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Retrospective evaluation of albuterol inhalant exposure in dogs: 36 cases (2007-2017)
Emiliana R Meroni1, Roxanna Khorzad2, Kiko Bracker1
1Department of Emergency and Critical Care, Angell Animal Medical Center, Boston, Massachusetts.
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 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+] < 3.62 mmol/L]). Hyperlactatemia ([lactate] > 2.80 mmol/L) was noted in 23 of 28 (82%) dogs. A negative correlation was found between serum lactate and potassium (r = -0.64, r2 = 0.40, P = 0.0003). Hyperglycemia ([glucose] > 6.44 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.
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