Page 1798 - Cote clinical veterinary advisor dogs and cats 4th

Salt Toxicosis 900.e3

contains osmotically active ingredients PROGNOSIS & OUTCOME • Patients administered activated charcoal
(e.g., glycerol, sorbitol). • Poor if serum sodium > 180 mEq/L and should have free access to water and/or SQ
VetBooks.ir facilitation of excretion of sodium, and • Good if treated early and intensively • Serum sodium levels can lag behind clinical Diseases and Disorders
• Replacement of water and electrolytes,
or IV fluids. They should be monitored for
seizures occur
4 hours for signs of hypernatremia.
supportive care includes IV administration
of low-sodium fluids, free water replacement
with warm water enemas (10 mL/kg), and PEARLS & CONSIDERATIONS signs and may continue to increase even after
treatment is instituted.
oral water if not vomiting.
• Diazepam 0.5-1 mg/kg IV can be used for Comments SUGGESTED READING
seizure control if indicated. • Minimal lethal dose of NaCl in dogs = Thompson LJ: Sodium chloride (salt). In Gupta RC,
4 g/kg; minimal toxic dose = 1.9 g/kg. editor: Veterinary toxicology, ed 3, St. Louis, 2018,
Chronic Treatment Equivalents: 1 tsp NaCl = 6 g; 1 lb table Elsevier, pp 479-482.
Do not decrease serum sodium concentration salt = 454 g.
faster than 0.5 mEq/L/h in patients with long- • A widely used homemade play dough recipe ADDITIONAL SUGGESTED
standing (>24 hours) hypernatremia. A rapid contains 2 cups of flour, 1 cup of table salt, READINGS
decrease in serum sodium concentration can and 0.5-1 cup of water; ingestion by dogs is Barr JM, et al: Hypernatremia secondary to home-
cause water influx into the CNS and cerebral a common cause of severe hypernatremia. made play dough ingestion in dogs: a review of 14
edema (p. 1428). ○ A 10-lb (4.5-kg) dog needs to eat 3.4 tsp cases from 1998 to 2001. J Vet Emerg Crit Care
(18 g) of homemade play dough to reach 14:196-202, 2004.
Possible Complications a minimal toxic dose of NaCl. DiBartola SP: Disorders of sodium and water:
Permanent CNS damage (osmotic demyelin- • Ingestion of more than 1 paintball per 10 hypernatremia and hyponatremia. In DiBartola SP,
ation, microvascular trauma) if excessively pounds of body weight can result in a fluid editor: Fluid, electrolyte, and acid-base disorders
rapid correction of chronic (>24 hours) shift with relative hypernatremia. in small animal practice, ed 3, St. Louis, 2006,
Saunders, p 47.
hypernatremia • In less severely affected patients, frequent Donaldson CW: Paintball toxicosis in dogs. Vet Med
access to small amounts of drinking water
Recommended Monitoring may be sufficient to prevent toxicosis. 98(12):995-997, 2003.
• Serum electrolytes (serial samples) during AUTHOR: Laura Stern, DVM, DABVT
treatment Technician Tips EDITOR: Tina Wismer, DVM, MS, DABVT, DABT
• Hydration status/body weight • Do not use salt to induce vomiting.
• Packed cell volume/total solids • Hypernatremic patients should be allowed
• Serum biochemistry profile free access to water as long as they are not
• Acid-base status vomiting.

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