Difference between revisions of "Ethylene Glycol Toxicity"
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==Treatment== | ==Treatment== | ||
| − | * Ethanol | + | *'''Ethanol:''' useful in both dogs and cats <ref name="multiples">'''The 5-Minute Veterinary Consult, Canine and Feline''' (Second Edition),''Lippencott, Williams and Wilkins </ref>. |
| − | *4-methylpyrazole | + | |
| + | *'''4-methylpyrazole''':''Dogs only'' mode of action is to inhibit ADH in the liver. Recommended doses 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>. | ||
| + | |||
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> | 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> | ||
Revision as of 16:51, 17 November 2010
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This article is still under construction. |
Introduction
Ethylene Glycol is a sweet tasting fluid that is the main constituent of anti-freeze products.[1]. Consequently in northern hemishpere ethylene glycol toxicity is frequently encountered in practice. It has a relatively low minimum lethal dose, and its sweet, palatable taste makes it attractive to dogs, cats and other small animals. [1], [2],[3]
Signalment
- Dogs: all ages, both sexes, following intoxication lower incidence of fatalities in dogs compared to cats [1]
- Cats: all ages, both sexes
- Birds
- Other including pigs and cattle [1]
Diagnosis
Clinical Signs
Severity of clinicals signs is inversely proportional to amount ingested. Time post-ingestion is also important.[3].
- Dogs: Ataxia, mild to severe increasing depression and other neurological signs, tachycardia, tachypnoea, polydypsia, polyuria, dehydration, anorexia, emesis, miosis, hypothermia
- Cats: Ataxia, pronounced depression and other neurological signs, tachycardia, tachypnoea, polyuria, dehydration, anorexia, emesis, miosis [1],
[1].
- coma and death if untreated, or if lesser amount ingested oliguric acute renal failure within 1 day after ingestion
- if untreated anuric acute renal failure
- coma and death if untreated, or if lesser amount ingested oliguric acute renal failure within 1 day after ingestion
Laboratory Tests
- Metabolic Acidosis, increased serum osmolality, increased anion gap, decreased plasma bicarbonate concentration, decreased PCO2, decrease blood pH
- increased urea and creatinine, hyperkalaemia,
- Hyperphosphataemia due to acute renal failure [3].
- Hypocalcaemia as a consequence of this[3].
Ultrasonography
- Renal accumulation of calcium oxalate crystals results in hyperechogenicity upon ultrasound examination [4].
Biopsy
- Needle or surgical wedge biopsy of kidney [5].
Pathology
- Tetany results from the binding of Ethylene Glycol meatabolites to calcium ions present in serum [3].
Treatment
- Ethanol: useful in both dogs and cats [3].
- 4-methylpyrazole:Dogs only mode of action is to inhibit ADH in the liver. Recommended doses 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 [3].
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.[6]
Prognosis
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 The 5-Minute Veterinary Consult, Canine and Feline, Lippencott, Williams and Wilkins Cite error: Invalid
<ref>tag; name "multiple" defined multiple times with different content Cite error: Invalid<ref>tag; name "multiple" defined multiple times with different content Cite error: Invalid<ref>tag; name "multiple" defined multiple times with different content Cite error: Invalid<ref>tag; name "multiple" defined multiple times with different content Cite error: Invalid<ref>tag; name "multiple" defined multiple times with different content Cite error: Invalid<ref>tag; name "multiple" defined multiple times with different content - ↑ Feline Medicine and Therapeutics
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/210900.htm, accessed on 31.10.2010 Cite error: Invalid
<ref>tag; name "multiples" defined multiple times with different content Cite error: Invalid<ref>tag; name "multiples" defined multiple times with different content Cite error: Invalid<ref>tag; name "multiples" defined multiple times with different content Cite error: Invalid<ref>tag; name "multiples" defined multiple times with different content Cite error: Invalid<ref>tag; name "multiples" defined multiple times with different content - ↑ Textbook of Veterinary Internal Medicine, (Seventh Edition), Ettinger and Feldman; p1968
- ↑ Textbook of Veterinary Internal Medicine, (Seventh Edition), Ettinger and Feldman; p1968
- ↑ Canine Medicine and Therapeutics (Fourth Edition, 1998),Blackwell Science, p1049