Gabriel Leah, Walton Rebecca A L, Young Timothy, Cai Jiazhang, Mochel Jonathan P, Peterson Katherine
VCA West Los Angeles, Los Angeles, CA, United States.
Precision One Health Initiative, The University of Georgia, Athens, GA, United States.
Front Vet Sci. 2025 May 12;12:1584162. doi: 10.3389/fvets.2025.1584162. eCollection 2025.
To retrospectively evaluate the incidence of hypernatremia in dogs administered multi-dose activated charcoal (MDAC) for acute toxicant ingestion.
Retrospective 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.
Ninety-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 ( < 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 ( < 0.01). For dogs that received 5 or 6 doses of AC, there was a significant decrease in serum Na at 6-12 h ( = 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.
In 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.
回顾性评估因急性毒物摄入而接受多剂量活性炭（MDAC）治疗的犬高钠血症的发生率。
2018年至2023年的回顾性研究。97只犬由大学教学医院和私立执业急诊医院评估，因急性毒物摄入接受多剂量活性炭治疗，同时使用或不使用山梨醇。
纳入97只犬。就诊时血清钠浓度（Na）中位数为146.7 mEq/L（范围139 - 154.7 mEq/L），6 - 12小时为145.6 mEq/L（范围137 - 152.3 mEq/L），12 - 24小时为144 mEq/L（范围132.5 - 155），24 - 48小时为144 mEq/L（范围134 - 150 mEq/L）。21只犬（21.6%）接受2剂活性炭，37只犬（38.1%）接受3剂，25只犬（25.8%）接受4剂，3只犬（3%）接受5剂，11只犬（11.3%）接受6剂。摄入毒物类型与血清钠变化无统计学显著差异。没有犬的血清钠高于155 mEq/L。接受2剂活性炭的犬，在任何时间点血清钠均无显著差异。接受3剂活性炭的犬，在12 - 24小时和24 - 48小时血清钠有统计学显著下降（P < 0.01）。接受4剂活性炭的犬，在12 - 24小时和24 - 48小时血清钠有统计学显著下降（P < 0.01）。接受5或6剂活性炭的犬，在6 - 12小时血清钠有显著下降（P = 0.02）。所有犬均住院，95只（98%）接受静脉输液。输液速度和类型与血清钠变化无显著关联。就诊时的红细胞压积、总血浆蛋白、血糖和乳酸与任何时间段血清钠变化均无显著关联。所有犬均存活出院。
在本研究中，接受多剂量活性炭治疗的犬均未发生高钠血症，且血清钠随时间有下降趋势，这在临床上不太可能具有显著意义。
