Small Animal Emergency &
Care Case Study 10
Small Animal Emergency & Critical Care Case Study
Dog Ingests Antifreeze
Linda R Knight
Small Animal Emergency &
Care Case Study 10
History:
Skip is a 2 year MN Beagle, who presented today for possibly ingesting antifreeze.
Ethylene glycol is the key ingredient in most antifreeze brands, it has a sweet flavor. Its alluring
smell and taste frequently tempt animals to drink the extremely poisonous substance. It merely
takes a few tablespoons of highly toxic antifreeze to extremely threaten an animal's life. There
are three stages of poisoning that can been seen with ethylene glycol (Pet Poison Helpline, 2015)

Stage 1: 30 minutes to 12 hours, walking drunk, drooling, vomiting, Seizuring, and
excessive thirst, and urination may be seen

Stage 2: 12-24 hours may seen to have resolved, but in fact more severe internal injury is
occurring.

Stage 3: In cats, this stage occurs 12-24 hours after ethylene glycol exposure. In dogs,
this stage occurs 36-72 hours post-ingestion. For the duration of this stage, severe acute
kidney failure is occurring. Signs of inappetance, lethargy, drooling, halitosis (secondary
to kidney failure), coma, depression, vomiting, and seizures (Pet Poison Helpline, 2015).
Skip should be bathed in a mild hand dishwashing detergent and repeated if necessary, and it’s
recommended that Skip should be bought into the clinic. Skip has no known health concerns, is
current on vaccines, and lives an active lifestyle.
Physical Examination:
Weight: 33 kg
Temperature: 101.5*F
P: 88 bpm
R: 64 rpm
Small Animal Emergency &
Care Case Study 10
Upon examination, Skip is normal in all parameters and is acting fine. Skip was
ambulatory on all four limbs, Skip appeared well-muscled and symmetrical. His hair was clean,
mucous membranes were pink, capillary refill time of less < 2 seconds, teeth were clean, both
ears were clean from debris and no inflammation was noted, both eye were clean and no
discharged was noted. Auscultation of the heart revealed a normal sinus rhythm, murmur was not
assaulted and femoral pulses were synchronous with the heart, no organomegaly were noted
during palpation of the abdomen. The rest of the exam was unremarkable.
Diagnostic Tests & Results:
The veterinarian wants to induce vomiting in Skip and decides to use apomorphine
conjunctively. Apomorphine is an emetic of choice for dogs, and it usually takes about 15
minutes. It vital that we monitor Skip for hypersensitivity or any allergic reaction to the drug,
sometimes it may cause excitement, restlessness, nervous system depress, and respiratory
depression can occur. Although conjunctival administration is usually effective, it is not as fast
or reliable as the injectable route, after treatment it’s critical to rinse the conjunctival sac with
saline, decreasing residual drug absorption. Vomiting should not be induced if the animals has
ingested acid, caustic agents, or petroleum distillates (Forney, 2004-2013)
Skip will be placed under heavy sedation for a procedure known as gastric lavage. This
procedure allows us to evacuate the stomach contents to prevent absorption, it is relatively safe,
simple, and effective and is approximately 20-30 minutes. Materials required, stomach tube
(18F rubber catheter), mouth gag (i.e. roll of tape), appropriate size cuffed endotracheal tube,
suction device, water soluble lubricant, syringe with 5-10ml water/saline for checking positon of
tube, syringe or funnel for administering lavage fluid. Skip will be intubated with an
endotracheal tube and cuffed to prevent aspiration of stomach contents as well as aspiration
Small Animal Emergency &
Care Case Study 10
pneumonia. We placed the stomach tube into the stomach through the esophagus, instilled warm
water through a funnel (about 5-10ml/kg at a time), placed a bucket at floor level to act as a
drain, flushed water into the tube until returning fluid is clear, then flush in fluid to distend the
stomach and then aspirate using a syringe and repeat about 10 times, palpate abdomen during
process to avoid over distension of the stomach (Harkin, 2014). A dose of activated charcoal
(AC) will be administered. AC is used to increase surface area and allow many binding sites for
adsorption of toxic agents. A few areas should be monitored such as, urine pH, azotemia,
oliguria, renal failure, CNS depression, stupor, coma, ataxic and knuckling.
Treatment:
Skip received 4-methylpyazole at four different times throughout the night and received
continuous IV fluids. The veterinarian orders the following dosage regime:
Immediate 11am 1-10-12
2.724ml
11pm same day 1-10-12
2.043ml
11am following day 1-11-12
2.043ml
11pm same day 1-12-12
.681ml
IV Drip
21.28ml/hr
Instructions:
It’s important to know that other foods that can be toxic to pets are listed below:
Avocado, Raisins Currants, Cooked Bones, Walnuts, Macadamias, Onions, Garlic, Grapes,
Mushrooms, Caffeine, Xylitol, and Chocolate. Not only are many household foods are
dangerous to animals, but you should also be aware of household products such as, acids, bleach,
pine-sol, detergents, fluoride, gorilla glue, hand sanitize, potpourri, and mothballs.
Small Animal Emergency &
Care Case Study 10
Rhododendrons can have serious effect on pets, if they eat even a few leaves it can result in
vomiting, diarrhea and excessive drooling, without immediate attention, the pet could fall into a
coma and possibly die. A few other plants that can be fatal if ingested are, lilies, cyclamen,
kalanchoe, oleander, sago palm. However, a few plants that may just cause irritation are
bittersweet, wisteria, autumn crocus, English holly, and buckeye.
Please contact us immediately if Skip continues to have any issues. Thank you for entrusting us
with Skips care.
References:
Harkin, Ken DVM, (2014) Gastric Lavage, Vetstream, Retrieved April 2, 2015
https://www.vetstream.com/canis/Content/Technique/teq00664
Pet Poison Helpline, Retrieved April 2, 2015
http://www.petpoisonhelpline.com/poison/antifreeze/
Forney, Barbara, DVM, (2004-2013) Retrieved April 2, 2015
http://www.wedgewoodpetrx.com/learning-center/medication-information-for-pet-andhorse-owners/apomorphine-for-dogs.html#_Toc239745957
Antifreeze Is a Sweet but Deadly Poison for Pets (2015) Retrieved April 2, 2015
http://www.humanesociety.org/animals/resources/tips/antifreeze.html
Richardson, Jill, DVM. ASPCA Tips to Manage a Poison Emergency, Retrieved April 2, 2015,
http://www.vspn.org/Library/misc/VSPN_M01158.htm
Loftin, Erika DVM, DACVECC, (2012) Toxicities in the ER. Retrieved April 2, 2015
http://www.dovelewis.org/pdf/events/Erika_toxins.pdf