Anton RUSENOV, Galina SIMEONOVA, Radostin SIMEONOV, Rosen DIMITROV, Kamelia STAMATOVA-YOVCHEVA, Yordan NIKOLOV, Krassimira UZUNOVA

A Case of Acute Renal Failure Following Ethylene Glycol Intoxication in a Dog

ABSTRACTThe manuscript describes a clinical case of severe oligoanuric acute renal failure in a young dog following ethylene glycol intoxication. Significant deviations were established in urinary renal markers and blood biochemical parameters: severe azotemia, hypocalcaemia, hyperphosphataemia, hyperkalaemia and metabolic acidosis. The ultrasound renal findings demonstrated increased renal cortex echogenicity the typical for ethylene glycol intoxication, with a characteristic halo sign around the medulla. Electrocardiography showed a progressive decrease in amplitudes of P and R peaks, increased sharp edged repolarisation T wave. The performed symptomatic therapy did not lead to favourable outcome due to delayed intervention by the owner and non-administered antidotal therapy. The histopathological finding was consisted in degeneration, necrosis, desquamation of kidney epithelial cells, dilated tubules and multiple calcium oxalate deposits. The described changes, in our opinion, are relevant and could be used for diagnostics of the studied pathology.Key Words: Acute renal failure, ethylene glycol, intoxication, glomerular marker, dogs ÖZETBİR KÖPEKTE ETİLEN GLİKOL İNTOKSİKASYONU ARDINDAN GELİŞEN AKUT RENAL YETMEZLİK VAKASI Bu metin genç bir köpekte etilen glikol intoksikasyonu ardından gelişen şiddetli oligoanürik renal yetmezlik sonucu oluşan klinik vakayı tanımlamaktadır. Üriner renal markerlarda ve kan biyokimyasal parametrelerinde önemli sapmalar belirlenmiştir: şiddetli azotemi, hipokalsemi, hiperfosfatemi, hiperkalemi ve metabolik asidoz. Böbrekteki ultrason bulguları, etilen glikol intoksikasyonunda tipik olarak görülen renal korteks ekojenitesinde artış ile birlikte medulla çevresinde karakteristik hale işaretini ortaya koymuştur. Elektrokardiyografi sonucunda, P ve R piklerinin amplitüdlerinde progresif azalma, T dalgasının tepe noktasının repolarizasyonunda artış meydana geldiği görülmüştür. Uygulanan semptomatik tedavi, hayvan sahibinin gecikmiş müdahalesi ve antidot terapsinin ilaç verilmeden gerçekleştirilmesi yüzünden olumlu sonuca ulaşamamıştır. Görülen histopatolojik bulgular; böbrek epitel hücrelerinin dejenerasyon, nekroz ve deskuamasyonu, tubul dilatasyonu, çoklu kalsiyum okzalat birikintilerinden meydana gelmektedir. Bizce, tarif edilen değişiklikler, çalışılan patolojik durumla ilgilidir ve diagnostik açıdan kullanılabilir.Anahtar Kelimeler: Akut renal yetersizlik, etilen glikol, intoksikasyon (zehirlenme), glomeruler marker, köpekler

Anahtar Kelimeler:

Akut renal yetersizlik, etilen glikol, intoksikasyon (zehirlenme), glomeruler marker, köpekler

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The manuscript describes a clinical case of severe oligoanuric acute renal failure in a young dog following ethylene glycol intoxication. Significant deviations were established in urinary renal markers and blood biochemical parameters: severe azotemia, hypocalcaemia, hyperphosphataemia, hyperkalaemia and metabolic acidosis. The ultrasound renal findings demonstrated increased renal cortex echogenicity the typical for ethylene glycol intoxication, with a characteristic halo sign around the medulla. Electrocardiography showed a progressive decrease in amplitudes of P and R peaks, increased sharp edged repolarisation T wave. The performed symptomatic therapy did not lead to favourable outcome due to delayed intervention by the owner and non-administered antidotal therapy. The histopathological finding was consisted in degeneration, necrosis, desquamation of kidney epithelial cells, dilated tubules and multiple calcium oxalate deposits. The described changes, in our opinion, are relevant and could be used for diagnostics of the studied pathology.

Keywords:

Acute renal failure, ethylene glycol, intoxication, glomerular marker, dogs,

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Byun, H.S., Kim, M.C., 1998. Clinical and ultrasonographic investigations into the diagnosis of ethylene glycol intoxication in dogs. Korean Journal of Veterinary Research 38, 629-641.
Choi, H.J., Lee, Y.W., Wang, J.H., Jung, I.J., Yeon, S.C., Lee, H.J., Lee, H.C., 2007. Radiographic diagnosis of 'rubber jaw syndrome' secondary to chronic renal failure due to ethylene glycol intoxication in a dog. Journal of Veterinary Clinics 24, 260-263.
Civelek, T., Birdane, F.M., Elitok, B., 2006. Renal ultrasonographic findings in dogs with experimentally induced ethylene glycol nephrosis. Veteriner Bilimleri Dergisi 22, 21
Connally, H.E., Thrall, M.A., Hamar, D.W., 2010. Safety and efficacy of high-dose fomepizole compared with ethanol as therapy for ethylene glycol intoxication in cats. Journal of Veterinary Emergency and Critical Care 20, 191-20
Dircks, B., Mischke, R., Niedorf, F., Kietzmann, M., 200 Ethylene glycol poisoning in a dog - case report and literature review. Praktische Tierarzt 88, 878-884. Goicoa, A., Barreiro, A., López Peña, M., Espino, L., Pérez-López, M., 200 Atypical presentation of long-term ethylene glycol poisoning in a German shepherd dog. Veterinary and Human Toxicology 45, 207-209. Grauer, G.F., Thrall, M.A., Henre, B.A., Grauer, R.M., Hamar, D.W., 19 Early clinicopathologic findings in dogs ingesting ethylene glycol. American Journal of Veterinary Research 45, 2299-2303.
Grauer, G.F., Thrall, M.A.H., 1982. Ethylene glycol (antifreeze) poisoning in the dog and cat. Journal of American Animal Hospital Association 18, 492-497.
Hristov, T., Lazarov, L., Rusenov, A., 2005. Poisoning with ethylene glycol in dog – clinical case. In: Proceedings of Scientific conference with international participation, 2-3 June, Stara Zagora, Bulgaria, 219-223.
Keller, N., Goddard, A., 2005. First report of suspected ethylene glycol poisoning in 2 dogs in South Africa. Journal of South African Veterinary Association 76, 116-119.
Kimmel, P., 1998. Management of the patient with chronic renal disease. In: Greenberg, A. (Ed), Primer on Kidney Diseases. Academic press, San Diego, 433-440.
Lulich, J., Osborne, C., O’brien, T., Polzin, D., 1992. Feline renal failure: Questions, answers, questions. Compendium on Continuing Education for the Practicing Veterinarian 14, 127-1
Mantis, P., Lamb, C.R., 2000. Most dogs with medullary rim sign on ultrasonography have no demonstrable renal dysfunction. Veterinary Radiology and Ultrasound 41, 164-166.
Martin, М., 2001. Manual of small animal electrocardiography. Aquarium Ltd, Moscow, Russia, 89-90.
Rowland, J., 1987. Incidence of ethylene glycol intoxication in dogs and cats seen at Colorado State University Veterinary Teaching Hospital. Veterinary Human Toxicology 29, 41-44.
Smets, P., Meyer, E., Maddens, B., Duchateau, L., Daminet, S., 2010. Urinary Markers in Healthy Young and Aged Dogs and Dogs with Chronic Kidney Disease. Journal of Veterinary Internal Medicine 24, 65–72.
Vanhoider, R., 1998. The uremic syndrome. In: Greenberg A., (Ed), Primer on Kidney Diseases. Academic Press, San Diego, 403-440.