Toxicology Brief: Sodium hypochlorite bleach ingestion in two dogs


Typically, sodium hypochlorite bleach ingestion causes caustic gastrointestinal tract injury in animals and people. In people, severe clinical illness and death are rare.1,2 To date, there have been no published case reports regarding sodium hypochlorite bleach ingestion in animals.

In this case report, two dogs ingested an unknown volume of Clorox Regular-Bleach (The Clorox Company) containing 6.15% sodium hypochlorite and subsequently developed marked hypernatremia and hyperchloremia as well as numerous other biochemical abnormalities. Ultimately, the dogs were euthanized because of the severity of their clinical signs from the toxicosis.

CASE HISTORY

A 13-year-old 35.2-lb (16-kg) spayed female Shar-Pei and a 5-year-old 39.6-lb (18-kg) castrated male mixed-breed dog were presented to the Texas Veterinary Medical Center at Texas A&M University for evaluation of an acute onset of vomiting, diarrhea, and ataxia. The dogs had been housed in a kitchen and laundry area for about six hours before the owner returned home and found both dogs in distress. Multiple areas of vomit and diarrhea and copious amounts of clear fluid were found on the floor along with a severely chewed and punctured empty bleach bottle near the dogs. The owner transported the dogs to the Texas Veterinary Medical Center shortly after she discovered the situation.

The owner reported that she frequently used empty plastic milk jugs as toys for the dogs, and they likely had mistaken the bleach bottle for a toy. The owner estimated that the 2.83-L bottle of bleach had been about 75% (2.12 L) full before being damaged. The owner stated that there was no evidence that the animals had been exposed to any other potentially toxic material.

Clinical and laboratory findings

On presentation, both dogs were poorly responsive and hypothermic (94 F [34.4 C]). The female dog was laterally recumbent, and the male dog was markedly ataxic. Both dogs vomited clear-yellow, foamy fluid during their physical examinations, and their skin and coats were damp and smelled of urine and bleach. The female was also salivating excessively and had a green, mucoid nasal discharge.

Both dogs had a respiratory rate of 16 to 20 breaths/min with shallow, labored breathing. The male dog had a heart rate of 150 beats/min with tacky mucous membranes and a slightly prolonged capillary refill time. The female dog had a heart rate of 100 beats/min with a normal capillary refill time. No obvious oral lesions were observed.


Table 1: Selected Complete Blood Count Results
Venous blood samples were obtained for a complete blood count (CBC) and a serum chemistry profile in both dogs and a coagulation profile in the female dog. The CBC results revealed an elevated calculated hematocrit in the female and a high normal calculated hematocrit in the male (Table 1). There was a moderate discrepancy between the calculated hematocrit and spun hematocrit in the female and a mild discrepancy between the calculated hematocrit and spun hematocrit in the male. A decreased mean corpuscular hemoglobin concentration (MCHC) and a high or high normal mean corpuscular volume (MCV) were noted in both dogs.


Table 2: Selected Coagulation Profile Results
The coagulation profile in the female dog revealed a mild increase in prothrombin time and a marked increase in the D-dimer concentration (Table 2).