The recommended dosage is 5 mL of 20% ethanol/kg body wt diluted in IV fluids and given as a drip over 6 hr for five treatments, and then over 8 hr for four more treatments. How do dogs get ethylene glycol poisoning? A pharmacokinetic study was conducted to determine the effectiveness of lower doses of ethanol in the treatment of ethylene glycol (EG) poisoning. 4-Methylpyrazole (4-MP, fomepizole) effectively inactivates alcohol dehydrogenase in dogs without the adverse effects of ethanol and is the treatment of choice. The formula 0.3 − (0.5 × kg body wt) × (24 − plasma bicarbonate) is used to determine the dose, in mEq of bicarbonate. When in doubt, you or your veterinarian can contact Pet Poison Helpline (800-213-6680) 24/7 for life-saving assistance in managing a poisoned patient. Diagnosis, Treatment, Prognosis and Prevention. Ethylene glycol can also be found, in lower concentrations, in some windshield de-icing agents, hydraulic brake fluid, motor oils, solvents, paints, film processing solutions, wood stains, inks, printer cartridges, etc. Renal tubular epithelial necrosis with calcium oxalate crystals in the tubular lumina is the characteristic finding of EG intoxication. The signs that the antifreeze poisoning in dogs has proceeded to severe levels include the presence of excess urea levels and other nitrogenous waste in the kidney and blood. Signs include lethargy, anorexia, dehydration, vomiting, diarrhea, oral ulcers, salivation, tachypnea, and possibly seizures or coma. Stage 3 (24 to 72 hours) kidney failure is the result of ethylene glycol poisoning. Progressive depression, lethargy, lack of appetite, vomiting, seizures, coma, and death may be seen. Poultry usually do not develop gross lesions. Ethylene glycol can also be found, in lower, less harmful, concentrations, in some windshield de-icing agents, hydraulic brake fluid, motor oils, solvents, paints, film processing solutions, wood stains, inks, printer cartridges, etc. Additional information can be found online at www.petpoisonhelpline.com. Within 30 minutes of ingestion, they may resemble a person who has had too much to alcohol drink. Pulmonary edema and hemorrhagic gastroenteritis are common secondary findings in dogs and cats. Poultry may become drowsy, ataxic, dyspneic, and recumbent; torticollis, ruffled feathers, and watery droppings are also seen. Calcium oxalate crystalluria may be observed as early as 3 and 6 hr after ingestion in cats and dogs, respectively. Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. Left untreated, the animal may die. Ethylene glycol poisoning is common because antifreeze is widely used, it has a sweet taste and small lethal dose (only 3 to 4 teaspoons in dogs, 1 to 2 teaspoons in cats), and it … The prognosis varies inversely with the amount of time that elapses between ingestion and initiation of treatment. Dogs and cats exhibit vomiting due to GI irritation, polydipsia and polyuria, and neurologic signs (CNS depression, stupor, ataxia, knuckling, decreased withdrawal and righting reflexes). Monitoring urine pH may also be helpful, with a goal of maintaining the urine pH between 7.0 and 7.5. Excessive urination 6. Commercial formulations of 4-MP are available. Toxic metabolites of EG cause severe metabolic acidosis and renal tubular epithelial damage. The liver quickly breaks down ethylene glycol into toxic products that can lead to kidney failure and death. These 95% commercial antifreeze preparations are diluted ~50% with water when used in vehicle cooling systems. EG intoxication occurs most commonly in temperate and cold climates, because antifreeze is used both to decrease the freezing point and to increase the boiling point of radiator fluid. It is given intravenously for 36 hours, and stops the metabolism of ethylene glycol into its damaging metabolites. Untreated, antifreeze poisoning can be fatal to pets. Antifreeze poisoning in dogs typically occur when ethylene glycol, one of the main ingredients in antifreeze, leaks from car radiators or screen wash containers. Glycolic acid and oxalate are the metabolites thought to be most responsible for acute tubular necrosis associated with EG ingestion. Calcium oxalate crystals form within the lumina of tubules as water is reabsorbed from the glomerular filtrate and the pH decreases (smaller numbers of calcium oxalate crystals may also be observed in the adventitia of blood vessel walls throughout the body). Ethylene glycol itself is not toxic, but it is metabolized in the animal’s body to several extremely toxic chemicals that are responsible for its potentially lethal effects. Seizures/Convulsions/Shaking tremors 11. Emergency Situations, Treatment, Pet Services. We’re committed to keeping clients and staff safe during COVID-19 with NEW admittance and check-out processes. Glyoxylic acid is rapidly metabolized to formic acid, carbon dioxide, glycine, serine, and oxalate. Stage 2 - 12 to 24 hours after ingestion: Some of the signs seem to dramatically improve, luring pet owners into a false sense of security. Whereas all animal species are susceptible, to ethylene glycol toxicity, cats … Pet Poison Helpline is available in North America by calling 800-213-6680. EG is rapidly absorbed from the GI tract; in dogs, blood concentrations of EG peak within 3 hr of ingestion. The acronym SLUD stands for salivation, lacrimation, urination, and defecation, which are the clinical signs associated with muscarinic cholinergic overstimulation caused by certain toxins. The poison primarily affects the kidneys and can do irreversible damage. Fomepizole is a new agent with a specific indication by the U.S. Food and Drug Administration for the treatment of ethylene glycol poisoning.4, 6, 7, … It’s extremely important that you have your dog seen by a veterinarian as quickly as possible after ingestion of anything that contains ethylene glycol. Approximately 50% of ingested EG is excreted unchanged by the kidneys; however, a series of oxidation reactions in the liver and kidneys metabolize the remaining EG. In colder climates, the incidence of EG intoxications is seasonal, with most cases occurring in the fall, winter, and early spring, when antifreeze is added to radiator fluid or when cooling systems are flushed. Clinical signs are dose- and time-dependent and can be divided into those caused by unmetabolized EG and those caused by its toxic metabolites. The onset of clinical signs is almost immediate and resembles alcohol (ethanol) intoxication. Oliguric acute renal failure usually develops between 12 and 24 hr in cats and between 36 and 72 hr in dogs. Pigs may also have pulmonary edema with tan fluid in the pleural and peritoneal cavities. The sweet taste and smell can be … Oxalate is not further metabolized and is cytotoxic to the renal tubular epithelium and exacerbates the metabolic acidosis. Please confirm that you are a health care professional. Propylene glycol is a common ingredient in antifreeze, lubricants, and products of plasticity. Within 24 hours, some animals show apparent improvement which may prevent pet owners from realizing that their pet is in r… EG is rapidly absorbed from the GI tract; in dogs, blood concentrations of EG peak within 3 hr of ingestion. Calcium oxalate crystals appear birefringent when viewed with polarized light. The link you have selected will take you to a third-party website. All dogs were anesthetized … Ethylene glycol (C2H6O2 Ethylene glycol is an odorless, colorless, sweet-tasting syrupy substance with a molecular weight of 62.07, freezing point of -13°C and a boiling point of 197.6°C. Once absorption has occurred, excretion of EG is increased by fluid therapy designed to correct dehydration and increase urine production. Weakness 10. The difference between measured and calculated (1.86 [Na+ + K+] + glucose/18 + BUN/2.8 + 9) osmolality is referred to as the osmolal gap. Acidosis (acidic blood) can also be detected through the biochemistry profile. Stage 1:  (within 30 minutes of ingestion): The signs include lethargy, vomiting, incoordination, excessive urination, excessive thirst, hypothermia (low body temperature), seizures, and coma. Comp Contin Educ Pract Vet 21 (12), 1124-1133 VetMedResource. Many animals will voluntarily drink ethylene glycol if antifreeze is spilled or leaks onto garage floors or driveways. Dogs may be attracted to ethylene glycol by its sweet taste. As … Ethylene glycol poisoning is divided into three stages. Especially if your dog has only licked a bit of motor oil. The first of two rate-limiting biotransformation steps is the production of glycoaldehyde from EG by the enzyme alcohol dehydrogenase. Even if you only suspect that your dog has ingested ethylene glycol, if the dog is showing all of the effects of ethylene glycol toxicity, and the substance is accessible in any way, you should take your dog to be checked. • It is the most toxic of similarly used alcohols (ethyl alcohol, butylene glycol and propylene glycol). In cats, 4-MP is ineffective at the canine dosage, and either a higher, extra-label dosage (125 mg/kg initially, followed by 31.3 mg/kg at 12, 24, and 36 hr after the initial dose) or ethanol is used. Younger animals may be more susceptible. Ethylene glycol toxicosis is a type of poisoning that occurs in dogs after ingestion of antifreeze or other fluids containing the ingredient ethylene glycol. Urine fluorescence has been used as a qualitative adjunctive test in suspected EG ingestions in people and may be of value in veterinary medicine. Lastly, a special black-light lamp (Wood’s lamp) can sometimes be used to examine the urine, muzzle, and paws of the patient to look for the presence of the warning dye which is added to automotive antifreeze. Even a small amount of antifreeze can be fatal to dogs and cats. In addition, antifreeze may be ingested by way of intentional poisoning or because it is the only available liquid in cold weather. Some common signs of antifreeze poisoning in dogs and cats include: 1. Gaynor A R et al (1999) Acute Ethylene Glycol Intoxication. Oxalate also combines with calcium to form a soluble complex that is excreted via glomerular filtration. Studies were made prior to and after ingestion on an hourly basis over a period of 8 to 10 hours. (Blog #83) Dec 29, 2020 | Blog, Companion Blog, Dog Care, Dogs. Wobbly, uncoordinated movement 4. In addition, a test kit that can be used in the veterinary clinic is available to detect the amount of ethylene glycol present in the bloodstream. ©Copyright VCA Hospitals all rights reserved. Some antifreeze preparations contain fluorescein, which appears bright yellow-green when viewed under a Wood’s lamp. Epistaxis and hemoglobinuria have also been seen in cattle that have ingested large doses of EG. Antifreeze carries a sweet taste, and only a relatively small amount need be consumed for a lethal dose. Euphoria/Delirium 3. The Merck Veterinary Manual was first published in 1955 as a service to the community. During this stage, severe kidney failure is developing secondary to calcium oxalate crystals forming in the kidneys. Ethylene glycol has a very narrow margin of safety – which means only a tiny amount can result in severe poisoning. *Pet Poison Helpline, is an animal poison control service available 24 hours, seven days a week for pet owners and veterinary professionals who require assistance treating a potentially poisoned pet. Additional doses of bicarbonate based on the above formula are frequently necessary. As CNS depression increases in severity, dogs and cats drink less; however, the osmotic diuresis continues and results in dehydration. If ingestion of EG is not witnessed, diagnosis is usually based on a combination of history, physical examination, and laboratory data. Commercial test kits can detect serum EG concentrations of ≥50 mg/dL. Its concentration in automotive radiator fluid is high (95%), a source to which pets (dogs and cats) have easy access. Coma When in doubt, if you suspect your dog has ingested ethylene glycol, immediate veterinary attention is imperative as the prognosis is very poor once clinical signs have developed. Glycolaldehyde is then rapidly metabolized to glycolic acid. Signs of SLUD are most consistent with exposure to which of the following classes of chemicals? Pigs and cattle often develop renal and perirenal edema. If 4-MP is not available, an ethanol regimen (5.5 mL of 20% ethanol/kg body wt, IV, every 4 hr for five treatments and then every 6 hr for four additional treatments) is recommended. Diarrhea 7. Incoordination, excessive urination, excessive thirst, vomiting, and lethargy are amongst the first signs to appear. Most intoxications are associated with ingestion of antifreeze, which is typically 95% EG. Rapid heart beat 8. It is critical that you bring your dog to a veterinary clinic if you know or even suspect that he has consumed ethylene glycol, or if he is exhibiting any of the early symptoms. This depression appears similar to ethanol intoxication, but without the characteristic odor of alcohol. All animals are susceptible to ethylene glycol (EG) toxicity, but it is most common in dogs and cats. The dose of 4-MP (5% solution [50 mg/mL]) is 20 mg/kg body wt, IV, initially, followed by 15 mg/kg, IV, at 12 and 24 hr, and 5 mg/kg, IV, at 36 hr. Vomiting should not be induced in a dog or cat exhibiting neurologic signs because of increased risk of aspiration. Learn more. This chemical is extremely toxic to dogs and is also very sweet so they like the taste. Clinicopathologic findings were retrospectively evaluated in 26 cats and 24 dogs with ethylene glycol intoxication. A urinalysis may also confirm ethylene glycol poisoning and underlying kidney damage by the presence of dilute urine containing blood, protein, cellular casts (plugs of cells which have taken the shape of dying tubules in the kidneys), and calcium oxalate crystals (which are seen with ethylene glycol poisoning). Treatment should include correction of fluid, electrolyte, and acid-base disorders and, if possible, induction of diuresis. Ethylene Glycol In contrast to the other two types of antifreeze, it only takes a small amount of ethylene glycol to poison your dog, and even less to poison your cat – just two tablespoons for a ten-pound dog and one teaspoon for a cat. Other sources of EG include some heat-exchange fluids used in solar collectors and ice-rink freezing equipment and some brake and transmission fluids. The metabolic acidosis associated with metabolism of EG is corrected by administration of sodium bicarbonate. Stage 1: This occurs within 30 minutes to 12 hours and looks similar to alcohol poisoning. In cats, this stage occurs 12–24 hours after consuming antifreeze; in dogs, at 36–72 hours after consuming antifreeze. As little as half a teaspoon per pound of a dog’s body weight can result in fatality. Ethanol is the treatment of choice for cats and is administered for up to 64 hours. Polydipsia occurs due to osmotic stimulation of the thirst center, and polyuria occurs due to an osmotic diuresis and decreased production and release of antidiuretic hormone. It is most commonly encountered as automotive antifreeze.Diethylene glycol behaves similarly to ethylene glycol in an overdose. The prognosis for these animals is guarded to poor. However, these tests are not specific for ethylene glycol toxicity, and by the time these blood tests show evidence of kidney failure, the prognosis is grave to poor (since it is too late to treat with the antidote). Part II. Ethylene glycol itself is not toxic, but it is metabolized in the animal's body to several extremely toxic chemicals that are responsible for its potentially lethal effects. The kidneys are often swollen and painful on abdominal palpation. Thrall M A et al (1998) Advances in therapy for antifreeze poisoning. 5 The mortality rate in dogs is reported to range from 59% to 70% 1, 5 and is thought to be even higher in cats. However, during this stage, dogs become dehydrated, and develop an elevated breathing and heart rate. Antifreeze Poisoning in Dogs & Cats (Ethylene Glycol Poisoning) During certain times of the year (such as summer and winter), dogs and cats are more exposed to antifreeze. The best way to confirm ethylene glycol poisoning is by measuring the blood concentration of ethylene glycol. Further absorption of EG is prevented by induction of emesis or gastric lavage (or both) within 1–2 hr of ingestion, although the rapidity of EG absorption from the GI tract suggests these procedures may not be beneficial. Fomepizole (Antizol-Vet®, 4-methylpyrazole) is the treatment of choice for ethylene glycol poisoning in dogs. Nausea/Vomiting 5. The legacy of this great resource continues as the Merck Veterinary Manual in the US and Canada and the MSD Manual outside of North America. To prevent metabolism of EG, the activity of alcohol dehydrogenase is decreased by direct inactivation or by competitive inhibition. Last full review/revision May 2013 | Content last modified May 2013, © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA), © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, Overview of Health-Management Interaction: Small Animals, Monitoring the Critically Ill Animal Using The Rule of 20. They have taste buds that detect sugars just like we do. Ethylene glycol, a sweet-tasting, odorless liquid, is the active ingredient in antifreeze. How to Prevent Your Dog From Antifreeze Poisoning. One-half of this dose should be given IV slowly to prevent overdose, and plasma bicarbonate concentrations should be monitored every 4–6 hr. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The active ingredient in antifreeze is a substance called ethylene glycol. Depression 9. The minimum lethal dose of ethylene glycol is 4-6 ml/kg body weight in dogs.” According to Pet Poison Helpline, common signs of ethylene glycol poisoning occur in stages. This hyperphosphatemia resolves before the onset of EG-induced acute renal failure and azotemia, then recurs when the animal becomes azotemic. Stage 3 - (36-72 hours after ingestion): At this stage, signs of severe kidney dysfunction, which is characterized by swollen, painful kidneys and the production of minimal to no urine, may occur. Cutaneous absorption from topical products that contain EG has been reported to cause toxicity in cats. Within 3 hr of ingestion of toxic doses of EG, dogs and cats develop normochloremic metabolic acidosis with an increased anion gap, minimally concentrated or isosthenuric urine with an acidic pH, and marked serum hyperosmolality with an increased osmolal gap. Monohydrate calcium oxalate crystals (clear, 6-sided prisms) are more common than dihydrate calcium oxalate crystals (maltese cross or envelope-shaped). This site complies with the HONcode standard for trustworthy health information: We do not control or have responsibility for the content of any third-party site. Ethylene glycol is converted by the liver into toxic byproducts that are damaging to the kidneys. Ethylene Glycol Poisoning in Dogs. Max has no prior history of seizures to the owners’ knowledge, but they have owned him for only three months. Again, because the antidote (fomepizole) is only effective if given within 8-12 hours in dogs, it is imperative that you see a veterinarian immediately. There are three recognised stages of ethylene glycol poisoning The widespread availability of antifreeze, its sweet taste and small minimum lethal dose, and the lack of public awareness of the toxicity (ie, improper storage and disposal) contribute to the frequency of this intoxication. Antifreeze poisoning occurs when pets drink antifreeze containing ethylene glycol. Ethylene glycol damages doggie kidneys by acting as a magnet for calcium. Prompt, immediate treatment is necessary in order to save a dog … Ethylene glycol has a very narrow margin of safety – which means only a tiny amount can result in severe poisoning. This damage can be identified in a serum biochemistry profile by increases in the levels of creatinine and BUN (blood urea nitrogen) that are normally removed from the blood by the kidneys. It is important to recognize the signs that accompany ethylene glycol poisoning with your dog or cat. Dogs may be attracted to ethylene glycol by its sweet taste. By as early as 24 hours after ingestion, insufficient ethylene glycol remains to allow detection on this blood test; however, the damage to your pet’s body from ethylene glycol has already occurred. Treatment is aimed at decreasing absorption of ingested EG, increasing excretion of unmetabolized EG, preventing metabolism of EG, and correcting the metabolic acidosis that occurs with EG metabolism. Toxic metabolites of EG cause severe metabolic acidosis and renal tubular epithelial damage. There is no known exposure to drugs, medications, toxins, compost, garbage, etc. Common clinical signs were ataxia, depression, vomiting, and hypothermia. Fainting 12. Propylene glycol poisoning in dogs is caused by ingesting propylene glycol. While the above treatment is appropriate for ethylene glycol poisoning in dogs, where it has already been metabolized this may not help. Ethylene glycol poisoning can set in rather quickly after the dog consumes it and will actually occur in stages. Dogs must be treated within 8-12 hours of ingesting antifreeze, as the antidote only has a narrow time period to work. EG concentrations in serum and urine are detectable by 1–2 hr after ingestion. Symptoms of ethylene glycol poisoning. Do not wait; time is of the essence and immediate treatment is essential! Four dogs were maintained at serum ethanol concentrations of 0, 35 and 140 mg/dl prior to EG (i.v., 2 ml/kg) administration. However, these types of tests may not be as accurate, and false positives can be seen (for instance, false positives may occur from products with similar chemical structures such as propylene glycol, glycerol, mannitol, isopropyl alcohol, sorbitol, etc.). Serum osmolality can be increased as much as 100 mOsm/kg above normal (280–310 mOsm/kg) within 3 hr of EG ingestion. Antifreeze and dogs. The oxidation of glycolic acid to glyoxylic acid is the second rate-limiting step, which allows glycolic acid to accumulate, resulting in acidosis and nephrotoxicosis. The minimum lethal dose of undiluted EG is 1.4 mL/kg body wt in cats, 4.4 mL/kg in dogs, 7–8 mL/kg in poultry, and 2–10 mL/kg in cattle. Ethylene glycol, a sweet-tasting, odorless liquid, is the active ingredient in most automotive antifreeze products. The animal becomes azotemic person who has had too much to alcohol drink help the world well... 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