pathophysiology of ethylene glycol toxicity in cats

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 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. Antifreeze is the main source of exposure, but ethylene glycol is also used in a variety of household products including cleaning Most intoxications are associated with ingestion of antifreeze, which is typically 95% EG. 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. Ethylene glycol (antifreeze): Antifreeze remains one of the most common causes of poisoning in small animals. Officially known as ethylene glycol, antifreeze is also found in some inks and snowglobes. 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? The legacy of this great resource continues in the online and mobile app versions today. Again, because the antidote (fomepizole) is only effective if given within 3 hours of ingestion, it is imperative that you see a veterinarian immediately. 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. Toxicokinetics. Oxalate is not further metabolized and is cytotoxic to the renal tubular epithelium and exacerbates the metabolic acidosis. These 95% commercial antifreeze preparations are diluted ~50% with water when used in vehicle cooling systems. Causes. Monohydrate calcium oxalate crystals (clear, 6-sided prisms) are more common than dihydrate calcium oxalate crystals (maltese cross or envelope-shaped). Limited information is available on the pathological features of EG poisoning in pet animals, with special emphasis on cats. 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. This testing method is very accurate, but not always available in the middle of the night. 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. Commercial test kits can detect serum EG concentrations of ≥50 mg/dL. The formula 0.3 − (0.5 × kg body wt) × (24 − plasma bicarbonate) is used to determine the dose, in mEq of bicarbonate. Oxalate also combines with calcium to form a soluble complex that is excreted via glomerular filtration. Most intoxication is associated with ingestion of radiator antifreeze which is usually 95% EG. The prognosis varies inversely with the amount of time that elapses between ingestion and initiation of treatment. Limited information is available on the pathological features of EG poisoning in pet animals, with special emphasis on cats. Symptoms of ethanol poisoning may also be similar to early stages of antifreeze (ethylene glycol) poisoning. Progressive depression, lethargy, lack of appetite, vomiting, seizures, coma, and death may be seen. The gastrointestinal tract is the primary route of exposure. Emergency Situations, Treatment, Pet Services. The lethal dose for dogs is 2-3 ml/lb, and for cats it is 0.64 ml/lb. Vomiting should not be induced in a dog or cat exhibiting neurologic signs because of increased risk of aspiration. 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). Poultry may become drowsy, ataxic, dyspneic, and recumbent; torticollis, ruffled feathers, and watery droppings are also seen. Ethylene glycol has a sweet taste … 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. Ethylene glycol (EG) was orally administered to 27 cats at dose levels of 4, 6, or 8 ml/kg of body weight. Ethylene glycol toxicity Ethylene glycol poisoning. Glycolaldehyde is then rapidly metabolized to glycolic acid. Ethylene glycol is metabolized in the animal’s body to several extremely toxic chemicals that are responsible for its potentially lethal effects. 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. Renal tubular epithelial necrosis with calcium oxalate crystals in the tubular lumina is the characteristic finding of EG intoxication. A test to determine the blood levels can be done at some veterinary diagnostic laboratories or human hospitals. 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. Please confirm that you are a health care professional. Pathophysiology. Signs: Triphasic clinical syndrome. This site complies with the HONcode standard for trustworthy health information: verify here. Urine fluorescence has been used as a qualitative adjunctive test in suspected EG ingestions in people and may be of value in veterinary medicine. [emedicine.com] Pathophysiology There is limited data regarding DEG and most information is derived from published experimental studies. 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. metabolic acidosis. Ethanol poisoning can occur from the ingestion of a variety of products. It is important to recognize the signs that accompany ethylene glycol poisoning with your dog or cat. Do not wait; time is of the essence and immediate treatment is essential! The kidneys are often swollen and painful on abdominal palpation. 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. The metabolic acidosis associated with metabolism of EG is corrected by administration of sodium bicarbonate. It is often claimed that cats are attracted to the sweet taste of antifreeze, but as cats cannot taste sweet. The trusted provider of veterinary information since 1955. The first of two rate-limiting biotransformation steps is the production of glycoaldehyde from EG by the enzyme alcohol dehydrogenase. Within 24 hours, some animals show apparent improvement which may prevent pet owners from realizing that their pet is in r… That is roughly 16 mL of 50% ethylene glycol for an 80 kg adult and 4 mL for a 20 kg child. The clinical signs associated with ethylene glycol intoxication > “In both dogs and cats, toxic doses of ethylene glycol cause CNS depression followed by acute … As little as one eighth of a teaspoon per pound of body weight in a cat of undiluted antifreeze can result in fatality. Commercial formulations of 4-MP are available. 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 toxic dose of undiluted antifreeze in cats is 1.4ml per kg body weight This means a standard 10lb (4.5kg) cat only needs to drink a little over 6ml of antifreeze to develop a fatal poisoning. renal tubules. Ethylene glycol itself may cause some alteration of mental status but it is a relatively nontoxic compound before it is metabolized. Other sources of EG include some heat-exchange fluids used in solar collectors and ice-rink freezing equipment and some brake and transmission fluids. Epistaxis and hemoglobinuria have also been seen in cattle that have ingested large doses of EG. We’re committed to keeping clients and staff safe during COVID-19 with NEW admittance and check-out processes. 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. Whereas all animal species are susceptible, to ethylene glycol toxicity, cats remain more susceptible. 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. All animals are susceptible to ethylene glycol (EG) toxicity, but it is most common in dogs and cats. This hyperphosphatemia resolves before the onset of EG-induced acute renal failure and azotemia, then recurs when the animal becomes azotemic. Ethylene glycol, the toxic component of antifreeze, causes severe kidney damage. 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. The widespread availability of antifreeze, its sweet taste, and small minimum lethal dose contribute to the frequency of this intoxication. Calcium oxalate crystals appear birefringent when viewed with polarized light. 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. 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. Treatment should include correction of fluid, electrolyte, and acid-base disorders and, if possible, induction of diuresis. 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. 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. 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. All animals (including humans) are susceptible to ethylene glycol poisoning, but cats are more susceptible than most due to differences in their metabolism. And oxalate ) intoxication extremely toxic to humans and is also toxic to humans and is also as... Watery droppings are also seen 7.0 and 7.5 clients and staff safe during COVID-19 with NEW and. 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Should not be induced in a cat of undiluted antifreeze can result in severe poisoning pathological findings,.! Zoopro lattico Sperimentale del Lazio e della Toscana `` M. Aleandri '', Rome, Italy some screen washes but! Most intoxication is associated with ingestion of radiator antifreeze which has been disposed of improperly sodium.! And between 36 and 72 hr in dogs and cats best way to confirm ethylene glycol, Ethylen,...

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