Canis ISSN: 2398-2942
Ethylene glycol poisoning
Synonym(s): Antifreeze poisoning
Contributor(s): Dawn Ruben, Larry Thompson
Introduction
- One of the most common poisonings.
- Highly palatable, drunk willingly, especially if no other water sources available.
- Signs: vomiting, ataxia, polydipsia.
- Treatment: ethanol, supportive fluid therapy, 4-methyl pyrazole.
- Cause: antifreeze poisoning.
- Diagnosis: signs, history, urinalysis, serum chemistry, commercial test kit.
- Prognosis: guarded if delayed presentation.
Follow the diagnostic tree for Evaluating Ataxia in Suspected Ethylene Glycol Toxicity Evaluating Ataxia in Suspected Ethylene Glycol Toxicity.
Pathogenesis
Etiology
- Antifreeze consumed as concentrated solution. (undiluted = 95% ethylene glycol, working solution in car radiator is 50%).
- Poisoning from drained radiator water.
- Malicious poisoning.
Pathophysiology
- Gastric irritant, metabolites are cytotoxic.
- Absorption slowed by presence of food in gut.
- Rapidly absorbed from GI tract and distributed in circulation.
- Metabolized in liver.
- Ethylene glycol → glycoaldehyde → glycolate → oxalate.
- Excreted via kidneys.
- Aldehydes cause central nervous system (CNS) toxicity.
- Oxalate crystal formation → renal tubular damage.
- Metabolites cytotoxic to renal tubular cells, also contribute to metabolic acidosis.
- LD50 2-6 mg/kg (3-5 ml/kg).
Timecourse
- Signs occur within 1 hour of ingestion, usually mild incoordination and ataxia. These resolve quickly.
- Urinary excretion evident between 6-48 h.
- 1-6 h CNS signs predominate.
- 12-24 h cardiopulmonary signs appear.
- 24-72 h oliguric renal failure.
- Onset is quicker with greater ingestions.
Diagnosis
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Treatment
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Gaynor A R et al (1999) Acute Ethylene Glycol Intoxication. Part II. Diagnosis, Treatment, Prognosis and Prevention. Comp Contin Educ Pract Vet 21 (12), 1124-1133 VetMedResource.
- Thrall M A et al (1998) Advances in therapy for antifreeze poisoning. Calif Vet 52, 18-22.
- Murphy M J (1994) Toxin exposure in dogs and cats - drugs and household products. JAVMA 205 (4), 557-560 VetMedResource.
- Crisp M S et al (1989) Peritoneal dialysis in dogs and cats - 27 cases (1976-1987). JAVMA 195 (9), 1262-1266 PubMed.
Organisation(s)