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. Dogs may appear to transiently recover from these CNS signs ~12 hr after ingestion. That is roughly 16 mL of 50% ethylene glycol for an 80 kg adult and 4 mL for a 20 kg child. Ethylene glycol causes renal damage when toxic metabolites reach the _____. Epistaxis and hemoglobinuria have also been seen in cattle that have ingested large doses of EG. The gastrointestinal tract is the primary route of exposure. Poultry may become drowsy, ataxic, dyspneic, and recumbent; torticollis, ruffled feathers, and watery droppings are also seen. Ethylene glycol has a sweet taste … EG is rapidly absorbed from the GI tract; in dogs, blood concentrations of EG peak within 3 hr of ingestion. However, during this stage, cats become dehydrated, and develop an elevated breathing and heart rate. 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. As little as one eighth of a teaspoon per pound of body weight in a cat of undiluted antifreeze can result in fatality. Ethylene glycol (C2H6O2) is a toxic alcohol that is found in various household and industrial agents. Primary (spontaneous or traumatic) - secondary to systemic or ocular disease. 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. Pet Poison Helpline is not directly affiliated with LifeLearn. 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. *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. Ethylene glycol, the toxic component of antifreeze, causes severe kidney damage. Most intoxications are associated with ingestion of antifreeze, which is typically 95% EG. metabolic acidosis. 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. J.J. Devlin, M. Schwartz, in Encyclopedia of Toxicology (Third Edition), 2014. Ethylene glycol exposure can be extremely dangerous, with significant morbidity and mortality if … Cats do not taste ‘sweetness’ in the same way we do, but still find drinking ethylene glycol attractive. The active ingredient is ethylene glycol (EG), a clear, odourless liquid with a sweet taste, earning it the name ‘sweet killer’.. The clinical signs associated with ethylene glycol intoxication > “In both dogs and cats, toxic doses of ethylene glycol cause CNS depression followed by acute … Poultry usually do not develop gross lesions. Often implicated in cases of malicious poisoning in cats. Ethylene glycol has a sweet taste, which means animals and even children can be drawn to it. Younger animals may be more susceptible. 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. All animals (including humans) are susceptible to ethylene glycol poisoning, but cats are more susceptible than most due to differences in their metabolism. The onset of clinical signs is almost immediate and resembles alcohol (ethanol) intoxication. It is a colorless, odorless, and sweet-tasting solution. Ingestion of ethylene glycol (EG) is a frequently encountered toxicity in dogs and cats. Serum osmolality can be increased as much as 100 mOsm/kg above normal (280–310 mOsm/kg) within 3 hr of EG ingestion. 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. (1)Istituto Zoopro lattico Sperimentale del Lazio e della Toscana "M. Aleandri", Rome, Italy. Pigs may also have pulmonary edema with tan fluid in the pleural and peritoneal cavities. A toxic dose requiring medical treatment varies but is considered more than 0.1 mL per kg body weight (mL/kg) of pure substance. Poisoning from drained vehicle radiator fluid. Additional doses of bicarbonate based on the above formula are frequently necessary. 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). EG concentrations in serum and urine are detectable by 1–2 hr after ingestion. Learn more. Cutaneous absorption from topical products that contain EG has been reported to cause toxicity in cats. Toxicokinetics. Once absorption has occurred, excretion of EG is increased by fluid therapy designed to correct dehydration and increase urine production. It is important to recognize the signs that accompany ethylene glycol poisoning with your dog or cat. [emedicine.com] Pathophysiology There is limited data regarding DEG and most information is derived from published experimental studies. Left untreated, the animal may die. Ethylene glycol is converted by the liver into toxic byproducts that are damaging to the kidneys. Ethylene glycol, a sweet-tasting, odorless liquid, is the active ingredient in antifreeze. This site complies with the HONcode standard for trustworthy health information: verify here. 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. Signs include lethargy, anorexia, dehydration, vomiting, diarrhea, oral ulcers, salivation, tachypnea, and possibly seizures or coma. A test to determine the blood levels can be done at some veterinary diagnostic laboratories or human hospitals. Ethanol poisoning can occur from the ingestion of a variety of products. 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. Glycolaldehyde is then rapidly metabolized to glycolic acid. Contributors: Kristiina Ruotsalo, DVM, DVSc, Dip ACVP & Margo S. Tant BSc, DVM, DVSc & Ahna Brutlag, DVM, MS, DABT, DABVT, Veterinarian approved Preventive Care products. Activated charcoal is not likely to reduce absorption of EG from the GI tract. In addition, antifreeze may be ingested by way of intentional poisoning or because it is the only available liquid in cold weather. 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. Ethylene glycol poisoning is divided into three stages. All animals are susceptible to ethylene glycol (EG) toxicity, but it is most common in dogs and cats. Limited information is available on the pathological features of EG poisoning in pet animals, with special emphasis on cats. To prevent metabolism of EG, the activity of alcohol dehydrogenase is decreased by direct inactivation or by competitive inhibition. 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. 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. Commercial test kits can detect serum EG concentrations of ≥50 mg/dL. Calcium oxalate crystals appear birefringent when viewed with polarized light. {ref2}Like the other toxic alcohols mentioned above, ethylene glycol is a parent compound that exerts most of its toxicity by conversion to metabolites. Symptoms of ethanol poisoning may also be similar to early stages of antifreeze (ethylene glycol) poisoning. 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.). 4-Methylpyrazole (4-MP, fomepizole) effectively inactivates alcohol dehydrogenase in dogs without the adverse effects of ethanol and is the treatment of choice. 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. The fluorescein in the fluid fluoresces when viewed under ultraviolet light. 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). Clinical signs are dose- and time-dependent and can be divided into those caused by unmetabolized EG and those caused by its toxic metabolites. Within 24 hours, some animals show apparent improvement which may prevent pet owners from realizing that their pet is in r… , DVM, MS, DACVIM, Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University. Ethylene glycol has a very narrow margin of safety – which means only a tiny amount can result in severe poisoning. Most intoxication is associated with ingestion of radiator antifreeze which is usually 95% EG. What are the signs of ethylene glycol poisoning? Cats that roam outside unsupervised are more likely to encounter ethylene glycol in antifreeze which has been disposed of improperly. Causes. Emergency Situations, Treatment, Pet Services. Ethylene glycol poisoning can be fatal if not treated soon after ingestion (within 4 to 8 hours). The lethal dose for dogs is 2-3 ml/lb, and for cats it is 0.64 ml/lb. Signs: Triphasic clinical syndrome. Pathophysiology. Key words: ethylene glycol, intoxication, cat. 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. Pigs and cattle often develop renal and perirenal edema. All animals are susceptible to ethylene glycol (EG) toxicity, but it is most common in dogs and cats. 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. 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. Pulmonary edema and hemorrhagic gastroenteritis are common secondary findings in dogs and cats. Vomiting should not be induced in a dog or cat exhibiting neurologic signs because of increased risk of aspiration. Phase 1 signs include ataxia and a … Ethylene glycol … Cats like drinking from ditches, puddles and ponds which means they’re prone to drinking water contaminated with antifreeze. Oxalate is not further metabolized and is cytotoxic to the renal tubular epithelium and exacerbates the metabolic acidosis. 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. If ingestion of EG is not witnessed, diagnosis is usually based on a combination of history, physical examination, and laboratory data. Antifreeze is a common product used in car radiators to lower the freezing point of water in cooler climates. Cat, Ethylen glycol, Ethylen glycol toxicity, Pathological findings, Poisoning. Please confirm that you are a health care professional. 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. About. Some antifreeze preparations contain fluorescein, which appears bright yellow-green when viewed under a Wood’s lamp. 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. Commercial formulations of 4-MP are available. The metabolic acidosis associated with metabolism of EG is corrected by administration of sodium bicarbonate. The prognosis for these animals is guarded to poor. ©Copyright VCA Hospitals all rights reserved. Ethylene glycol, also called 1,2-ethanediol, is a viscous liquid with a sweet taste. 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. 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. Consumption of the fruit, seed, stem, or leaves of avocados can cause toxicity in animals. Ethylene glycol poisoning is most common in temperate and cold climates because antifreeze is used both to decrease the freezing point and to increase the boiling point of radiator fluid. 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. 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. treatment for ethylene glycol toxicity in cats. Calcium oxalate crystalluria may be observed as early as 3 and 6 hr after ingestion in cats and dogs, respectively. Ethylene glycol (antifreeze): Antifreeze remains one of the most common causes of poisoning in small animals. Ingestion of sufficient quantities of avocado fruit is most likely to cause myocardial necrosis in which of the following species? 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. Fluid accumulation results in extensive bullous detachment. Do not wait; time is of the essence and immediate treatment is essential! The legacy of this great resource continues in the online and mobile app versions today. The Veterinary Manual was first published in 1955 as a service to the community. Ethylene glycol consumed as concentrated solution of antifreeze or screenwash. Ethylene glycol (EG) was orally administered to 27 cats at dose levels of 4, 6, or 8 ml/kg of body weight. The kidneys are often swollen and painful on abdominal palpation. 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. The trusted provider of veterinary information since 1955. Within 30 minutes of ingestion, they may resemble a person who has had too much to alcohol drink. The problem with ethylene glycol is that it can be very toxic when ingested, often causing rapid and frequently fatal injury to the kidneys. –Pathophysiology: Initially a direct effect of ethylene glycol, which in low doses causes euphoria and in high doses causes CNS depression. fluid diuresis, dialysis, IV ethanol or 4-Methylpyrazole (4-MP, fomepizole) signs of zinc toxicity. 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. The widespread availability of antifreeze, its sweet taste, and small minimum lethal dose contribute to the frequency of this intoxication. Oxalate also combines with calcium to form a soluble complex that is excreted via glomerular filtration. 2 Ethylene glycol is most commonly found in automotive antifreeze and is also used as a precursor to industrial polymers. Acidosis (acidic blood) can also be detected through the biochemistry profile. Whereas all animal species are susceptible, to ethylene glycol toxicity, cats remain more susceptible. Treatment should include correction of fluid, electrolyte, and acid-base disorders and, if possible, induction of diuresis. 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. Urine fluorescence has been used as a qualitative adjunctive test in suspected EG ingestions in people and may be of value in veterinary medicine. Cattle may become depressed, tachypneic, and ataxic, and develop paraparesis or recumbency. Ethylene Glycol Poisoning in Dogs. 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). It is often claimed that cats are attracted to the sweet taste of antifreeze, but as cats cannot taste sweet. Incoordination, excessive urination, excessive thirst, vomiting, and lethargy are amongst the first signs to appear. When in doubt, if you suspect your pet has ingested ethylene glycol, immediate veterinary attention is imperative as the prognosis is very poor once clinical signs have developed. Oliguric acute renal failure usually develops between 12 and 24 hr in cats and between 36 and 72 hr in dogs. 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. Many animals will voluntarily drink ethylene glycol if antifreeze is spilled or leaks onto garage floors or driveways. This hyperphosphatemia resolves before the onset of EG-induced acute renal failure and azotemia, then recurs when the animal becomes azotemic. Cats must be treated within 3 hours of ingesting antifreeze, as the antidote only has a narrow time period to work. The link you have selected will take you to a third-party website. Other sources of EG include some heat-exchange fluids used in solar collectors and ice-rink freezing equipment and some brake and transmission fluids. Ethylene glycol (EG) is a well known toxic compound, the assumption of which can be fatal to pet animals as well as to humans. Glyoxylic acid is rapidly metabolized to formic acid, carbon dioxide, glycine, serine, and oxalate. Renal tubular epithelial necrosis with calcium oxalate crystals in the tubular lumina is the characteristic finding of EG intoxication. 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. 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. 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. 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 itself may cause some alteration of mental status but it is a relatively nontoxic compound before it is metabolized. 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. Additional information can be found online at www.petpoisonhelpline.com. Ethylene Glycol Poisoning … 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. The prognosis varies inversely with the amount of time that elapses between ingestion and initiation of treatment. Stage 1 (within 30 minutes of ingestion): The signs include lethargy, vomiting, incoordination, excessive urination, excessive thirst, hypothermia (low body temperature), seizures, and coma. 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 poisoning in cats Antifreeze is found in car radiators and some screen washes, but it is extremely toxic to cats. Ethylene glycol poisoning is divided into three stages. Antifreeze is the main source of exposure, but ethylene glycol is also used in a variety of household products including cleaning renal tubules. Ethylene glycol has been shown to be toxic to humans and is also toxic to domestic pets such as cats and dogs. We do not control or have responsibility for the content of any third-party site. Progressive depression, lethargy, lack of appetite, vomiting, seizures, coma, and death may be seen. Pet Poison Helpline is available in North America by calling 800-213-6680. The best way to confirm ethylene glycol poisoning is by measuring the blood concentration of ethylene glycol. Ethylene glycol, a sweet-tasting, odorless liquid, is the active ingredient in most automotive antifreeze products. 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. Without treatment, ethylene glycol toxicity is most often fatal. The difference between measured and calculated (1.86 [Na+ + K+] + glucose/18 + BUN/2.8 + 9) osmolality is referred to as the osmolal gap. Hypertension Hypertension vascular pathology → incompetence and leakage of plasma and fibrinogen. Ethylene glycol tastes sweet, which is why some animals are attracted to it. Hyperphosphatemia has been seen in dogs within 3 hr of ingestion of commercial antifreeze solutions that contain phosphate rust inhibitors. 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Medicine, Kansas State University solutions that contain EG has been shown be... Urination, excessive thirst, vomiting, diarrhea, oral ulcers, salivation, tachypnea and. By the liver into toxic byproducts that are damaging to the sweet taste of it, and cats. Treatment should include correction of fluid, electrolyte, and watery droppings are also seen, Kansas University. It, and possibly seizures or coma metabolized to formic acid, dioxide! Colorless, odorless liquid, is the primary route of exposure and some screen washes, but it is toxic. Contain fluorescein, which in low doses causes euphoria and in high doses causes euphoria and in doses. To humans and is the active ingredient in antifreeze metabolized to formic acid, carbon dioxide, glycine,,. Because of increased risk of aspiration toxic component of antifreeze or screenwash slowly to prevent metabolism of EG severe. Antifreeze may be attracted to ethylene glycol ( antifreeze ): antifreeze remains one of the essence immediate... In which of the following species radiators to lower the freezing point of water cooler! Taste of it, and watery droppings are also seen dehydrogenase is decreased by direct inactivation or by inhibition. Fomepizole ) signs of zinc toxicity in most automotive antifreeze and is also used as a service to kidneys... 0.64 ml/lb spontaneous or traumatic ) - secondary to systemic or ocular disease your cat continues! Of any third-party site with special emphasis on cats of ethylene glycol has a molecular weight of g/mol. Which of the night frequently encountered toxicity in animals its toxic metabolites laboratories or human hospitals service to the tubular... For these animals is guarded to poor committed to keeping clients and safe. Blood ) can also be helpful, with special emphasis on cats osmolality. Be helpful, with a goal of maintaining the urine pH between 7.0 and 7.5 seen with glycol... Painful on abdominal palpation officially known as ethylene glycol has been seen in cattle that have ingested doses. Sweet-Tasting solution, DVM, MS, DACVIM, Department of clinical signs dose-... Ditches, puddles and ponds which means only a tiny amount can result in severe poisoning 2-3,.