Retrospective evaluation of acute salbutamol (albuterol) exposure in dogs: 501 cases

Crouchley, Joanna; Bates, Nicola

doi:10.1111/vec.13182

Cited by 4 publications

(11 citation statements)

References 18 publications

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“…It is possible the incidence of adverse effects could increase with higher doses of albuterol IH in dogs. This theory is supported by the results from 2 recent retrospective studies that revealed tachycardia (81%‐94%), hypokalemia (21%‐69%), and hyperglycemia (67%) were common sequela to intoxication by high‐dose salbutamol (albuterol) exposure in dogs 40,41 …”

Section: Discussionmentioning

confidence: 72%

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Effect of inhaled albuterol on whole blood potassium concentrations in dogs

Ogrodny

Jaffey

Kreisler

et al. 2022

Veterinary Internal Medicne

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Background: Albuterol by inhalation (IH) is a common treatment for hyperkalemia in humans but its effect on blood potassium concentrations in dogs is unknown.Objective: Determine whether albuterol (IH) decreases blood potassium concentrations in healthy normokalemic dogs and if effects are dose-dependent.Animals: Ten healthy dogs.Methods: Prospective, crossover experimental study. Albuterol sulfate was administered at a low-dose (90 μg) in phase I and, 7 days later, high-dose (450 μg) in phase II.Blood potassium and glucose concentrations (measured via blood gas analyzer) and heart rates were obtained at baseline and then 3, 5, 10, 15, 30, 60, 90, 120, 180, and 360 minutes after inhaler actuation.Results: Blood potassium concentrations decreased rapidly after albuterol delivery with a significant reduction compared to baseline within 30 minutes in both phases (P = .05).The potassium nadir concentration of phase I occurred at 60 minutes (mean, SD; 4.07 mmol/L, 0.4) and was significantly decreased from baseline, (4.30 mmol/L, 0.3; t (9) = 2.40, P = .04). The potassium nadir concentration of phase II occurred at 30 minutes (mean, SD; 3.96 mmol/L, 0.39) and was also significantly decreased from baseline, (4.33 mmol/L, 0.4; t(9) = 2.22, P = .05). The potassium nadir concentration decreased by 0.1 mmol/L for each 10 μg/kg increase in dose of albuterol (P = .01). Five dogs had ≥1 hyperglycemic measurement (ie, >112 mg/dL). No median heart rate was tachycardic nor was any mean blood glucose concentration hyperglycemic at any time point. Conclusion and Clinical Importance:Albuterol IH decreases blood potassium concentrations in a dose-dependent manner without clinically meaningful alterations to heart rate or blood glucose concentrations in healthy dogs. The mean decrease in potassium concentration at the high-dose of albuterol was modest (0.38 mmol/L).

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Section: Discussionmentioning

confidence: 72%

“…This theory is supported by the results from 2 recent retrospective studies that revealed tachycardia (81%-94%), hypokalemia (21%-69%), and hyperglycemia (67%) were common sequela to intoxication by high-dose salbutamol (albuterol) exposure in dogs. 40,41 This study had several limitations that require further elucidation.…”

Section: Discussionmentioning

confidence: 99%

Effect of inhaled albuterol on whole blood potassium concentrations in dogs

Ogrodny

Jaffey

Kreisler

et al. 2022

Veterinary Internal Medicne

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“…Albuterol, a selective ß2‐adrenergic agonist, is used for its bronchodilator effects in the treatment of asthma in human, canine, and feline patients 1 . Albuterol toxicosis is encountered in veterinary medicine, as dogs tend to chew on albuterol‐containing inhalers, resulting in sudden massive exposures 2 . Acute toxicosis can result in significant clinical and laboratory abnormalities, including cardiac arrhythmias, weakness, hypokalemia, hypomagnesemia, hyperglycemia, and hyperlactatemia 1–4 .…”

Section: Introductionmentioning

confidence: 99%

“…These effects are mediated by the stimulatory effects of ß2‐adrenergic agonists on the pancreatic islet cells and cell membrane Na/K‐ATPase pumps, as well as the direct increase in glycogenolysis 3,5 . With extreme overdoses, specificity for the ß2 receptor is decreased, and albuterol binds to both ß1 and ß2 receptors 2,3 2 …”

Section: Introductionmentioning

confidence: 99%

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Rebound hyperkalemia in a dog with albuterol toxicosis after cessation of potassium supplementation

Guida,

Bazzle

2023

J Vet Emergen Crit Care

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ObjectiveTo describe the presentation of rebound hyperkalemia as a delayed side effect of albuterol toxicity in a dog.Case SummaryA 3‐year‐old female neutered mixed‐breed dog was presented for albuterol toxicosis that led to a severe hypokalemia, hyperlactatemia, and hyperglycemia. The dog also experienced sinus tachycardia and generalized weakness. Treatment was instituted with intravenous fluid therapy and potassium supplementation, and the dog was monitored with a continuous electrocardiogram. Resolution of hypokalemia was documented 12 hours after initial presentation, at which time fluid therapy and potassium supplementation were discontinued. There were no further periods of sinus tachycardia, but instead the dog developed ventricular ectopy with rapid couplets (instantaneous rates of 300/min). An echocardiogram revealed normal cardiac size and function. Twenty‐four hours after presentation, the patient developed severe hyperkalemia, despite discontinuation of fluids and potassium supplementation for 12 hours. Serial venous and urinary electrolytes were performed for determination of the fractional excretion of electrolytes. These data confirmed rebound hyperkalemia (7.0 mmol/L), consistent with a markedly increased fractional excretion of potassium, and secondary to the release of potassium from inside the cells. Fluid therapy with dextrose supplementation was provided until 36 hours postpresentation. The hyperkalemia resolved, and the dog was discharged after 44 hours of hospitalization.New or Unique Information ProvidedThis case documents rebound hyperkalemia following treatment of albuterol toxicosis in a dog. This case highlights the importance of understanding the distribution of total body potassium when treating serum hypokalemia. Transcellular shifts of potassium, as in the case of albuterol toxicosis, can lead to rebound hyperkalemia even after discontinuation of potassium supplementation. This case further explores the utility of fractional excretion of electrolytes in elucidating the etiology and management of electrolyte disturbances.

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Salbutamol toxicosis in dogs

Bates¹

2023

Companion Animal

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Salbutamol exposure in dogs typically occurs when they bite and pierce a salbutamol inhaler. Onset of clinical signs can be rapid. Dogs may appear anxious and distressed, and common signs include tachycardia, tachypnoea and hypokalaemia. Transient hyperglycaemia may occur. Potential complications include muscle weakness, flaccid paralysis, arrhythmias, rhabdomyolysis and oral injury from the compressed gas in some inhalers. Any dog exposed to salbutamol requires examination and evaluation. The heart rate, blood pressure, electrocardiogram and electrolytes should be monitored. Treatment is aimed at correcting tachycardia and hypokalaemia, for which the treatment of choice is a non-selective beta-blocker. Salbutamol exposed dogs require hospitalisation until the heart rate and rhythm, central nervous system status and electrolytes normalise. Recovery generally occurs within 24 hours, but there is risk of persistent cardiac injury.

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Retrospective evaluation of acute salbutamol (albuterol) exposure in dogs: 501 cases

Abstract: Objective: To determine the common clinical signs, with onset and duration, treatments given, and outcome in dogs with acute, accidental exposure to salbutamol.

Cited by 4 publications

References 18 publications

Effect of inhaled albuterol on whole blood potassium concentrations in dogs

Effect of inhaled albuterol on whole blood potassium concentrations in dogs

Rebound hyperkalemia in a dog with albuterol toxicosis after cessation of potassium supplementation

Salbutamol toxicosis in dogs

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