Peer-reviewed veterinary case report
How common is high sodium in dogs given activated charcoal
By Gabriel, Leah et al.·Published in Frontiers in veterinary science·2025·VCA West Los Angeles, United States·View original on PubMed →
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Original publication title: Incidence of hypernatremia in dogs treated with multi-dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018-2023).
- Species:
- dog
Plain-English summary
A group of 97 dogs who ingested toxic substances were treated with multiple doses of activated charcoal to help remove the toxins from their system. Throughout their treatment, none of the dogs developed dangerously high sodium levels, and in fact, their sodium levels tended to decrease over time. Most of the dogs received intravenous fluids during their hospital stay, which also did not lead to any significant changes in sodium levels. All the dogs recovered and were discharged from the hospital.
People also search for: dog toxic ingestion treatment · activated charcoal for dogs · dog sodium levels after charcoal
Abstract
OBJECTIVE: To retrospectively evaluate the incidence of hypernatremia in dogs administered multi-dose activated charcoal (MDAC) for acute toxicant ingestion. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/40420949/