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

Abstract

OBJECTIVE: To retrospectively evaluate the incidence and clinical significance of hypernatremia in dogs administered a single dose of activated charcoal (AC) or activated charcoal with sorbitol (ACS) for acute toxicant ingestion. METHODS: Retrospective study between the years 2018-2023. Ninety-six dogs evaluated by a university teaching hospital and private practice emergency hospital treated for acute toxicant ingestion with a single dose of activated charcoal, with or without sorbitol. RESULTS: Medical records were retrospectively reviewed. No dog developed hypernatremia, defined as sodium >155 mEq/L, during the study period. The toxicant ingested was not significantly associated with a change in sodium (Na) at any time point (= 0.433 at 6-12 h,= 0.09 at 12-14 h, and= 0.486 at 24-48 h). Ingestion of multiple toxicants, compared to single toxicant ingestion, was also not significantly associated with a change in Na at any time point (= 0.126 at= 6-12 h,= 0.452 at 12-24 h, and= 0.516 at 24-48 h). Time from ingestion to presentation was not significantly associated with a change in Na at any time point (= 0.422 at 6-12 h,= 0.881 at 12-24 h, and= 0.516 at 24-48 h). The administration of AC compared to ACS was not significantly associated with a change in Na at any time period (= 0.715 at 6-12 h,= 0.137 at 12-24 h,= 0.582 at 24-48 h). There was a significant difference between Na on presentation and at 12-24 h and 24-48 h (= 0.025 and= 0.015, respectively.) Median Na values decreased at all-time points when compared to presentation, -0.90 at 6-12 h (standard deviation (SD) 2.74), -1.38 at 12-24 h (SD 4.81) and -2.11 at 24-48 h (SD 5.34). CONCLUSIONS: This study demonstrated a statistically significant, but unlikely clinically significant, decrease in Na in dogs who received single dose AC or ACS for acute toxicant ingestion.