The consumption of

grape A grape is a fruit, botanically a berry, of the deciduous woody vines of the flowering plant genus ''Vitis''. Grapes are a non- climacteric type of fruit, generally occurring in clusters. The cultivation of grapes began perhaps 8,000 years ago, ...

s and

raisin A raisin is a dried grape. Raisins are produced in many regions of the world and may be eaten raw or used in cooking, baking, and brewing. In the United Kingdom, Ireland, New Zealand, and Australia, the word ''raisin'' is reserved for the d ...

s presents a potential health threat to

dog The dog (''Canis familiaris'' or ''Canis lupus familiaris'') is a domesticated descendant of the wolf. Also called the domestic dog, it is derived from the extinct Pleistocene wolf, and the modern wolf is the dog's nearest living relative. Do ...

s. Their toxicity to dogs can cause the animal to develop acute kidney injury (the sudden development of

kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...

failure) with anuria (a lack of urine production). The phenomenon was first identified by the Animal Poison Control Center (APCC), run by the American Society for the Prevention of Cruelty to Animals (ASPCA). Approximately 140 cases were seen by the APCC in the one year from April 2003 to April 2004, with 50 developing symptoms and seven dying. It is not clear that the observed cases of kidney failure following ingestion are due to grapes only. Clinical findings suggest raisin and grape ingestion can be fatal, but the mechanism of toxicity is still considered unknown.

Cause and pathology

The reason some dogs develop

kidney failure Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...

following ingestion of grapes and raisins is not known. Types of grapes involved include both seedless and seeded, store-bought and homegrown, and grape pressings from

wineries A winery is a building or property that produces wine, or a business involved in the production of wine, such as a wine company. Some wine companies own many wineries. Besides wine making equipment, larger wineries may also feature warehouses, b ...

. A mycotoxin is suspected to be involved, but none has been found in grapes or raisins ingested by affected dogs. (Requires registration.) The dose-response relationship has not been determined, but one study estimated 3 g/kg or greater for grapes or raisins. An April 2021 letter to the editor of ''

JAVMA The American Veterinary Medical Association (AVMA), founded in 1863, is a not-for-profit association representing more than 99,500 veterinarians in the US. The AVMA provides information resources, continuing education opportunities, publicatio ...

'' hypothesized that the

tartaric acid Tartaric acid is a white, crystalline organic acid that occurs naturally in many fruits, most notably in grapes, but also in bananas, tamarinds, and citrus. Its salt, potassium bitartrate, commonly known as cream of tartar, develops naturally i ...

in grapes could be the cause. The most common pathological finding is proximal

renal tubular The nephron is the minute or microscopic structural and functional unit of the kidney. It is composed of a renal corpuscle and a renal tubule. The renal corpuscle consists of a tuft of capillaries called a glomerulus and a cup-shaped structure ca ...

necrosis Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. Necrosis is caused by factors external to the cell or tissue, such as infection, or trauma which result in the unregulated dige ...

. In some cases, an accumulation of an unidentified golden-brown pigment was found within renal epithelial cells.

Clinical signs and diagnosis

Vomiting Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the Human nose, nose. Vomiting can be the result of ailments like Food-poisoning, foo ...

and

diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin wi ...

are often the first clinical signs of grape or raisin toxicity. They often develop within a few hours of ingestion. Pieces of grapes or raisins may be present in the vomitus or stool. Further symptoms include weakness, not eating, increased drinking, and abdominal pain. Acute kidney failure develops within 48 hours of ingestion. A

blood test A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a hypodermic needle, or via fingerprick. Multiple tests for specific blood components, such as a glucose test or a cholester ...

may reveal increases in

blood urea nitrogen Blood urea nitrogen (BUN) is a medical test that measures the amount of urea nitrogen found in blood. The liver produces urea in the urea cycle as a waste product of the digestion of protein. Normal human adult blood should contain 6 to 20 mg/dL ...

(BUN), creatinine,

phosphorus Phosphorus is a chemical element with the symbol P and atomic number 15. Elemental phosphorus exists in two major forms, white phosphorus and red phosphorus, but because it is highly reactive, phosphorus is never found as a free element on Ear ...

, and

calcium Calcium is a chemical element with the symbol Ca and atomic number 20. As an alkaline earth metal, calcium is a reactive metal that forms a dark oxide-nitride layer when exposed to air. Its physical and chemical properties are most similar to ...

Treatment

Emesis (induction of vomiting) is the generally recommended treatment if a dog has eaten grapes or raisins within the past two hours. A

veterinarian A veterinarian (vet), also known as a veterinary surgeon or veterinary physician, is a medical professional who practices veterinary medicine. They manage a wide range of health conditions and injuries in non-human animals. Along with this, vet ...

may use an emetic such as apomorphine to cause the dog to vomit. Further treatment may involve the use of

activated charcoal "Activated" is a song by English singer Cher Lloyd. It was released on 22 July 2016 through Vixen Records. The song was made available to stream exclusively on ''Rolling Stone'' a day before to release (on 21 July 2016). Background In an interv ...

adsorb Adsorption is the adhesion of atoms, ions or molecules from a gas, liquid or dissolved solid to a surface. This process creates a film of the ''adsorbate'' on the surface of the ''adsorbent''. This process differs from absorption, in which a fl ...

remaining toxins in the

gastrointestinal tract The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organ (biology), organs of the digestive syste ...

and intravenous fluid therapy in the first 48 hours following ingestion to induce

diuresis Diuresis () is increased urination (polyuria) or, in the related word senses more often intended, the physiological process that produces such an increase or the administration of medications to encourage that process. It involves extra urine pro ...

and help to prevent acute kidney failure. Vomiting is treated with antiemetics and the stomach is protected from uremic gastritis (damage to the stomach from increased BUN) with H₂ receptor antagonists. BUN, creatinine,

sodium Sodium is a chemical element with the symbol Na (from Latin ''natrium'') and atomic number 11. It is a soft, silvery-white, highly reactive metal. Sodium is an alkali metal, being in group 1 of the periodic table. Its only stable iso ...

, and

potassium Potassium is the chemical element with the symbol K (from Neo-Latin ''kalium'') and atomic number19. Potassium is a silvery-white metal that is soft enough to be cut with a knife with little force. Potassium metal reacts rapidly with atmosphe ...

levels are closely monitored.

Dialysis Dialysis may refer to: *Dialysis (chemistry), a process of separating molecules in solution **Electrodialysis, used to transport salt ions from one solution to another through an ion-exchange membrane under the influence of an applied electric pote ...

of the blood ( hemodialysis) and peritoneal dialysis can be used to support the kidneys if anuria develops.

Oliguria Oliguria or hypouresis is the low output of urine specifically more than 80 ml/day but less than 400ml/day.Boon et al, Davidson's Principles & Practice of Medicine (20th Ed), p475 The decreased output of urine may be a sign of dehydration, kidney ...

(decreased urine production) can be treated with

dopamine Dopamine (DA, a contraction of 3,4-dihydroxyphenethylamine) is a neuromodulatory molecule that plays several important roles in cells. It is an organic compound, organic chemical of the catecholamine and phenethylamine families. Dopamine const ...

furosemide Furosemide is a loop diuretic medication used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. It may also be used for the treatment of high blood pressure. It can be taken by injection into a vein or by mouth ...

to stimulate urine production. The

prognosis Prognosis (Greek: πρόγνωσις "fore-knowing, foreseeing") is a medical term for predicting the likely or expected development of a disease, including whether the signs and symptoms will improve or worsen (and how quickly) or remain stabl ...

is guarded in any dog developing symptoms of toxicosis. A negative prognosis has been associated with oliguria or anuria, weakness, difficulty walking, and severe hypercalcemia (increased blood

levels).

References

{{reflist, 2 Dog health Grape Veterinary toxicology