Retrospective evaluation of the clinical course and outcome following grape or raisin ingestion in dogs (2005-2014): 139 cases.

OBJECTIVE: To describe the prevalence of acute kidney injury (AKI), clinical course, decontamination procedures, and outcome in dogs following grape or raisin ingestion. DESIGN: Retrospective case series from 2005 to 2014. SETTING: Three university veterinary teaching hospitals. ANIMALS: One hundred thirty-nine client-owned dogs with known grape or raisin ingestion. MEASUREMENTS AND MAIN RESULTS: Among dogs with biochemical data, the prevalence of AKI was 6.7% (8/120). The prevalence of AKI in the early presentation (3/67) and late (5/53) presentation groups were 4.5% and 9%, respectively. The prevalence of AKI was not significantly different between groups (P = 0.27). Four dogs (3.3%) were azotemic at presentation and 4 dogs (3.3%) had increases in creatinine of ≥26.5 µmol/L (0.3 mg/dL) at recheck (3 from the early and 1 from the late group). Vomiting was the most common clinical sign (18/139). One hundred twenty-two dogs (88%) underwent gastrointestinal decontamination and significantly more dogs in the early group were decontaminated (P < 0.0001). Two dogs received continuous renal replacement therapy. One hundred thirty-eight dogs survived and 1 died. CONCLUSIONS: The prevalence of AKI and mortality was low in dogs with confirmed grape or raisin ingestion. Due to the retrospective nature of the study, conclusions about the utility of gastrointestinal decontamination and other therapies cannot be made.

A systematic review of human and veterinary applications of noninvasive tissue oxygen monitoring.

OBJECTIVE: To describe the methodology for and utilization of tissue oxygen monitoring by near infrared spectroscopy, and to review the current literature on the use of this monitoring modality in human and veterinary settings. DATA SOURCES: Scientific reviews and original research found using the PubMed and CAB Abstract search engines with the following keywords: "tissue oxygen monitoring," "near-infrared tissue spectroscopy," and "tissue oxygen saturation (StO2 )." HUMAN DATA SYNTHESIS: Tissue oxygen monitors have been evaluated in a wide variety of human clinical applications including trauma and triage, surgery, sepsis, and septic shock, and early goal-directed therapy. StO2 more rapidly identifies occult shock in human patients compared to traditional methods, which can lead to earlier intervention in these patients. VETERINARY DATA SYNTHESIS: Veterinary studies involving tissue oxygen monitoring are limited, but the technology may have utility for identification of hemorrhagic shock earlier than changes in base excess, blood lactate concentration, or other traditional perfusion parameters. CONCLUSION: Tissue oxygen monitoring is most commonly performed utilizing a noninvasive, portable monitor, which provides real-time, continuous, repeatable StO2 measurements. A decline in StO2 is an early indicator of shock in both human and veterinary patients. Low StO2 values in human patients are associated with increased morbidity, mortality, and length of hospitalization, as well as the development of multiple organ system dysfunction and surgical site infections.