Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
ISSN:
0003-1488
Publication Date:
01 Sep 2010

  • 1. Marples D, Christensen S, Christensen EI, et al. Lithium-induced downregulation of aquaporin-2 water channel expression in rat kidney medulla. J Clin Invest 1995; 95:1838-1845.

    • Search Google Scholar
    • Export Citation

  • 2. Hoffman R. Fluid, electrolyte, and acid-base principles. In: Goldfrank L, Flomenbaum N, Lewin N, et al, eds. Goldfrank's toxicologic emergencies. 7th ed. New York: McGraw-Hill Co, 2002;364–380.

    • Search Google Scholar
    • Export Citation

  • 3. Ahlawat SK, Sachdev A. Hypokalaemic paralysis. Postgrad Med J 1999; 75:193-197.

  • 4. Wells JA, Wood KE. Acute barium poisoning treated with hemodialysis. Am J Emerg Med 2001; 19:175-177.

  • 5. Bahlmann H, Lindwall R, Persson H. Acute barium nitrate intoxication treated by haemodialysis. Acta Anaesthesiol Scand 2005; 49:110-112.

  • 6. Sigue G, Gamble L, Pelitere M, et al. From profound hypokalemia to life-threatening hyperkalemia: a case of barium sulfide poisoning. Arch Intern Med 2000; 160:548-551.

    • Search Google Scholar
    • Export Citation

  • 7. Mauras Y, Allain P. Dosage du baryum dans l'eau et les liquides biologiques par spectrometrie d'emission avec source plasma haute frequence. Anal Chim Acta 1979; 110:271-277.

    • Search Google Scholar
    • Export Citation

  • 8. Sutton A, Shepherd H. Urinary barium excretion in man and its reduction by alginate. Health Phys 1973; 25:182-184.

  • 9. Baselt RC, Cravey RH. Barium. In: Baselt RC, Cravey RH, eds. Disposition of toxic drugs and chemicals in man. 3rd ed. Chicago: Year Book Medical Publishers, 1989;75–77.

    • Search Google Scholar
    • Export Citation

  • 10. Schorn TF, Olbricht C, Schuler A, et al. Barium carbonate intoxication. Intensive Care Med 1991; 17:60-62.

  • 11. Jacobs IA, Taddeo J, Kelly K, et al. Poisoning as a result of barium styphnate explosion. Am J Ind Med 2002; 41:285-288.

  • 12. Phelan DM, Hagley SR, Guerin MD. Is hypokalaemia the cause of paralysis in barium poisoning? Br Med J (Clin Res Ed) 1984; 289:882.

  • 13. Koch M, Appoloni O, Haufroid V, et al. Acute barium intoxication and hemodiafiltration. J Toxicol Clin Toxicol 2003; 41:363-367.

  • 14. Kakar A, Anand I, Sethi P. Barium carbonate intoxication: an electrophysiological study. J Neurol Neurosurg Psychiatry 1998; 65:606-607.

  • 15. Ramanathan R. Barium and barium salts. In: Committee on Spacecreft Exposure Guidelines, ed. Spacecraft water exposure guidelines for selected contaminants. Washington, DC: National Academies Press, 2007;52–95.

    • Search Google Scholar
    • Export Citation

  • 16. World Health Organization. Barium: environmental health criteria series No 107. New York: World Health Organization, 1990.

  • 17. Chou C, Chin YC. The absorption, fate and concentration in serum of barium in acute experimental poisoning. Chin Med J (Engl) 1943; 61:313-322.

    • Search Google Scholar
    • Export Citation

  • 18. Dawson A. Barium. In: Flomenbaum N, Goldfrank L, Hoffman R, et al, eds. Goldfrank's toxicologic emergencies. 8th ed. Norwalk, Conn: Appleton and Lange, 2006;1480–1483.

    • Search Google Scholar
    • Export Citation

  • 19. Sax NI. Barium chloride. In: Lewis RJ, eds. Dangerous properties of industrial materials. Vol 2. 6th ed. New York: Van Nostrand Reinhold, 1984;340.

    • Search Google Scholar
    • Export Citation

  • 20. Johnson CH, VanTassel V. Acute barium poisoning with respiratory failure and rhabdomyolysis. Ann Emerg Med 1991; 20:1138-1142.

  • 21. Ellenhorn MJ, Schonwald S, Orgdog G, et al. Barium. In: Ellenhorn MJ, ed. Ellenhorn's medical toxicology: diagnosis and treatment of human poisoning. 2nd ed. Baltimore: Williams & Wilkins, 1997;1363–1395.

    • Search Google Scholar
    • Export Citation

  • 22. Roza O, Berman LB. The pathophysiology of barium: hypokalemic and cardiovascular effects. J Pharmacol Exp Ther 1971; 177:433-439.

  • 23. Bradberry SM, Vale JA. Disturbances of potassium homeostasis in poisoning. J Toxicol Clin Toxicol 1995; 33:295-310.

  • 24. Layzer RB. Periodic paralysis and the sodium-potassium pump. Ann Neurol 1982; 11:547-552.

  • 25. Thomas M, Bowie D, Walker R. Acute barium intoxication following ingestion of ceramic glaze. Postgrad Med J 1998; 74:545-546.

  • 26. Smith RP, Gosselin RE. Current concepts about the treatment of selected poisonings: nitrite, cyanide, sulfide, barium, and quinidine. Annu Rev Pharmacol Toxicol 1976; 16:189-199.

    • Search Google Scholar
    • Export Citation

  • 27. Sjodin RA, Ortiz O. Resolution of the potassium ion pump in muscle fibers using barium ions. J Gen Physiol 1975; 66:269-286.

  • 28. Bryson P. Miscellaneous metals. In: Bryson P, ed. Comprehensive review in toxicology for emergency clinicians. 3rd ed. London: Taylor and Francis, 1996;633–640.

    • Search Google Scholar
    • Export Citation

  • 29. Chaudhary SC, Aggarwal A, Avasthi R. Acute severe poisoning by barium carbonate (rat poison). J Indian Acad Clin Med 2008; 9:133-135.

  • 30. Wetherill SF, Guarino MJ, Cox RW. Acute renal failure associated with barium chloride poisoning. Ann Intern Med 1981; 95:187-188.

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Barium toxicosis in a dog

Fiona H. Adam BVM&S1, Peter J. M. Noble BVM&S, PhD2, Simon T. Swift MA, VetMB3, Brent M. Higgins BVSc4, and Christine E. Sieniawska MPhil, PhD5
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  • 1 Small Animal Teaching Hospital, University of Liverpool, Leahurst, Cheshire CH64 7TE, England
  • | 2 Small Animal Teaching Hospital, University of Liverpool, Leahurst, Cheshire CH64 7TE, England
  • | 3 Small Animal Teaching Hospital, University of Liverpool, Leahurst, Cheshire CH64 7TE, England
  • | 4 Small Animal Teaching Hospital, University of Liverpool, Leahurst, Cheshire CH64 7TE, England
  • | 5 SAS Unit for Trace Elements, Southampton University Hospitals NHS Trust, Southampton General Hospital, Southampton, Hampshire SO16 6YD, England
DOI:
https://doi.org/10.2460/javma.237.5.547
Volume/Issue:
Volume 237: Issue 5
Online Publication Date:
01 Sep 2010
Restricted access
Reprints and Permissions Purchase Article

Abstract

Case Description—A 2-year-old 14.9-kg (32.8-lb) neutered female Shetland Sheepdog was admitted to the University of Liverpool Small Animal Teaching Hospital for evaluation of acute collapse.

Clinical Findings—At admission, the dog was tachypneic and had reduced limb reflexes and muscle tone in all limbs consistent with diffuse lower motor neuron dysfunction. The dog was severely hypokalemic (1.7 mEq/L; reference range, 3.5 to 5.8 mEq/L). Clinical status of the dog deteriorated; there was muscle twitching, flaccid paralysis, and respiratory failure, which was considered a result of respiratory muscle weakness. Ventricular arrhythmias and severe acidemia (pH, 7.18; reference range, 7.35 to 7.45) developed. Intoxication was suspected, and plasma and urine samples submitted for barium analysis had barium concentrations comparable with those reported in humans with barium toxicosis. Analysis of barium concentrations in 5 control dogs supported the diagnosis of barium toxicosis in the dog.

Treatment and Outcome—Fluids and potassium supplementation were administered IV. The dog recovered rapidly. Electrolyte concentrations measured after recovery were consistently unremarkable. Quantification of plasma barium concentration 56 days after the presumed episode of intoxication revealed a large decrease; however, the plasma barium concentration remained elevated, compared with that in control dogs.

Clinical Relevance—To our knowledge, this case represented the first description of barium toxicosis in the veterinary literature. Barium toxicosis can cause life-threatening hypokalemia; however, prompt supportive treatment can yield excellent outcomes. Barium toxicosis is a rare but important differential diagnosis in animals with hypokalemia and appropriate clinical signs.

Contributor Notes

Dr. Swift's present address is Northwest Surgeons, Delamere House, Ashville Point, Sutton Weaver, Cheshire WA7 3FW, England.

The authors thank Dr. Valerie Walker and Alan Lack for technical assistance.

Address correspondence to Dr. Adam (F.H.Adam@liv.ac.uk).