Diagnosis, Treatment, Prognosis and Prevention. As CNS depression increases in severity, dogs and cats drink less; however, the osmotic diuresis continues and results in dehydration. Dogs may be attracted to ethylene glycol by its sweet taste. Urine fluorescence has been used as a qualitative adjunctive test in suspected EG ingestions in people and may be of value in veterinary medicine. As little as half a teaspoon per pound of a dog’s body weight can result in fatality. 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. Renal tubular epithelial necrosis with calcium oxalate crystals in the tubular lumina is the characteristic finding of EG intoxication. In dogs and cats with azotemia or in oliguric acute renal failure, inhibition of alcohol dehydrogenase is of little benefit, because almost all of the EG has already been metabolized. Thrall M A et al (1998) Advances in therapy for antifreeze poisoning. Most intoxications are associated with ingestion of antifreeze, which is typically 95% EG. Characteristic alterations in the hemogram and serum chemical profile included neutrophilia, lymphopenia, azot … A dog with ethylene glycol poisoning might suddenly start peeing every couple of minutes, or might develop urinary incontinence and have trouble "holding it." 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. 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. Within 30 minutes of ingestion, they may resemble a person who has had too much to alcohol drink. 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). Studies were made prior to and after ingestion on an hourly basis over a period of 8 to 10 hours. The Merck Veterinary Manual was first published in 1955 as a service to the community. Max has no prior history of seizures to the owners’ knowledge, but they have owned him for only three months. 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. 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. Diarrhea 7. 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. Signs include lethargy, anorexia, dehydration, vomiting, diarrhea, oral ulcers, salivation, tachypnea, and possibly seizures or coma. There are three recognised stages of ethylene glycol poisoning 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. Many animals will voluntarily drink ethylene glycol if antifreeze is spilled or leaks onto garage floors or driveways. Ethylene glycol has a very narrow margin of safety – which means only a tiny amount can result in severe poisoning. Weakness 10. The link you have selected will take you to a third-party website. but he is free to roam three acres … Propylene glycol poisoning in dogs is caused by ingesting propylene glycol. Ethylene glycol also forms acidic chemicals in the body, which can change the body's acid/base balance and affect your nervous system, lungs, and heart,” a … Seizures/Convulsions/Shaking tremors 11. • Dogs treated less than 5 hours following ingestion of ethylene glycol—prognosis is excellent with fomepizole treatment • Dogs treated up to 8 hours following ingestion of ethylene glycol—most recover • Dogs treated up to 36 hours following ingestion of ethylene glycol—may benefit from prevention of … It is most commonly encountered as automotive antifreeze.Diethylene glycol behaves similarly to ethylene glycol in an overdose. Clinicopathologic findings were retrospectively evaluated in 26 cats and 24 dogs with ethylene glycol intoxication. 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. In addition, antifreeze may be ingested by way of intentional poisoning or because it is the only available liquid in cold weather. Oxalate is not further metabolized and is cytotoxic to the renal tubular epithelium and exacerbates the metabolic acidosis. 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. 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. 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. While the above treatment is appropriate for ethylene glycol poisoning in dogs, where it has already been metabolized this may not help. This depression appears similar to ethanol intoxication, but without the characteristic odor of alcohol. Oliguric acute renal failure usually develops between 12 and 24 hr in cats and between 36 and 72 hr in dogs. Once absorption has occurred, excretion of EG is increased by fluid therapy designed to correct dehydration and increase urine production. Commercial test kits can detect serum EG concentrations of ≥50 mg/dL. Glycolic acid and oxalate are the metabolites thought to be most responsible for acute tubular necrosis associated with EG ingestion. Oxalate also combines with calcium to form a soluble complex that is excreted via glomerular filtration. Learn more. Glyoxylic acid is rapidly metabolized to formic acid, carbon dioxide, glycine, serine, and oxalate. During this stage, severe kidney failure is developing secondary to calcium oxalate crystals forming in the kidneys. Ethylene glycol (EG) poisoning is common in dogs and cats 1 – 4 and often results in death if it is not diagnosed and treated promptly. Other sources of EG include some heat-exchange fluids used in solar collectors and ice-rink freezing equipment and some brake and transmission fluids. 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. Ethylene Glycol Poisoning in Dogs. The trusted provider of veterinary information since 1955, Insecticides, Acaricides, and Molluscicides. When A Dog’s Sweet Tooth And Cars Collide. Serum osmolality can be increased as much as 100 mOsm/kg above normal (280–310 mOsm/kg) within 3 hr of EG ingestion. 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. Diagnosis is often difficult because the nonspecific multisystemic signs may appear similar to other types of CNS disease or trauma, gastroenteritis, pancreatitis, ketoacidotic diabetes mellitus, and acute renal failure due to renal ischemia or other nephrotoxicants. Toxic metabolites of EG cause severe metabolic acidosis and renal tubular epithelial damage. Signs of SLUD are most consistent with exposure to which of the following classes of chemicals? Propylene glycol is not as toxic as another common antifreeze ingredient known as ethylene glycol; however, it is still poisonous and dogs require medical treatment if ingested. Stage 3 (24 to 72 hours) kidney failure is the result of ethylene glycol poisoning. 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. If ingestion of EG is not witnessed, diagnosis is usually based on a combination of history, physical examination, and laboratory data. How do dogs get ethylene glycol poisoning? The formula 0.3 − (0.5 × kg body wt) × (24 − plasma bicarbonate) is used to determine the dose, in mEq of bicarbonate. This site complies with the HONcode standard for trustworthy health information: 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. Max is a 3 year old, castrated male Pit Bull mix that presented to Iowa Veterinary Specialties due to loss of balance and coordination, walking in circles, and urinating while walking. EG concentrations in serum and urine are detectable by 1–2 hr after ingestion. The active ingredient in antifreeze is a substance called ethylene glycol. 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. Whereas all animal species are susceptible, to ethylene glycol toxicity, cats … , DVM, MS, DACVIM, Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University. Acidosis (acidic blood) can also be detected through the biochemistry profile. Wobbly, uncoordinated movement 4. 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). Ethanol is the treatment of choice for cats and is administered for up to 64 hours. Younger animals may be more susceptible. 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. 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. 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 gap is caused by the presence of osmotically active particles (eg, ethylene glycol) in the serum that are not factored into the above equation. 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, … Toxic metabolites of EG cause severe metabolic acidosis and renal tubular epithelial damage. Depression 9. Pet Poison Helpline is not directly affiliated with LifeLearn. 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. 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. CNS depression begins soon after exposure, lasting for up to 12 hours after ingestion. This hyperphosphatemia resolves before the onset of EG-induced acute renal failure and azotemia, then recurs when the animal becomes azotemic. Dogs must be treated within 8-12 hours of ingesting antifreeze, as the antidote only has a narrow time period to work. ©Copyright VCA Hospitals all rights reserved. Drunken behavior 2. 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. Calcium oxalate crystals appear birefringent when viewed with polarized light. Coma Pulmonary edema and hemorrhagic gastroenteritis are common secondary findings in dogs and cats. 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.). Poultry may become drowsy, ataxic, dyspneic, and recumbent; torticollis, ruffled feathers, and watery droppings are also seen. 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. Fomepizole is expensive but life-saving when administered to dogs within the first 8-12 hours of ingestion. Car radiator coolant is the most dangerous because it can be made up entirely of ethylene glycol. Additional information can be found online at www.petpoisonhelpline.com. Emergency Situations, Treatment, Pet Services. Its concentration in automotive radiator fluid is high (95%), a source to which pets (dogs and cats) have easy access. It is given intravenously for 36 hours, and stops the metabolism of ethylene glycol into its damaging metabolites. Also, if this test kit is run too late, it may test falsely negative; in other words, since peak levels of ethylene glycol are detected in the first 1- 6 hours after ingestion of the toxin, it is important that this test kit be used early in the course of suspected poisonings. 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. 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. Monohydrate calcium oxalate crystals (clear, 6-sided prisms) are more common than dihydrate calcium oxalate crystals (maltese cross or envelope-shaped). 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. Vomiting should not be induced in a dog or cat exhibiting neurologic signs because of increased risk of aspiration. The difference between measured and calculated (1.86 [Na+ + K+] + glucose/18 + BUN/2.8 + 9) osmolality is referred to as the osmolal gap. The poison primarily affects the kidneys and can do irreversible damage. Within 24 hours, some animals show apparent improvement which may prevent pet owners from realizing that their pet is in r… verify here. The onset of clinical signs is almost immediate and resembles alcohol (ethanol) intoxication. Some common signs of antifreeze poisoning in dogs and cats include: 1. Pet Poison Helpline is available in North America by calling 800-213-6680. Gaynor A R et al (1999) Acute Ethylene Glycol Intoxication. The kidneys are often swollen and painful on abdominal palpation. Common clinical signs were ataxia, depression, vomiting, and hypothermia. Stage 1: This occurs within 30 minutes to 12 hours and looks similar to alcohol poisoning. Fomepizole (Antizol-Vet®, 4-methylpyrazole) is the treatment of choice for ethylene glycol poisoning in dogs. Fainting 12. Progressive depression, lethargy, lack of appetite, vomiting, seizures, coma, and death may be seen. Poultry usually do not develop gross lesions. Potential sources of ethylene glycol in the environment include antifreeze (the most common source of ethylene glycol poisoning), air-conditioning coolants, brake fluid, heat exchange fluids from so… *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. 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. Cattle may become depressed, tachypneic, and ataxic, and develop paraparesis or recumbency. (Blog #83) Dec 29, 2020 | Blog, Companion Blog, Dog Care, Dogs. Antifreeze poisoning occurs when pets drink antifreeze containing ethylene glycol. A test to determine the blood levels can be done at some veterinary diagnostic laboratories or human hospitals. Nausea/Vomiting 5. The best way to confirm ethylene glycol poisoning is by measuring the blood concentration of ethylene glycol. Pigs may also have pulmonary edema with tan fluid in the pleural and peritoneal cavities. Renal ultrasonographic changes were evaluated in 5 dogs administered 10 ml of commercial antifreeze (95% ethylene glycol)/kg of body weight, PO, and in 2 dogs given placebos. 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. In cats, this stage occurs 12–24 hours after consuming antifreeze; in dogs, at 36–72 hours after consuming antifreeze. 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. 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. Do not wait; time is of the essence and immediate treatment is essential! One-half of this dose should be given IV slowly to prevent overdose, and plasma bicarbonate concentrations should be monitored every 4–6 hr. Rapid heart beat 8. Especially if your dog has only licked a bit of motor oil. 4-Methylpyrazole (4-MP, fomepizole) effectively inactivates alcohol dehydrogenase in dogs without the adverse effects of ethanol and is the treatment of choice. 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. Prompt, immediate treatment is necessary in order to save a dog … Ethylene glycol damages doggie kidneys by acting as a magnet for calcium. 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). 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. Propylene glycol is a common ingredient in antifreeze, lubricants, and products of plasticity. Calif Vet 52, 18-22. Calcium oxalate crystalluria may be observed as early as 3 and 6 hr after ingestion in cats and dogs, respectively. Ethylene glycol poisoning can set in rather quickly after the dog consumes it and will actually occur in stages. Please confirm that you are a health care professional. Euphoria/Delirium 3. This chemical is extremely toxic to dogs and is also very sweet so they like the taste. Treatment should include correction of fluid, electrolyte, and acid-base disorders and, if possible, induction of diuresis. Dogs may appear to transiently recover from these CNS signs ~12 hr after ingestion. Hyperphosphatemia has been seen in dogs within 3 hr of ingestion of commercial antifreeze solutions that contain phosphate rust inhibitors. Ethylene glycol toxicosis is a type of poisoning that occurs after ingestion of antifreeze or other fluids containing the ingredient ethylene glycol. Ethylene glycol toxicosis is a type of poisoning that occurs in dogs after ingestion of antifreeze or other fluids containing the ingredient ethylene glycol. Some antifreeze preparations contain fluorescein, which appears bright yellow-green when viewed under a Wood’s lamp. Monitoring urine pH may also be helpful, with a goal of maintaining the urine pH between 7.0 and 7.5. Antifreeze carries a sweet taste, and only a relatively small amount need be consumed for a lethal dose. 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, during this stage, dogs become dehydrated, and develop an elevated breathing and heart rate. EG is rapidly absorbed from the GI tract; in dogs, blood concentrations of EG peak within 3 hr of ingestion. The metabolic acidosis associated with metabolism of EG is corrected by administration of sodium bicarbonate. Activated charcoal is not likely to reduce absorption of EG from the GI tract. A pharmacokinetic study was conducted to determine the effectiveness of lower doses of ethanol in the treatment of ethylene glycol (EG) poisoning. Symptoms of ethylene glycol poisoning. All dogs were anesthetized … Dogs like sweet things. Clinical signs are dose- and time-dependent and can be divided into those caused by unmetabolized EG and those caused by its toxic metabolites. Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. The acronym SLUD stands for salivation, lacrimation, urination, and defecation, which are the clinical signs associated with muscarinic cholinergic overstimulation caused by certain toxins. We’re committed to keeping clients and staff safe during COVID-19 with NEW admittance and check-out processes. Untreated, antifreeze poisoning can be fatal to pets. Best Answer Treatment for ethylene glycol poisoning includes the antidote fomepizole (also known as 4-MP) or ethanol. 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 … Antifreeze poisoning in dogs typically occur when ethylene glycol, one of the main ingredients in antifreeze, leaks from car radiators or screen wash containers. EG is rapidly absorbed from the GI tract; in dogs, blood concentrations of EG peak within 3 hr of ingestion. 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. Contributors: Kristiina Ruotsalo, DVM, DVSc, Dip ACVP & Margo S. Tant BSc, DVM, DVSc & Ahna Brutlag, DVM, MS, DABT, DABVT, Veterinarian approved Preventive Care products. Pigs ingesting EG are usually depressed, weak, and reluctant to move; knuckling, posterior ataxia, trembling, collapse, abdominal distention, pulmonary edema, and muffled heart sounds are common sequelae. Excessive urination 6. To prevent metabolism of EG, the activity of alcohol dehydrogenase is decreased by direct inactivation or by competitive inhibition. As … Epistaxis and hemoglobinuria have also been seen in cattle that have ingested large doses of EG. All animals are susceptible to ethylene glycol (EG) toxicity, but it is most common in dogs and cats. 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). These 95% commercial antifreeze preparations are diluted ~50% with water when used in vehicle cooling systems. The prognosis varies inversely with the amount of time that elapses between ingestion and initiation of treatment.