Toxicology: Grapes, Raisins, Tamarinds, and Cream of Tartar

Question 1

Discuss toxicity associated with grapes, raisins, etc

Answer 1

• The proposed toxin is tartaric acid
• With regards to toxicity, the current recomendation is: 1 grape or raisin/10 lb BW (raw)
• For dogs, if the dog vomits within several hours after ingestuion, then it is more likely to develop renal disease

Question 2

What is the mechanims of action for grape toxicity

Answer 2

Water soluble, rapidly absorbed, high renal excretion
Dogs are uniquely sensitive to organic acids (OAT expression)
- Organic anion transporter (OAT) selectively uptakes from blood –> proximal tubule
- Lack OAT-4 needed for proximal tubule –> lumen excretion

Question 3

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Discuss the lcinical pathology associated with grape toxicity

Answer 3

Typically see renal disease changes within 6-24 hours
- Hemoconcentration, hypochloremia
- Azotemia: pre renal and renal
- Hyperphosphatemia, hyperkalemia
- Metabolic acidosis
- Polyuria –> olig/an-uria
- Isosthenuria, casts without crystals, proteinuria

Question 4

What are the clinical signs, and lesions associated with grape toxicity

Answer 4

Clinical signs: vomitting, diahhrea, renal disease (anorexia, lethargy) and neuroogical sign (ataxia, CN deficits). The signs mimic anything that targets kidney/liver/GI

Lesions:
- Gross: nospoecific
- Histological: Proximal tubule degeneratoion and necrosis; intact basement membrane

Question 5

Discuss the treatment associated with grape toxicity

Answer 5

Asymptomatic: 4 Ds + M
1) dont do the math
2) do the risk assessment
3) decontaminate
4) diurese: fluid therapy –> 2 - 2.5x maintenance for 48 hours
5) Monitor

Question 6

Discuss prognosis and diagnosis for grape toxicity

Answer 6

Prognosis: great (if caught early) - guarded
Diagnosis: main point here is that its based mainlky off exposure history