DCM is primarily believed to be a genetic disease, most commonly found in giant dog breeds and Cocker Spaniels, but reports arose of small- and medium-sized dogs (including Retrievers, Whippets, a Shih Tzu, a Bulldog, Miniature Schnauzers, and mixed breeds) being diagnosed in recent years. The common thread between each home was the grain-free food their dogs ate.

The Food and Drug Administration issued an alert this July, notifying pet owners and veterinarians of the reports. According to the alert, DCM was being diagnosed in dogs with grain-free diets “containing peas, lentils, other legume seeds, or potatoes as main ingredients.”

“High levels of legumes or potatoes appear to be more common in diets labeled as ‘grain-free,’ but it is not yet known how these ingredients are linked to cases of DCM,” wrote the FDA.

According to the Post‘s report, the FDA is still investigating the link at this time. More than 250 cases of DCM with a potential link to diet have been recorded, with increasing frequency, and at least 24 dogs have died from the condition. Despite these numbers, no dog foods have been recalled.

With DCM, the dog’s heart becomes weak, unable to properly pump blood. The heart enlarges to compensate, but as the heart’s ability to pump deteriorates, fluid can build up in the lungs, causing coughing or shortness of breath. According to PetMD, additional symptoms may include lethargy, loss of appetite, bloating, and occasional loss of consciousness. If left untreated, the dog’s heart can become overburdened, leading to congestive heart failure.

DCM has been linked to a lack of taurine, an amino acid that dogs primarily get from their diet. According to the Post, chicken and beef are high in taurine, but rabbit, lamb, legumes, pea-protein, and other ingredients common to grain-free recipes contain little or no traces of the vital amino acid.

While larger brands have the ability to test their products to ensure a balance of nutrients, boutique brands may not have these resources. The FDA is not required to approve dog foods before they reach shelves, so smaller brands are not held accountable for their food’s nutrient balance. According to a statement provided to the Post, the FDA only has the authority to intervene “when animal food is unsafe or if a label is inaccurate or misleading.”

Pet owners can check the quality of their food selection by looking for a “complete and balanced” notation on the label, associated with the Association of American Feed Control Officials (AAFCO). This organization has no regulatory authority, but does monitor the quality of pet food products on the shelves. According to the AAFO, “complete and balanced” means the food has all the nutrients necessary for your pet, in the proper ratios.