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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

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).