{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:36:24Z","timestamp":1753893384583,"version":"3.41.2"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Vet. Sci."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To retrospectively evaluate the incidence of hypernatremia in dogs administered multi-dose activated charcoal (MDAC) for acute toxicant ingestion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective study between the years 2018\u20132023. Ninety-seven dogs evaluated by a university teaching hospital and private practice emergency hospital treated for acute toxicant ingestion with multi-dose of activated charcoal, with or without sorbitol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety-seven dogs were included. The median serum sodium concentration (Na) on presentation was 146.7\u202fmEq\/L (range 139\u2013154.7\u202fmEq\/L), at 6\u201312\u202fh 145.6\u202fmEq\/L (range 137\u2013152.3\u202fmEq\/L), at 12\u201324\u202fh 144\u202fmEq\/L (range 132.5\u2013155) and at 24\u201348\u202fh 144\u202fmEq\/L (range 134\u2013150\u202fmEq\/L). Twenty-one dogs (21.6%) received 2 doses of AC, 37 dogs (38.1%) received 3 doses, 25 dogs (25.8%) received 4 doses, 3 dogs (3%) received 5 doses, and 11 dogs (11.3%) received 6 doses. There was no statistically significant difference in the type of toxicant ingested and changes in serum Na. No dog had a serum Na above 155\u202fmEq\/L. In dogs that received 2 doses of AC, there was no significant difference in serum Na at any time point. In dogs that received 3 total doses of AC there was a statistically significant decrease in serum Na at 12\u201324 and 24\u201348\u202fh (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.01). In dogs that had a total of 4 doses of AC, there was a statistically significant decrease in Na was noted at 12\u201324\u202fh and 24\u201348\u202fh (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.01). For dogs that received 5 or 6 doses of AC, there was a significant decrease in serum Na at 6\u201312\u202fh (<jats:italic>p<\/jats:italic>\u202f=\u202f0.02). All dogs were hospitalized and 95 (98%) received intravenous fluids. The fluid rate and type were not significantly associated with changes in serum Na. Packed cell volume, total plasma protein, blood glucose and lactate on presentation were not significantly associated with change in serum Na at any time frame. All dogs survived to discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, no dog receiving multi-dose activated charcoal developed hypernatremia and serum Na tended to decrease over time, which is unlikely to be clinically significant.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fvets.2025.1584162","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T06:07:40Z","timestamp":1747030060000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence of hypernatremia in dogs treated with multi-dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018\u20132023)"],"prefix":"10.3389","volume":"12","author":[{"given":"Leah","family":"Gabriel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca A. L.","family":"Walton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Young","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiazhang","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan P.","family":"Mochel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Peterson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1081\/clt-200051867","article-title":"American Academy of clinical toxicology; European Association of Poisons Centres and Clinical Toxicologists. 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American Academy of clinical toxicology; European Association of Poisons Centres and Clinical Toxicologists","volume":"37","year":"1999","journal-title":"J Toxicol Clin Toxicol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1111\/vec.12305","article-title":"Effect of sorbitol, single, and multidose activated charcoal administration on carprofen absorption following experimental overdose in dogs","volume":"25","author":"Koenigshof","year":"2015","journal-title":"J Vet Emerg Crit Care"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1111\/vec.12887","article-title":"Effect of single dose administration activated charcoal containing sorbitol on serum sodium concentration and hydration status in dogs","volume":"29","author":"Mix","year":"2019","journal-title":"J Vet Emerg Crit Care"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1547076","DOI":"10.33389\/fvets.2025.1547076","article-title":"Incidence of hypernatremia in dogs treated with single dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018-2023)","volume":"12","author":"Young","year":"2025","journal-title":"Front Vet Sci"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1067\/mem.2003.86","article-title":"The frequency of complications associated with the use of multiple-dose activated charcoal","volume":"41","author":"Dorrington","year":"2003","journal-title":"Ann Emerg Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1111\/vec.12980","article-title":"Gastrointestinal obstruction secondary to activated charcoal granule impaction in a dog","volume":"30","author":"Farrell","year":"2020","journal-title":"J Vet Emerg Crit Care (San Antonio)"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/j.cvsm.2016.10.015","article-title":"Disorders of sodium and water homeostasis","volume":"47","author":"Guillaumin","year":"2017","journal-title":"Vet Clin North Am Small Anim Pract"},{"key":"ref11","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-24277-4","volume-title":"ggplot2: Elegant Graphics for Data Analysis","author":"Wickham","year":"2016"}],"container-title":["Frontiers in Veterinary Science"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fvets.2025.1584162\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T06:07:41Z","timestamp":1747030061000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fvets.2025.1584162\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,12]]},"references-count":11,"alternative-id":["10.3389\/fvets.2025.1584162"],"URL":"https:\/\/doi.org\/10.3389\/fvets.2025.1584162","relation":{},"ISSN":["2297-1769"],"issn-type":[{"type":"electronic","value":"2297-1769"}],"subject":[],"published":{"date-parts":[[2025,5,12]]},"article-number":"1584162"}}