Acute Salt Toxicity Caused by Whey Ingestion in Mixed-breed 6-months old Puppy: A case study

This case report aims to emphasize the acute management of a dog with suspected salt intoxication, which consists of a treatment protocol with hematological and Modified Glasgow Coma Scale (MGCS) changes and electrocardiographic (ECG) evaluation. A 6-month-old male mixed-breed dog was admitted to the emergency clinic with complaints of weakness, hypersalivation, vomiting, diarrhea and gait disturbance. It was learned from the owner that the dog was fed on whey for the first time on the morning of the admission day. Salt toxication was suspected based on history and clinical symptoms. The diagnosis was confirmed by laboratory analysis (pH: 7.185, Na: 178 mmol./L, Cl: 155 mmol./L, K: 8.3 mmol./L, HCO3: 16.1 mmol./L, BE: -8.8 mmol./L, BUN: 105.7 mg/dl, creatinine: 5.4 mg/dl, AST: 513 U/L, amylase: 2324 U/L, LDH: 794 U/L, calcium: 11.8 mg/dl, phosphorus: 13.9 mg/dl, cholesterol: 515 mg/dl, magnesium: 3.6 mg/dl, GGT: 62 U/L CPK: 450 U/L and CK-MB: 324.5 U/L), ECG (sinus tachycardia (180 bpm) and mild ST depression) and MGCS evaluation (pre-treatment score; 7, grave). A treatment protocol including fluid therapy, antiemetic, diuretic, anticonvulsant, beta-blocker to prevent sodium retention and oxygen therapy was administrated to the dog during the hospitalization period. It was observed that the clinical findings and MGCS score improved and some blood parameters returned to their reference range on Day 2. Since the dog died on Day 3 after the hospitalization period, which was terminated at the owner's request, it was concluded that an adequate hospitalization period is important. The presented treatment protocol with MGCS evaluation in salt toxicity was successful enough only in acute management.