CVC Highlight: Your toolbox for troublesome toxicoses in cats - Veterinary Medicine
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CVC Highlight: Your toolbox for troublesome toxicoses in cats
For cats, just a little snack in the garden—or the inappropriate treatment of common ailments by well-meaning owners—can result in an emergency situation.


VETERINARY MEDICINE


PHOSPHATE ENEMA TOXICOSIS

"But if it's safe for kids...?"

When owners are faced with a constipated cat, they may be tempted to take the matter into their own hands and administer an enema. Fleet enemas (Fleet Company) labeled for children ages 2 to 9 are commonly selected, but they contain sodium phosphate and biphosphate (several Fleet enemas labeled for adults do not contain phosphates). Acute hyperphosphatemia associated with this enema administration is not unique to cats and has been seen in people with a preexisting compromising factor.

Rapid absorption of sodium and phosphate results in hypernatremia, hyperphosphatemia, hypocalcemia, and hypomagnesia. This rapid shift in electrolytes produces cerebral dehydration.

Clinical signs

Within one hour of enema administration (attributed to cerebral dehydration and hypocalcemia):

  • Lethargy
  • Ataxia
  • Miosis
  • Arrhythmias
  • Muscle tremors
  • Seizures
  • These patients are too sick to display the facial itching associated with hypocalcemia.

Diagnosis

  • Clinical signs and history (ask "Has your cat been constipated?")
  • Electrolyte abnormalities (hypernatremia, hyperphosphatemia, hypocalcemia, and hypomagnesemia)

Treatment

Treatment is supportive only and must be initiated promptly.

  • Low-sodium fluids, if given soon after the enema, can be given rapidly without concern for cerebral edema.
  • If therapy is not initiated for several hours after the enema, isotonic fluids must be used judiciously to bring down plasma sodium concentrations slowly to avoid cerebral edema.
  • Phosphorus will decrease as other electrolytes normalize and with fluid diuresis.
  • Treat any life-threatening arrhythmias by monitoring ECG while giving 10% calcium gluconate intravenously at a rate of 50 to 150 mg/kg (0.5 to 1.5 ml/kg) over 20 to 30 minutes. If bradycardia develops, halt infusion.


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Source: VETERINARY MEDICINE,
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