Title: Effects of Oral Administration of a Commercial Activated Charcoal Suspension on Serum Osmolality and Lactate Concentration in the Dog
Abstract: Journal of Veterinary Internal MedicineVolume 19, Issue 5 p. 683-686 Open Access Effects of Oral Administration of a Commercial Activated Charcoal Suspension on Serum Osmolality and Lactate Concentration in the Dog Jamie M. Burkitt, Corresponding Author Jamie M. Burkitt Veterinary Medical Teaching Hospital, University of California, Davis, CA. DVM, Veterinary Medical Teaching Hospital, One Shields Avenue, University of California, Davis, CA 95616; e-mail: [email protected].Search for more papers by this authorSteve C. Haskins, Steve C. Haskins Veterinary Medical Teaching Hospital, University of California, Davis, CA.Search for more papers by this authorJanet Aldrich, Janet Aldrich Veterinary Medical Teaching Hospital, University of California, Davis, CA.Search for more papers by this authorKarl E. Jandrey, Karl E. Jandrey Veterinary Medical Teaching Hospital, University of California, Davis, CA.Search for more papers by this authorMarlis L. Rezende, Marlis L. Rezende Veterinary Medical Teaching Hospital, University of California, Davis, CA.Search for more papers by this authorJennifer E. Boyle, Jennifer E. Boyle Veterinary Medical Teaching Hospital, University of California, Davis, CA.Search for more papers by this author Jamie M. Burkitt, Corresponding Author Jamie M. Burkitt Veterinary Medical Teaching Hospital, University of California, Davis, CA. DVM, Veterinary Medical Teaching Hospital, One Shields Avenue, University of California, Davis, CA 95616; e-mail: [email protected].Search for more papers by this authorSteve C. Haskins, Steve C. Haskins Veterinary Medical Teaching Hospital, University of California, Davis, CA.Search for more papers by this authorJanet Aldrich, Janet Aldrich Veterinary Medical Teaching Hospital, University of California, Davis, CA.Search for more papers by this authorKarl E. Jandrey, Karl E. Jandrey Veterinary Medical Teaching Hospital, University of California, Davis, CA.Search for more papers by this authorMarlis L. Rezende, Marlis L. Rezende Veterinary Medical Teaching Hospital, University of California, Davis, CA.Search for more papers by this authorJennifer E. Boyle, Jennifer E. Boyle Veterinary Medical Teaching Hospital, University of California, Davis, CA.Search for more papers by this author First published: 05 February 2008 https://doi.org/10.1111/j.1939-1676.2005.tb02746.xCitations: 30AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Abstract The purpose of this investigation was to determine the effects of an activated charcoal (AC) suspension containing propylene glycol and glycerol on serum osmolality, osmolal gap, and lactate concentration in dogs. Six healthy adult dogs were administered 4 g/kg AC in a commercially available suspension that contained propylene glycol and glycerol as vehicles. Blood samples were taken before and 1, 4, 6, 8, 12, and 24 hours after the administration of the test suspension. Samples were analyzed for osmolality, blood gases, and concentrations of lactate, sodium, potassium, serum urea nitrogen, and glucose. Osmolal gaps were calculated for each time point. Mean serum osmolality, osmolal gap, and lactate concentration were significantly increased after suspension administration compared to baseline. Serum osmolality increased from 311 mOsm/kg at baseline to 353 mOsm/kg, osmolal gap increased from 5 to 52 mOsm/kg, and lactate concentration increased from 1.9 to 4.5 mmol/L after suspension administration (all P < .01). Three of the 6 dogs vomited between 1 and 3 hours after the administration of the test suspension, and 4 of 6 dogs were lethargic. All dogs drank frequently after AC administration. Commercial AC suspension administered at a clinically relevant dose increases serum osmolality, osmolal gap, and lactate concentration in dogs. These laboratory measures and the clinical signs of vomiting, lethargy, and increased frequency of drinking might complicate the diagnosis or monitoring of some intoxications (such as ethylene glycol) in dogs that have previously received AC suspension containing propylene glycol, glycerol, or both as vehicles. References 1 Cate JC, Hedrick R. Propylene glycol intoxication and lactic acidosis. N Engl J Med 1980; 303: 1237. 10.1056/NEJM198011203032116 PubMedWeb of Science®Google Scholar 2 Lehman A., Newman H. Propylene glycol: Rate of metabolism, absorption, and excretion, with a method for estimation in body fluids. J Pharmacol Exp Ther 1937; 60: 312–322. CASWeb of Science®Google Scholar 3 Morshed KM, Nagpaul JP, Majumdar S., et al. Kinetics of oral propylene glycol-induced acute hyperlactatemia. Biochem Med Metab Biol 1989; 42: 87–94. 10.1016/0885-4505(89)90044-3 CASPubMedWeb of Science®Google Scholar 4 Saini M., Amma MK, Dash S., et al. Hematological alterations in propylene glycol-dosed female rats are minimal. Vet Hum Toxicol 1996; 38: 81–85. CASPubMedWeb of Science®Google Scholar 5 Morshed KM, Nagpaul JP, Majumdar S., et al. Kinetics of propylene glycol elimination and metabolism in rat. Biochem Med Metab Biol 1988; 39: 90–97. 10.1016/0885-4505(88)90062-X CASPubMedWeb of Science®Google Scholar 6 Yu DK, Elmquist WF, Sawchuk RJ. Pharmacokinetics of propylene glycol in humans during multiple dosing regimens. J Pharm Sci 1985; 74: 876–879. 10.1002/jps.2600740815 CASPubMedWeb of Science®Google Scholar 7 van Winkle W. Quantitative gastrointestinal absorption and renal excretion of propylene glycol. J Pharmacol Exp Ther 1941; 72: 344–353. Google Scholar 8 van der Westhuyzen JH, Berger GM, Beyers N., et al. Iatrogenic hyperosmolality in a neonate. A case report. S Afr Med J 1981; 60: 996–998. PubMedWeb of Science®Google Scholar 9 Tourtellotte WW, Reinglass JL, Newkirk TA. Cerebral dehydration action of glycerol. I. Historical aspects with emphasis on the toxicity and intravenous administration. Clin Pharmacol Ther 1972; 13: 159–171. 10.1002/cpt1972132159 CASPubMedWeb of Science®Google Scholar 10 Rottenberg DA, Hurwitz BJ, Posner JB. The effect of oral glycerol on intraventricular pressure in man. Neurology 1977; 27: 600–608. 10.1212/WNL.27.7.600 CASPubMedWeb of Science®Google Scholar 11 Johnson V., Carlson AJ, Johnson A. Studies on the physiological action of glycerol on the animal organism. Am J Physiol 1933; 103: 517–534. 10.1152/ajplegacy.1933.103.3.517 CASGoogle Scholar 12 Wittman JS III, Bawin RR. Stimulation of gluconeogenesis by propylene glycol in the fasting rat. Life Sci 1974; 15: 515–524. 10.1016/0024-3205(74)90349-X CASPubMedWeb of Science®Google Scholar 13 Miller ON, Bazzano G. Propanediol metabolism and its relation to lactic acid metabolism. Ann N Y Acad Sci 1965; 119: 957–973. 10.1111/j.1749-6632.1965.tb47455.x CASPubMedWeb of Science®Google Scholar 14 Rudney H. Propanediol phosphate as a possible intermediate in the metabolism of acetone. J Biol Chem 1954; 210: 361–371. CASPubMedWeb of Science®Google Scholar 15 Newman HW, van Winkle W., Kennedy NK, et al. Comparative effects of propylene glycol, other glycols, and alcohol on the liver directly. J Pharmacol Exp Ther 1940; 68: 194–200. CASWeb of Science®Google Scholar 16 Frank MS, Nahata MC, Hilty MD. Glycerol: A review of its pharmacology, pharmacokinetics, adverse reactions, and clinical use. Pharmacotherapy 1981; 1: 147–160. 10.1002/j.1875-9114.1981.tb03562.x CASPubMedWeb of Science®Google Scholar 17 Robergs RA, Griffin SE. Glycerol. Biochemistry, pharmacokinetics and clinical and practical applications. Sports Med 1998; 26: 145–167. 10.2165/00007256-199826030-00002 CASPubMedWeb of Science®Google Scholar 18 Swanson RE, Thompson RB. Renal tubular handling of glycerol and ethylene glycol in the dog. Am J Physiol 1969; 217: 553–562. CASPubMedWeb of Science®Google Scholar 19 Fulop M., Brenner BM. Diuretic action of glycerol in dogs. Proc Soc Exp Biol Med 1967; 124: 893–897. 10.3181/00379727-124-31880 CASPubMedWeb of Science®Google Scholar 20 Parker MG, Fraser GL, Watson DM, et al. Removal of propylene glycol and correction of increased osmolar gap by hemodialysis in a patient on high dose lorazepam infusion therapy. Intensive Care Med 2002; 28: 81–84. 10.1007/s00134-001-1125-1 PubMedWeb of Science®Google Scholar 21 Demey HE, Daelemans RA, Verpooten GA, et al. Propylene glycol-induced side effects during intravenous nitroglycerin therapy. Intensive Care Med 1988; 14: 221–226. 10.1007/BF00717993 CASPubMedWeb of Science®Google Scholar 22 Fligner CL, Jack R., Twiggs GA, et al. Hyperosmolality induced by propylene glycol. A complication of silver sulfadiazine therapy. JAMA 1985; 253: 1606–1609. PubMedWeb of Science®Google Scholar 23 Cawley MJ. Short-term lorazepam infusion and concern for propylene glycol toxicity: Case report and review. Pharmacotherapy 2001; 21: 1140–1144. 10.1592/phco.21.13.1140.34611 CASPubMedWeb of Science®Google Scholar 24 Reynolds HN, Teiken P., Regan ME, et al. Hyperlactatemia, increased osmolar gap, and renal dysfunction during continuous lorazepam infusion. Crit Care Med 2000; 28: 1631–1634. 10.1097/00003246-200005000-00063 CASPubMedWeb of Science®Google Scholar 25 Kelner MJ, Bailey DN. Propylene glycol as a cause of lactic acidosis. J Anal Toxicol 1985; 9: 40–42. 10.1093/jat/9.1.40 CASPubMedWeb of Science®Google Scholar 26 Demey H., Daelemans R., de Broe ME, et al. Propylene glycol intoxication due to intravenous nitroglycerin. Lancet 1984; 1: 1360. 10.1016/S0140-6736(84)91860-9 CASPubMedWeb of Science®Google Scholar 27 Murch S., Costeloe K. Hyperosmolality related to propylene glycol in an infant. BMJ 1990; 301: 389. 10.1136/bmj.301.6748.389-c CASPubMedWeb of Science®Google Scholar 28 Huggon I., James I., Macrae D. Hyperosmolality related to propylene glycol in an infant treated with enoximone infusion. BMJ 1990; 301: 19–20. 10.1136/bmj.301.6742.19 CASPubMedWeb of Science®Google Scholar 29 Glasgow AM, Boeckx RL, Miller MK, et al. Hyperosmolality in small infants due to propylene glycol. Pediatrics 1983; 72: 353–355. CASPubMedWeb of Science®Google Scholar 30 Kulick MI, Lewis NS, Bansal V., et al. Hyperosmolality in the burn patient: Analysis of an osmolal discrepancy. J Trauma 1980; 20: 223–228. 10.1097/00005373-198003000-00006 PubMedWeb of Science®Google Scholar 31 MacDonald MG, Fletcher AB, Johnson EL, et al. The potential toxicity to neonates of multivitamin preparations used in parenteral nutrition. J Parenter Enteral Nutr 1987; 11: 169–171. 10.1177/0148607187011002169 CASPubMedWeb of Science®Google Scholar 32 Bekeris L., Baker C., Fenton J., et al. Propylene glycol as a cause of an elevated serum osmolality. Am J Clin Pathol 1979; 72: 633–636. 10.1093/ajcp/72.4.633 PubMedWeb of Science®Google Scholar 33 Kulick MI, Wong R., Okarma TB, et al. Prospective study of side effects associated with the use of silver sulfadiazine in severely burned patients. Ann Plast Surg 1985; 14: 407–419. 10.1097/00000637-198505000-00003 CASPubMedWeb of Science®Google Scholar 34 Hershey SD, Gursel E. Hyperosmolality caused by percutaneously absorbed glycerin in a burned patient. J Trauma 1982; 22: 250–252. 10.1097/00005373-198203000-00015 CASPubMedWeb of Science®Google Scholar 35 Cantore G., Guidetti B., Virno M. Oral glycerol for the reduction of intracranial pressure. J Neurosurg 1964; 21: 278–283. 10.3171/jns.1964.21.4.0278 CASPubMedWeb of Science®Google Scholar 36 Connally HE. Critical care monitoring considerations for the diabetic patient. Clin Tech Small Anim Pract 2002; 17: 73–78. 10.1053/svms.2002.33039 PubMedWeb of Science®Google Scholar 37 Firth A. Treatments used in small animal toxicoses. In: MJ Murphy, JD Bonagura, eds. Kirk's Current Veterinary Therapy. Philadelphia , PA : WB Saunders; 2000: 207–211. Google Scholar 38 Rosendale ME. Decontamination strategies. Vet Clin North Am Small Anim Pract 2002; 32: 311–321. 10.1016/S0195-5616(01)00007-9 PubMedWeb of Science®Google Scholar 39 DC Plumb, ed. Charcoal, activated. In: DC Plumb, ed. Veterinary Drug Handbook, 4th ed. White Bear Lake , MN : Pharma Vet Publishing; 2002: 162–163. Google Scholar 40 Fort FL, Heyman IA, Kesterson JW. Hemolysis study of aqueous polyethylene glycol 400, propylene glycol and ethanol combinations in vivo and in vitro. J Parenter Sci Technol 1984; 38: 82–87. CASPubMedGoogle Scholar 41 Seidenfeld MA, Hanzlik PJ. The general properties, actions and toxicity of propylene glycol. J Pharmacol Exp Ther 1932; 44: 109–121. CASWeb of Science®Google Scholar 42 Christopher MM, Perman V., Eaton JW. Contribution of propylene glycol-induced Heinz body formation to anemia in cats. J Am Vet Med Assoc 1989; 194: 1045–1056. CASPubMedWeb of Science®Google Scholar Citing Literature Volume19, Issue5September 2005Pages 683-686 ReferencesRelatedInformation