Читать книгу Canine and Feline Epilepsy - Luisa De Risio - Страница 169

Treatment should be instituted promptly even if the results of confirmatory tests are not available yet. Treatment is aimed at preventing absorption, increasing excretion and preventing metabolism of ethylene glycol using a chemical antidote such as fomepizole or ethanol. Although therapeutic recommendations have traditionally included induction of vomiting, gastric lavage and administration of activated charcoal, it is likely that these procedures are not beneficial because of the rapidity of ethylene glycol absorption (Thrall et al., 2006). In addition, absorption of ethanol is inhibited by charcoal. Fomepizole (4-methylpyrazole), a competitive inhibitor of alcohol dehydrogenase, is considered safe and effective for dogs if started within 8 h of exposure (Table 4.2) (Dial et al., 1994a; Connally et al., 1996). Fomepizole can be used also in cats, although a much higher dosage is required (Dial et al., 1994b). If Fomepizole is not available, 20% ethanol can be used (Table 4.2). It acts as a competitive substrate for the enzyme alcohol dehydrogenase. Although effective in the treatment of ethylene glycol toxicity, ethanol may result in CNS and respiratory depression. Supportive and symptomatic care includes intravenous fluids to correct dehydration, acid-base and electrolyte imbalances and to promote diuresis, and AEMs in seizuring animals (see Table 4.1 and Chapters 12 and 24).