Changes

==Treatment==

==Treatment==

*'''Prevent further absorption of Ethylene Glycol:''' ''only if animal presented early enough'' <ref name="multiples"> '''http://www.merckvetmanual.com/mvm/index.jsp''', accessed on 09.12.2010 </ref>.

*'''Prevent further absorption of Ethylene Glycol:''' ''only if animal presented early enough'' <ref name="multiples"> '''http://www.merckvetmanual.com/mvm/index.jsp''', accessed on 09.12.2010 </ref>.

**''Administration of Emetic''' eg syrup of ipecachuanha, apomorphine, sodium carbonate crystals <ref name="multiples"> '''BSAVA Manual of Canine and Feline Emergency Care''', (Second Edition), p286-7 </ref>.  

**'''Administration of an Emetic''' eg syrup of ipecachuanha, apomorphine, sodium carbonate crystals <ref name="multiples"> '''BSAVA Manual of Canine and Feline Emergency Care''', (Second Edition), p286-7 </ref>.  

**'''Gastric Lavage'''

**'''Gastric Lavage'''

**'''Administration of Adsorbents''' eg activated charcoal <ref name="multiples"> '''http://www.merckvetmanual.com/mvm/index.jsp''', accessed on 09.12.2010 </ref>, <ref name="multiples"> '''BSAVA Manual of Canine and Feline Emergency Care''', (Second Edition), p286-7 </ref>.  

**'''Administration of Adsorbents''' eg activated charcoal <ref name="multiples"> '''http://www.merckvetmanual.com/mvm/index.jsp''', accessed on 09.12.2010 </ref>, <ref name="multiples"> '''BSAVA Manual of Canine and Feline Emergency Care''', (Second Edition), p286-7 </ref>.  

**'''4-Methyl Pyrazole''': ''Fomepizole'' Initially thought to be effective in dogs only but if given at a higher dose can be effective in cats also <ref name="multiples"> '''BSAVA Manual of Canine and Feline Emergency Care''', (Second Edition), p286-7 </ref>. Its advantage over ethanol is that it has less side effects and is the treatment of choice in dogs <ref name="multiples"> '''BSAVA Manual of Canine and Feline Emergency Care''',(Second Edition), p286-7 </ref> . It acts by directly inactivating the enzyme alcohol dehydrogenase <ref name="multiples"> '''http://www.merckvetmanual.com/mvm/index.jsp''', accessed on 09.12.2010 </ref>. Recommended doses for dogs are 20mg per kg of a 50mg/ml solution (intravenous) followed by 15mg per kg (intravenous) 12 hours and 24 hours later and a final dose of 5mg per kg 36 hours later <ref name="multiples">'''The 5-Minute Veterinary Consult, Canine and Feline''' (Second Edition),''Lippencott, Williams and Wilkins'' </ref>. Cats require a dose of 125mg per kg body weight to be administered intravenously every hour for three hours post ingestion, followed by a lower intravenous dose of 31.25mg per kg body weight at twelve hour intervals post-ingestion untill 36 hours have passed.

**'''4-Methyl Pyrazole''': ''Fomepizole'' Initially thought to be effective in dogs only but if given at a higher dose can be effective in cats also <ref name="multiples"> '''BSAVA Manual of Canine and Feline Emergency Care''', (Second Edition), p286-7 </ref>. Its advantage over ethanol is that it has less side effects and is the treatment of choice in dogs <ref name="multiples"> '''BSAVA Manual of Canine and Feline Emergency Care''',(Second Edition), p286-7 </ref> . It acts by directly inactivating the enzyme alcohol dehydrogenase <ref name="multiples"> '''http://www.merckvetmanual.com/mvm/index.jsp''', accessed on 09.12.2010 </ref>. Recommended doses for dogs are 20mg per kg of a 50mg/ml solution (intravenous) followed by 15mg per kg (intravenous) 12 hours and 24 hours later and a final dose of 5mg per kg 36 hours later <ref name="multiples">'''The 5-Minute Veterinary Consult, Canine and Feline''' (Second Edition),''Lippencott, Williams and Wilkins'' </ref>. Cats require a dose of 125mg per kg body weight to be administered intravenously every hour for three hours post ingestion, followed by a lower intravenous dose of 31.25mg per kg body weight at twelve hour intervals post-ingestion untill 36 hours have passed.

*'''Managemenf of Metabolic Acidosis'''

*'''Management of Metabolic Acidosis'''

Ethylene Glycol is a weak acid. Therefore in order to increase the rate of renal clearance sodium bicarbonate can be administered to dogs. Intravenous administration of sodium bicarbonate at a concentration of 1-2 mmol/kg every 3 to 6 hours achieves sufficient alkalinisation of the urine.<ref>'''Canine Medicine and Therapeutics''' (Fourth Edition, 1998),''Blackwell Science'', p1049 </ref>.

 

**'''Sodium Bicarbonate:''' Ethylene Glycol is a weak acid. Therefore in order to increase the rate of renal clearance sodium bicarbonate can be administered to dogs. Intravenous administration of sodium bicarbonate at a concentration of 1-2 mmol/kg every 3 to 6 hours achieves sufficient alkalinisation of the urine.<ref>'''Canine Medicine and Therapeutics''' (Fourth Edition, 1998),''Blackwell Science'', p1049 </ref>.

*'''Management of Acute Renal Failure'''

*'''Management of Acute Renal Failure'''