Ethylene Glycol Flashcards
What is the best treatment for ethylene glycol toxicosis?
Fomepazole (4-MP)
**it will NOT created a false positive when testing for ethylene glycol
What is the most common route of exposure of ethylene glycol?
Ingestion
- *has a sweet taste
- low molecular weight - activated charcoal does not work well
What is the mortality rate reported for ethylene glycol toxicosis in dogs and cats?
59-70%
What is the minimal lethal does of antifreeze in dogs and cats?
Dogs: 4.2 - 6.6 ml/kg
Cats: 1.4 ml/kg
How is antifreeze absorbed?
Readily absorbed in the GIT
absorption will be delayed by food
What is the half life of antifreeze?
3-4 hours in dogs
shorter in cats
Dog - peak plasma level at 2 hours
What synthesis does antifreeze undergo in the liver?
Lethal synthesis
E.G. is oxidized to glycoaldehyde
Glycoaldehyde is oxidized to glycolic acid
Glycolid acid is oxidized GyloXylic acid—> TONS of other acids are made after this
What crystals are created from Oxalic acid and calcium binding due to the ingestion and absorption of antifreeze?
Insoluble calcium oxalate monohydrate crystals
form in the tissues - causing damage and passed in the uring
How long are the metabolites of ethylene glycol present for?
Several days
a small amount of ethylene glycol will be excreted in the urine unchanged (within 24 hrs)
What side effect do calcium oxalate monohydrate crystals have?
Hypocalcemia
What are the main toxic effects of the metabolites of ethylene glycol?
Metabolic acidosis and acute renal failure
What toxic effects does ethylene glycol itself, have on the body?
Direct GI irritation
increased serum osmolality = osmotic diuresis
CNS depression
What CNS effects does ethylene glycol have?
CNS dysfunction resulting in inhibition of respiration, dysfunction of: glucose and serotonin metabolism, alteration of amine concentration
marked cerebral edema in later stages
What are the early clinical signs noted in patients with ethylene glycol toxicosis ? (30min to 12 hours post ingestion)
DOG: nausea, vomiting, anorexia, CNS depression, ataxia, incoordination, hypothermia, PUPU, dehydration, tachycardia/pnea… death
*CATS: are markedly depressed and usually do not show polydipsia
**these signs are associated with EG and systemic acidosis
What are the late clinical signs noted in patients with ethylene glycol toxicosis ? (12 - 24 hours post ingestion)
Animals that survive early stage will develop oliguric renal failure
vomiting, anorexia, depression, severe lethargy, coma, seizures, oliguria, and renal pain
Anuria (72-96 hours post ingestion)