. 

Fortunately, technology has offered solutions to the absorption challenges of traditional CBD oils. There are companies that have altered their products to be absorbed through liposome (fat) technology or nano-particle technologies that allow for oral use and absorption through the GI tract when consumed. The later technology has the highest bioavailability and allows CBD to cross the blood-brain barrier since the particles are so small. However – most CBD oils, treats, and edibles available are not nano-particle, so it’s important to ask. In addition, edibles, especially dog treats that have traditional oil have likely had a heat process applied (i.e. baking). Heat significantly reduces the bioavailability and therefore effectiveness of the CBD within the product. 

Summary

CBD can come from hemp or marijuana, with hemp lacking enough THC to product the psychotropic “high” effect marijuana is most known for. Although Hemp based-CBD supplements are widely available on the market, the reality is that there is a real lack of information regarding its exact benefit or benefits. However, we know enough about the human and animal endocannabinoid system to theorize how and what these supplements may be useful for. The type of CBD is important when choosing a product because not all are easily absorbed or effective due to a variety of processing techniques. 

This article is part of a Hemp Education Series. Over the course of this series, we will further explore hemp legality, safety, dosing, and how to spot quality from potentially dangerous products. 

For further reading, continue to part II, III, IV

About the Author: Nicole Cammack

Nicci is the owner of award-winning NorthPoint Pets & Company, in Connecticut. She is also the Founder & CEO of Undogmatic Inc. Her undergraduate and graduate education includes biology, chemistry, business, and nutrition. She has worked in the pharmaceutical industry on multiple R&D projects and has had the privilege to learn from leading international figures in the human and pet health industry. She regularly lectures at national conferences, including federal, state, and municipal K9 events. Her current research involves identifying pathogenic risk factors and transmission among raw fed pets through a comprehensive worldwide survey.

www.northpointpets.com
www.undogmaticinc.com

References

1. Sawler J, Stout JM, Gardner KM, et al. The Genetic Structure of Marijuana and Hemp. PLoS ONE. 2015;10(8). doi:10.1371/journal.pone.0133292

2. Marijuana, the Second Trip. Revised Edition by Bloomquist, Edward R.: Good PAPERBACK | Earthlight Books. Accessed June 3, 2020. https://www.abebooks.com/Marijuana-Second-Trip-Revised-Edition-Bloomquist/22676164305/bd

3. Kogan L, Schoenfeld-Tacher R, Hellyer P, Rishniw M. US Veterinarians’ Knowledge, Experience, and Perception Regarding the Use of Cannabidiol for Canine Medical Conditions. Front Vet Sci. 2019;5. doi:10.3389/fvets.2018.00338

4. Fitzgerald KT, Bronstein AC, Newquist KL. Marijuana Poisoning. Top Companion Anim Med. 2013;28(1):8-12. doi:10.1053/j.tcam.2013.03.004

5. Mackie K. Cannabinoid Receptors: Where They are and What They do. J Neuroendocrinol. 2008;20(s1):10-14. doi:10.1111/j.1365-2826.2008.01671.x

6. Maroon J, Bost J. Review of the neurological benefits of phytocannabinoids. Surg Neurol Int. 2018;9. doi:10.4103/sni.sni_45_18

7. Levinsohn EA, Hill KP. Clinical uses of cannabis and cannabinoids in the United States. J Neurol Sci. 2020;411:116717. doi:10.1016/j.jns.2020.116717

References

8. Mechanisms of CB1 receptor signaling: endocannabinoid modulation of synaptic strength | International Journal of Obesity. Accessed June 5, 2020. https://www.nature.com/articles/0803273

9. Commissioner O of the. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). FDA. Published online March 10, 2020. Accessed June 4, 2020. https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd

10. Commissioner O of the. FDA Warns Companies Illegally Selling CBD Products to Treat Medical Conditions, Opioid Addiction. FDA. Published April 26, 2020. Accessed June 6, 2020. https://www.fda.gov/news-events/press-announcements/fda-warns-companies-illegally-selling-cbd-products-treat-medical-conditions-opioid-addiction

11. How CBD pet product brands avoid federal warnings. Accessed June 12, 2020. https://www.petfoodindustry.com/articles/8793-how-cbd-pet-product-brands-avoid-federal-warnings

12. Drug Scheduling. Accessed June 6, 2020. https://www.dea.gov/drug- scheduling

13. AVMA weighs in at cannabis hearing. American Veterinary Medical Association. Accessed June 17, 2020. https://www.avma.org/javma-news/2019-08-15/avma-weighs-cannabis-hearing

14. FAQs. NASC LIVE. Accessed June 13, 2020. https://nasc.cc/faqs/

15. Resnik DB. Beyond post-marketing research and MedWatch: Long-term studies of drug risks. Drug Des Devel Ther. 2007;1:1-5.

16. Deabold KA, Schwark WS, Wolf L, Wakshlag JJ. Single-Dose Pharmacokinetics and Preliminary Safety Assessment with Use of CBD-Rich Hemp Nutraceutical in Healthy Dogs and Cats. Animals. 2019;9(10):832. doi:10.3390/ani9100832

17. McGrath S, Bartner LR, Rao S, Kogan LR, Hellyer PW. A Report of Adverse Effects Associated With the Administration of Cannabidiol in Healthy Dogs. :5.

18. Commissioner O of the. What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD. FDA. Published online March 3, 2020. Accessed June 12, 2020. https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis

19. Wakshlag JJ, Cital S, Eaton SJ, Prussin R, Hudalla C. Cannabinoid, Terpene, and Heavy Metal Analysis of 29 Over-the-Counter Commercial Veterinary Hemp Supplements. Vet Med Res Rep. 2020;11:45-55. doi:10.2147/VMRR.S248712

June 2020: Journal of Animal Sciences Grain Free & Heart Disease Summary

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Background & History of DCM Investigation

In June of 2018 a blog titled “A broken heart: Risk of heart disease in boutique or grain-free diets and exotic ingredients” was published on the Tuft’s University blog ‘Petfoodology’. This blog was followed by a commentary article in JAVMA causing increased media and public attention. It’s important to note that neither of these papers were peer reviewed, and the AVMA (American Veterinary Medical Association) disseminated it as gospel.  This is unfortunate considering 80% of veterinarians believe or look at AVMA as a source of truth even if an article does not contain true or accurate science content.

These articles were composed by Lisa Freeman, a board-certified veterinary nutritionist from Tufts University in order to warn the public and veterinary community about the imminent danger from ‘BEG’ foods. This blog caught the media by storm followed by the FDA launching an investigation into the matter. As a result, the FDA launched an investigation which was complicated by sampling bias, overrepresentation of subgroups and confounding variables. For the past two years, despite additional commentary articles, scarce and vague scientific data and inconclusive FDA reports, information regarding DCM has been incomplete at best. Lack of information has been accompanied by abbreviated synopses of case studies with multiple variables and treatments, incomplete medical information and conflicting medical data and opinions from veterinary nutrition influencers.1  

The reality is that there are many variables that may, or may not, impact the onset, disease process and outcome of DCM. Available studies lack evaluation of isolated variables in a controlled environment free from sampling bias. For example, many unknowns exist surrounding numerous nutrients, genetics, hypothyroidism, myocarditis, arrhythmias and other diet-related etiologies.1

Critical Part of the Conversation: DCM Disease Process & Role of Nutrition

One of the largest points of contention within this investigation is that pet owners and even some within the veterinary community are unaware of the multiple etiologies and the complex relation of nutrition to DCM. Causative factors behind DCM have been oversimplified to blame grain-free foods – which is fundamentally incorrect and is a disservice to the field of nutrition and the health and wellbeing of pets. 

Any self-respecting nutritionist knows that nutrients, not ingredients, make up a well-formulated diet. Nutrition is far more complex than this 2-year conversation has given credit to – and this review acknowledged that. At the same time, this paper also cited the importance of having a general knowledge of the incidence, clinical manifestations, diagnostics and potential treatments required before digging into the rest of the DCM conversation. Let’s have a look:

Incidence & Genetics

The most common cardiovascular disease in canines is chronic degenerative valve disease (approx. 75%), followed by DCM as the second most common. The incidence of DCM appears to be 0.5 and 1.3% of the population, with the majority of cases being an inherited, genetically linked condition.1  In context, the estimated population of dogs in the United States equals 77,000,000 which suggests a minimum of 308,000 to 1,001,000 dogs in the United States have DCM at any given time. Certain breeds and male dogs are often reported to have a higher incidence of DCM – with most cases appearing in middle age to older dogs.1  It was thought that mixed breed dogs had a greater protection against developing genetically linked types of DCM, however statistics show this is not the case. The authors highlight the need for more research in both purebred and mixed breed dogs and the genetic relationship to DCM.

Manifestation & Diagnostics

Clinical manifestation, or presentation of the disease is elusive in many cases. Most dogs have no outward symptoms in the beginning stages of the disease. If undiagnosed DCM progresses on to include decreased efficiency and effectiveness of the heart muscle leading to exercise intolerance, congestive heart failure (CHF), syncope (passing out), and even sudden death. Unfortunately, sometimes there are no outward symptoms, and sudden death is the only sign, especially in Doberman Pinschers1.

The smallest section of the paper titled “Histopathological Manifestation” has one of the most interesting facts in the entire review: “Histopathological changes vary from myocardial samples in dogs with DCM, reflecting the numerous underlying etiologies.” Simply put, biopsies, or samples of heart muscle from various dogs are showing multiple and variable changes to the cardiac tissue that indicate differing causative factors. These factors could include arrythmia, genetics, hypothyroid disease, doxorubicin (chemotherapy), myocarditis, digestive impairment, low protein diets, high fiber diets and deficiencies of l-carnitine, taurine, sulfur amino acids – among many others.1

While the gold standard of diagnostics in humans, cardiac muscle biopsy is rarely conducted in canines due to the invasive nature and high cost of the procedure.  Traditional diagnostics used to rule out other diseases and arrive at a DCM diagnosis include, but are not limited to radiograph(x-ray), echocardiogram, electrocardiogram (EKG), 24-Holter monitoring, and cardiac biomarkers (blood testing). Often, many of these options are limited due to accessibility due to location and the cost prohibitive nature of some of these tests.

Presumptive Diagnosis & Misdiagnosis

As a result of limited access to testing for various reasons, presumptive diagnosis and misdiagnosis are of concern. For example, both left and right sided valve disease may lead to characteristics that could lead to pathologies that resemble DCM. In addition, neoplasia, CHF, pericarditis and left atrial rupture can all cause pericardial effusion which leads to increased silhouette of the heart.1 Ignoring these other potential disease pathologies could lead to misdiagnosis and result in inadequate treatment.

Treatment of DCM

As we’ve learned within the past two years treatment of cases of DCM vary widely, and are complicated by accompanying disease states, age and nutritional status – among other factors. In general, treatment of DCM depends largely on the severity of disease. Treatment for primary DCM can involve use of pharmaceutical drugs, management of arrythmias, l-carnitine supplementation, taurine supplementation, and diet change. Management of secondary DCM may focus on treating the underlying condition in addition to the treatments listed above.1

Nutrition Considerations:

Choline – an abundant nutrient having several important roles within the body and potentially several that may influence DCM in different ways. In humans, choline is important for the regeneration from methionine from homocysteine. When choline is deficient elevated homocysteine elevations occur which likely increases risk of cardiovascular disease. Additional risks related to choline may be indicated by its involvement in the production of trimethylamine N-oxide (TMAO) which promotes inflammation and cardiovascular disease development in humans.1

This review states that choline is deserving of more research to determine if there is a relationship to DCM in canines. It’s important to call out that much of the information in the discussion on choline is from human data highlighting the knowledge gap in this area.

Methionine and Cysteine – These are sulfur containing amino acids which are involved in the synthesis of taurine. There are multiple factors that influence the synthesis of taurine from these two precursors. These influences include low bioavailability, thermal processing of food, diet formulation, deficiency of methionine which is a limiting amino acid – among others. In addition, sulfur amino acid requirements may vary between breed and size of dogs.1

Again, we need more research to determine breed, size and potentially age specific requirements for these nutrients.1 It’s also important to note that we lack the ability to measure functional adequacy of these nutrients highlighting another knowledge gap.

Taurine – Another sulfur containing amino acid, is not considered essential in dogs. This is because canines can synthesize taurine on their own. Taurine is an essential amino acid for cardiovascular function, skeletal muscle, nervous system function and as a component bile acids. Since the initial DCM investigation taurine has been questioned as being essential, however insufficient data exist to make any conclusions.1  That being said, canines with various cardiovascular diseases have been found to have low taurine levels. Further research is needed to determine if low bioavailability of taurine, low taurine synthesis and/or increased requirement of taurine are factors in these pathologies.

Taurine status is also deserving of more research. It is likely that various breeds, and disease states have different taurine requirements. In addition, several factors may influence bioavailability and synthesis of this amino acid. Variables affecting these factors need to be studied in a controlled environment.

Carnitine – Another nutrient that has been given attention is carnitine. This is because carnitine is beta-oxidized to generate continued energy, and 60% of cardiac energy production is through beta-oxidation. Therefore, deficiency or increased need of carnitine may cause cardiac dysfunction leading to cardiac disease such as DCM.1  Like other nutrition considerations discussed, functional assessments for carnitine status are lacking through blood testing. In order to accurately measure carnitine, biopsy of the heart muscle is required. 

Taurine, carnitine and a variety of other nutrients and amino acids require specific balances of vitamins and minerals in bioavailable forms for proper function. Examples include, but are not limited to zinc, iron, selenium and niacin. This means that adequate levels of carnitine or taurine could be present but be unable to be utilized properly by the body.

Thiamine – Insufficient evidence exists regarding thiamine deficiency and cardiac function in canines. However, thiamine does play a role in the metabolism of carbohydrates, fats and specific amino acids. Thiamine can also be rendered unavailable by the presence of certain enzymes in some foods. In short, more research is needed to determine if thiamine deficiency, or lack of bioavailability, potentially contributes to the disease process of DCM in dogs. 

Copper – Copper is known to play an important role of many enzyme functions, hemoglobin synthesis, nerve structure and function, blood vessels and various tissues. Copper deficiency on cardiac health has been studied in other species, but not dogs. While copper is routinely supplemented, it’s status could be negatively impacted by excess zinc and/or iron.1 This again indicates another knowledge gap in the area of canine nutrition and DCM. 

Vitamin E – Vitamin E is a potent antioxidant which has links to cardioprotective mechanisms. Dogs with DCM have been found to have lower vitamin E in comparison to healthy dogs.

Selenium – Selenium deficiency may be related to reduced ability for cysteine synthesis. In addition, selenium deficiency results in increased oxidative stress, and decreases other antioxidant activity. Further, decreased bioavailability of selenium may inhibit the absorption of other metabolic constituents creating further complications. Additional research is needed to determine the involvement of selenium in the pathology of DCM.

Heavy Metals & Other Toxin Considerations:

Heavy metals and various toxins have well documented roles of nutrient interference in humans, canines and other species:

  • Cyanide can increase the sulfur amino acid requirement
  • Certain raw foods (fruits/vegetables) can inhibit iodine function and increase risk of hypothyroid disease
  • Heavy metals such as arsenic, cadmium and mercury increase taurine requirements since taurine detoxifies these metals

Limitations in Current Available Data:

We know that DCM in dogs is not a new concern. Given that, we also know there are significant limitations to research studies currently available due to small sample sizes, sample bias, sample parameter inconsistencies, lack of complete data and known genetic predisposition. Extrapolating data from a small sample size to a large population can be highly inaccurate because subsets of populations are likely to skew results. 

In addition, confounding variables and lack of control for independent variables can infer correlation when none exists. 

The FDA Reports & Sample:

The sample population from the FDA reports resulted from a call for submission of DCM cases in dogs eating suspect (boutique, exotic, grain-free) diets. This resulted in a polluted data set for multiple reasons, including breed reporting, media attention, lack of all confirmed and suspect DCM cases reported, and other confounding factors such as health status of the dog. These confounding factors include obesity and other underlying conditions and diseases.

Summary:

As discussed, DCM has many etiologies, and many variables affecting disease manifestation. Considerable research is needed into these etiologies, and this paper largely serves as a call to action. While researchers state no definitive link can be found between DCM and ‘BEG’ diets, the largest points are that all etiologies of DCM need more investigation and science of nutrition is complex, and oversimplifying suspicions can lead to misguided and incorrect conclusions.

Nicole Cammack

Nicci is the owner of award-winning NorthPoint Pets & Company, in Connecticut. She is also the Founder & CEO of Undogmatic Inc. Her undergraduate and graduate education includes biology, chemistry, business, and nutrition. She has worked in the pharmaceutical industry on multiple R&D projects and has had the privilege to learn from leading international figures in the human and pet health industry. She regularly lectures at national conferences, including federal, state, and municipal K9 events. Her current research involves identifying pathogenic risk factors and transmission among raw fed pets through a comprehensive worldwide survey.

www.northpointpets.com
www.undogmaticinc.com

Link to article: https://academic.oup.com/jas/article/98/6/skaa155/5857674?fbclid=IwAR3A8FdX_DBMbEsi8CGh3tyBgNmSoy712FQf-sUkt4k2n2Ch_larxBQ0aJw

1.         McCauley SR, Clark SD, Quest BW, Streeter RM, Oxford EM. Review of canine dilated cardiomyopathy in the wake of diet-associated concerns. J Anim Sci. 2020;98(6). doi:10.1093/jas/skaa155

NorthPoint Pets team

How to Ensure Quality and Transparency in Pet Products

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The Importance of Transparency in the Pet Industry

Transparency is a buzzword that has been used frequently in recent years, especially by companies within the pet industry. However, it’s important to note that transparency is not just a feel-good term – it’s a crucial aspect that should be present in all pet products, including food and supplements. The lack of transparency in the pet industry can have severe consequences for both pets and their owners.

The Dangers of Poor Transparency

Many pet products, including food and supplements, lack transparency, quality control, and accountability. This means that there may be toxins, poor sourcing, and formulation errors that can potentially harm pets. In the past, there have been recalls of pet food and supplements due to vitamin D and melamine recalls, pathogen recalls, and other contamination and formulation issues.

The Lack of Accountability and Standards in the Pet Industry

Pet food and supplement manufacturers often cut corners and do not do their due diligence because there are no set standards and accountability measures in place. Major organizations such as the FDA, AAFCO, WSAVA, and PNA have minimal standards, and these standards can be influenced by corporate funding. As a result, it’s often difficult for these organizations to police everyone all the time.

There are minimal requirements for foods, supplements, and other pet products to come to market. Some organizations allow these products to come to market without any adequacy testing, digestibility, or feeding trials. Unfortunately, animals often become sick or die before red flags are raised and an investigation is initiated. This underscores the need for more transparency and accountability in the pet industry.

reading a pet food ingredient label

Ask Questions Verifying Pet Food Quality:

  • Do you conduct a 3rd party nutrition analysis on all of your finished products?
    • Do your products meet an AAFCO profile?
    • Are you willing to provide a copy of that analysis? Note that most companies are deceptive and provide Target analysis, which is predicted. This does not equal a typical analysis, be careful
  • Do you conduct 3rd party digestibility studies for each of your formulas?
    • Do you make those publicly available?
  • Do you source any ingredients from China? Are you willing to provide certificates of origin? 
    • Note that ingredients from China are not necessarily bad as long as they are well-sourced, they are ensuring and verifying quality and purity via analysis and contamination testing. 
  • Do you complete analysis of your final product to ensure the formulation is correct and ensure there are not any contamination issues?

Keep in mind that digestibility and typical nutrient analysis mean nothing without the other. Digestibility shows the amount of nutrients absorbed. The analysis shows the amount of nutrients contained within a product.

Beware of the word proprietary – this does not hold a strong argument and may imply a lack of testing, or inadequate testing.

Ask Questions Verifying Supplement Quality:

When looking for any supplement for yourself or your pets you must ask the manufacturing company the following questions:

  • Do you inbound test your raw and/or concentrated ingredients for contaminants such as heavy metals, fertilizers, and other agricultural chemicals?
  • Do you test your ingredients, specifically active ingredients to ensure their concentrations are correct?
  • Do you source any ingredients from China? 
    • Are you willing to provide certificates of origin? 
    • Note that ingredients from China are not necessarily bad as long as they are well-sourced and they are verifying quality and purity. 
  • Do you complete analysis of your final product to ensure the formulation is correct and ensure there are not any contamination issues? This is important to ensure that active ingredients match the label.
    • Are you willing to provide an analysis for each lot/batch of your final product?
  • Do your company and products meet requirements to utilize the NASC (National Animal Supplement Council) seal?
    • I would not recommend supplement companies that are not members of the NASC, especially CBD companies.

Advice to Consumers

This is not a comprehensive list by any stretch. The key take away is that consumers should start asking questions of manufacturers in order to encourage change. The reality is that very few companies can answer these questions because most do not adequately test their products at all stages. By opening up a dialogue about the importance of doing so can help prevent future issues within the industry.

If companies are unwilling to transparently answer these questions or use the excuse of information being proprietary I would strongly suggest that you find another brand. Not being transparent or testing products when it comes to ensuring safety is unacceptable. Brands that are not meeting these standards could potentially be poisoning the market for other companies who do their due diligence. As consumers demand better.

About the Author: Nicole Cammack

Nicci is the owner of award-winning NorthPoint Pets & Company, in Connecticut. She is also the Founder & CEO of Undogmatic Inc. Her undergraduate and graduate education includes biology, chemistry, business, and nutrition. She has worked in the pharmaceutical industry on multiple R&D projects and has had the privilege to learn from leading international figures in the human and pet health industry. She regularly lectures at national conferences, including federal, state, and municipal K9 events. Her current research involves identifying pathogenic risk factors and transmission among raw fed pets through a comprehensive worldwide survey.

www.northpointpets.com
www.undogmaticinc.com

Journal of Animal Science Article Full Summary, Volume 98, Issue 6, June 2020

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BACKGROUND & HISTORY OF DCM INVESTIGATION

In June of 2018, Lisa Freeman, a board-certified veterinary nutritionist from Tufts University published a blog titled “A broken heart: Risk of heart disease in boutique or grain-free diets and exotic ingredients.” This blog warned pet owners and veterinarians that ‘BEG’ (boutique, exotic, grain free) diets were causing heart disease in dogs. This left professionals and the public scrambling for more information, which was further fueled by media frenzy. As a result, the FDA launched an investigation which was complicated by sampling bias, overrepresentation of subgroups and confounding variables. For the past two years, despite additional commentary articles, scarce and vague scientific data and inconclusive FDA reports, information regarding DCM has been incomplete at best. Lack of information has been accompanied by abbreviated synopses of case studies with multiple variables and treatments, incomplete medical information and conflicting medical data and opinions from veterinary nutrition influencers.1

The reality is that there are many variables that may, or may not, impact the onset, disease process and outcome of DCM. Available studies lack evaluation of isolated variables in a controlled environment free from sampling bias. For example, many unknowns exist surrounding numerous nutrients, genetics, hypothyroidism, myocarditis, arrythmias and other diet-related etiologies.1

[vc_single_image image=”3552″ img_size=”full”]

CRITICAL PART OF THE CONVERSATION: DCM DISEASE PROCESS & ROLE OF NUTRITION

One of the largest points of contention within this investigation is that pet owners and even some within the veterinary community are unaware of the multiple etiologies and the complex relation of nutrition to DCM. Causative factors behind DCM have been oversimplified to blame grain-free foods – which is fundamentally incorrect and is a disservice to the field of nutrition and the health and wellbeing of pets.

Any self-respecting nutritionist knows that nutrients, not ingredients, make up a well-formulated diet. Nutrition is far more complex than this 2-year conversation has given credit to – and this review acknowledged that. At the same time, this paper also cited the importance of having a general knowledge of the incidence, clinical manifestations, diagnostics and potential treatments required before digging into the rest of the DCM conversation. Let’s have a look:

 

Incidence & Genetics

The most common cardiovascular disease in canines is chronic degenerative valve disease (approx. 75%), followed by DCM as the second most common. The incidence of DCM appears to be 0.5 and 1.3% of the population, with the majority of cases being an inherited, genetically linked condition.1 Certain breeds and male dogs are often reported to have a higher incidence of DCM – with most cases appearing in middle age to older dogs.1 It was thought that mixed breed dogs had a greater protection against developing genetically linked types of DCM, however statistics show this is not the case. The authors highlight the need for more research in both purebred and mixed breed dogs and the genetic relationship to DCM.

 

Manifestation & Diagnostics

Clinical manifestation, or presentation of the disease is elusive in many cases. Most dogs have no outward symptoms in the beginning stages of the disease. If undiagnosed DCM progresses on to include decreased efficiency and effectiveness of the heart muscle leading to exercise intolerance, congestive heart failure (CHF), syncope (passing out), and even sudden death. Unfortunately, sometimes there are no outward symptoms, and sudden death is the only sign, especially in Doberman Pinschers1.

The smallest section of the paper titled “Histopathological Manifestation” has one of the most interesting facts in the entire review: “Histopathological changes vary from myocardial samples in dogs with DCM, reflecting the numerous underlying etiologies.” Simply put, biopsies, or samples of heart muscle from various dogs are showing multiple and variable changes to the cardiac tissue that indicate differing causative factors. These factors could include arrythmia, genetics, hypothyroid disease, doxorubicin (chemotherapy), myocarditis, digestive impairment, low protein diets, high fiber diets and deficiencies of l-carnitine, taurine, sulfur amino acids – among many others.1

While the gold standard of diagnostics in humans, cardiac muscle biopsy is rarely conducted in canines due to the invasive nature and high cost of the procedure. Traditional diagnostics used to rule out other diseases and arrive at a DCM diagnosis include, but are not limited to radiograph(x-ray), echocardiogram, electrocardiogram (EKG), 24-Holter monitoring, and cardiac biomarkers (blood testing). Often, many of these options are limited due to accessibility due to location and the cost prohibitive nature of some of these tests.

 

Presumptive Diagnosis & Misdiagnosis

As a result of limited access to testing for various reasons, presumptive diagnosis and misdiagnosis are of concern. For example, both left and right sided valve disease may lead to characteristics that could lead to pathologies that resemble DCM. In addition, neoplasia, CHF, pericarditis and left atrial rupture can all cause pericardial effusion which leads to increased silhouette of the heart.1 Ignoring these other potential disease pathologies could lead to misdiagnosis and result in inadequate treatment.

 

Treatment of DCM

As we’ve learned within the past two years treatment of cases of DCM vary widely, and are complicated by accompanying disease states, age and nutritional status – among other factors. In general, treatment of DCM depends largely on the severity of disease. Treatment for primary DCM can involve use of pharmaceutical drugs, management of arrythmias, l-carnitine supplementation, taurine supplementation, and diet change. Management of secondary DCM may focus on treating the underlying condition in addition to the treatments listed above.1

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NUTRITION CONSIDERATIONS:

Choline – an abundant nutrient having several important roles within the body and potentially several that may influence DCM in different ways. In humans, choline is important for the regeneration from methionine from homocysteine. When choline is deficient elevated homocysteine elevations occur which likely increases risk of cardiovascular disease. Additional risks related to choline may be indicated by its involvement in the production of trimethylamine N-oxide (TMAO) which promotes inflammation and cardiovascular disease development in humans.1

This review states that choline is deserving of more research to determine if there is a relationship to DCM in canines. It’s important to call out that much of the information in the discussion on choline is from human data highlighting the knowledge gap in this area.

Methionine and Cysteine – These are sulfur containing amino acids which are involved in the synthesis of taurine. There are multiple factors that influence the synthesis of taurine from these two precursors. These influences include low bioavailability, thermal processing of food, diet formulation, deficiency of methionine which is a limiting amino acid – among others. In addition, sulfur amino acid requirements may vary between breed and size of dogs.1

Again, we need more research to determine breed, size and potentially age specific requirements for these nutrients.1 It’s also important to note that we lack the ability to measure functional adequacy of these nutrients highlighting another knowledge gap.

Taurine – Another sulfur containing amino acid, is not considered essential in dogs. This is because canines can synthesize taurine on their own. Taurine is an essential amino acid for cardiovascular function, skeletal muscle, nervous system function and as a component bile acids. Since the initial DCM investigation taurine has been questioned as being essential, however insufficient data exist to make any conclusions.1 That being said, canines with various cardiovascular diseases have been found to have low taurine levels. Further research is needed to determine if low bioavailability of taurine, low taurine synthesis and/or increased requirement of taurine are factors in these pathologies.

Taurine status is also deserving of more research. It is likely that various breeds, and disease states have different taurine requirements. In addition, several factors may influence bioavailability and synthesis of this amino acid. Variables affecting these factors need to be studied in a controlled environment.

Carnitine – Another nutrient that has been given attention is carnitine. This is because carnitine is beta-oxidized to generate continued energy, and 60% of cardiac energy production is through beta-oxidation. Therefore, deficiency or increased need of carnitine may cause cardiac dysfunction leading to cardiac disease such as DCM.1 Like other nutrition considerations discussed, functional assessments for carnitine status are lacking through blood testing. In order to accurately measure carnitine, biopsy of the heart muscle is required.

Taurine, carnitine and a variety of other nutrients and amino acids require specific balances of vitamins and minerals in bioavailable forms for proper function. Examples include, but are not limited to zinc, iron, selenium and niacin. This means that adequate levels of carnitine or taurine could be present but be unable to be utilized properly by the body.

Thiamine – Insufficient evidence exists regarding thiamine deficiency and cardiac function in canines. However, thiamine does play a role in the metabolism of carbohydrates, fats and specific amino acids. Thiamine can also be rendered unavailable by the presence of certain enzymes in some foods. In short, more research is needed to determine if thiamine deficiency, or lack of bioavailability, potentially contributes to the disease process of DCM in dogs.

Copper – Copper is known to play an important role of many enzyme functions, hemoglobin synthesis, nerve structure and function, blood vessels and various tissues. Copper deficiency on cardiac health has been studied in other species, but not dogs. While copper is routinely supplemented, it’s status could be negatively impacted by excess zinc and/or iron.1 This again indicates another knowledge gap in the area of canine nutrition and DCM.

Vitamin E – Vitamin E is a potent antioxidant which has links to cardioprotective mechanisms. Dogs with DCM have been found to have lower vitamin E in comparison to healthy dogs.

Selenium – Selenium deficiency may be related to reduced ability for cysteine synthesis. In addition, selenium deficiency results in increased oxidative stress, and decreases other antioxidant activity. Further, decreased bioavailability of selenium may inhibit the absorption of other metabolic constituents creating further complications. Additional research is needed to determine the involvement of selenium in the pathology of DCM.

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Heavy Metals & Other Toxin Considerations:

Heavy metals and various toxins have well documented roles of nutrient interference in humans, canines and other species:

  • Cyanide can increase the sulfur amino acid requirement
  • Certain raw foods (fruits/vegetables) can inhibit iodine function and increase risk of hypothyroid disease
  • Heavy metals such as arsenic, cadmium and mercury increase taurine requirements since taurine detoxifies these metals
Limitations in Current Available Data:

We know that DCM in dogs is not a new concern. Given that, we also know there are significant limitations to research studies currently available due to small sample sizes, sample bias, sample parameter inconsistencies, lack of complete data and known genetic predisposition. Extrapolating data from a small sample size to a large population can be highly inaccurate because subsets of populations are likely to skew results.

In addition, confounding variables and lack of control for independent variables can infer correlation when none exists.

 

The FDA Reports & Sample:

The sample population from the FDA reports resulted from a call for submission of DCM cases in dogs eating suspect (boutique, exotic, grain-free) diets. This resulted in a polluted data set for multiple reasons, including breed reporting, media attention, lack of all confirmed and suspect DCM cases reported, and other confounding factors such as health status of the dog. These confounding factors include obesity and other underlying conditions and diseases.

 

SUMMARY

As discussed, DCM has many etiologies, and many variables affecting disease manifestation. Considerable research is needed into these etiologies, and this paper largely serves as a call to action. While researchers state no definitive link can be found between DCM and ‘BEG’ diets, the largest points are that all etiologies of DCM need more investigation and science of nutrition is complex, and oversimplifying suspicions can lead to misguided and incorrect conclusions.

 

1. McCauley SR, Clark SD, Quest BW, Streeter RM, Oxford EM. Review of canine dilated cardiomyopathy in the wake of diet-associated concerns. J Anim Sci. 2020;98(6). doi:10.1093/jas/skaa155

Summary Journal of Animal Science Article, Volume 98, Issue 6, June 2020

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In 2018 a blog from a veterinary nutritionist sparked a controversy between ‘BEG’ diets and heart disease in dogs. For the past two years, despite an FDA investigation, scarce and vague scientific data has created major issues for pet owners and the pet industry. For clarity, ‘BEG’ diets are known as Boutique, Exotic protein or Grain Free.

A recent article published in the Journal of Animal Science titled, “Review of canine dilated cardiomyopathy in the wake of diet-associated concerns” that appeared to be a saving grace for many advocates of ‘BEG’ diets. This paper investigated a potential association between grain-free pet food and dilated cardiomyopathy (DCM) in dogs. The authors state, “based on this review of the current literature, there is no definitive relationship between these implicated diet characteristics and DCM.” Despite this statement, realize the purpose of this paper was to identify numerous knowledge gaps surrounding DCM and nutrition, rather than to draw conclusions. While no link between ‘BEG’ (boutique, exotic, grain-free) was found, this does not mean that nutrition and other considerations are not at play.

ARTICLE HIGHLIGHTS:

Background of DCM & Diagnostics:
  • Approximately 75% of all heart disease in dogs is chronic degenerative valve disease, with second most common being DCM.
  • Genetics play a significant role in purebred and mix breed dogs. In addition, various genes are implicated. Certain breeds have a greater genetic predisposition than others.
  • Studies investigating the incidence rate of DCM date back to 1988 until recently. Consistently, the incidence appears to remain between 0.5-1.3% of the canine population. This is inclusive of available FDA data.
  • Diagnosis can be limited by accessibility and affordability of various diagnostic tools. Because of this, other types of heart disease could be misdiagnosed as DCM based on similar presentation.
Multiple Causations & Secondary Factors of DCM:
  • Biopsy of heart tissue shows numerous underlying causes of DCM – including but not limited to infection, inflammation, endocrine disease, heart arrhythmia, toxins and various nutritional deficiencies.
  • Nutritional considerations include fiber content, potassium, choline, methionine, cysteine, taurine, carnitine, thiamine, copper, Vitamin E and selenium. It’s important to note that a deficiency of one or more of these nutrients in direct relation to DCM is an oversimplification and fundamentally incorrect to assume. As discussed below, nutrients have varying and complex roles when it comes to metabolism.
  • Other considerations for consideration include cyanide exposure from food (cassava, tapioca), goitrogenic foods (suppress function of thyroid gland), and heavy metals.
FDA Report Considerations:
  • Boutique pet food manufacturers and exotic protein sources are likely not associated with DCM per current available data and publications.
  • Grain-free foods are also likely not associated with canine DCM, and current data shows any nutritional relationship is likely far more complex than has been portrayed.
  • More research is needed to determine risk factors for DCM including, but not limited to, infection, inflammation, endocrine disease, arrythmias, toxins and various nutritional deficiencies.
  • The FDA data pool was polluted. Meaning that it was a biased data set with subgroups (like golden retrievers, and dogs eating grain-free food being overrepresented) leading to biased conclusions.