08 Sep Patient of the Week – Charlie Bruno
Charlie Bruno came immediately to Mountainside after ingesting a single grape. We induced vomiting with Apomorphine, and injectable drug that induces nausea in dogs. We induced vomiting and he brought up some green grape remnants. He was given Maropitant (an-antinauseant), subcutaneous fluids to aid in kidney function and hydration, and activated charcoal to absorb any remaining toxins before going home. He followed up with his regular veterinarian for bloodwork to be sure his kidneys were unaffected.
There are many unknowns associated with poisoning due to raisin and grape ingestion, but what we do know is that raisins, grapes, and currants are associated with acute kidney damage. There is no known dose that causes this, but it should not be left untreated. If untreated, generally vomiting will be seen in the first 24 hours, as well as lack of appetite, lethargy, and diarrhea.
More severe signs aren’t seen until the kidney damage has occurred. These signs include diarrhea, abdominal pain, excessive thirst, and excessive urination. As the poisoning progresses, the kidneys become unable to eliminate urine. At this point the prognosis is poor.
The goal with this type of ingestion is to eliminate the toxin by inducing vomiting (if they present in hospital early enough). This is followed by decontamination with activated charcoal to absorb toxins, and hospitalization with intravenous fluid therapy to help support and flush the kidneys to avoid the irreversible damage from the toxin.