With all the good and grace that is the Doberman there is a dark shadow; Dilated Cardiomyopathy, DCM. DCM is a form of heart disease common among all dogs but particularly plagues the Doberman. Statistics vary but it is safe to say at the current diagnosis rate reported to the AVMA nearly 60% of all Doberman will be diagnosed with DCM by the age of 8 years old. American bred Doberman tend to have slightly less rates of DCM, about 45% being diagnosed by age 8. European Doberman tend to be upwards to 58% diagnosed by age 8. There is no way to prevent DCM. It is a very complex disease. There are many factors to DCM, from environmental, hereditary, genetic, nutritional, eugenics, and more. It is a devastating disease, often fatal, and hard to detect early.
The rise of Dcm
Before the 1970's DCM was barely heard of. Since the rise of the Doberman's popularity in the AKC show ring and in the hearts of people globally DCM has been on the rise. One theory, the "Popular Sire Syndrome", believes one or a few select dogs corrupted the once diverse gene pool and sacrificed the breeds health. The thought is one or a few very popular and in demand dogs dominated pedigrees eliminating much of the diversity that was once there. Another theory is inbreeding reduced the diversity. It is thought by selecting only certain traits or from certain popular kennel lines the breed foundation was sacrificed thus causing the decline of health and diversity. Many other theories exist but one thing is certain, the obvious lack of genetic diversity is the reason the Doberman suffers DCM like it does today.
Doberman and genetics
DCM was thought to have a genetic basis but the research is showing genetic mutations alone aren't the cause. The two most common genes researched are DCM1 (aka PDK4) and DCM2. The Doberman Diversity Project states 73% of unaffected Doberman tested in their research had one or both DCM genes and 99% of dogs diagnosed with DCM had one or both genes. Putting it in other words; 7/10 Doberman without clinical DCM carry a DCM gene. 99/100 Doberman who were clinically diagnosed with DCM had at least one DCM gene. Genes alone don't predict DCM. There have been many Doberman to develop DCM and not have the genes, as well as many to have a gene or both and not develop DCM. There is no proven known way to prevent DCM. It is a very complex disease with many factors from environmental, hereditary, genetic, nutritional, to eugenics, and even more. It is a devastating disease and so widespread in the breed there may not be a way to reverse it without drastic measures.
DCM can be bred out. - Sadly, no. Research fails to provide evidence that selective breeding practices of "DCM free" dogs lessens the rate of DCM affected dogs.
There are DCM free lines. - No, absolutely not! All Doberman are subject to develop DCM. Some lines seem more affected than others and some less, but no line is free from DCM.
European Dobermann don't get DCM. - False! FALSE! The original DCM study used European Dobermann. All Doberman come from the same ancestry, the same roots, the same foundation dogs, and thus have the same risk.
Holter testing/Echos prevent DCM. - I wish they did. Unfortunately, many dogs who tested clear/normal have died later on of DCM.
Grain free foods cause DCM. - Maybe. There is a lot of strong evidence suggesting a link between grain free diets and nutritional DCM. Where that line falls in dobes, between nutritional and hereditary, is extremely blurred. It is best to er on the side of caution and feed a well rounded, inclusive diet.
Raw feeding like BARF prevent DCM. - Nope. Many raw fed dogs still go on to develop DCM. The only diet linked to DCM is grain free. Raw feeding can help reduce the rate of kidney disease as dry kibble tends to be really hard on a dog's urological system.
Supplements will prevent or cure DCM. - How I wish it was a simple as that. Human models show some promise in supplementation with l-arginine as a management aid as well as a way to prevent and reverse DCM but no such studies exist in Doberman or other dog breeds.
DCM is always fatal. - Not always, just usually. Predictably usually. DCM can be managed and sometimes reversed with early intervention and extensive treatment. Nutritional DCM can be reversed in most early and mild cases. The type/method of DCM in Doberman tends to be a silent and sudden killer making treating it difficult.
Stem Cell Therapy can cure DCM. No, it can't cure DCM but may be a good treatment. Stem Cell Therapy is still a new industry and needs more study and time to show if it is an effective treatment. It shows promise, but is extremely expensive and not easily accessible. For now, it just is not a practical option for managing DCM positive dogs.
Doberman diversity crisis, Diet, and dcm as an autoimmune disease
Doberman are one of the most inbred of all the dog world. All Doberman share the same 10 halotypes. That means they are all so closely related to one another it is as if breeding family members together! The average inbreeding ratio is 43%! There is not much diversity left to support healthy dogs and sustain a stable population for long.
Doberman Genetic Crisis - https://www.instituteofcaninebiology.org/blog/an-update-on-the-genetic-status-of-the-doberman-pinscher https://www.instituteofcaninebiology.org/blog/are-we-watching-the-extinction-of-a-breed-or-why-are-we-focused-on-consequence-instead-of-cause Doberman Longevivity Study - https://www.veterinarypracticenews.com/uf-announces-lifetime-study-on-fatal-heart-disease-in-doberman-pinschers/ Doberman Diversity Project (open to select populations) - https://www.dobermandiversityproject.org/ Grain Free Diet/Nutritional DCM - https://news.vin.com/vinnews.aspx?articleId=52712 https://www.vin.com/apputil/content/defaultadv1.aspx?meta=&pId=11149&id=3846592 Rates of DCM - https://www.ufaw.org.uk/dogs/doberman-pinscher-dilated-cardiomyopathy Predictors of DCM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913570/ DCM Related Autoantibodies - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214263
Methods to reduce dcm ocurrence
Elimination Method - Stop breeding dogs with DCM genes or who have positive echos/holter tests.
Avoidance Method - Avoid lines and familial groups who develop or are related to a dog that develops DCM.
Selective Breeding - Breed only certain dogs who meet a strict genetic and physical standard.
Outcross Genepools - Staying within the breed, bring in unrelated lines and breed together
Outcross Other Breeds - Select one or multiple breeds to crossbreed into the Doberman and selectively breed the desirable dogs back to purebred Doberman, continuing to breed back to more purebred Doberman.
Low COI Method - Selectively breed dogs with testes low COI (Coefficient of Inbreeding) to produce low COI litters
Why what was recommended isn't working
"Clearly, the efforts made by breeders over the last three decades to decrease the incidence DCM have had no effect at all on the prevalence of the disorder. Not even a little." - Carol Beuchat PhD The above chart shows a striking and steady increase in DCM in the Doberman breed. Efforts to reduce DCM seem ineffective. Efforts such as the Holter Project failed to reduce DCM rates by avoiding DCM families and DCM positive dogs.
What to take from this
When looking for a Doberman keep in mind NO line is free from the DCM risk. It is the shadow that haunts the breed. Maybe in time research will find a way to eliminate it. Right now, many scientists are leaning towards low COI as the key to reduce and potentially eliminate DCM one day.
"Important note about the TTN mutation (also known as DCM2): The vast majority of research exploring the genetics of DCM has been performed on purebred American Dobermans, a high risk population for DCM. Even in the Doberman, DCM2 is incompletely penetrant, meaning that while having one or two copies of this mutation is thought to confer some increased risk of developing DCM, it is by no means predictive of disease. DCM is a highly complex disease that is modulated by many genetic factors, most unknown. In addition, Embark and others have identified this mutation in multiple breeds, including breeds where DCM is not a common disease. The impact of this mutation in these breeds is unknown: Embark hopes to change this." - Embark on TTN/DCM2
Outcrossing? Is it a viable option?
I am not shy about supporting outcrossing. I believe outcrossing done right, to breeds not prone to the same cardiac, eye, and cancers that plague Doberman, would benefit the breed. One risk of outcrossing with other breeds is it could potentially lose what the Doberman is. I believe crossing back to the breeds that helped establish the Doberman will help reduce any lost traits (if any), making it easier to cross back into the Doberman we all know and cherish. Much like the LUA program that outcrossed to correct and reduce the rate of painful and often fatal bladder stones in the Dalmatian, an outcross program may help save the Doberman breed and allow for fresh, untapped lines to be worked into the diversity pool. Diversity can't be added without actually adding to the gene pool. You can't just create new diversity from the diversity we have now.
Say an outcross program is started. How should it be done? I personally feel we should avoid breeds with VWD, PRA, and cardiac issues. Selecting the best dogs genetically as well as health-wise is crucial. Second, you would breed to look at the dog physically, matching with breeds similar in build to the Doberman. Thirdly, you want to consider the temperament and working ability. You don't just want a dog to look like a Doberman, you want it to be a Doberman. Once you have established a solid base of dogs to cross, you start the tedious process of selecting which dogs fit the Doberman standard and your health/program aim and keep them back. You continue to selectively breed until you have worked back up to purebred Doberman (genetically testing as 98% and higher). Temperament testing and working ability can be assessed by professional trainers.
I firmly believe the key to saving the Doberman and preserving the breed is to create more diversity. How that is to be best done is the million dollar question!
Keeping purebreds purebred
I am passionate about maintaining the breeds integrity. Doberman are a unique and versatile breed. There is always a risk that keeping within the breed will not reduce the current rate of DCM and health decline. I feel there may be hope for the breed as long as pockets of lesser known or used lines are tapped into. I want to see the breed preserved and to thrive. Maintaining the Doberman as we know it today is crucial to keeping the breed intact. Many fear a true outcross program would ruin the breed integrity. The key to keeping purebreds purebred is to find and use lesser known dogs. Pet lines offer invaluable genetic material that is often snubbed by fanciers of champion dogs and champion pedigrees. Working lines bred to show lines can help create diversity. Show lines bred to service lines, pet lines bred to working lines, American pedigrees bred to imports ... we still have some tangible room to work with!
How we manage our breeding program and dcm
I aim to breed from pedigrees with longevity. I seek out various lines and origins to keep as diverse as possible. I feel that we are limited in what pools are available in the Doberman world, but I still strive to bring the most diversity into my program that I can find. I focus primarily on genetic health. I breed for sound health more than aesthetics or flashy pedigrees. I want better dogs for a better future. I feel the best direction is in taking a step backwards and focusing on the pools of Doberman that get overlooked so often just because they lack champions or prestigious names (pet lines, outside pedigrees, imports from lesser known countries, old lines, ect.). I work closely with many breeders who share a similar vision and passion for the breed, who want to see better dogs produced health and genetic wise.
The Real Question: Do I Holter/Echo? Holter: I do not routinely holter test. Echo/Auscualation: I do echos and auscuatlations examining for congenital defects as well as changes in the heart.
Evidence points to lack of diversity causing DCM to behave more as an autoimmune disease. Holter and echos are diagnostic tools used to identify DCM and cardiac abnormalities. It can not prevent DCM, just diagnose it. The last 30 years of holter and echo testing has failed to reduce the rate of DCM, even with the Holter project and DCM education. DCM effects over 50+% of the breed. With half of all Doberman developing DCM in their lifetime testing has failed to be a reliable method in eliminating DCM. That said, I do plan to buy a holter to keep with my facility to test when I want. Knowing is valuable, but it won't stop DCM. DCM is much more complex than originally believed. Again, I redirect back to the topic of diversity. Lack of diversity has given way to the rise of DCM.