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Ethylene Glycol Toxicity (view source)
Revision as of 19:19, 8 December 2010
, 19:19, 8 December 2010→Treatment
*'''Specific Antidotes that Prevent Metabolism of Ethylene Glycol''' ''benefits are dependent on time since ingestion, see prognosis''
*'''Specific Antidotes that Prevent Metabolism of Ethylene Glycol''' ''benefits dependent of time post ingestion, see prognosis''
**'''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> ethanol acts as an antidote by competitively inhibiting alcohol dehydrogenase <ref name="multiples"> '''http://www.merckvetmanual.com/mvm/index.jsp''', accessed on 09.12.2010 </ref>. Recommended intravenous dose for cats is 5ml of 20% ethanol solution per kg body weight every 6 hours for the first 30 hours and then every 8 hours for the next 32 hours <ref name="multiples"> '''BSAVA Manual of Canine and Feline Emergency Care''',(Second Edition), p286-7 </ref>.
**'''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> ethanol acts as an antidote by competitively inhibiting alcohol dehydrogenase <ref name="multiples"> '''http://www.merckvetmanual.com/mvm/index.jsp''', accessed on 09.12.2010 </ref>. Recommended intravenous dose for cats is 5ml of 20% ethanol solution per kg body weight every 6 hours for the first 30 hours and then every 8 hours for the next 32 hours <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.
*'''Promote excretion of Ethylene Glycol'''
**'''Fluid Therapy''' promotes diureses and helps prevent dehydration <ref name="multiples"> '''http://www.merckvetmanual.com/mvm/index.jsp''', accessed on 09.12.2010 </ref>. Also useful in acute renal failure.
**'''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>. Also useful in management of metabolic acidosis ''see below''
*'''Management of Metabolic Acidosis'''
*'''Management of Metabolic Acidosis'''
*'''Management of Acute Renal Failure'''
*'''Management of Acute Renal Failure'''
**Attempt to re-establish normal fluid and electrolyte balance
==Prognosis==
==Prognosis==