Winter Weather Hazards-Part 2 of 2

Ethylene Glycol Poisoning

What is ethylene glycol?

Ethylene glycol, a sweet-tasting, odorless liquid, is the active ingredient in antifreeze. Ethylene glycol can also be found, in lower concentrations, in some windshield de-icing agents, hydraulic brake fluid, motor oils, solvents, paints, film processing solutions, wood stains, inks, printer cartridges, etc.

How do animals get ethylene glycol poisoning?

Dogs and cats are attracted to ethylene glycol by its sweet taste. Many animals will voluntarily drink ethylene glycol if antifreeze is spilled or leaks onto garage floors or driveways. Ethylene glycol has a very narrow margin of safety – which means only a tiny amount can result in severe poisoning. As little as one eighth of a teaspoon per pound of cat can result in fatalities in cats, while as little as half a teaspoon per pound of dog can result in fatalities in dogs.

What are the signs of ethylene glycol poisoning?

Early signs of ethylene glycol poisoning are called “Stage 1”, and can be seen within 30 minutes of toxin ingestion.  The signs include lethargy, vomiting, incoordination (walking drunk), excessive urination, excessive thirst, hypothermia (low body temperature), seizures, and coma.  In “Stage 2” (which occurs 12 to 24 hours after ingestion), some of the signs seem to dramatically improve, luring pet owners into a false sense of security. However, during this stage, pets become dehydrated, and develop an elevated breathing and heart rate.  “Stage 3” occurs 12-24 hours after ingestion in cats, and 36-72 hours after ingestion in dogs. At this stage, signs of severe kidney dysfunction, which is characterized by swollen, painful kidneys and the production of minimal to no urine, may occur. Progressive depression, lethargy, lack of appetite, vomiting, seizures, coma, and death may be seen.

If you suspect that your pet has consumed ethylene glycol, or is exhibiting early symptoms, bring it to your veterinarian immediately.  Do not wait; time is of the essence and immediate treatment is essential! Left untreated, the animal will die. Dogs must be treated within 8-12 hours of ingesting antifreeze, while cats must be treated within 3 hours of ingesting antifreeze, as the antidote only has a narrow time period to work.

How do we confirm ethylene glycol poisoning?

The best way to confirm ethylene glycol poisoning is by measuring the blood concentration of ethylene glycol. A test to determine the blood levels can be done at some veterinary diagnostic laboratories or human hospitals. This testing method is very accurate, but not always available in the middle of the night. In addition, a test kit that can be used in the veterinary clinic is available to detect the amount of ethylene glycol present in the bloodstream. However, these types of tests may not be as accurate, and false positives can be seen (for instance, certain agents other than ethylene glycol interact with the test, like propylene glycol, glycerol, mannitol, isopropyl alcohol, sorbitol, etc.). Also, if this test kit is run too late, it may test falsely negative; in other words, since peak levels of ethylene glycol are detected in to the first 1- 6 hours after ingestion of the toxin, it is important that this test kit be used early in the course of suspected poisonings. By as early as 24 hours after ingestion, insufficient ethylene glycol remains to allow detection on this blood test; however, the damage to your pet’s body from ethylene glycol has already occurred.

Are there other tests that can indicate ethylene glycol poisoning?

Ethylene glycol is converted by the liver into toxic byproducts that are damaging to the kidneys. This damage can be identified in a serum biochemistry profile by increases in the levels of creatinine and BUN (blood urea nitrogen) that are normally removed from the blood by the kidneys. However, these tests are not specific for ethylene glycol toxicity, and by the time these blood tests shows evidence of kidney failure, the prognosis is grave to poor (since it is already too late to treat with the antidote).  Acidosis (acidic blood) can also be detected through the biochemistry profile.  A urinalysis may also confirm ethylene glycol poisoning and underlying kidney damage by the presence of dilute urine containing blood, protein, cellular casts (plugs of cells which have taken the shape of dying tubules in the kidneys), and calcium oxalate crystals (which are seen with  ethylene glycol poisoning).  Lastly, a special lamp (Wood’s lamp) can sometimes be used to examine the urine, muzzle, and paws of the patient to look for the presence of the dye (which is added to automotive antifreeze); this dye is excreted up to 6 hours after ingestion.

When in doubt, if you suspect your pet has ingested ethylene glycol, immediate veterinary attention is imperative; as the prognosis is very poor once clinical signs have developed. Again, as the time period within which to treat pets with the antidote (fomepizole) is only 3 hours in cats and 8-12 hours in dogs, it is imperative that you see a veterinarian immediately. When in doubt, you or your veterinarian can contact Pet Poison Helpline (800-213-6680) 24/7 for life-saving assistance in managing a poisoned patient.

Cold Weather Tips for the Outdoor Pet       

I have pets that is housed outside.  How do I keep them safe in the winter?
Make sure you have appropriate shelter from the wind and precipitation. Good bedding is also key; straw or blankets are a good option.  Avoid electric heating due to the risk of fire.

Fresh water is important at all times for pets, therefore in the frigid winter it is necessary to check the water bowl for freezing muliple times per day. Heated water bowls are another option.

Outdoor pets may need additional calories to help maintain their body temperature.  If you keep a pet outdoors, please consider consulting with your veterinarian to ensure you are doing everything to keep your pets safe. If you are in doubt about leaving a pet outside due to temperature or precipitation, it is better to err on the side of caution and keep it inside.

Kristiina Ruotsalo, DVM, DVSc, Dip ACVP & Margo S. Tant BSc, DVM, DVSc & Justine A. Lee, DVM, DACVECC, with additions by Kristen Ferguson, DVM
© Copyright 2012 Lifelearn Inc. Used and/or modified with permission under license.

Oh the weather outside is frightful…

Winter Weather Hazards—Part 1 of 2

Snow covering the ground.  Ice shining the streets.  Blustery wind cutting to the bone.  With the winter weather come a few hazards to your pets that you should be aware of.

Frostbite in Dogs and Cats

What is frostbite?

Frostbite or congelatio in medical terminology is the damage that is caused to skin and other tissues due to extreme cold. When the environmental temperature drops below 32°F (0°C), blood vessels close to the skin start to narrow or constrict. This constriction of the blood vessels helps to preserve core body temperature by diverting blood toward the core and away from the cooler parts of the body. In extreme cold or when the body is exposed to cold for long periods, this protective mechanism can reduce blood flow in some areas of the body, especially the extremities, to critically low levels. The combination of cold temperature and reduced blood flow can allow the tissues to freeze, causing severe tissue injury.

Where is a dog or cat most likely to get frostbite?
The paws, ears and tail are the most common tissues to be affected. If a pet is wet or damp, these areas are more vulnerable to frostbite.

What are the clinical signs of frostbite?

• Discoloration of the affected area of skin – this discoloration is often pale, gray or bluish
• Coldness and/or brittleness of the area when touched
• Pain when you touch the body part(s)
• Swelling of the affected area(s)
• Blisters or skin ulcers
• Areas of blackened or dead skin

As frostbitten tissues thaw, they may become red and very painful due to inflammation.The clinical signs of frostbite may take several days to appear, and severely frostbitten areas will become necrotic or die. As the tissue starts to die, it changes to a dark blue to black color; then, over a period of several days to weeks, it sloughs or falls off. During this time, pus may form or the tissue may develop a foul smell, due to secondary bacterial infection.
Dogs and cats with heart disease, diabetes mellitus or other conditions that cause reduced blood flow to the extremities are at greater risk for frostbite.

How is frostbite treated?
If you suspect your pet has frostbite, you should seek medical attention immediately. Interim first aid suggestions that you can begin include:

• Move your pet to a warm, dry area as quickly and as safely as possible.
• If your pet is suffering from hypothermia or low core body temperature, treat the hypothermia first. Do this slowly by wrapping its body in warm dry towels or blankets and placing hot water bottles wrapped in towels near its body.
• DO NOT rub or massage the affected area.
• If you are outdoors, DO NOT warm a frostbitten area if you cannot keep it warm. Additional cold exposure or refreezing will more severely injure the tissues.
• You may carefully warm the affected area with warm (NOT HOT) water. The recommended water temperature is 104 to 108°F (40 to 42°C) – at this temperature, you should be able to comfortably place your hand in the warm water. If the water is too hot, you may cause more damage than not using any water at all. You may apply warm water compresses or soak the affected area in a bowl of warm water. DO NOT use direct dry heat such as a heating pad or hair dryer.
• After you have warmed the area, pat it dry carefully and thoroughly.
• While traveling to the veterinarian for further medical treatment, keep your dog warm by wrapping the pet in dry towels or blankets that have been warmed in the clothes dryer.
• DO NOT give any pain medication unless specifically instructed by your veterinarian. Many human pain relievers, including acetaminophen and aspirin can be toxic to pets.

Your veterinarian will examine your pet and treat any other conditions, especially systemic shock or hypothermia. Since the thawing tissues are extremely painful, your pet will probably be given pain medication. Antibiotics are used to prevent secondary bacterial skin infection if tissue necrosis or death is suspected. Some dogs will require amputation of a severely affected body part.

What is the prognosis for frostbite?
The prognosis for frostbite depends on the extent of your dog’s injuries. Mild cases of frostbite usually resolve with little permanent damage while more severe frostbite may result in permanent disfiguration or alteration of the affected tissues. In extreme cases, amputation or surgical removal of the necrotic tissues is required. Your veterinarian will discuss the appropriate diagnostic and treatment plan for your dog.

Ice-Related Musculoskeletal Injuries
With how easy it is for people to slide on the ice, it’s important to be careful when walking your dog outside or letting them loose in dog parks or backyards that may have ice patches.  It is easy for them to splay their legs on a slippery surface and fall.  A fall on ice can result in strained or torn ligaments or tendons, or even fractures.When walking your dog on a leash outside, make sure to go slow.  If your dog becomes lame after a slip on the ice, set up an appointment with your veterinarian.  Do not try any over-the-counter pain medication without consulting your veterinarian, as some medications can be harmful to your pet if given too high of a dose.Please remember, the winter weather can pose some serious threats to your critters.  It is best to keep pets indoors in freezing temperatures to prevent hypothermia, frostbite, and other injuries.  Keep them inside instead—and let them help keep you warm during these cold winter months.

The next blog will focus on some additional cold weather hazards. Stay tuned.

Ernest Ward, DVM, with additions made by Kristen Ferguson, DVM.
© Copyright 2009 Lifelearn Inc. Used and/or modified with permission under license.