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Related Experiment Video

Updated: May 15, 2026

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

Iatrogenic water intoxication in two cats.

Joyce Y Lee¹, Elizabeth Rozanski, Maryanne Anastasio

¹Emergency Pet Clinic of San Gabriel Valley, 3254 Santa Anita Avenue, El Monte, CA, USA.

Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001)

|January 16, 2013

Summary

Acute water intoxication in cats can occur from excessive water via esophagostomy tubes or subcutaneous 5% dextrose in water (D5W) administration, leading to severe hyponatremia. Prompt recognition and treatment are crucial for rapid correction and full recovery without lasting consequences.

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Area of Science:

Veterinary Medicine
Internal Medicine
Toxicology

Background:

Fluid therapy is essential for managing dehydration in cats.
Iatrogenic complications can arise from improper fluid administration.
Understanding fluid dynamics and electrolyte balance is critical in veterinary critical care.

Observation:

Case 1: A cat receiving continuous water infusion via esophagostomy tube developed lethargy and severe hyponatremia (116 mmol/L).
Case 2: A cat administered subcutaneous 5% dextrose in water (D5W) presented with lethargy, paresis, and hyponatremia (126 mmol/L).
Both cases highlight potential risks associated with specific fluid administration routes and types.

Findings:

Continuous water infusion via esophagostomy tube can lead to dangerous water intoxication and hyponatremia.
Subcutaneous administration of D5W as a bolus is not recommended and can cause hyponatremia.
Prompt recognition and intervention, including fluid restriction, diuretics, and hypertonic saline, rapidly corrected hyponatremia in both cases.

Implications:

Clinicians must carefully monitor fluid administration rates and types to prevent iatrogenic hyponatremia.
Esophagostomy tube fluid therapy requires precise rate control to avoid water intoxication.
D5W should not be used as a subcutaneous bolus in feline patients due to the risk of hyponatremia.