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Old 07-17-2004, 09:33 AM
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Renee750il Renee750il is offline
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Join Date: Dec 2003
Location: Where the selas blooms
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Default Finally, some reliable info on grapes & raisins

This is long, (I'm going to have to split it up into two posts) but worthwhile considering how many times I've seen questions and speculation about whether or not it is dangerous for dogs to eat grapes and raisins. I found it on a Fila forum with permission to cross-post:

This paper is a summation of a recent case in my clinic of acute renal failure attributed to raisin consumption/toxicity. The information about this patient is provided by permission of his owner, Michelle Rine. I have also attempted to summarize some of the current literature available on grape and raisin toxicity. For those who receive this information either directly or in a forward, please be advised that this is an actual case and not another Internet hoax. I am sending it out in response to the many, many telephone calls we received at the clinic from not only veterinarians, but technicians, groomers, breeders and pet owners who wanted to verify a very brief initial warning I sent out to about 25 friends and acquaintances the night of Scotchie’s untimely passing. Anyone receiving this information has my permission to publish it in club or breed newsletters, bulletins, magazines, newspapers or in any other form necessary to reach as many people as possible. Further verification may be obtained by consulting the sources I have noted or by calling my office at 740-599-5991. It is the hope of Michelle, my staff and myself that in sharing this information, the devastating loss of Scotch will not have been in vain should one pet be saved from it.


740-599-5991

[email protected]

TOXIN ALERT: GRAPES AND RAISINS



It has been a common practice to use grapes and raisins in various capacities with our pets—veterinarians have often suggested a grape or two as a low calorie snack for our weight conscious patients, and trainers have recommended using raisins as training treats for such events as obedience and agility. If a question had arisen just a few short years ago regarding potential grape or raisin toxicity, even the ASPCA’s Animal Poison Control Center (APCC) would have discounted any concern.

As a senior veterinary student at The Ohio State University College of Veterinary Medicine in the spring of 2001, I avidly read all veterinary journals delivered to my doorstep. A <st1:date Year="2001" Day="15" Month="5">May 15, 2001</st1:date> letter to the editor in the Journal of the American Veterinary Medical Association (JAVMA) caught my eye. Written by Sharon Gwaltney-Brant, DVM, PhD, et al. from the ASPCA’s APCC, it summarized a review of cases from their database. They noted 10 dogs with evidence of ingestion of large amounts of grapes or raisins and a correlation with acute renal failure (ARF). I recall being surprised at the information but resolved to not recommend grapes or raisins to my clients as treats for their pets.

Unfortunately in April, 2004, that mentally filed snippet of knowledge became essential information. Scotchie, a 5-year-old, 56 pound, male castrated Labrador mix had indulged in some mischievous activity while his owners were at work. Sometime between 7:30 AM and 4:30 PM, Scotch removed a cardboard canister of raisins (15 ounce container) and ingested the remaining contents (approximately 8 ounces). When his owner, Michelle, returned from work that evening, she cleaned up the pieces of the container but didn’t give the contents a second thought. Most pet owners wouldn’t. After all, as humans, we consume raisins with no ill effects, so why should pets be any different? Scotch began vomiting and having diarrhea about 1 AM with some body tremors. Still thinking the signs were due to dietary indiscretion and not wanting to wake anyone at that time of night, his owner kept him comfortable until she called our service at 7 AM. Our receptionist, Lois, had fortunately also seen something about raisin toxicity at some point and advised Michelle to bring Scotchie in at 8 AM. She then called me.

“Acute renal failure,” I thought. I commended Lois for her quick and accurate thinking and said we would run a general health profile, electrolytes and CBC on presentation. I also called our local specialty/emergency referral center and talked to one of the ER doctors, a former classmate, who was on duty. He had also heard about ARF and raisins but knew no more than I. He recommended contacting poison control. Our owner called the North Shore Animal Protection League Poison Hotline and received a case number and treatment recommendations for Scotch—IV fluids at 1 ½ times maintenance and follow-up renal values for 48-72 hours. On presentation, Scotch was bright and alert, weight was 58#, temperature 99.9 degrees F, panting, HR 130. Blood profile abnormalities indicated ALT 126 u/L (10-100), BUN 32.8 mg/dl (7.0-12.0), calcium 12.01 ng/dl (7.90-12.0), creatinine 5.20 ng/dl (0.50-1.80) and glucose 145.3 mg/dl (77.0-125.0). Electolytes and CBC were within normal limits. An IV catheter was placed in the left cephalic vein and Scotchie was started on lactated Ringer’s solution at 93 ml/hr. He remained alert with no vomiting and was taken out on 3 occasions to urinate. He failed to produce any urine in any of the three trips. At 5 PM his renal functions and electrolytes were repeated. Electrolytes were still normal but BUN had increased to 43.7 mg/dl and creatinine to 7.1 mg/dl. He had received nearly a liter of fluids at this point. I felt it was in his best interest to send him to the referral clinic for overnight monitoring and a urinary catheter. The owners agreed and headed out for the hour plus drive with fluids still running. I called the center and spoke with the ER doctor then on duty to alert her to my concerns for Scotchie. She had also heard of a correlation between ARF and raisins but had never seen a case. She concurred with my thoughts of placing a urinary catheter and monitoring urine output as well as continuing fluid therapy.

On presentation to the referral center, Scotchie was ambulatory and alert, temperature was 100.3 degrees F, HR/pulse 124, respiration: panting, mucous membranes slightly injected, weight 56#. He had managed to chew his IV catheter out in the car so it was replaced. He had no abdominal pain but his bladder was not palpable. Heart sounds were normal and lungs were clear with normal respiratory effort.

Once the IV catheter was in place, he was started on 0.9% NaCl with 20 meq KCl at 140 ml/hr—2 times maintenance. He was given 15 mg famotidine IV and 600 mg keflin IV q 8 hr. (for the urinary catheter). A urinary catheter was placed and put on a closed collection system. An in house urinalysis was performed. Protein was 2+, pH 8 and specific gravity 1.012. All other values were normal. A urine culture/sensitivity (recommended by the Internal Medicine department) was sent out and was subsequently found to have no growth. Overnight Scotchie produced small amounts of urine (with lasix given) and began vomiting. At 1 AM he was bolused with 500 ml 0.9% NaCl and given 7.5 mg reglan IV. At 1:30 AM he vomited 3 more times. It was recommended then that he be transferred to Internal Medicine (IM) in the morning since the vomiting had become a problem. The owners agreed.


When I spoke to Scotchie’s IM doctor on the morning of the 15th, now two days after the exposure, he said the vomiting was still an issue and that urine production waxed and waned with lasix boluses. An abdominal ultrasound was planned as well as more bloodwork and continued aggressive fluid therapy and IV anti-emetics. That evening, I received a report of a normal ultrasound with minimal abdominal effusion and structurally normal kidneys. The blood chemistry profile, however, noted an ever-increasing BUN (76), creatinine (7.4), phosphorous (6.5) and potassium (6.3). On the CBC, hemoglobin was low at 12.8 gm/dl (14.0-18.0) as was plasma protein at 5.1 gm/dl (6.0-7.5) and lymphocytes at 0.66 x 1000 ul (1.20-5.20). Scotchie was bright and alert when his owners visited. At some point during hospitalization, Scotch’s fluids were switched to 0.45% NaCl with 2.5% dextrose, the rate in conjunction with urine output. He continued to receive IV keflin tid and blood pressures were monitored every 12 hours. His urine output was monitored every 2 hours.

On the morning of the 16th I learned that the vomiting had begun again. The plan was to continue with therapy as per the previous day and to recheck blood values. When I checked in that evening, I was told that Scotch was again bright and alert when his family visited. However, today his BUN rose to 106, creatinine to 8.5, phosphorous to 9.4 and potassium to 7.0. It had been decided to continue therapy through Saturday and then decide if any response to treatment had been achieved.

(continued on next post)
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