Reprinted from VETgirl blog.
Grapes and raisins (Vitis spp.) have been recently associated with development of acute kidney injury (AKI) with ingestion. All types have been implemented with toxicosis, including organic grapes, commercial grapes, homegrown grapes, and seedless or seeded grapes. Common kitchen items also contain grapes, raisins, or currants in their active ingredient, including raisin bread, trail mix, chocolate-covered raisins, cereal with raisins, etc. Currently, grapeseed extract has not been associated with nephrotoxicity.1 While the mechanism of how grapes and raisins cause AKI is unknown, there are several suspected hypotheses, including individual inability to metabolize certain components of the fruit (e.g., tannins, high monosaccharide content),1 the presence of mycotoxins or pesticide residues on the fruit,1 or salicylate-like chemicals within the grape or raisin.
While older publications2 report a toxic dose of grapes and raisins (e.g., grapes: 0.7 oz/kg; raisins 0.11 oz/kg), VetGirl suspects it is idiosyncratic and not necessarily dose-dependent... and hence, we treat any significant ingestion (e.g., more than a few). While 1-2 grapes or raisins is unlikely to result in an toxicity issue, more significant amounts should be decontaminated and treated. The majority of ingestions should be treated as potentially idiosyncratic and should be appropriately decontaminated and treated.
Clinical signs of grape and raisin toxicity include:
Additional treatment includes aggressive intravenous fluid therapy, anti-emetics, blood pressure and urine output monitoring, and serial blood work monitoring (q. 12-24 hours). In severe cases, hemodialysis or peritoneal dialysis may be necessary. Asymptomatic patients that have been adequately decontaminated and survive to discharge should have a renal function and electrolytes monitored 24-48 hours post-ingestion.
When in doubt, ASPCA Animal Poison Control Center can be consulted for life-threatening emergencies or azotemic, oliguric patients. Referral for a 24/7 specialty clinic is warranted for oliguric or anuric patients. Overall, the prognosis is fair to good, depending on time to decontamination, response to therapy, and prevalence of oliguria or anuria. Overall, 50% of dogs that ingest grapes and raisins never develop clinical signs or azotemia. As with any toxicant, the sooner a toxicity is identified (e.g., prior to clinical signs developing), the sooner it can be decontaminated and treated for a better prognosis.
1. Craft E, Lee JA. Grapes and raisins. In: Osweiler G, Lee JA, et al. Blackwell’s Five-Minute Veterinary Consult Clinical Companion: Small Animal Toxicology, 1st Ed. Iowa City: Wiley-Blackwell, 2010. pp. 429-435.
2. Eubig PA, Brady MC, Gwaltney-Brant SM, et al. Acute renal failure in dogs after the ingestion of grapes or raisins: a retrospective evaluation of 43 dogs (1992-2002). J Vet Int Med 2005;19(5):663-674.
Holistic veterinary medicine is a philosophy of treating the whole animal, taking into account mental, social and environmental factors, rather than just the symptoms of a disease. The techniques used in holistic medicine are gentle, minimally invasive, and incorporate patient well-being and stress reduction. Holistic thinking is centered on love, empathy, and respect.
We will determine the best combination of both conventional and alternative (or complementary) therapies for your pet. This mixture of healing arts and skills is as natural as life itself. As a holistic practitioner, I am not only in a medical history, but also genetics, nutrition, environment, family relationships, stress levels, and other factors.
Many patients present in a state of “disease.” At this point the holistic challenge lies in the question “why?” A simple-appearing symptom may have several layers of causation. When one area of the body is ill, it can manifest in many different ways. Only when the true cause of the ailment has been found is there the possibility for a lasting recovery.
Through a series of analytic observations and appropriate testing, the true root source of the pathology is identified. It is at this point that the most efficacious, least invasive, least expensive, and least harmful path to cure is selected.
Once the symptoms have been treated, the task is not complete until the underlying disease patterns have been redirected. The goal is to discover a new level of health thus preventing and minimizing future ailments and illnesses. The wholeness inherent in the scope of holistic veterinary medicine nurtures all aspects of an animal’s well-being, resulting in lasting physical, mental, and emotional health.
When you visit TOVS, you may notice a pleasant but perhaps unfamiliar aroma in the room. That is because we diffuse essential oils to enhance relaxation, elevate feelings of happiness and cleanse the air of toxins. When animals are stressed and fearful we use special oils on our hands or allow the owner to apply the oils to their pets to aid in relaxation. The uses of essential oils in pets are so broad that books are written on using essential oils to treat everything from allergies to vestibular disease. Many times essentials oils can take the place of conventional drugs or are used to provide an additive beneficial effect. Essential oils are used in a special massage technique called "Raindrop Technique"; which combines the effects of ten oils, applied from the sacrum to the base of the skull resulting in relaxation and rejuvenation of the entire body.
Acupuncture is another holistic treatment modality aimed at restoring harmony in the body by treating acupoints located along meridians on the body. The meridians are like rivers of energy that are all interconnected and when tissue damage or disease interrupts the flow, acupoints are treated to keep the meridians open. Interestingly, acupuncture is traditionally thought of being done with needles; however, we also use our Class IV laser to stimulate acupoints, which is a nice alternative for needle-shy animals.
Laser therapy is yet another holistic therapy used at TOVS. Laser therapy works on the principle of photons of light stimulating cellular processes involved in restoring damaged tissue, reducing pain and decreasing inflammation. Laser therapy is tolerated extremely well by most pets and is another soothing, relaxing form of therapy.
More information may be found at each of these modalities essential oils, acupuncture, laser therapy under the Holistic Services section of our website.
Please call us to set up a holistic evaluation of your pet by Dr. Woerner.
Its investigation is ongoing and the agency hasn't changed its recommendation to pet owners whose pets are not ill.
The FDA has issued an update to its investigation into reports of dogs developing dilated cardiomyopathy (DCM) while eating certain pet foods, according to a release from the agency. Since first announcing it would investigate the issue in July 2018, the agency has analyzed reports it has received from January 1, 2014, through November 30, 2018. This update doesn’t include reports received in December 2018 and January 2019 because of a loss of appropriations during the government shutdown in that time period, and it was unable to continue its investigation at that time, the release notes.
The FDA has taken a multi-faceted approach to its investigation, collaborating with other groups in the animal health sector to collect and evaluate information about the DCM cases and the diets the affected pets were eating prior to becoming ill. As of now, it has not identified specific recommendations about changes to the diets of dogs that are not displaying clinical signs of DCM, but encourages pet owners to consult their veterinarian directly for advice about their pet’s diet, the release notes.
The investigation has included the following steps to date:
> Analysis of reported cases to search for correlations between diagnosed DCM cases and what the dogs did or did not eat.
> Collaboration with the Veterinary Laboratory Investigation and Response Network (Vet-LIRN) to test blood, serum and tissue samples from affected dogs.
> Collaboration with Chesapeake Veterinary Cardiology Associates (CVCA) to collect case summaries as well as blood, serum and tissue samples of dogs diagnosed with DCM to see if there are unique factors that separate diet-associated DCM from genetic-associated cases. The agency is also reviewing echocardiograms of dogs that are not showing clinical signs of DCM to evaluate the significance of early changes in heart function.
> Consultation with board-certified veterinary nutritionists to identify factors such as nutrient bioavailability and ingredient digestibility that may contribute to the development of heart disease.
> Examination of ingredient sourcing, processing and product formulation with pet food manufacturers.
Between January 1, 2014, and November 30, 2018, the FDA received 300 reports of DCM, the release notes—294 were canine patients and six were feline. Of those cases, 276 (273 canine and three feline) of them were received after the notification about the FDA’s investigation was made public in July 2018. Some of the reports involved more than one animal affected from the same household, the release says.
According to the agency’s documentation there are some dog breeds that are known to have a genetic predisposition to DCM, typically large and giant breeds and cocker spaniels. But the reports the FDA has received span a wide range of breeds, many that don’t have a known genetic predisposition. While it has received reports of cats with DCM, the low number of reports—only 10 since January 2014—has led the FDA to focus on cases in dogs only.
In the cases where the dogs ate only a single primary diet and did not eat multiple foods, excluding treats, 90 percent reported feeding a grain-free food, the release states. About 10 percent of cases reported feeding food containing grains, some of which were diets considered to be vegan or vegetarian. A large proportion of the reported diets in the DCM cases, both in the grain-free and grain-containing cases, contained peas and/or lentils in various forms (whole, flour, protein) as a main ingredient, i.e. listed within the first 10 ingredients and before vitamins and minerals. These diets were commercially available kibble, canned and raw foods, as well as home-cooked diets, the release says.
The agency notes that it appreciates the assistance from pet owners and veterinarians that have submitted case reports, but that due to a high volume of reports, it can’t respond to each report individually, though each report is valuable and becomes part of the FDA’s investigation. Veterinary professionals and pet owners are encouraged to report both symptomatic and asymptomatic cases of dogs suspected to have DCM connected to diet using the electronic Safety Reporting Portal or calling their state’s FDA Consumer Complaint Coordinators.
For more details about the number or reports that have been made to the FDA, visit it’s DCM Investigation webpage.
The agency states that it will continue to provide updates on the progress of this investigation and will alert the public about significant developments, the release says.
Eight companies now affected; common manufacturer cited as potential source of formulation error.
Following a voluntary recall of two dry dog food brands due to excess levels of vitamin D last month, the FDA has expanded this recall to include foods sold by six more companies: Sunshine Mills, ANF, Lidl (Orlando brand), Kroger, ELM and Ahold Delhaize, according to an alert from the agency. The recalled products were sold nationwide.
After receiving reports from pet owners that their dogs had suffered vitamin D toxicosis, one company told the FDA that it was voluntarily recalling its dry pet food because of potentially toxic levels of the nutrient. Other brands made by the same contract manufacturer have also been recalled, the agency says. It is working with the manufacturer to provide a list of affected products, and FDA scientists are investigating reports and evaluating samples of some of the products to determine if the reported illnesses are definitively connected to the diets.
So far, the agency, as well as state and private lab testing, have found that the food contained about 70 times the intended amount of vitamin D. This amount is potentially toxic to dogs, and in severe cases could lead to kidney failure or death, the release says.
Pet owners and veterinary professionals should stop feeding the affected brands immediately. Pets exhibiting signs of toxicosis—vomiting, loss of appetite, increased thirst, increased urination, excessive drooling and weight loss—should be taken to the veterinarian immediately, the release says.
Veterinarians and pet owners can report suspected illness to the FDA through its safety reporting portal or by calling their state’s FDA consumer complaint coordinators.
Veterinarians treating vitamin D toxicosis cases should ask for the pet’s diet history. The FDA is also interested in reading case reports, particularly those confirmed with diagnostics. The agency notes that vitamin D toxicosis could also present as hypercalcemia, similar to dogs that have consumed rodenticide. In these cases, it suggests confirmation through diet history to verify whether the dog has been eating any of the recalled products.
The list of brands affected by the recall is below. This list is current as of time of publication, but it could include additional products as the FDA monitors the situation, the release notes.
Click the linked company name for complete information about the recalled product.
• Chicken and Chickpea Dry Dog Food
Natural Life Pet Products
• Chicken & Potato Dry Dog Food
Sunshine Mills, Inc.
• Evolve Chicken & Rice Puppy Dry Dog Food
• Sportsman’s Pride Large Breed Puppy Dry Dog Food
• Triumph Chicken & Rice Recipe Dry Dog Food
• ANF Lamb and Rice Dry Dog Food
Lidl (Orlando brand)
• Orlando Grain-Free Chicken & Chickpea Superfood Recipe Dog Food
• Abound Chicken and Brown Rice Recipe Dog Food
ELM Pet Foods, Inc.
• ELM Chicken and Chickpea Recipe
• ELM K9 Naturals Chicken Recipe
Ahold Delhaize (no press release provided)
• Nature’s Promise Chicken & Brown Rice Dog Food
• Nature’s Place Real Country Chicken and Brown Rice Dog Food
Two Paws, Infinite Gusto
It’s nearly impossible to spend more than a moment feeling like I’ve had a bad day when my closest companion is a spunky, spirited cat who has lived his whole life with two paws. Roger was born without back paws or a full tail, but in his mind, he is nothing less than regal.
Six years ago, I was browsing through a thrift shop in Rehoboth Beach. While I was aware the store donates proceeds to local animal shelters, I never expected to come across an onsite “cat room”. This is where I first met an orange tabby, named Roger. After petting him for 15 minutes, I realized he had stubs rather than back paws. From observing his behavior, it became clear that he was energetic, loving, and highly capable. I brought him home the next day.
Several of my friends immediately fell in love with Roger - and due to their accents - pronounced his name “Raja”. In Hindi, “raja” translates to “king”. I officially changed his name accordingly.
Over the years, his relentless determination, vigor, and courage never cease to inspire me. Like most cats, he loves to hunt, pounce, run, and chase. (I have often been gifted with dead rodent parts on the back porch.)
This amazing cat has taught me many important lessons:
Never feel sorry for yourself.
If you do something, do it with all your might.
Incorporate play into each day.
And freely give and receive affection.
We are excited to announce that we recently purchased an iCare Tonovet Plus Pen; a state of the art tool to measure intraocular pressure in dogs, cats and horses. The Tonovet Plus Pen has revolutionized the diagnosis of increased intraocular pressure, otherwise known as glaucoma, in pets. The use of this tool does not require any sedation or eye drops and takes less than 10 seconds per eye. Instant results are provided at the time of the examination allowing for an immediate diagnosis of glaucoma.
Glaucoma is a serious eye condition that results from increased pressure inside the eye that damages intraocular structures, such as the retina. When the retina is damaged, it cannot repair itself and permanent blindness can result. Early in the disease there may be little to no clinical signs or very mild eye redness, discharge and squinting; however, as the disease progresses you may see any or all of the following: ,
Glaucoma must be recognized and treated early on in the course of the disease. Glaucoma in animals can be hereditary or secondary to other systemic or ocular diseases. Regular ophthalmic examinations with measurement of intraocular pressure are very important in the early detection of glaucoma and other serious eye conditions. Cat breeds more predisposed to glaucoma include Persians and Siamese.
There are two types of glaucoma in dogs, primary and secondary. Primary glaucoma in dogs can be easier to predict and anticipate, since it is largely a hereditary condition. Although primary glaucoma in dogs has been recorded in most every breed of dog, it affects certain dog breeds more than others. Dog breeds prone to glaucoma include:
Call us today to learn more about glaucoma testing in your pet.