Ethylene glycol poisoning
Poisoning from ingesting ethylene glycol, often found in antifreeze.
Ingesting the sweet, colorless liquid ethylene glycol, which is a common component of antifreeze, leads to poisoning.[1] Even a small ingested quantity can be lethal and cause toxicity.[2] Annually, over 5,000 poisoning incidents are recorded in the United States.[3] A diagnosis is considered when blood tests show acidosis or an elevated osmol gap, or when urine analysis reveals calcium oxalate crystals.[1]
Quick Facts
- Field
- Emergency medicine
- Symptoms
- Early: intoxication
- vomiting
- abdominal pain; Later: decreased level of consciousness
- headache
- seizures
- Complications
- Kidney failure, brain damage
- Causes
- Drinking ethylene glycol
- Diagnosis
- Calcium oxalate crystals in the urine, acidosis or increased osmol gap in the blood
- Treatment
- Antidote, hemodialysis
- Medication
- Fomepizole, ethanol
- Frequency
- > 5,000 cases per year (US)
Facts from the source article.
Key facts and history
Untreated, antifreeze poisoning can be fatal to pets, and prompt treatment is necessary to save a dog or cat's life.[4] Intoxication, vomiting, and abdominal pain are early indicators; later, one might experience a reduced level of consciousness, headache, and seizures.[2] Glycolic acid and oxalic acid, produced when the body metabolizes ethylene glycol, are responsible for the majority of its toxic effects.[1] The earliest documented fatalities from ethylene glycol date back to 1930.[3]
A 1937 outbreak of deaths, linked to a medication that contained diethylene glycol, prompted the United States to pass the Food, Drug, and Cosmetic Act in 1938.[3] Fomepizole is the first-choice antidote; ethanol serves as an alternative when fomepizole is not accessible.[5] For patients with organ damage or severe acidosis, hemodialysis is a treatment option.[5] To be effective, treatment for cats must begin within 3 hours of ingestion; for dogs, the window is 8-12 hours.[4]
What the research sources say
The Pet Poison Helpline states that ethylene glycol typically comes in 95-100% concentrations.[4] The Pet Poison Helpline notes that some snow globes have been found to contain antifreeze in the liquid.[4] The Pet Poison Helpline describes three stages of poisoning: stage 1 (30 minutes to 12 hours) looks similar to alcohol poisoning, and stage 2 (12-24 hours) shows apparent resolution of drunkenness while internal damage continues.[4] The Pet Poison Helpline reports that only two antidotes exist for antifreeze poisoning: ethanol or 4-MP (fomepizole).[4]
The Pet Poison Helpline advises seeking immediate veterinary care for blood testing if a pet has ingested antifreeze.[4]
References
- Wikipedia, "Ethylene glycol poisoning" (CC BY-SA 4.0), which cites: Kruse, "Methanol and ethylene glycol intoxication.", Critical Care Clinics, October 2012, p. 661–711; Beauchamp, "Toxic Alcohol Ingestion: Prompt Recognition And Management In The Emergency Department.", Emergency Medicine Practice, September 2016, p. 1–20; Kruse, "Methanol and ethylene glycol intoxication.", Critical Care Clinics, October 2012, p. 661–711; Ferri, "Ferri's Clinical Advisor 2017: 5 Books in 1", Elsevier Health Sciences, 2016, p. 794; Kruse, "Methanol and ethylene glycol intoxication.", Critical Care Clinics, Oc en.wikipedia.org
- Wikipedia, "Ethylene glycol poisoning" (CC BY-SA 4.0), which cites: Kruse, "Methanol and ethylene glycol intoxication.", Critical Care Clinics, October 2012, p. 661–711; Kruse, "Methanol and ethylene glycol intoxication.", Critical Care Clinics, October 2012, p. 661–711; Kruse, "Methanol and ethylene glycol intoxication.", Critical Care Clinics, October 2012, p. 661–711; Kruse, "Methanol and ethylene glycol intoxication.", Critical Care Clinics, October 2012, p. 661–711; Kruse, "Methanol and ethylene glycol intoxication.", Critical Care Clinics, October 2012, p. 661–711 (original not read by u en.wikipedia.org
- Wikipedia, "Ethylene glycol poisoning" (CC BY-SA 4.0), which cites: Naidich, "Imaging of the Brain: Expert Radiology Series", Elsevier Health Sciences, 2012, p. 960; Ferri, "Ferri's Clinical Advisor 2017: 5 Books in 1", Elsevier Health Sciences, 2016, p. 794; Shaw, "The Clinical Toxicology Laboratory: Contemporary Practice of Poisoning Evaluation", Amer. Assoc. for Clinical Chemistry, 2001, p. 197; Shaw, "The Clinical Toxicology Laboratory: Contemporary Practice of Poisoning Evaluation", Amer. Assoc. for Clinical Chemistry, 2001, p. 197; Beauchamp, "Toxic Alcohol Ingestion: Prompt Recognition en.wikipedia.org
- "Antifreeze Poisoning in Dogs & Cats (Ethylene Glycol Poisoning)" , Pet Poison Helpline, accessed Sept. 11, 2014.. facts only, no text reused. petpoisonhelpline.com
- Wikipedia, "Ethylene glycol poisoning" (CC BY-SA 4.0), which cites: Beauchamp, "Toxic Alcohol Ingestion: Prompt Recognition And Management In The Emergency Department.", Emergency Medicine Practice, September 2016, p. 1–20; Beauchamp, "Toxic Alcohol Ingestion: Prompt Recognition And Management In The Emergency Department.", Emergency Medicine Practice, September 2016, p. 1–20; Beauchamp, "Toxic Alcohol Ingestion: Prompt Recognition And Management In The Emergency Department.", Emergency Medicine Practice, September 2016, p. 1–20; Beauchamp, "Toxic Alcohol Ingestion: Prompt Recognition And Mana en.wikipedia.org
Each numbered sentence above was checked against the source it cites before publication. Sentences citing Wikipedia adapt text from the English Wikipedia article Ethylene glycol poisoning (contributors), used under CC BY-SA 4.0; this entry is available under the same licence. Other sources were used for facts only; no text or images are copied from them.
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