Retrospective evaluation of albuterol inhalant exposure in dogs: 36 cases (2007-2017).

Abstract

OBJECTIVE: To describe the clinical features, clinicopathological features, treatment, and outcome of dogs presented for albuterol exposure. DESIGN: Retrospective case series from January 2007 to December 2017. SETTING: Tertiary veterinary facility. ANIMALS: Thirty-six client-owned dogs presenting for known or suspected albuterol exposure secondary to chewing on albuterol metered-dose inhalers (MDIs). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: All dogs presented with clinical signs attributable to albuterol exposure. The most common physical examination abnormality was sinus tachycardia, noted in 34 of 36 (94%) dogs. Twenty-seven patients (75%) were admitted to the hospital for therapy, with a median length of hospitalization of 20.5&#xa0;hours (16.75-24.5). Thirty-two of 36 dogs had serum electrolytes evaluated at admission, with 22 of 32 (69%) presenting with hypokalemia ([K+]&#xa0;<&#xa0;3.62&#xa0;mmol/L]). Hyperlactatemia ([lactate]&#xa0;>&#xa0;2.80&#xa0;mmol/L) was noted in 23 of 28 (82%) dogs. A negative correlation was found between serum lactate and potassium (r&#xa0;=&#xa0;-0.64, r&#xa0;= 0.40, P&#xa0;= 0.0003). Hyperglycemia ([glucose]&#xa0;>&#xa0;6.44&#xa0;mmol/L) was noted in 20 of 30 (67%) dogs. Beta antagonist therapy was utilized in 20 of 36 (56%) of dogs. CONCLUSIONS: Although uncommon, albuterol intoxication can lead to significant clinical and electrolyte abnormalities. Albuterol-induced hypokalemia and associated tachyarrhythmias can be successfully managed, and albuterol intoxication has an excellent prognosis for survival to discharge. A minimum database should be evaluated in all dogs presenting for suspected albuterol exposure, with lactate and glucose monitored carefully in dogs with moderate or severe hypokalemia given the correlation found.