Section: Veterinary Care In-depth
Diagnosis In-depth
Veterinary care should include diagnostic tests and subsequent treatment recommendations. Diagnostic tests are needed to recognize ethylene glycol toxicosis. These include:
A complete medical history and physical examination to determine if exposure to ethylene glycol or other toxins has occurred. Unfortunately, in many cases the owner is not aware that the pet has consumed ethylene glycol and first recognizes the non-specific signs of severe acute kidney failure such as lethargy, loss of appetite, vomiting.
An chemical test to detect ethylene glycol in the blood. The test is only accurate if performed within 6 to 12 hours of ingestion.
Urinalysis to evaluate for dilute urine, casts, and calcium oxalate crystals, which appear in the urine within 3 to 5 hours of ethylene glycol ingestion. Failure to identify calcium oxalate crystals in the urine does not rule out the possibility of ethylene glycol poisoning because crystal formation may cease within a few days of poisoning.
Venous blood gas analysis to identify severe acidosis (low blood pH) characteristic of early ethylene glycol poisoning.
Serum biochemistry tests to evaluate for low blood calcium concentration (hypocalcemia) that may occur soon after ethylene glycol ingestion. Abnormal kidney function tests, like high blood urea nitrogen, serum creatinine, and serum phosphorus, will be observed if acute kidney failure has developed between 12 and 72 hours after ingestion of ethylene glycol. Serum biochemistry tests also help identify electrolyte disturbances, like abnormal blood sodium, potassium, and chloride concentrations, and help evaluate other organ systems, for example liver function and pancreas function, which will help your veterinarian eliminate other diagnostic possibilities.
A calculation called the "osmolal gap," if your veterinarian suspects recent ethylene glycol poisoning. A high osmolal gap raises suspicion that a large amount of ethylene glycol metabolites are present in the blood.
An ultrasound examination and ultrasound-guided kidney biopsy for diagnosis if the pet is presented in kidney failure. The ultrasound examination typically shows very bright kidneys with ethylene glycol poisoning. A biopsy is recommended to confirm the diagnosis of acute kidney failure due to ethylene glycol poisoning because of the extensive treatment required and the poor prognosis.
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