Successful Treatment of a Dog With Polyethylene Glycol Electrolyte and Activated Charcoal Solution Aspiration Pneumonitis With Bronchoalveolar Lavage and Mechanical Ventilation

Abstract

Objective

To describe a dog with aspiration pneumonitis resulting from administration of polyethylene glycol (PEG) electrolyte and activated charcoal (AC) solution into the airway that was successfully treated using bronchoalveolar lavage and mechanical ventilation (MV).

Case Summary

A young female Chihuahua–Pomeranian crossbreed initially presented with constipation to the primary care clinician. The dog was sedated for the placement of a nasoesophageal tube, after which the PEG and AC solution wer administered. The administration of this solution into the airways led to aspiration pneumonitis, causing respiratory distress and coughing. Initial treatment involved bronchoscopic suction and airway lavage and medical support, including an antimicrobial and a bronchodilator. Due to increasing respiratory effort and hypoxemia, MV was needed. Pressure-controlled synchronized intermittent mandatory ventilation mode, which allows spontaneous breathing and the administration of mandatory breaths, was initiated. Two complications occurred during MV. The first was hyperkalemia of unknown origin, which was treated with glucose, calcium gluconate, insulin, and terbutaline. The second complication involved severe clogging of the heat–moisture exchanger filters by the PEG and AC solution, resulting in hypercapnia. After 4 days, the dog was successfully weaned from the ventilator and eventually made a full recovery.

New or Unique Information Provided

To the authors’ knowledge, this is the first report describing successful treatment of a dog using bronchoalveolar lavage and MV for the inadvertent administration of PEG electrolyte and AC solution into the airways.