Teichmann-Knorrn S, Doerfelt S, Doerfelt R. Retrospective evaluation of the use of hemodialysis in dogs with suspected metaldehyde poisoning (2012-2017): 11 cases.
J Vet Emerg Crit Care (San Antonio) 2020;
30:194-201. [PMID:
32077221 DOI:
10.1111/vec.12934]
[Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/06/2018] [Accepted: 06/16/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE
To evaluate dogs treated with hemodialysis for severe metaldehyde intoxication and to compare them with conventionally-managed patients.
DESIGN
Retrospective study (2012-2017).
SETTING
University teaching hospital.
ANIMALS
Data from 18 dogs with severe metaldehyde intoxication were analyzed. Eleven dogs were treated with intermittent hemodialysis and 7 managed conventionally.
INTERVENTIONS
None.
MEASUREMENT AND MAIN RESULTS
Metaldehyde poisoning was diagnosed based on clinical signs and toxicological analysis or presence of turquoise material in the gastrointestinal content. Clinical signs, additional treatments, dialysis prescription, duration of anesthesia and hospitalization, complications, and outcome were documented. Results were analyzed by t-test, Mann-Whitney U-test, and Chi-square test. P < 0.05 was considered significant. Dialysis was performed for median (range) 180 min (150-420 min) with median of 2.28 L/kg (1.66-4.48 L/kg) blood volume processed. In the hemodialysis group, anesthesia was discontinued at a median of 3.0 hours (1.5-6.7 h) after starting dialysis. The conventional-group received general anesthesia for a median of 17.5 hours (7.0-30.5 h). No further anticonvulsive treatment was necessary for the hemodialysis group. Time to hospital discharge was shorter in dialyzed dogs (median 18 h; 15-41 h) compared to conventionally treated dogs (median 89 h; 61-168 h; P = 0.0014). Aspiration pneumonia was reported in 5 conventionally treated dogs and none of the dialyzed dogs (P = 0.001). Five dialyzed dogs developed hematoma at the dialysis catheter site. One dog in each group was euthanized.
CONCLUSION
Hemodialysis significantly decreases the requirement for anesthesia and length of hospitalization in dogs with metaldehyde intoxication. Aspiration pneumonia occurred less often in dialyzed patients. Prospective studies are warranted to confirm the clinical utility of hemodialysis in dogs with metaldehyde poisoning.
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