Incidence of hypernatremia in dogs treated with multi-dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018–2023)

ObjectiveTo retrospectively evaluate the incidence of hypernatremia in dogs administered multi-dose activated charcoal (MDAC) for acute toxicant ingestion.MethodsRetrospective study between the years 2018–2023. Ninety-seven dogs evaluated by a university teaching hospital and private practice emerge...

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Main Authors: Leah Gabriel, Rebecca A. L. Walton, Timothy Young, Jiazhang Cai, Jonathan P. Mochel, Katherine Peterson
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Veterinary Science
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Online Access:https://www.frontiersin.org/articles/10.3389/fvets.2025.1584162/full
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author Leah Gabriel
Rebecca A. L. Walton
Timothy Young
Jiazhang Cai
Jonathan P. Mochel
Katherine Peterson
author_facet Leah Gabriel
Rebecca A. L. Walton
Timothy Young
Jiazhang Cai
Jonathan P. Mochel
Katherine Peterson
author_sort Leah Gabriel
collection DOAJ
description ObjectiveTo retrospectively evaluate the incidence of hypernatremia in dogs administered multi-dose activated charcoal (MDAC) for acute toxicant ingestion.MethodsRetrospective study between the years 2018–2023. Ninety-seven dogs evaluated by a university teaching hospital and private practice emergency hospital treated for acute toxicant ingestion with multi-dose of activated charcoal, with or without sorbitol.ResultsNinety-seven dogs were included. The median serum sodium concentration (Na) on presentation was 146.7 mEq/L (range 139–154.7 mEq/L), at 6–12 h 145.6 mEq/L (range 137–152.3 mEq/L), at 12–24 h 144 mEq/L (range 132.5–155) and at 24–48 h 144 mEq/L (range 134–150 mEq/L). Twenty-one dogs (21.6%) received 2 doses of AC, 37 dogs (38.1%) received 3 doses, 25 dogs (25.8%) received 4 doses, 3 dogs (3%) received 5 doses, and 11 dogs (11.3%) received 6 doses. There was no statistically significant difference in the type of toxicant ingested and changes in serum Na. No dog had a serum Na above 155 mEq/L. In dogs that received 2 doses of AC, there was no significant difference in serum Na at any time point. In dogs that received 3 total doses of AC there was a statistically significant decrease in serum Na at 12–24 and 24–48 h (p < 0.01). In dogs that had a total of 4 doses of AC, there was a statistically significant decrease in Na was noted at 12–24 h and 24–48 h (p < 0.01). For dogs that received 5 or 6 doses of AC, there was a significant decrease in serum Na at 6–12 h (p = 0.02). All dogs were hospitalized and 95 (98%) received intravenous fluids. The fluid rate and type were not significantly associated with changes in serum Na. Packed cell volume, total plasma protein, blood glucose and lactate on presentation were not significantly associated with change in serum Na at any time frame. All dogs survived to discharge.ConclusionIn this study, no dog receiving multi-dose activated charcoal developed hypernatremia and serum Na tended to decrease over time, which is unlikely to be clinically significant.
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spelling doaj-art-5111cf91bfc2422586d14c1f508e19da2025-08-20T01:51:06ZengFrontiers Media S.A.Frontiers in Veterinary Science2297-17692025-05-011210.3389/fvets.2025.15841621584162Incidence of hypernatremia in dogs treated with multi-dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018–2023)Leah Gabriel0Rebecca A. L. Walton1Timothy Young2Jiazhang Cai3Jonathan P. Mochel4Katherine Peterson5VCA West Los Angeles, Los Angeles, CA, United StatesVCA West Los Angeles, Los Angeles, CA, United StatesVCA West Los Angeles, Los Angeles, CA, United StatesPrecision One Health Initiative, The University of Georgia, Athens, GA, United StatesPrecision One Health Initiative, The University of Georgia, Athens, GA, United StatesBluePearl, Duluth, MN, United StatesObjectiveTo retrospectively evaluate the incidence of hypernatremia in dogs administered multi-dose activated charcoal (MDAC) for acute toxicant ingestion.MethodsRetrospective study between the years 2018–2023. Ninety-seven dogs evaluated by a university teaching hospital and private practice emergency hospital treated for acute toxicant ingestion with multi-dose of activated charcoal, with or without sorbitol.ResultsNinety-seven dogs were included. The median serum sodium concentration (Na) on presentation was 146.7 mEq/L (range 139–154.7 mEq/L), at 6–12 h 145.6 mEq/L (range 137–152.3 mEq/L), at 12–24 h 144 mEq/L (range 132.5–155) and at 24–48 h 144 mEq/L (range 134–150 mEq/L). Twenty-one dogs (21.6%) received 2 doses of AC, 37 dogs (38.1%) received 3 doses, 25 dogs (25.8%) received 4 doses, 3 dogs (3%) received 5 doses, and 11 dogs (11.3%) received 6 doses. There was no statistically significant difference in the type of toxicant ingested and changes in serum Na. No dog had a serum Na above 155 mEq/L. In dogs that received 2 doses of AC, there was no significant difference in serum Na at any time point. In dogs that received 3 total doses of AC there was a statistically significant decrease in serum Na at 12–24 and 24–48 h (p < 0.01). In dogs that had a total of 4 doses of AC, there was a statistically significant decrease in Na was noted at 12–24 h and 24–48 h (p < 0.01). For dogs that received 5 or 6 doses of AC, there was a significant decrease in serum Na at 6–12 h (p = 0.02). All dogs were hospitalized and 95 (98%) received intravenous fluids. The fluid rate and type were not significantly associated with changes in serum Na. Packed cell volume, total plasma protein, blood glucose and lactate on presentation were not significantly associated with change in serum Na at any time frame. All dogs survived to discharge.ConclusionIn this study, no dog receiving multi-dose activated charcoal developed hypernatremia and serum Na tended to decrease over time, which is unlikely to be clinically significant.https://www.frontiersin.org/articles/10.3389/fvets.2025.1584162/fulldecontaminationelectrolyte derangementstoxicitysorbitolhypernatremia
spellingShingle Leah Gabriel
Rebecca A. L. Walton
Timothy Young
Jiazhang Cai
Jonathan P. Mochel
Katherine Peterson
Incidence of hypernatremia in dogs treated with multi-dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018–2023)
Frontiers in Veterinary Science
decontamination
electrolyte derangements
toxicity
sorbitol
hypernatremia
title Incidence of hypernatremia in dogs treated with multi-dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018–2023)
title_full Incidence of hypernatremia in dogs treated with multi-dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018–2023)
title_fullStr Incidence of hypernatremia in dogs treated with multi-dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018–2023)
title_full_unstemmed Incidence of hypernatremia in dogs treated with multi-dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018–2023)
title_short Incidence of hypernatremia in dogs treated with multi-dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018–2023)
title_sort incidence of hypernatremia in dogs treated with multi dose activated charcoal for acute toxicant ingestion multi center retrospective study 2018 2023
topic decontamination
electrolyte derangements
toxicity
sorbitol
hypernatremia
url https://www.frontiersin.org/articles/10.3389/fvets.2025.1584162/full
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