By Dr. Ed Mapes
Stonebridge Animal Hospital

Rowdy was a monster of a dog – a St. Bernard that tipped the scales at over 220 pounds. As is the case with most really big dogs, he was as gentle as he was big – all he wanted to do was be friends.

The animal control truck – used mostly to pick up stray animals – pulled up to the hospital as snow fell lightly a few days before Christmas. Rowdy’s owner, Joe Harden, had called the police for help, who then called Animal Control, who had the only truck available to transport Rowdy to the hospital. He was vomiting and weak – so weak he could barely wag his tail when I opened the back door of the truck.

He was on a stretcher, borne from home by two police officers that had accompanied the dog catcher to the hospital.
”Doesn’t look very good, doc”, said Officer Brad Kerrigan of the Roseville Police Department.
“He’s got the look of death on him”.
We hefted Rowdy into the hospital and I’d almost finished my examination – he was dehydrated, had a very fast pulse, and pale mucous membranes.
We had already taken blood and urine samples and placed an intravenous catheter when Joe Harden rushed into the room. He’d driven from his job two cities away when his wife called there to tell how Rowdy had gotten so sick. Snow flakes were still on his face as he raced over to his friend on the stretcher. I started to ask Joe questions when he finally let go of Rowdy’s head.
The big dog had stopped eating the night before, and then began vomiting throughout the night. There was no history of eating a tee shirt or underwear, and he’d been perfectly healthy the previous morning. Then I asked a standard question when patients are sick in the winter; could he have gotten into antifreeze?
“That could be”, Joe said after a few seconds thought. “Our neighbor worked on his car yesterday, and Rowdy was over there playing with their dog.”
“I don’t know what he was doing on the car though.”
By that time the technician had tested the urine and a sample had been spun in the centrifuge. There was blood in the urine all right, and a glance through the microscope confirmed my suspicions. Calcium oxalate crystals (Figure 1) in the urine are definitive evidence that Rowdy had ethylene glycol poisoning from drinking antifreeze.

Figure 1

Figure 1

Figure 1 these crystals that look like small coffins are appropriately seen in urine of victims of ethylene glycol poisoning.

The policemen helped us get Rowdy back to our biggest cage, and we started IV fluids and antibiotics. He was very acidotic (antifreeze is metabolized into several types of acidic compounds) and I added a dose of sodium bicarbonate to the IV mixture.
“Joe”, I said, “I need you to do two things”.
“Find out how much antifreeze Rowdy could have gotten”.
“Then go to the liquor store and buy three fifths of vodka and get them here as fast as you can”.
“Yeah Joe, ethanol is an antidote for the antifreeze”.
“We’ve got to put Rowdy on an IV drip of pure ethanol to save his life, if that’s still possible”.
“We have to keep Rowdy drunk as a skunk for the next few days”.
“Whatever you say, Doc’, he said, glancing back with a shrug of the shoulders.
Joe showed up about a half hour later with a brown shopping bag containing three bottles individually wrapped in smaller brown bags. I calculated the dosage need to shnocker Rowdy, added it to the IV bag, and served him the first round of drinks.

Over the next three days we never let Rowdy sober up. We dosed him with antibiotics and sodium bicarbonate and of course his vodka cocktail. We catheterized his urinary bladder to maintain drainage of urine for testing, monitored his vital signs, and cleaned up the diarrhea that flowed on a regular basis.
I visited nightly at around 2:00 in the morning to keep the treatment going. Sometimes Rowdy barely seemed to know I was there.
Ever so gradually, we tapered the IV booze off. If ethanol doesn’t turn the tide within the first couple of days, the kidney damage is just too severe and there’s no hope for recovery left. We monitored his progress with blood and urine tests, just hoping for signs of improvement. In the afternoon of the third day, I called Joe Harden and advised that he come to the hospital.

A custom of mine was that any vodka left after treating patients for antifreeze poisoning goes back to the owners. I’m not much of a drinker myself, and they bought the stuff after all.

I’d been talking with Joe for about a half hour and the hospital was closing when the receptionist ushered Joe’s wife, Annie, to join us in my office. I guess you could say they were both surprised when they saw Joe and I clicking plastic glasses together for a toast – about the fifth one we’d made. Rowdy leaped up and rushed toward Annie. His tail knocked papers off my desk and he slobbered all over her coat as he barreled into her rowdy-style.
“We’re shelebrating!” I slurred. “Would you like a drink?”
“You might as well help us finish off the rest of Rowdy”s medicine!”

Note: Fomepizole is a more modern medication useful for treating ethylene glycol toxicosis. It is an antidote much like ethanol, but it’s just not as fun to celebrate with as vodka.

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