Pathology in Practice

A six-year-old, female spayed German shepherd dog presented with an acute onset of disorientation, lethargy, polydipsia, vomiting and one episode of seizure activity. MRI of the brain revealed diffuse contrast enhancement of meninges and the grey matter in the cerebral hemispheres and cerebellum on T1-weighted images. Abdominal ultrasonography showed bilateral renal changes. The dog deteriorated and was euthanised. On postmortem examination small oxalate crystals were identified in the kidneys, meningeal vessels and capillaries of the grey matter confirming ethylene glycol intoxication. BACKGROUND

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MRI findings of diffuse polioencephalopathy secondary to ethylene glycol intoxication in a dog

Pivetta

Beltrán

Stewart

et al. 2014

Vet Record Case Reports

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Ethylene glycol poisoning

Bates¹

2016

Companion Animal

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has worked in human and veterinary toxicology for 25 years and has been with the Veterinary Poisons Information Service (VPIS) since it started. As well as providing emergency advice via the telephone she has written extensively on veterinary toxicology. In addition to service provision, she is involved in training of VPIS staff and veterinary professionals. She is currently the congress abstract editor for the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT). Nicola Bates BSc (Brunel) BSc (Open) MSc MA Ethylene glycol poisoningEthylene glycol poisoning is extremely serious in cats. A small dose can result in signs which are initially non-specific and may be easily missed. Ethanol is the antidote to ethylene glycol toxicity and works by preventing metabolism to toxic compounds. However, it is generally only worthwhile if started within a few hours of ingestion. Although a potentially lethal dose of ethylene glycol can be survived if treatment is prompt, many cats with ethylene glycol poisoning present late and as a result most cases have a fatal outcome.

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Poisons affecting the kidney

Bates¹

2021

Companion Animal

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The kidney has an essential role in maintaining normal physiological functions but it can be affected by various drugs and chemicals. A common seasonal cause of renal failure in cats is ingestion of antifreeze containing ethylene glycol. It is not the ethylene glycol itself which causes renal failure but toxic metabolites which result in deposition of calcium oxalate crystals in the renal tubules. Various non-steroidal anti-inflammatory drugs, particularly those used in human medicine such as ibuprofen, flurbiprofen and naproxen, cause renal effects through inhibition of prostaglandin synthesis which results in reduced renal blood flow and disruption of normal renal function and homeostatic mechanisms. For some common substances, such as lilies in cats and grapes and their dried fruit in dogs, kidney injury occurs through unknown mechanisms. Management of poison-induced kidney injury is supportive with monitoring and support of renal function. Although haemodialysis and other extracorporeal techniques can be used, they are rarely available in veterinary medicine and therefore preventive measures are used. This includes aggressive intravenous fluid therapy before onset of signs for lily and grape poisoning and early use of the antidote (ethanol) in ethylene glycol poisoning to prevent formation of toxic metabolites, allowing excretion of the parent compound. In most cases, once kidney injury is advanced, prognosis is poor.

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Pathology in Practice

Cited by 6 publications

References 6 publications

MRI findings of diffuse polioencephalopathy secondary to ethylene glycol intoxication in a dog

MRI findings of diffuse polioencephalopathy secondary to ethylene glycol intoxication in a dog

Ethylene glycol poisoning

Poisons affecting the kidney

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