Ethanol Poisoning in Cats

If you think your cat has ingested ethanol, it is important to visit a veterinarian as soon as possible, because if treated early there is a good chance the cat will recover.

Ethanol poisoning occurs in cats when they ingest a substance that either contains alcohol, such as a beverage or fuel, or produces ethanol inside the body after ingestion, such as uncooked pizza or bread dough. Ethanol is quickly absorbed in the gastrointestinal tract and goes to the brain.

Ethanol poisoning may cause depression of the central nervous system, which may result in the following symptoms within an hour of ingestion:

• Vomiting
• Lethargy
• Ataxia
• Hypothermia
• Sedation
• Dehydration
• Metabolic acidosis

The cat may become comatose and develop respiratory depression. The abdomen may become distended if the cat ingested uncooked bread dough. Cats may have kidney failure between 12 and 24 hours after ingestion. As soon as any of these symptoms are seen, a veterinarian should be called for diagnoses and treatment, but if you know your cat could be poisoned, you shouldn’t wait for symptoms.

Ethanol, also called ethyl alcohol, is a two-carbon alcohol that is contained in many household products. The most common causes of poisoning are antifreeze, hand sanitizer, and raw bread dough. Ethanol is quickly absorbed in the gastrointestinal tract and goes to the brain. How this happens is not clear, but research shows that ethanol may inhibit N-methyl-D-aspartate glutamate receptors in the brain. This may affect the production of cyclic guanosine monophosphate causing the blockage of messages between brain cells. Cats may get ethanol poisoning when they eat one or more of the following household substances:

• Alcoholic beverages
• Perfume and mouthwash
• Paint and varnish
• Certain medications
• Certain types of antifreeze
• Uncooked bread or pizza dough

It is not recommended to wait and see or to try to diagnose ethanol poisoning yourself because the symptoms are very complex and the cat may have more than one symptom that you cannot see. In some cases, obvious symptoms may subside while more severe injury is continuing internally. Only a veterinarian can thoroughly diagnose ethanol poisoning because, in most cases, cats are not observed ingesting ethanol. Your vet will collect blood and urine samples for analysis to determine if the kidneys are functioning properly. Urinalysis will help detect calcium oxalate monohydrate crystals and isosthenuria. Hyperechoic cortices may be detected with renal ultrasound. If the bladder is unusually small, it may mean the cat is producing less urine.

If you know that your cat has ingested any of the above substances, you should contact a vet before symptoms start to materialize. If you keep antifreeze in your garage, you should make sure it is properly stored and there are no leaks. If your cat roams the neighborhood, it might be a good idea to help your neighbors be aware of the dangers of unprotected antifreeze.

The type of treatment used depends on several variables. For example, the amount of time that has elapsed since the cat ate the poison is the main factor in determining the treatment. The aim of the treatment is to decrease the absorption of the ingested ethanol by the intestines. Induced vomiting is one possible treatment if the cat reaches the vet within one or two hours after eating the poison. Once the poison is absorbed, liquids may be used to stop dehydration and increase urine production. The treatments for ethanol poisoning in cats are nonsurgical. However, a venous catheter may be placed to make sure the fluid therapy is working. 

Medication may be given intravenously for four or five treatments in six hours, followed by four more treatments in the next eight hours. Sodium bicarbonate may also be administered according to the body weight of the cat with the goal of maintaining the pH of the urine at a proper level.

If all of the poison has been absorbed by the body, kidney failure is possible. The prognosis for these cats is poor at best. The treatment at this stage may include fluids, electrolytes, and possibly dialysis.

Ethanol poisoning kills quickly. If a cat receives treatment before the poison has affected the kidneys-- usually within three hours--  there is a good prognosis for a full recovery. The cat should be regularly re-assessed by the vet every 30 minutes during the initial treatment. After initial treatment, the cat should have ongoing fluid therapy. Your vet will continue to measure the blood, urine and body acidity until the danger has passed.

If the cat is successfully treated, there will be no relapse from the initial poisoning, but you need to make sure it doesn’t happen again.