Food and Plants

Question 1

Grapes and Raisin:

Whats the toxic dose of grapes and raisins

Answer 1

Raisins more potent: more likely to cause adverse effects
Large variabilities in tolerance
- Grapes ( 0.2-1.3 oz / kg)
- Raisins (0.11- 5.3 oz/ kg)

Question 2

Grapes & Raisins : what is the mechanism of toxicity of raisins?

Answer 2

Nephrotoxic agent /Unkown mechanism- we just know that it causes hypovolemic shock
- vasoconstriction in the kidneys which is going to cause episodes of shock, we can have renal ischemia and then you are going to end up with some proximal tubule necrosis or degeneration (this is the end result)

Question 3

Grapes and raisins : Discuss the clinical signs seen with this toxicity

Answer 3

24 hrs : Vomiting
Primary ?- Vomiting due to irritation to Gi
OR
Secondary: renal failure –> uremia-> vomiting

Several days ?: Dull, dehydrated, oliguria/ anuria

Question 4

Grapes and Raisins: Dog ( because cats havent been reported as having toxicity to this) eats raisins. what diagnostics should be ran?

Answer 4

Minimum database: Renail failure resukts
- hyperphosphatemia
- azotemia
-hyperkalemia
- isosthenuria 
\+/- casts in urine

elevated calcium, elevated phosphorus, azotemia, hyperkalemia
- confirmatory testing - So your diagnosis is really going to be based on the history of exposure, clinical signs and then if you end up with pathology results (take a biopsy of that kidney).

Question 5

Grape ad raisins: How do we treat an animal who has had exposure?

Answer 5

AGGRESSIVE
Recent : Decontamination through emesis, gastric lavage, activated charcoal
Fluid therapy : monitor if possible central venous pressure and urine output. Diuresis: Furosemide / mannitol
Supportive care
Dialysis

Question 6

Grapes and Raisins: What is the prognosis for an animal with this toxicity?

Answer 6

NOT GOOD

• poor w/ oliguric/anuric renal failure
• 75% Mortality

GOOD
- if quick decontamination happens ( 2hrs)

Question 7

What are differentials for an animal with acute renal failure?

Answer 7

o	Leptospirosis
o	Lillies (kitties)
o	Ethelyne glycol tox (anti freeze)
o	Acute obstruction (stones) in the kidneys
o	NSAIDs
o	Medications that are renal toxic
-	Amikacin
-	Aminoglycosides
-	Gentamicin

Question 8

Caffeine/ Methylxanthines: What types of foods contain this? what is the toxic dose

Answer 8

Foods: coffee, tea, soft drinks, otc meds

• LD50 in dogs 140-150 mg/kg
• Average cup of coffee: 40 mg caffeine/ oz – so it would take a couple of cups for intoxication
• Cats are more sensitive than dogs

Question 9

Cafine/ methylxanthines: What are the toxicokinetics of caffeine. How quick/ where does it distribute?

Answer 9

• Peak serum levels 30-60 minutes
- Distributed around the body quickly, crossing that BBB
• Widespread distribution
• Crosses blood brain barrier
• Metabolized in the liver
• Excreted in bile
- Enterohepatic circulation

Question 10

Theobromine/ Methylxanthines: What foods contain theobromine? What is the toxic dose of theobromine?

Answer 10

Theobromine foods: Chocolate, cacao bean hulls
theobromine toxicity:  LD50 in dogs: 100-200 mg/kg
- More bitter chocolate the MORE toxic
• Milk chocolate is not doing to be as toxic and if it’s baked it is going to be less toxic as well. It is more of the bittersweet, baking chocolate.
 20 mg/kg: mild signs
 40-50 mg/kg: sever signs
 >60 mg/kg: seizures

Question 11

Theobromine/ Methylxanthines: what are the toxicokinetics of theobromines vs. caffeine ( as in the time it takes and what organs metabolize)

Answer 11

 Absorbed more slowly
• Peak levels about 10 hours post ingestion
• Metabolized by liver
• Excreted slowly (half-life is 17.5 hours)
• Metabolites reabsorbed in urinary bladder

Question 12

What is the mechanism of toxicity of methlyxanthines

Answer 12

o Antagonize actions of adenosine –> cerebral cortical stimulation —> myocardial contraction (and tachycardia)

Question 13

What are the initial clinical signs of methylxanthines, occurring around 1-2 hours?

Answer 13

• Vomiting
• Panting
• Ataxia
• Diarrhea

Question 14

What are the progressive clinical signs of methylxanthines, after the initial signs ?

Answer 14

• Hypertension
• Arrythmias – secondary to tachycardia
• Muscle rigidity
• Seizures

Question 15

How does one treat an animal with meythlyxanthines?

Answer 15

o Activated charcoal + cathartic
- ingest a lot actual paper of the candy = gastric lavage
o Managed neurologic signs
o Monitor cardiac arrythmias

prognosis is good