Doberman Pinscher Dilated Cardiomyopathy (DCM) Simplified

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DCM in Doberman Pinschers

Reviewed by Dr. Donald Buchanan, DVM

There has been a lot of confusion, and even panic, surrounding dilated cardiomyopathy (DCM), also known as simply “an enlarged heart”, within the Doberman community lately. Unfortunately, instances of Doberman’s diagnosed with DCM seems to be increasing in recent years.

To make the panic worse, the FDA has released a list of dog foods that have been linked to DCM in canines. So what does this all mean? Before you panic, let’s simplify all of this so the average owner (like you and me) can get a better grasp on things.

What is DCM in Dobermans? Dilated cardiomyopathy (or DCM) in Dobermans, also known as an enlarged heart, is a condition where chambers of the heart have become enlarged and the walls of the heart have become thinner. As a result, the heart is no longer able to pump blood as efficiently to the rest of the body.

After discussions with other owners, reviewing the most recent studies possible, and consulting with various veterinary professionals, I’ve compiled this information specifically for Doberman owners who are concerned about, or dealing with, DCM. My goal is to make this disease easier for the average dog owner like you and me to understand.

Symptoms

I think it’s very important that we discuss the signs and symptoms to look for in your dog. Besides discussing just the general symptoms, I want to designate which of these symptoms are most likely to show themselves during the early stages of DCM because catching this condition early will make managing the disease much easier, and can often result in better outcomes.

Early Stages

Unfortunately, dilated cardiomyopathy is very difficult (or impossible) to detect during the early stages. However, the symptoms listed below are usually the first to show up and may still be detectable during the early stages. Of course, these are certainly more noticeable during the later stages. These early signs can include:

  • Decreased tolerance to exercise.
  • Unusual heart sounds or murmurs.
  • Irregular heart rhythm or arrhythmias.

In the early stages of this disease, these symptoms may not be detectable at all. A qualified veterinarian with the correct test equipment will be much more likely to detect these issues. A subtle heart arrhythmia, for example, may only be detectable through the use of a 24-hour, wearable, electrocardiogram (or ECG) device called a “Holter monitor.” These devices record the electrical activity of your dog’s heart. Think of it as a recording of your dog’s heartbeat.

An ECG done at the veterinarian may not always detect the issue. This is because the arrhythmia may not be constant throughout the day. So your dog can test normal during a 5 minute long ECG test at the vet, but still have an arrhythmia and possibly even DCM. That’s why a take-home, wearable, ECG device like a Holter monitor will often detect these issues where an ECG done at the veterinarian may miss them.  

A diagram of a dog's heart that's affected by DCM.

Later Stages

As this disease progresses, the signs and symptoms become much more apparent. All the early signs listed above are usually present, but more apparent. There are also many additional symptoms during the later stages of DCM. These signs can include:

  • Lethargy (even less tolerance to exercise)
  • Unusual heart sounds or murmurs
  • Irregular heart rhythm or arrhythmias
  • Increased heart rate
  • Weakness
  • Sudden collapse/fainting
  • Loss of appetite
  • Weight loss
  • Coughing
  • Faster and more labored breathing
  • Abdominal swelling
  • Pale gums
  • Sudden death

Unfortunately, if the issue isn’t detected until the later stages, intervention is usually minimally successful (if at all). 

If you suspect that your dog may have DCM, it’s important to get him to a qualified veterinarian as soon as possible. Early diagnosis is key to successful treatment.

“Many cardiac cases in large breed dogs present to me as lameness cases. Large dogs that are slow to get up out of bed, weak (especially in the hind end), or intolerant of normal exercise should be considered as possible cardiac patients.”

– Donald Buchanan, DVM

For more information about what DCM is, and how it affects your Doberman, see my video about DCM in Dobermans on YouTube here.

Diagnosis

Dilated cardiomyopathy in your dog should only be diagnosed by a qualified veterinarian or specialist. There are many tools and techniques they may use to help diagnose your dog, but an echocardiogram (or echo test) of the heart is the most definitive method. Below are some of the tools or techniques that your veterinarian may use to help them diagnose DCM.

  • Echocardiogram (echo test): Your veterinarian may also refer to this test as a transthoracic echo (or TTE). This is the most definitive method of diagnosis. This is simply an ultrasound of your dog’s heart. It’s painless and provides a detailed image of the heart, it’s valves, and most importantly the chambers of the heart (also known as “ventricles”) using soundwaves. This makes it possible to measure the muscle wall thickness and pumping ability of the heart.
  • Electrocardiogram (EKG or ECG): This test measures and records the electrical activity of the heart through small electrodes that are attached to your dog. During this test, your vet will be looking for signs of unusual heart activity such as arrhythmias.
  • Holter Monitor: This is basically another form of electrocardiogram (ECG), however, this device is wearable for an extended period. A Holter monitor is typically carried by your dog in a specialized vest and a few adhesive pads are attached to monitor your dog’s heart. Heart arrhythmias may not be consistent throughout the day, so often a wearable ECG device such as this is best to identify any arrhythmias that are present. This may only provide a possible indication of DCM, however, since it’s certainly possible for your dog to have an arrhythmia without having DCM.
  • Thoracic Radiography (x-ray): An x-ray may be used to help evaluate the size of the heart and the condition of the lungs. Your veterinarian will most likely also be using this as a way to gauge fluid accumulation in, or around, the lungs—another sign of DCM.
  • NT-proBNP Blood Test: This simple blood test checks for the amount of a certain protein that is associated with hormones that the heart produces. The heart will produce these in larger quantities when it’s needing to work harder. That means it can provide insight into whether or not the heart is struggling to pump blood to the body.
  • Troponin Blood Test: This test checks for the levels of troponin T or troponin I proteins in the blood. These proteins are released when there is damage to the heart. The greater the damage, the higher levels of these proteins will be present.
  • Other Blood Tests: Other blood tests may be used to help determine if there are any dietary deficiencies as these can lead to the development of nutritionally-linked DCM. One of the most common is a test to check taurine levels (an important amino acid). Normal whole blood taurine concentration is generally considered to be 266 ± 5.1 nmol/ml (source).

All of the tests listed above are tools that your veterinarian may use to help them to make a decision on a DCM diagnosis. Each one provides a piece to the puzzle. Your vet may not need to perform all of these tests. Instead, they’ll make a DCM diagnosis once he or she is confident that your dog is affected by this disease.

Treatment

Treatment for DCM is tailored to the individual dog and is rarely the same from one dog to the next. This is because every case is different. So it’s fairly difficult to outline what your veterinarian is likely to recommend for your specific case. However, below are some of the common approaches us Doberman owners see for this disease.

Most commonly treatment plans will involve the use of certain medications meant to help reduce the workload of the heart and allow blood to pump more easily, as well as medications to improve the pumping action (or contraction) of the heart. Medications such as pimobendan can be used for this. In Dobermans, pimobendan has shown to be beneficial in prolonging lifespan when started at the time of diagnosis of DCM, as opposed to waiting until clinical heart failure is realized.

“Unfortunately, even well managed dog on heart medications can rapidly decompensate. Owners of pets with DCM should be prepared to call their veterinarian’s emergency line at any time, especially dogs in later stages of the disease.”

– Donald Buchanan, DVM

Diuretics (such as furosemide) may be used to reduce fluid buildup in the lungs or abdomen. There are some side effects of using diuretics though, so often medications such as enalapril or benazepril, which are “angiotensin-converting enzyme” (or ACE) inhibitors, may be used to reduce the harmful side effects of the diuretics. ACE inhibitors also help improve general blood flow, which is another benefit for a dog suffering from DCM. A procedure to physically remove the buildup of fluid in the dog’s abdomen or chest cavity may be used for DCM cases that are more severe.

Additional medications might be used to help control heart rate and arrhythmias (if present). These medications can be injected in an emergency situation, however, they’re most often given orally to dogs who are in a more stable condition. Dietary supplementation may also be used in an attempt to help support the heart. This often includes the use of L-carnitine, taurine, and omega-3 fatty acid supplements.

DCM tends to be progressive and is usually not reversible in Dobermans. This is because the Doberman breed is pre-dispositioned toward genetically linked DCM. Therefore the number and quantities of medications tend to need to be increased with time. The exception to this is DCM that is the result of dietary deficiencies (such as low taurine levels) which may be reversible if caught early enough. DCM caused by low taurine levels can be identified by a blood test to check for the presence of a taurine deficiency. Unfortunately, most DCM cases in Dobermans are of the genetic type and are not reversible.

Update on Possible Treatments

The results of a new study suggests that DCM may, in fact, be an autoimmune disease (source). This is possibly very good news for Doberman owners since there are drugs known to suppress autoimmune reactions in humans. Basically, this study means that a medication that actually prevents DCM (or stops it from progressing) may not be far off. For an in-depth explanation of this, see the article DCM in Dobermans is an autoimmune disease on the Better Bred website.

Doberman being seen by a vet.
Early diagnosis is key for successful treatment ensuring the longest possible lifespan.

Lifespan After Diagnosis

Once diagnosed, if a Doberman is already showing signs of congestive heart failure, they are most likely to die within about 6 months. However, some may live as long as 1 or 2 years in ideal situations and with proper intervention. 

If your veterinarian determines that your dog is one of the rare few to have DCM due to a dietary deficiency (such as a taurine deficiency), and you caught it early enough, there is a possibility of reversing the disease. However, this is exceptionally rare, especially with Dobermans.

“DCM in Dobermans is a fatal disease. In this breed, nearly one-third of all deaths due to DCM are in the form of sudden death, not congestive heart disease”

– Donald Buchanan, DVM

Exercising After Diagnosis

Always speak to your veterinarian about your dog’s activity levels if he or she has been diagnosed with DCM. In general, your vet will likely be working with you to find ways to reduce the strain placed on your dog’s heart. This includes finding ways to reduce strenuous exercise and general activity levels.

Lower physical exertion means less stress is placed on the heart. So strenuous activity is not recommended for a dog with DCM.

Preventing DCM

Sometimes there isn’t much you can do to prevent DCM, especially in dogs who are genetically predispositioned to have the disease such as Dobermans. However, quality diet and regular exercise are key to ensuring your dog has a strong heart.

If you are considering getting a Doberman puppy and are concerned with DCM, make sure you find a reputable breeder who performs genetic testing on their dogs (and puppies) to see if the dogs carry the gene mutation that is known to cause DCM.

Genetic Testing

There are currently two genetic tests available that look for a specific genetic mutation that is linked to DCM. These tests are called “DCM1” and “DCM2” and look for mutations in what’s called the “PDK4” gene. This gene mutation has been identified as being linked to DCM. If a dog is affected by this mutation, their likelihood of developing DCM sometime in their life greatly increases, and their pups also have a chance of inheriting this mutation.

This is a video I did about exactly HOW to easily test your Doberman’s DNA for known DCM markers. It’s a simple cheek swab you can do right at home. I do it on my dog in this video.

DCM1 was the original test for the genetic mutation that has traditionally been linked to the disease. More recently, however, a second genetic mutation has been linked to the development of DCM in Dobermans. This has led to the creation of the second test called DCM2.

If you want to be as thorough as possible with the testing of your dog, you should get both the DCM1 and DCM2 genetic tests performed. This will give the most complete picture currently possible as to your dog’s risk level of developing the disease. Below are a few companies that offer this testing online.

  • Embark: This is probably the most modern DNA testing kit on the market. This is my official recommendation for health Dobermans. Embark makes one specific kit that’s perfect for Dobermans and tests for both DCM1 and DCM2. You can get the DNA Testing Kit here. It will also test for over 170 other genetic disorders, the coefficient of inbreeding (COI) which will give you an idea on longevity, and a long list of other results. See my Doberman DNA testing guide here for an idea of how to use this kit at home and all the things this kit tests for.
  • VetGen: This company performs both DCM1 and DCM2 genetic testing. Their Doberman-specific DNA testing section can be found here. On that page, look for the test labeled as “DCM1 and DCM2”. This is their genetic testing for DCM in Dobermans and costs around $100.
  • VNC State Veterinary Hospital: This company offers both DCM1 and DCM2 testing. Their Doberman DCM testing page can be found here. At this time of this article, these tests can be purchased individually for around $50 each, or $70 for both tests. They also offer discounts if you are testing an entire litter of dogs, which is a great idea if you’re a breeder. 
  • AnimalGenetics.us: It appears that this company only offers DCM1 testing at this time. Their DCM genetic testing page can be found here. At the time of this article’s writing, tests cost around $45.
  • Paw Print Genetics: This company appears to only offer DCM1 testing at this time and it currently costs around $80. Information about their DCM genetic testing services can be found here.

Another option is to simply as your veterinarian. This actually may be easier since a lot of times vets will not only have access to a reputable genetic testing service but will collect and ship off your dog’s DNA sample for you. Then you also have the added benefit of having a veterinarian discuss the results with you and answer your questions once they come back.

Another great option is the Doberman Diversity Project, a non-profit dedicated to the betterment of the Doberman breed. This company not only offers DCM testing, but depending on your dog’s current status, you might even qualify for free testing with them. This is because their team is not only testing dogs but conducting research. If there is a need for further study of dogs like yours, you just might qualify for free testing. They also offer other wonderful options such as Holter monitor rentals and whole litter testing. From everything I’ve heard, they are a great non-profit doing wonderful things for the Doberman breed.

The results of DCM testing will indicate if your dog has one or two copies of the gene mutation. You can use the table below to better understand the three possible results of the test.

Possible Results of PDK4 Mutation Testing (DCM Testing)

Gene 1 Gene 2 Risk What it Means
Mutated Mutated At Risk Your dog has two copies of the mutated PDK4 gene. This means they are at the highest risk for developing DCM in their lifetime. Having two copies of the gene doesn’t mean your dog is certain to develop DCM in their lifetime, however. They will also certainly pass this mutation onto their offspring.
Non-Mutated Mutated Low Risk/Carrier Also called a “positive heterozygous” result. This means your dog has only one copy of the mutated PDK4 gene, and one copy of the normal gene. Their risk of developing DCM is low, although they can still pass the mutation on to their offspring.
Non-Mutated Non-Mutated Clear There is no mutation of the PDK4 gene detected, your dog’s risk is even lower, and they will not pass a PDK4 gene mutation on to their offspring.

If you are considering breeding your Doberman, please get genetic DCM testing performed prior to mating and only breed dogs who are clear of this mutation. It’s important that all breeders take it upon themselves to help ensure a healthy future for the Doberman.

Reversing or Curing DCM

Unfortunately, dilated cardiomyopathy is almost always a lifelong disease, especially in the Doberman breed. Typically, the best that can be done is careful management of the disease and its symptoms in an attempt to extend life as much as possible.

On rare occasions, DCM caused by nutritional deficiencies (such as taurine deficiencies) can be reversed. A 1997 study of Cocker Spaniels affected with DCM as a result of taurine deficiency showed that supplementation of taurine and l-carnitine partially or completely reversed the disease (source).

However, DCM as the result of a taurine deficiency is rare in the Doberman breed. A qualified veterinarian can help to determine if the DCM is likely the result of a taurine deficiency through the use of blood testing and other means.

Recent information from the FDA however, does seem to suggest that many breeds who are genetically susceptible to developing DCM may actually do so due to a combination of genetic and dietary influences.

Dog Foods Linked to DCM (Diet Associated DCM)

It has been long known that diet plays a role in the develope of DCM in dogs, although the extent of this is unclear. In the publication “Diet-Associated Dilated Cardiomyopathy in Dogs: What Do We Know?”, written by Lisa M. Freeman DVM, Ph.D., Joshua A. Stern DVM, Ph.D., and others who are well known in the field, they note that pet food marketers have outpaced science and “owners are not always making healthy, science-based decisions even though they want to do the best for their pets.” They also state “there appears to be an association between DCM and feeding BEG, vegetarian, vegan, or home-prepared diets in dogs…” (source).

TIP:

“BEG” stands for boutique, exotic and grain-free foods.

In June 2019, the U.S. Food and Drug Administration (FDA) released information regarding their investigation into a potential link between certain dog foods and DCM. To see this information, take a look at the FDA DCM investigation here.

This investigation has sparked a lot of conversation among Doberman owners, mainly because of two things. For one, the investigation is very specific and groups diagnosed DCM cases by (among other things) the brand of food that the dog was on. Secondly, it shows a drastic increase in reported DCM cases in recent years.

The Number of Reported DCM Cases

In 2014 and 2015 there was one case of suspected diet-linked DCM reported each year to the FDA. In 2016 there were 2 cases, and in 2017 there were 3 cases. In 2018, that number jumped to an astonishing 320 cases and in 2019 it was 197 cases. This is a very sharp, and somewhat alarming increase.

It’s very important to point out that this really has little to no bearing on how many diagnosed cases of DCM are occurring in dogs. This is only a reflection of which cases were reported. This report itself states, “the vast majority of the reports were submitted after the agency notified the public about the potential DCM/diet issue in July 2018.” This means simply that people were more likely to report the issue to the FDA after the department made that announcement than they were previously, therefor the numbers increased drastically. Reporting DCM to the FDA is a process that is completely voluntary for both owners and veterinarians, so awareness of the issue certainly has a strong impact on the number of reports made.

Also, of the 524 cases reported, only 15 involved the Doberman breed. This also shouldn’t be seen as an accurate reflection of the occurrence of DCM in Dobermans as it relates to other breeds. There are just too many other factors, including (as the report itself notes) efforts made by certain breed communities to increase reporting of their breed’s cases of DCM to the FDA. The report states “FDA has observed a reporting bias for breeds like Golden Retrievers due to breed-specific social media groups and activities that have raised awareness of the issue in these communities…”

In fact, Dobermans may be underrepresented in this report. As noted by Lisa M. Freeman, DVM, PhD, DACVN in her article Diet-Associated Dilated Cardiomyopathy (DCM): Update, July 2019, many veterinarians don’t think to report Doberman DCM cases since the breed commonly develops non-diet (genetic) associated DCM.

So it’s important that this information is taken in context since it’s far too easy to look at this sharp increase and believe that this, in and of itself, means there is an epidemic of DCM occurring. Of all these reported cases, only 15 were cases that involved the Doberman breed but yet it’s well known that instances of DCM in Dobermans are far more common than that each year in the United States. This is because reporting of DCM to the FDA is not commonly done. Also, in this case, it’s only done if it’s believed to be diet-related DCM, which is uncommon for the Doberman breed—they are more likely to suffer from genetically linked DCM.

Dog Food Brands Named Most Frequently in DCM Reports

This investigation also included detailed statistics about which brands of food these dogs were consuming. The study mentions that while many DCM cases are likely to be genetic in origin (such as is common with the Doberman breed), many are nutritionally related or even a combination of nutritionally related and genetically related.

Below is a table of the dog food brands that were named most frequently in the DCM reports the FDA received.

Number of DCM cases reported per brand of associated dog food.

Note: Brands linked to less than 10 cases of DCM are not included in this list.

It’s likely that some Dobermans who develope DCM do so from a combination of dietary factors and a genetic predisposition for the disease. Although you can’t control the genetic side of things once your dog’s born, you certainly can have an effect on the dietary side.

Common Characteristics Among the Brands Linked to DCM

There are some common traits of the dog foods that the FDA has identified in this list. Namely, that legumes, pulses (which are legume seeds), and/or potatoes were listed as a main ingredient in the food. According to the FDA, an ingredient is considered a “main ingredient” if it’s listed within the first 10 ingredients of the dog food, and before any vitamin or mineral ingredients.

The majority of foods that have one of these ingredients as a main ingredient are labeled and sold as “grain-free” dog food. Grain-free and other “BEG” foods have gained in popularity in recent years which may be partially to blame for the increase in DCM.

Dobermans in the FDA’s Investigation

The entire list of DCM reports to the FDA is available here. It’s worth searching the document and looking for instances of Doberman specific DCM. It’s an interesting document with many notes from the veterinarians for each dog. After careful study, there are some interesting cases that really help us to better understand DCM. Here are some of the cases involving Dobermans in this document.

  1. A 7-year-old Doberman Pinscher diagnosed with DCM had been eating Blue Buffalo Basics salmon and potato dry food for many years however the owner rotated between regular and grain-free versions of the food. Taurine levels were checked and found to be 29 nmol/ml. Remember that 266 ± 5.1 nmol/ml is considered normal, so this dog’s taurine levels were very low. At the direction of the vet, this dog was placed on cardiac medications, taurine, and fish oil supplements. Follow-up information about the dog’s progress after these changes are not available.
  2. A 5-year-old Doberman Pinscher was diagnosed with DCM. Veterinarians initially assumed the issues were genetically related due to the breed. However, they noted he had been eating ACAN grain-free dog food. The owner put the dog on Purina Pro Plan Bright Minds in May 2018. A recheck of the dog was done on August 14, 2018 and a significant improvement in his DCM was noted in both his clinical signs and diagnostic imaging. This owner has a second Doberman in the house that was also diagnosed with DCM and also improved when the dog was taken off of the grain-free diet.
  3. A 3-year-old Doberman Pinscher was on Natural Balance Sweet Potato and Bison diet (which is a grain-free food). He began getting finicky with his food. Three days after going on a hike he threw up and was rushed to the veterinarian. He was in congestive heart failure (CHF), which is common during the later stages of DCM. Vets were unable to stabilize his condition and he died.
  4. A 10-year-old Doberman Pinscher who was being given ACANA Free-Run Poultry Grain-Free Dog Food was taken to the vet due to lameness issues. He was diagnosed with DCM and was already in congestive heart failure. He was started on medications (furosemide, enalapril, and pimobendan). He was seen again 10 days later and had improved clinically, but still had significant DCM and associated congestive heart failure. A heart arrhythmia was also noted. He was given gabapentin, fish oil, and taurine supplements. No follow-ups of this dog’s condition were provided. Another Doberman living in the same house has been eating the same food and has no signs of DCM.
  5. A 10-year-old Doberman Pinscher being fed Taste of the Wild Pacific Stream dry dog food (a grain-free dog food) was diagnosed with DCM and congestive heart failure. The owner did not change the dog’s diet after diagnosis. On re-check there were no improvements in the dog’s condition.
  6. A 9-year-old Doberman Pinscher eating Earthborn Holistic Weight Control Grain-Free dry dog food for the past 5 years was diagnosed with DCM, congestive heart failure, and atrial fibrillation (heart arrhythmia). No follow-up information is available as to the dog’s condition.
  7. An 11-year-old Doberman Pinscher on an unbalanced home-cooked diet developed a heart arrhythmia. He was seen again about 20 days later and was diagnosed with DCM and two specific forms of heart arrhythmias. Whole blood taurine level was measured at 419 nmol/ml. The owner had already started taurine supplementation. The vet recommended the owner change the dog’s diet and re-check in 3 months. No follow-up information as to the dog’s condition is available.
  8. A 9-year-old Doberman Pinscher on Orijen Grain-Free Original dry dog food was diagnosed with DCM and congestive heart failure in the emergency clinic. He was started on various medications including furosemide, diltiazem, digoxin, and pimobendan. No follow-up information is available.
  9. A 9-year-old Doberman Pinscher on Taste of the Wild grain-free dog food for the last 4 years developed a cough and was taken to the emergency clinic after three days. He was diagnosed with DCM and died at the hospital from heart failure. This owner reported that she had a Doberman previously who died at 8 years of age, also from DCM, and who was also on the same dog food.
  10. A 9-year-old Doberman Pinscher on Taste of the Wild dog food (different varieties of this food were given on rotation—all grain-free) went to his vet for lameness issues. During his checkup, an intermittent heart arrhythmia was noted. This dog had a history of dental disease. No other typical symptoms of cardiac disease were noted by the owner—no unusual coughing, sneezing, vomiting, or diarrhea. No excessive urination or increased thirst. Appetite and activity levels are normal. He was diagnosed with DCM. The dog was started on the following medications: Pimobendan, Benazepril, Spironolactone. The vet discussed adding Taurine and L-Carnitine supplementation with the owner. The vet recommended transitioning off of the grain-free diet. A repeat echocardiogram and 24-hour Holter monitor every 6 months was recommended. No follow-up information is available.
  11. An 8-year-old Doberman Pinscher on Blue Wilderness dog food (unknown variety) or Wellness Core (grain-free) dog food. The dog had an on-going cough which eventually lead to changes in respiration. The dog was diagnosed with DCM and in congestive heart failure. He was put on the following medications/supplements:  Furosemide, Enalapril, Vetmedin (Pimobendan), Spironolactone, Taurine, and L-carnitine. The vet recommended a 24-hour Holter monitor to check heart rhythm, but the owner declined. The vet discussed the unlikely potential for a taurine deficiency secondary to a grain-free diet and taurine testing (whole blood/plasma), but the owner declined. No follow-up information is available.

Please Note: These are not all the cases involving the Doberman breed in the FDA’s document cited above. I did not include some entries which appeared to be repeat reports (sometimes both the veterinarian and the owner will make a report for the same dog). I also didn’t include reports with very little details that did not appear helpful to better understand this disease.

It’s too easy while reading through these cases to come away with a strong belief that DCM in Dobermans is all too tightly linked to the dog’s diet. However, it’s important to remember that DCM in Doberman Pinschers is still believed by experts to be mainly a genetically related issue. Veterinarians who see cases of genetically linked DCM would not report them to the FDA for this study. Only those cases which are suspected of being diet-linked are typically reported.

So remember that these are only cases that are “suspected” as being linked to the dog’s diet in some way. A case may be genetically related in reality, and the dog just happens to be on a grain-free diet. Or it could be a combination of a genetic predisposition towards the disease and dietary influences. Or it may be entirely diet-related—it’s impossible to tell from this study. The only way veterinarians can determine for sure if a specific case of DCM is diet-related is to change the diet and see if the dog improves.

An update in regards to this study was released by the FDA here: Vet-LIRN Update on Investigation into Dilated Cardiomyopathy. This article discusses an interesting case study of two Doberman’s living in the same household (see table 4 in that article). Both dogs had one copy of the PDK4 genetic mutation, which is a mutation that’s common in Dobermans and believed to be linked to the development of DCM (see the genetic testing section of this article for more on that mutation). They were also on grain-free diets. After switching to non-grain-free food. At a 3-month checkup, both dogs had improved significantly.

How Many Dobermans Have DCM?

A recent study showed that 58.2% of Dobermans will have DCM at some point in their lifetime (source). This is widely believed by experts to largely be the result of a genetic predisposition towards the disease in the Doberman breed.

DCM seems to become more common in Dobermans as they get older. The same study found the prevalence of DCM in Doberman Pinschers at various age groups to be as follows.

Prevalence of DCM in Dobermans by Age

Age Group Prevalence of DCM
1 – 2 Years 3.3%
2 – 4 Years 9.9%
4 – 6 Years 12.5%
6 – 8 Years 43.6%
Over 8 Years 44.1%

This study showed that there was about an equal occurrence of DCM in male versus female Dobermans. However, affected male Dobermans showed earlier detectable changes in the heart than females.

For a well-researched article about the prevalence of DCM in Doberman Pinschers, including breakdowns by age of the affected dog, see Prevalence of Dilated Cardiomyopathy in Doberman Pinschers in Various Age Groups.

As mentioned earlier, the FDA’s report on DCM should not be considered an accurate reflection of the prevalence of DCM in the Doberman breed. Unfortunately, the disease is still very common in Doberman’s and genetic testing by breeders is imperative in reducing the occurrence of this disease.

Final Thoughts: What Can Doberman Owners Do?

Hopefully, as a Doberman owner, you now have a better idea about DCM and what is currently known about the disease. With the recent release of the DCM investigation information by the FDA, there are a lot of concerned owners out there. Remember that the FDA’s report is only a very small snapshot of certain occurrences of the disease. If you are still concerned about this report, take a look at the FDA’s Question and Answer article in regards to this report.

There are only a few things that we have control over as Doberman owners. That being said, the following actions are about the best we can do:

  1. Perform genetic testing of your Dobermans to determine their risk level. I wrote this Doberman DNA testing guide to help you with that. This is especially important for breeders to perform prior to selecting breeding partners. Then check all puppies in the litter. This incredibly important to help reduce the occurrence of DCM in the Doberman breed.
  2. Provide plenty of exercise in a healthy manner to improve the strength of your dog’s heart.
  3. Feed your dog a quality grain-containing diet. 
  4. Get regular check-ups at the veterinarian that include checking heart functions and blood work to identify any dietary deficiencies or early signs of DCM.
  5. Bring your dog to the veterinarian immediately if you notice anything unusual about your dog or their behavior.

If Doberman breeders and owners stay responsible in the way in which we’re handling this disease, we may be able to make a significant impact in reducing the prevalence of DCM in this wonderful breed.

Related Questions

Is DCM painful in dogs? While dilated cardiomyopathy (DCM) is not painful or uncomfortable in and of itself for a dog, sometimes the symptoms can be. These symptoms can include coughing, abdominal swelling, labored breathing, exercise intolerance, and sudden collapse or fainting.

John Walter and Cooper, his Doberman Pinscher.

About the author

John Walter is a Family Doberman Specialist, holds a CPD certification in Canine Communication, and is an active dog trainer specializing in the Doberman Pinscher breed. He's been quoted in Doberman Network Magazine, Bark Magazine, Doberman Dispatch, and he's the founder of Doberman Planet. Learn More

13 thoughts on “Doberman Pinscher Dilated Cardiomyopathy (DCM) Simplified”

  1. This was a great article, thank you so much!!!! Our 8-year-old Doberman was diagnosed with DCM and congestive heart failure 6 months ago – which is when we also found out about the possible negative effects of a grain free diet (which she had been eating for many years). Upon learning about these possible negative impacts of a grain free diet, we immediately switched her back to a grain containing diet. Besides the medications her cardiologist prescribed (Vetmedin and Lasik), we also put her on CQ10, L-carnitine, taurine and fish oil supplements. She just had her 6-month checkup yesterday and she is doing fantastic! In her cardiologist’s words “I am pleasantly surprised and it’s remarkable how well she is doing”. All tests show her DCM has stabilized. The cardiologist said it is possible that she could potentially live 1-2 years. To all the Doberman owners out there who’s dog has DCM, all I can say is never give up hope!

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  2. Thanks John, a concise and clear piece. Unfortunately we are now trying to deal with DCM in our 5 yr old boy, Duke. We did not know about this condition, and are devastated to learn of it. We’ll be doing whatever we can to help him enjoy whatever time he has left.

    Reply
    • So sorry to hear that Joe! I think there are some dog DCM specific groups on Facebook full of veterinarians and other professionals that might be able to help. There are some supplements that have had some promising results (specifically taurine supplementation, and a few others) which could be good to ask about. Good luck to you, definitely make sure every day is spent wisely because although you hope for the best, you never know.

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  3. Hi John
    Thank you for the great, informative read. Unfortunately I had to learn the hard way about DCM when my girl was diagnosed at 6yo and died 10 months later. I wish I had known more before and had her screened earlier with echo and holter.
    I personally think that in addition to the gene testing, knowing what is in the breeder’s lines is really important given the incomplete penetrance of these genes and that dogs negative for both / one can still develop DCM. Unfortunately here I don’t think there is sufficient transparency on the part of breeders – between each other, and with owners – which helps perpetuate the problem. .
    Moving forward – I’m a huge fan of the Doberman Diversity Project – both my girls contributed to this. Anyhow, paws crossed my current girl reaches double digits ❤️

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    • That’s a great point Kris! Studying the lineage of the puppy will often tell you a lot more about genetic health of the dog than DNA testing. Pretty important.

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  4. Great article. Thanks!

    Lost my last girl at age 8 to DCM. It came on fast: she developed a cough that sounded up-high in her throat, after 2 days her energy levels took a nose dive. On the night before bringing her into the vet (going into day 3) she had some “indoor bathroom issues”. (I could tell this was an abnormality, and so while she was embarrassed of her mistake, I am so happy that I was able to lie next to her and tell her “it’s okay…it happens to the best of us. No worries”). The vet took her in and it wasn’t more than 15-minutes later when she informed me of the bad news. I forget the unit of measure, but her heart was at a 14 instead of the healthy 10. We agreed that it was not to her benefit to treat. Time to go.

    As hard as it is to deal with DCM, Dobi’s are still the best (though I may be a bit biased in my opinion.)

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  5. Hello John,
    Would I be safe to say that you don’t feed your Doberman a “grain free ” diet? Are there any significant differences between the American breed Doberman VS the European Doberman when it comes to DCM and or heart related diseases?
    If the mother & father Doberman have been tested and found to be free of any DCM and or other heart disease does it make the odds / chances better for the offspring?
    Does the percentiles between say the same parents are continually tested after a few generations of litters make the odds in each litter better each time for the pumps? Can DCM issues be breed out of Dobermans if the same family line generations after generations increase the odds for each litter down the line to become better for not showing positive that no more DCM?
    ( HOPEFULLY you can make sense of what I’m trying to ask)
    If tested negative for DCM say after a few months of birth, can they be retested say a year later ( the same litter) & then be retested and found markers that indicate that now test positive for DCM?
    My last Doberman, Zeus died just after turning 5 years old and we are interested in another Doberman but I’m a bit gun shy now. Thank you.

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    • I’m so sorry to hear about Zeus! That’s just too young! To answer your questions:

      1 – Yes, I feed my dog a diet that contains grains.
      2 – There are some studies that show that European Dobermans might be slightly more inclined towards DCM. But it’s slight at best. However, there is a lot more testing of health issues such as DCM done in America on Dobermans than there are in Europe.
      3 – Yes it makes the odds better, but doesn’t eliminate them completely. The most important thing is to do the DCM1 and DCM2 genetic tests to help get a better understanding of their risk level.
      4 – I would imagine it makes the odds better to not be affected DCM but I don’t know for sure and haven’t seen any research related to this specific situation.
      5 – Their genetic tests won’t change as they age (meaning their DCM1 and DCM2 results will be the same no matter what age they are tested). But you can do screening as the dog ages to see if they are possibly developing DCM since the genetic tests are only an indicator of their likelihood of getting the disease at some point in their lifetime. Regular screening, on the other hand, is your best bet for catching DCM issues early.

      Hopefully, that helps shed some light on some of your questions!

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