2Stir milk, grits, egg, cocktail sauce, 3 tablespoons ketchup, onion powder, salt, and black pepper together in a large bowl; add ground beef, mix with your hands until the texture is consistent, shape into a loaf, and put into a loaf pan. Spread 1/4 cup ketchup over the meat mixture.
3Bake in the preheated oven until no longer pink in the center, about 1 hour. An instant-read thermometer inserted into the center should read at least 160 degrees F (70 degrees C).
Footnotes
Cook's Note:
If you are strict about gluten-free, make sure your cocktail sauce and ketchup have no gluten-containing ingredients.
You could also make this with ground turkey instead of beef.