It may be sweet....

...but it’s deadly. IT is antifreeze. This icy and cold weather has brought this particular toxicity to the forefront of my mind.  I don’t see this as often in general practice like I did when I was in emergency medicine but it could happen at any time. 

This TENDS to be a dog thing.  Apparently the stuff tastes sweet which is why even some cats like it.  It doesn’t take a lot to cause a tragedy: in a cat, as little as ONE teaspoon is enough to be lethal, in a 50lb dog it would take 30 teaspoons (not hard for a large dog to lap up rather quickly). 

It is CRITICAL that we intervene within 8 to 12 hours of ingestion. Frankly, if it goes much beyond that, it could be too late. 

Ethylene glycol causes crystals to form that basically destroy kidney function. It is irreversible once it happens!

They will appear “normal” initially and if you KNOW they got into some of this stuff, intervening at that point gives you the best chance of having success.

The initial signs are vomiting and a drunken like state. They will also drink and urinate more during the first few hours after ingestion. Then they will seem to “get better”  BUT in fact, the more serious phase has begun. They lose their appetite, become severely depressed and weak and eventually go into kidney failure. 

We can induce vomiting and give them some activated charcoal (NOT the burnt toast kind :) - see  "Back to the Animal Realm" if you don’t get this!). If it’s been more than a few hours, this is pointless however. 

One of the most important parts of treatment is  IV fluid therapy - for SEVERAL days. During these days, we will want to recheck several bloodwork paramaters. Why? Because it takes 36-48 hrs to see changes in a dog’s bloodwork post ingestion.

There is an antidote for ethylene glycol called 4-methylpyrazole (4-MP). It can’t be used in cats however. It is expensive ($$$) and most general practices do not carry it because we simply don’t use it enough. It needs to be given several times at varying intervals and dosages. For cats and in cases where 4-MP is not available, we use ethanol (if it’s been <18hrs since the animal ingested the poison).  This is really the reason many vets have grain alcohol or vodka in the practice. It is NOT because there are some crazy people out there and we need a drink after work...well, ok...maybe but the stuff is not typically anything “good.” This is given IV so do NOT try this at home! 

Both of these compounds block or compete with enzymes to keep the ethylene glycol from being coverted to the toxic compounds. 

The biggest problem is that many times owners NEVER see the animal get into it. So they come in with signs that can be indicative of a lot of things. If there is any suspicion of it, we do have an in house test that is a bit tedious (wish they’d develop a SNAP test for it!). But if kidney failure is all we have to go on, there are a lot of things that have to be on the list: certain drugs, NSAIDs (ibuprofen, naproxen, carprofen, meloxicam, etc), plants (like Lilies - we’ll touch on that near Easter) and some infectious agents (Leptospirosis and Lyme to name a couple).

The bottom line is that it’s expensive and the prognosis in many cases is guarded. 

Use and encourage others to use the antifreeze that contains propylene glycol. 


Interestingly today in one of my animal health updates, I got a link to this article about a GA bill aiming to force manufacturers to add a bitter tasting agent to the product. No one seems opposed so they are confused as to why this didn't get through. Cost is minimal. Read here at:
Georgia Bill Aims to Protect Pets from Antifreeze.  The funny thing is, I had this topic done last night - just needed to tweak it.