Ethylene Glycol

1. • Signalment – 3 year old male cat
• History – acute lethargy, vomiting, anorexia
• Physical Examination – almost comatose,
obese.

2. Stress leukogram
• ↑ NCC
• ↑ segmented neutrophils
• ↓ lymphocytes
• ↑ PCV
Haematology

3. Renal parameters
• ↑ BUN, ↑ createnine = azotaemia
Liver parameters - within normal limits.
Electrolytes
• Hypocalcaemia, hyperphosphataemia,
hypernatraemia, hyperkalaemia,
hyperglycaemia.
Biochemistry

4. High anion gap
Equation = (Na + K) - (Cl + HCO3)
Variation of this equation will result in the anion gap
increasing.
Increased anion gap
• lactic acid
• ketoacids
• phosphate
• sulphate
Biochemistry cont..

5. Urinalysis
• USG = 1.016
• Protein, glucose and blood = 1+
• pH = 5.0
Urine Sediment
• WBC = 2-3
• RBC = 2-3
• Crystals = calcium oxalate monohydrate.
Urinalysis

6. Differential Diagnosis
• Ethylene glycol toxicity
• Diabetic ketoacidosis
• Hyperadrenocorticism

7. Ethylene Glycol Toxicity
Stage 1 – 30mins-12hours
• central nervous signs
• vomiting
• ataxia, weakness
• convulsions
• metabolic acidosis (high
anion gap)
• hypocalcaemia
• Stage 2 and 3 - 12-24 hours
• Cardio pulmonary signs
-tachycardia
-tachypnoea
-pulmonary oedema
• Renal signs
- oliguria
- azotaemia -> renal failure
Ethylene glycol is commonly found in antifreeze.
The sweet taste makes it palatable to cats.

8. Two young cats presented comatosed.
Bloods revealed ↑ anion gap and electrolyte abnormalities – most
significant being hypocalcaemia.
Cystocentesis showed calcium oxalate crystals and a decreased urinary
pH

9. • Ethanol – IV
• Fluids
• Calcium glucagonate
• Bicarbonate

10. Dependant on
• Quantity of ethylene glycol ingested
• Rate of absorption
• Time before intervention
Good prognosis if treatment is given within three hours post
ingestion
Worse prognosis as the time interval between treatment and
ingestion increases
Grave prognosis if already in renal failure.

11. Good news
From the case I saw one of the cats was treated with an
ethanol and supportive therapy. He made a full recovery and
was sent home 5 days later
Unfortunately one of the cats was euthanized just after
presentation due to his severe clinical signs.

12. A.Gough (2007)Differential Diagnosis in Small Animal
Medicine, Blackwell Publishing, pp 356,
BSAVA/VPIS Guide to Common Canine and Feline Poisons,
British Small Animal Veterinary Association pp130-131
http://www.readcube.com/articles/10.1111%2Fj.1939-
165X.1978.tb00791.x?r3_referer=wol&show_checkout=1
M.E. Peterson, P. A. Talcott (2006)Small Animal Toxicology
Second Edition, Saunders pp704 – 726.