As little as one eighth of a teaspoon per pound of body weight in a cat of undiluted antifreeze can result in fatality. One-half of this dose should be given IV slowly to prevent overdose, and plasma bicarbonate concentrations should be monitored every 4–6 hr. As little as one eighth of a teaspoon per pound of body weight in a cat of undiluted antifreeze can result in fatality. Primary (spontaneous or traumatic) - secondary to systemic or ocular disease. The link you have selected will take you to a third-party website. This testing method is very accurate, but not always available in the middle of the night. One of the most common toxicities in dogs and cats is ethylene glycol (EG) toxicity. We’re committed to keeping clients and staff safe during COVID-19 with NEW admittance and check-out processes. 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. All animals are susceptible to ethylene glycol (EG) toxicity, but it is most common in dogs and cats. 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. Stage 1 (within 30 minutes of ingestion): The signs include lethargy, vomiting, incoordination, excessive urination, excessive thirst, hypothermia (low body temperature), seizures, and coma. There are 15 ml in a tablespoon, so figure1 tablespoon (30 ml) per Papillion could be lethal, and a teaspoon is lethal for a cat. Ethylene glycol poisoning is divided into three stages. That is roughly 16 mL of 50% ethylene glycol for an 80 kg adult and 4 mL for a 20 kg child. 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. –Pathophysiology: Initially a direct effect of ethylene glycol, which in low doses causes euphoria and in high doses causes CNS depression. Calcium oxalate crystals appear birefringent when viewed with polarized light. The clinical signs associated with ethylene glycol intoxication > “In both dogs and cats, toxic doses of ethylene glycol cause CNS depression followed by acute … It is a colorless, odorless, and sweet-tasting solution. The best way to confirm ethylene glycol poisoning is by measuring the blood concentration of ethylene glycol. Left untreated, the animal may die. Ethylene glycol (EG) was orally administered to 27 cats at dose levels of 4, 6, or 8 ml/kg of body weight. The lethal dose for dogs is 2-3 ml/lb, and for cats it is 0.64 ml/lb. In addition, antifreeze may be ingested by way of intentional poisoning or because it is the only available liquid in cold weather. Ethylene glycol tastes sweet, which is why some animals are attracted to it. Ingestion of sufficient quantities of avocado fruit is most likely to cause myocardial necrosis in which of the following species? About. 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. All animals are susceptible to ethylene glycol (EG) toxicity, but it is most common in dogs and cats. Pet Poison Helpline is available in North America by calling 800-213-6680. 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. The first of two rate-limiting biotransformation steps is the production of glycoaldehyde from EG by the enzyme alcohol dehydrogenase. 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. What are the signs of antifreeze poisoning in cats? The fluorescein in the fluid fluoresces when viewed under ultraviolet light. The widespread availability of antifreeze, its sweet taste, and small minimum lethal dose contribute to the frequency of this intoxication. Stage 3 (12-24 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. The ethylene glycol is rapidly absorbed into the body after drinking, and triggers signs to appear from as little at 30 minutes to up to 8 hours after ingestion. Treatment was initiated 4 or 8 hours later and consisted of giving (intraperitoneal injection, IP) 5 ml of 20% ethanol in isotonic saline solution and 6 ml of 5% sodium bicarbonate in isotonic saline solution per kilogram of body weight. It is important to recognize the signs that accompany ethylene glycol poisoning with your dog or cat. Glyoxylic acid is rapidly metabolized to formic acid, carbon dioxide, glycine, serine, and oxalate. Key words: ethylene glycol, intoxication, cat. Ethylene glycol, a sweet-tasting, odorless liquid, is the active ingredient in antifreeze. 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. Antifreeze poisoning in cats Antifreeze is found in car radiators and some screen washes, but it is extremely toxic to cats. The prognosis varies inversely with the amount of time that elapses between ingestion and initiation of treatment. This site complies with the HONcode standard for trustworthy health information: verify here. Causes. Ethylene Glycol Poisoning … Pathophysiology [2] Like the other toxic alcohols mentioned above, ethylene glycol is a parent compound that exerts most of its toxicity by conversion to metabolites. Monohydrate calcium oxalate crystals (clear, 6-sided prisms) are more common than dihydrate calcium oxalate crystals (maltese cross or envelope-shaped). EG concentrations in serum and urine are detectable by 1–2 hr after ingestion. Cats that roam outside unsupervised are more likely to encounter ethylene glycol in antifreeze which has been disposed of improperly. Acidosis (acidic blood) can also be detected through the biochemistry profile. 4-Methylpyrazole (4-MP, fomepizole) effectively inactivates alcohol dehydrogenase in dogs without the adverse effects of ethanol and is the treatment of choice. 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. Phase 1 signs include ataxia and a … These 95% commercial antifreeze preparations are diluted ~50% with water when used in vehicle cooling systems. Ethylene glycol has a very narrow margin of safety – which means only a tiny amount can result in severe poisoning. Most intoxications are associated with ingestion of antifreeze, which is typically 95% EG. The trusted provider of veterinary information since 1955. Ethylene glycol … 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. renal tubules. Do not wait; time is of the essence and immediate treatment is essential! 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. fluid diuresis, dialysis, IV ethanol or 4-Methylpyrazole (4-MP, fomepizole) signs of zinc toxicity. Partial (focal or multifocal) - total. Glycolaldehyde is then rapidly metabolized to glycolic acid. EG is rapidly absorbed from the GI tract; in dogs, blood concentrations of EG peak within 3 hr of ingestion. This hyperphosphatemia resolves before the onset of EG-induced acute renal failure and azotemia, then recurs when the animal becomes azotemic. Ethylene glycol consumed as concentrated solution of antifreeze or screenwash. Pathophysiology [2] Like the other toxic alcohols mentioned above, ethylene glycol is a parent compound that exerts most of its toxicity by conversion to metabolites. 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. The toxic component of antifreeze is called ethylene glycol. The metabolic acidosis associated with metabolism of EG is corrected by administration of sodium bicarbonate. Ethylene glycol exposure can be extremely dangerous, with significant morbidity and mortality if … Ethylene glycol (EG) is a well known toxic compound, the assumption of which can be fatal to pet animals as well as to humans. Ethylene glycol, the toxic component of antifreeze, causes severe kidney damage. Pulmonary edema and hemorrhagic gastroenteritis are common secondary findings in dogs and cats. 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. Officially known as ethylene glycol, antifreeze is also found in some inks and snowglobes. Serum osmolality can be increased as much as 100 mOsm/kg above normal (280–310 mOsm/kg) within 3 hr of EG ingestion. Cats like the smell and taste of it, and it only takes 1.5ml/kg for a lethal dose in cats. A test to determine the blood levels can be done at some veterinary diagnostic laboratories or human hospitals. Toxicity: Ethylene glycol is the main toxic ingredient found in most antifreeze products, usually at a concentration of 95-97%.It is an extremely dangerous toxin. 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. Some antifreeze preparations contain fluorescein, which appears bright yellow-green when viewed under a Wood’s lamp. 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. We do not control or have responsibility for the content of any third-party site. Dogs may appear to transiently recover from these CNS signs ~12 hr after ingestion. Most intoxications are associated with ingestion of antifreeze, which is typically 95% EG. Ethylene glycol has a sweet taste, which means animals and even children can be drawn to it. The prognosis for these animals is guarded to poor. Glycolic acid and oxalate are the metabolites thought to be most responsible for acute tubular necrosis associated with EG ingestion. Oliguric acute renal failure usually develops between 12 and 24 hr in cats and between 36 and 72 hr in dogs. Poultry usually do not develop gross lesions. 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). Urine fluorescence has been used as a qualitative adjunctive test in suspected EG ingestions in people and may be of value in veterinary medicine. 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). Toxicokinetics. Fermented products such as bread dough and rotten apples, food that a cat can easily find while digging through the garbage, is one source of toxicity. Many animals will voluntarily drink ethylene glycol if antifreeze is spilled or leaks onto garage floors or driveways. Hypertension Hypertension vascular pathology → incompetence and leakage of plasma and fibrinogen. What are the signs of ethylene glycol poisoning? Reproductive Toxicity. The term “toxic alcohols” is a collective term that includes methanol, ethylene glycol, and isopropyl alcohol. Often implicated in cases of malicious poisoning in cats. metabolic acidosis. The Veterinary Manual was first published in 1955 as a service to the community. The active ingredient is ethylene glycol (EG), a clear, odourless liquid with a sweet taste, earning it the name ‘sweet killer’.. Ethylene glycol (EG) intoxication is one of the most common causes of acute kidney injury (AKI) and the second most common intoxication encountered in pet animals. , DVM, MS, DACVIM, Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University. Limited information is available on the pathological features of EG poisoning in pet animals, with special emphasis on cats. Animals with ethylene glycol intoxication (see Ethylene Glycol Toxicity) also have severe metabolic acidosis, azotemia, and hyperphosphatemia from the oliguric renal failure, which results from calcium oxalate crystal precipitation in the renal tubules. Ethylene glycol polymers with large carbon chains may be reproductive toxins, but ethylene glycol itself exhibits no developmental toxicity or detrimental effects to reproductive health in humans. The gastrointestinal tract is the primary route of exposure. (1)Istituto Zoopro lattico Sperimentale del Lazio e della Toscana "M. Aleandri", Rome, Italy. treatment for ethylene glycol toxicity in cats. Please confirm that you are a health care professional. Fluid accumulation results in extensive bullous detachment. As CNS depression increases in severity, dogs and cats drink less; however, the osmotic diuresis continues and results in dehydration. Ethylene glycol is metabolized in the animal’s body to several extremely toxic chemicals that are responsible for its potentially lethal effects. Pigs may also have pulmonary edema with tan fluid in the pleural and peritoneal cavities. 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. Cats may be attracted to ethylene glycol by its sweet taste. 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. J.J. Devlin, M. Schwartz, in Encyclopedia of Toxicology (Third Edition), 2014. Activated charcoal is not likely to reduce absorption of EG from the GI tract. 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.). Treatment should include correction of fluid, electrolyte, and acid-base disorders and, if possible, induction of diuresis. A teaspoon of ethylene glycol could kill your cat. Epistaxis and hemoglobinuria have also been seen in cattle that have ingested large doses of EG. Again, because the antidote (fomepizole) is only effective if given within 3 hours of ingestion, it is imperative that you see a veterinarian immediately. 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. Pet Poison Helpline is not directly affiliated with LifeLearn. Commercial formulations of 4-MP are available. Emergency Situations, Treatment, Pet Services. 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. Ethylene glycol itself may cause some alteration of mental status but it is a relatively nontoxic compound before it is metabolized. Ethylene glycol poisoning is divided into three stages. A toxic dose requiring medical treatment varies but is considered more than 0.1 mL per kg body weight (mL/kg) of pure substance. 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). Cattle may become depressed, tachypneic, and ataxic, and develop paraparesis or recumbency. Commercial test kits can detect serum EG concentrations of ≥50 mg/dL. Summary Ethylene glycol (EG) is a well known toxic compound, the assumption of which can be fatal to pet animals as well as to humans. Cats like drinking from ditches, puddles and ponds which means they’re prone to drinking water contaminated with antifreeze. Whereas all animal species are susceptible, to ethylene glycol toxicity, cats remain more susceptible. It is critical that you bring your cat 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. Ethylene glycol has a sweet taste … 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. Ethylene glycol, which is most commonly encountered in antifreeze, causes acidosis and renal failure and is a frequent cause of lethal poisoning in companion animals, particularly cats. Ethylene glycol, also called 1,2-ethanediol, is a viscous liquid with a sweet taste. Ethylene glycol toxicity Ethylene glycol poisoning. Ethylene glycol itself is a colourless fluid although the solutions it is commonly found in are often coloured in an attempt to prevent accidental ingestion. Vomiting should not be induced in a dog or cat exhibiting neurologic signs because of increased risk of aspiration. Progressive depression, lethargy, lack of appetite, vomiting, seizures, coma, and death may be seen. Ethylene glycol (C2H6O2) is a toxic alcohol that is found in various household and industrial agents. If ingestion of EG is not witnessed, diagnosis is usually based on a combination of history, physical examination, and laboratory data. Ethylene Glycol Poisoning in Dogs. 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). Cat, Ethylen glycol, Ethylen glycol toxicity, Pathological findings, Poisoning. Ethylene glycol has been shown to be toxic to humans and is also toxic to domestic pets such as cats and dogs. Toxic metabolites of EG cause severe metabolic acidosis and renal tubular epithelial damage. 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. Pathophysiology. {ref2}Like the other toxic alcohols mentioned above, ethylene glycol is a parent compound that exerts most of its toxicity by conversion to metabolites. Oxalate also combines with calcium to form a soluble complex that is excreted via glomerular filtration. https://www.petmd.com/cat/conditions/urinary/c_ct_antifreeze_poisoning Monitoring urine pH may also be helpful, with a goal of maintaining the urine pH between 7.0 and 7.5. The difference between measured and calculated (1.86 [Na+ + K+] + glucose/18 + BUN/2.8 + 9) osmolality is referred to as the osmolal gap. To prevent metabolism of EG, the activity of alcohol dehydrogenase is decreased by direct inactivation or by competitive inhibition. *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. Renal tubular epithelial necrosis with calcium oxalate crystals in the tubular lumina is the characteristic finding of EG intoxication. The formula 0.3 − (0.5 × kg body wt) × (24 − plasma bicarbonate) is used to determine the dose, in mEq of bicarbonate. Hyperphosphatemia has been seen in dogs within 3 hr of ingestion of commercial antifreeze solutions that contain phosphate rust inhibitors. Ethylene glycol poisoning can be fatal if not treated soon after ingestion (within 4 to 8 hours). Ethanol poisoning can occur from the ingestion of a variety of products. Incoordination, excessive urination, excessive thirst, vomiting, and lethargy are amongst the first signs to appear. 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. 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. Within 24 hours, some animals show apparent improvement which may prevent pet owners from realizing that their pet is in r… 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. Younger animals may be more susceptible. It is often claimed that cats are attracted to the sweet taste of antifreeze, but as cats cannot taste sweet. 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. Cats do not taste ‘sweetness’ in the same way we do, but still find drinking ethylene glycol attractive. Cats must be treated within 3 hours of ingesting antifreeze, as the antidote only has a narrow time period to work. Once absorption has occurred, excretion of EG is increased by fluid therapy designed to correct dehydration and increase urine production. Ethylene glycol (antifreeze): Antifreeze remains one of the most common causes of poisoning in small animals. Ingestion of ethylene glycol (EG) is a frequently encountered toxicity in dogs and cats. Clinical signs are dose- and time-dependent and can be divided into those caused by unmetabolized EG and those caused by its toxic metabolites. Limited information is available on the pathological features of EG poisoning in pet animals, with special emphasis on cats. 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. These 95% commercial antifreeze preparations are diluted ~50% with water when used in vehicle cooling systems. Learn more. 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. Additional doses of bicarbonate based on the above formula are frequently necessary. Merck & Co., Inc., Kenilworth, NJ, USA (known as MSD outside of the US and Canada) is a global healthcare leader working to help the world be well. 1,2 It is nonvolatile at ambient temperatures and has a molecular weight of 62.07 g/mol. Signs include lethargy, anorexia, dehydration, vomiting, diarrhea, oral ulcers, salivation, tachypnea, and possibly seizures or coma. Symptoms of ethanol poisoning may also be similar to early stages of antifreeze (ethylene glycol) poisoning. Poisoning from drained vehicle radiator fluid. All animals (including humans) are susceptible to ethylene glycol poisoning, but cats are more susceptible than most due to differences in their metabolism. However, during this stage, cats become dehydrated, and develop an elevated breathing and heart rate. 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 and cattle often develop renal and perirenal edema. Ethylene glycol has a very narrow margin of safety – which means only a tiny amount can result in severe poisoning. Ethylene glycol is converted by the liver into toxic byproducts that are damaging to the kidneys. Oxalate is not further metabolized and is cytotoxic to the renal tubular epithelium and exacerbates the metabolic acidosis. Without treatment, ethylene glycol toxicity is most often fatal. 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. The pH derangement seen with ethylene glycol toxicity is _____. 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 onset of clinical signs is almost immediate and resembles alcohol (ethanol) intoxication. Antifreeze is a common product used in car radiators to lower the freezing point of water in cooler climates. Diagnosis is usually 95 % commercial antifreeze preparations are diluted ~50 % with water when used in car radiators some. 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