Antifreeze poisoning

You know that old saying, "Lightning never strikes twice in the same place"?  We tend to think that when something unusually bad happens that we ought to be safe from that particular disaster for some time into the future.  You know: there’s a bad airline crash and you’re supposed to fly out the next day.  "Hey, what are the odds of TWO bad airline crashes in a row?"  Of course the lightning thing is wrong: if there’s a high spot with a metal pole on it, it will probably get struck over and over again.

I was feeling pretty safe based on this statistical thing.  Last week I had to treat two dogs that had ingested ethylene glycol antifreeze.  This requires round-the-clock treatment every few hours for about 36 hours if you use the old ethanol treatment, which I did.  There’s a better antidote (not so much more effective, but so much easier to use), but I didn’t have it on hand.  The last time I had to treat an antifreeze poisoning case was about fifteen years ago.  I’d forgotten how much trouble it was, and here I had two at once.  So I was thinking, "I’d better get me some of that there new antidote so I don’t have to stay up all night again. I’m too old for that stuff."  But, hey, I’ve got fifteen years to get it, so I’ll wait until my normal ordering day next Thursday.

Son of a gun, I’ve got another antifreeze poisoning case today, so it’s another all-nighter to use the ethanol treatment. 

See, ethylene glycol is what is in most antifreeze solutions.  It tastes sweet, so if you spill your radiator coolant, the dogs will drink it.  It’s not actually very toxic, until the liver breaks it down into something else, something else that will destroy your kidneys.  This process takes a number of hours, so when the animal first drinks the stuff he looks fine.  The unwary owner sees the dog looking fine and thinks, "Well, I guess he didn’t get enough to hurt him."  About three days later it becomes apparent that the dog is not doing so well.  At this point, he has lost his kidney function and is being poisoned by his own wastes.  The kidneys are ruined, and unless he’s getting a transplant, it’s all over but the crying.  It’s not that I haven’t seen any other cases of antifreeze poisoning in the last fifteen years — it’s just that all the others have been at the point of no return.  The treatment has to begin in the first few hours after drinking the stuff, or it just doesn’t work.

The treatments consist of keeping the liver tied up breaking down other stuff (ethanol or fomepizole) so that it doesn’t break down the ethylene glycol. You keep it up (along with I.V. fluids) until the ethylene glycol has been eliminated by the kidneys in it’s intact (and not too toxic) form.

There have been legislative initiatives to try to require the addition of "bittering agents" to antifreeze to make it taste bad.  That doesn’t appear to be generating enough bribes to get out of committee.  You can buy non-toxic antifreeze that contains propylene glycol instead. It works fine, but it costs more, so it’s just you, me and the Sierra Club buying that stuff.

Don’t dump your coolant solutions.  Hose down spills to dilute them. Put the antifreeze jug where the dogs can’t get to it and chew them open.  If you know that the animal has been exposed, seek treatment as soon as possible.  Early treatment is highly successful. If you wait until they look sick, there is no hope. 

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