When Deaken, the Nova Scotia Duck Tolling Retriever, was taken to Departure Bay Beach he romped and played in the surf and explored the area. The next morning Deaken was reluctant to get up but eventually did however staggering. When he wouldn't eat his food his caregivers knew something was terribly wrong so he was rushed to the Island Veterinary Hospital.
I first observed Deaken in the examination room….his head trembled and shook like he was very nervous, drugged or very disorientated. The possibility of a head injury from being hit by a car or ingestion of marijuana and other drugs were quickly ruled out. Deaken was only two years of age, so a brain tumor or a vascular accident was also not very likely. One of the frustrations of being a veterinarian is not being able to quiz your patients so I had to assume he could have gotten into something on the beach and had to assume if could have been mushrooms, compost, antifreeze or other toxins.
I began a blood screen and tested him for ethylene glycol, the toxic ingredient in antifreeze. The test was highly positive suggesting he had ingested a lethal amount. Antifreeze tastes sweet and if found, dogs will voluntarily drink it so that only 4 tablespoons could have been lethal to Deaken. Time was critical and we immediately gave him an injection of a drug 4-methylpyrazole (4-m-p). Ethylene glycol itself will be eliminated from the body but the problem is that the liver has enzymes that converts it into oxalate crystals that plug up the filters of the kidneys resulting in kidney failure. Deaken's kidney enzymes were still normal and we could not find any oxalate crystals in his urine…..we had a chance. Most cases of antifreeze poisoning come in too late when the kidneys have shut down and there is nothing we can do to reverse it, we could only hope that was not the case with Deaken.
After the initial injection of 4-m-p we scrambled to find more of the drug but the only other immediate source was St. Paul's hospital. They only had enough to treat a person if one came in so they would not release it. We had to go to our old stand-by - ethanol. Ethanol uses the same enzymes the liver uses to convert the ethylene glycol into oxalate crystals. If we could continuously have liver use up the enzymes breaking down alcohol it would have no enzymes available to convert the antifreeze into the damaging crystals. We also gave drugs to dilate the blood vessels in the kidneys, bicarbonate to keep the blood pH right and diuretics and intravenous fluids to help flush the toxin out.
Deaken was a bit of a vocal drunk and moaned and 'talked' for some time after his intial loading dose of alcohol. The following two days he still remained positive for ethylene glycol and all of our medical grade alcohol was used up. It was time for a trip to the liquor store. As I checked the various bottles I thought it was somewhat ironic that an Alberta Vodka could save a Nova Scotian breed of dog. Vodka was as pure an alcohol as we could quickly get and it would now have to be our treatment of choice.
As we mixed the vodka with his intravenous fluids we knew keeping him drunk until he was negative for ethylene glycol was our only chance of saving him. It was a four-day bender for poor Deacon but finally he tested negative and was sent home on Sunday. We jokingly teased him as a booze hound but finally when Deaken was able to go home he was so happy that my worries of a bad hang-over for him quickly disappeared.
Deaken was lucky to survive and serves as an example for immediate veterinarian attention. So the next time you see your veterinarian in a liquor store buying vodka - just remember it may not be for him - it might be for one of his patients.
