Chronic kidney disease following poisoning by ethylene glycol in a dog: a case report

Barros, Alexandre Có Mangoni; Vicente, Monica Chacon de; Guimarães, Ana Rita Rodrigues; Souza, Murilo Rodrigues de; Santin, Ana Paula Iglesias; Martins, Danieli Brolo; Botelho, Ana Flávia Machado

doi:10.1590/1809-6891v26e-83346E

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Veterinary medicine | Research article • Cienc. anim. bras. 26 • 2025 • https://doi.org/10.1590/1809-6891v26e-83346E linkcopy

Chronic kidney disease following poisoning by ethylene glycol in a dog: a case report

Authorship SCIMAGO INSTITUTIONS RANKINGS

A seven-year-old, 4.65 kg, male Shih-tzu dog was referred to the veterinary hospital with a history of vomiting after eating a commercial dog treat containing ethylene glycol (EG) in its formulation. The animal showed clinical signs of kidney damage and after additional tests was diagnosed with severe grade 4 acute kidney injury. Almost one and half years later, the patient was presented to veterinary care, with a grade 4, chronic kidney injury. During this period, several tests were carried out, including a complete blood count, serum biochemistry analysis, abdominal ultrasound, and blood gas analysis. In critical condition, the animal died shortly afterward. An anatomopathological necropsy exam revealed extensive kidney injury with tubular necrosis and glomerular sclerosis, fibrosis, and mineralization, accompanied by numerous mono and dihydrates oxalate crystals. To our knowledge, this is the first report describing clinical signs and pathological findings of a dog poisoned by EG in Brazil. We aim to contribute to the understanding of the pathogenesis of EG poisoning, especially regarding chronic kidney failure.

Keywords:
Canine; forensic toxicology; intoxication; kidney injury; toxicologic pathology

Date	Medication/Procedure	Dosage/Frequency	Duration
1st day	Ondansetron	1 mg/kg, IV, three times a day	7 days
	Omeprazole	1 mg/kg, orally, twice a day	7 days
	Fluid therapy with ringer lactate	19 ml/h, IV	-
	Gastrointestinal pate	Twice a day	-
	Urinary output	Every 24 hours	-
2nd day	Omeprazole	1 mg/kg, orally, every 12 hours	10 days
	Ondansetron	1 mg/kg, orally, every 8 hours	5 days
	Omega-3 supplementation	1500 mg, orally, every 36 hours	18 days
	Gastrointestinal diet	In case of food rejection	7 days
3rd day	Cyproheptadine	0.5 mg/kg, orally, every 12 hours	5 days
	Aluminum hydroxide	15 mg/kg, orally, every 12 hours	5 days
	Ambulatory fluid therapy with ringer lactate	150 ml, SC	7 days
	8th day	Omeprazole	1 mg/kg, orally, every 12 hours (instruct weaning after improvement in condition)	30 days
Praziquantel 175 mg, pyrantel palmoate 504 mg, febantel 525 mg		1/2 of a tablet, orally, every 24 hours (repeat with 15 days)	3 days
Gastrointestinal feed		-	Continuous
Fluid therapy with ringer lactate		27 ml/h, IV	1 day
Appetite stimulant (cobanamide 1 mg and cyproheptadine hydrochloride 4 mg)		-	-
18th day	Salute® nutritional supplement	1 sachet, orally, every 24 hours	7 days
520th day	Syrup with cyproheptadine, vitamins B1, B2, B6, C, and nicotinamide	0.1 ml/kg, orally, every 12 hours	7 days
520th day	Endoparasiticide with fenbendazole, pyrantel pamoate, and praziquantel	½ tablet, orally, every 24 hours	3 days
543th day	Fluid therapy with 0.9% NaCl solution	14 ml/h for the first 8 hours, 11 ml/h after evaluation	-
	Ondansetron	1 mg/kg, IV, three times a day	-
	Dipyrone	25 mg/kg, IV, three times a day	-
	Tramadol	4 mg/kg, IV, three times a day	-
	Urinary output	Every 4 hours for the first 12 hours, every 6 hours thereafter	-
	Nasogastric feeding with hypercaloric pate	Every 6 hours	-
			-
	Aluminum hydroxide 6%	30 mg/kg, orally, after feeding	-
545th day	Erythropoietin	100 UI/kg, SC, every 48 hours
545th day	Hylo-gel® eye drops	1 drop every 8 hours	-

BC
Erythrogram	1st day	18th day	520th day	543th day	545th day	REFERENCE VALUES*
Red blood cells	6.34	6.85	2.67	2.05	4.04	5.5 – 8.5 x 106
Hemoglobin	13.7	15	6.0	4.3	8.7	12 – 18 g/dL
Hematocrit	42	45	18	14	27	37 – 55 %
MCV	66.2	65.7	67.4	68.3	66.8	60 – 77 fL
MCHC	32.6	33.3	33.3	30.7	32.2	32 – 36%
RDW	13.6	13.4	12.5	13.4	14.2	12 – 15 %
Total plasma protein	7	6.6	6.6	7.6	6.6	6 -8 g/dL
Reticulocyte	-				0.2	0 – 1.5%
Platelet count						REFERENCE VALUES*
Platelet count	440	375	446	545	224	200 -500 x10³/uL
MPV	6.0	6.0	5.7	5.7	6
PDW	15.4	14.9	14.5	14.6	15.5	%
Leukogram						REFERENCE VALUES*
Leukocytes	16,000	5,300	4,200	7,500	6,900	6,000 – 17,000 x10³/uL
Myelocytes	0	0	0	0	0	0
Metamyelocytes	0	0	0	0	0	0
Band neutrophil	0	0	0	0	0	0 – 300
Segmented neutrophil	14,560	3,816	3,864	6,600	6,486	3,000 – 11,500
Eosinophil	160	530	168	0	138	150 – 1,250 mm³
Basophil	0	0	0	0	0	0
Lymphocytes	320	795	165	225	138	1,000 – 4,800 mm³
Monocytes	960	159	0	675	138	150 -1,350 mm³

BIOCHEMISTRY
Parameters	1st day	8th day	18th day	520th day	543th day	545th day	Reference Values*
ALT	63	-	74	91	-	-	21 – 86 UI/L
Creatinine	5.23	3.93	3.84	7.77	-	11.59	0.5 -1.4 mg/dL**
Phosphorus	6.48	3.85	4.15	-	28.20	-	2.6 – 6 mg/dL
Urea	145	-	96	254	504	-	21.4 – 59.9 mg/dL
ALP	-	-	45	-	53	-	20 – 156 UI/dL
Lactate	-	-	-	-	-	0.55	0.5 -2 mmol/L****
TOTAL SERUM PROTEIN AND FRACTIONS
Total serum protein	5.9	-	6.5	-	-	-	5.4 – 7.1 g/dL
Albumin	3.4	-	3.3	-	-	-	2.6 -3.3 g/dL
Globulins	2.5	-	3.2	-	-	-	2.7 -4.4 g/dL
LIPIDOGRAM
Total cholesterol	-	-	-	-	-	207	135-270 mg/dL
HDL Cholesterol	-	-	-	-	-	64	33-120 mg/dL
LDL Cholesterol	-	-	-	-	-	132	58-187 mg/dL
VLDL Cholesterol	-	-	-	-	-	11	6.5 -16.9 mg/dL
Triglycerides	-	-	-	-	-	55	20 -112 mg/dL

URINALYSIS
	1st day	8th day	18th day	REFERENCE VALUES*
Color	Light yellow	Light yellow	Light yellow	Citrine yellow
Odor	Sui Generis	Sui Generis	Sui generis	Sui Generis
Aspect	Cloudy	Clear	Clear	Clear
Specific gravity	1,012	1,010	1,014	1,015 – 1,045
pH	6.0	5.0	7.0	5.0 – 7.0
Proteins	+	Negative	+	<30 mg/dL
Glucose	Negative	Negative	Negative	<40 mg/dL
Ketone bodies	Negative	Negative	Negative	Negative
Urobilinogen	Normal	Normal	Normal	Normal
Bilirubin	Negative	Negative	Negative	Negative
Occult blood	+++	Negative	Negative	Negative
Nitrite	Negative	Negative	Negative	Negative
Bile salts	Negative	Negative	Negative	Negative
Sediment
Red blood cell	40 -50/camp	0 – 5/camp	1 -5/camp	<5 camp
Leukocytes	0 -3/camp	1 – 4/camp	0 -3/camp	<5 camp
Desquamation cells	0 -2/camp	0 – 1/camp	0 -1/camp	Rare
Transitional cells	0 -6/camp	0 – 3/camp	0 -2/camp	Rare
Microbiome	Rare	Rare	Rare	Absent
Pelvic kidney cells	0/camp	0/camp	0/camp	Absent
String of mucus	Absent	Present +	Absent	Absent
Casts	Granular 0 -2/camp	0/camp	Granular 0 -1/camp	Absent
Crystals	Calcium oxalate +++	Absent	Absent	Absent
Sperm	Present ++	Present +++	Present +	Absent
Observation	Transition cells
clusters +	Mucus +

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Universidade Federal de Goiás Universidade Federal de Goiás, Escola de Veterinária e Zootecnia, Campus II, Caixa Postal 131, CEP: 74001-970, Tel.: (55 62) 3521-1568, Fax: (55 62) 3521-1566 - Goiânia - GO - Brazil
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[TFN1] IV: intravenously; SC: subcutaneously.