Ethylene glycol

From Dog
Calcium oxalate crystaluria due to ethylene glycol toxicity[1]

Ethylene glycol (antifreeze) intoxication commonly results in acute renal injury (ARI) and death in dogs worldwide, with an estimated 10,000 to 45,000 cases occurring annually[2][3].

Because antifreeze is a widely available source of ethy­lene glycol, cases most often occur during seasons in which antifreeze is used. Ethylene glycol is also present in industrial solvents, rust removers, color film processing fluids, and heat-exchange fluids.

Ethylene glycol is absorbed quickly following ingestion and blood concentration peaks within 1 to 4 hours. Most is metabolized or excreted within 18 to 24 hours after ingestion[4]. Ethy­lene glycol initially crosses the blood-brain barrier, where it exerts narcotic or euphoric effects similar to those of ethanol.

The second clinical stage occurs when ethylene glycol is metabolized to acidic intermediates, including glycolic, glyoxylic, and oxalic acid, which cause severe metabolic acidosis; this occurs within 3 to 4 hours after ingestion. Oxalate binds to plasma calcium, forming calcium oxalate uroliths in the renal tubules. Signs of cardiopulmonary disease may also develop[5].

Lethal doses of 95% ethylene glycol in dogs is 4 - 6.6 ml/kg[6].

The effects of this drug can be counteracted by fomepizole[7].

References

  1. Vetlearn
  2. Tefend M (2005) Acute renal failure: Diagnosis and treatment. Proc ACVIM Forum pp:40-42
  3. Pascoe PJ et al (1996) Case-control study of the association between intraoperative administration of nafcillin and acute postoperative development of azotemia. JAVMA 208(7):1043-1047
  4. Oehme FW (2000) Antifreeze poisoning: Diagnosis, treatment options. Proc ACVIM Forum pp:50-51
  5. Dorman DC & Dye JA (2005) Chemical toxicities, in Ettinger SJ, Feldman EC (eds): Textbook of Veterinary Internal Medicine. Philadelphia, Elsevier Saunders. pp:257-258
  6. Tefend M (2005) Acute renal failure: Diagnosis and treatment. Proc ACVIM Forum pp:40-42
  7. Connally HE et al (1996) Safety and efficacy of 4-methylpyrazole for treatment of suspected or confirmed ethylene glycol intoxication in dogs: 107 cases (1983-1995). J Am Vet Med Assoc 209(11):1880-1883