Sodium Phosphate Enema Toxicity in Dogs

Sodium phosphate enemas usually contain sodium phosphate and other phosphates in a concentration of 25 mg/ml to 60 mg/ml per enema. Electrolyte imbalances can occur in dogs if given a sodium phosphate enema.

Sodium phosphate enemas, or fleet enemas, are used for bowel cleansing and to alleviate occasional constipation. These enemas can be toxic to dogs, especially in dogs that have underlying health conditions. Small dogs, especially those categorized as toys or micro-toys, are at a higher risk of developing sodium phosphate enema toxicity. Larger dogs have been reported to have severe effects to fleet enemas when ingested orally.

If you notice that your dog has ingested a sodium phosphate enema contact your veterinarian immediately. Should any of these symptoms present after administering a sodium phosphate enema, you need to make an appointment with your veterinarian for an examination.

• Vomiting
• Depression
• Hyperglycemia
• Hypothermia
• Anorexia
• Rapid breathing
• Shallow breathing
• Dehydration
• Weakness
• Diarrhea
• Tachycardia
• Pale gums
• Lethargy
• Muscle stiffness
• Death

The sodium and phosphorus from the fleet enema are absorbed very quickly within the gastrointestinal tract, creating an electrolyte imbalance. The electrolyte imbalance can cause severe problems for your dog requiring immediate veterinary care. The sodium and phosphorus that has been absorbed causes your dog to become dehydrated and he can then become hypertensive.

By ingesting a sodium phosphate enema, the sodium and phosphorus are absorbed within the GI tract. Some dogs do not expel the enema when inserted properly, in the rectum, and this can also cause sodium phosphate enema toxicity in dogs.

Your veterinarian will determine if your dog has been poisoned by a sodium phosphate enema by looking at your dog’s history, the clinical symptoms that have presented and laboratory testing.

Testing will determine if there is any evidence of hypocalcemia or hyperphosphatemia, this will show that your dog has indeed been poisoned by sodium phosphate. Other tests will rule out pancreatitis, renal failure and hypoproteinemia, all with similar symptoms of sodium phosphate toxicity.

Once your veterinarian has determined that your dog has indeed been poisoned by a sodium phosphate enema, treatments will begin to restore the calcium concentrations as well as the sodium and phosphorus imbalance. Death can occur if the toxicity within your dog’s system is extremely high. Veterinary care is imperative to ensure that your dog has the best chance of recovery.

Supplements

Vitamin D and calcium supplements should be given. If seizures or hypocalcemic tetany are occurring, then calcium should be given by IV rather than by oral administration. Over medicating can occur with both vitamin D and calcium, be sure to follow your veterinarian’s instructions when giving both supplements.

Monitoring

Your veterinarian will closely monitor renal function and electrolyte intake to ensure that both are returning to normal. Blood glucose should also be closely monitored to ensure that hypoglycemia is not occurring. 

In the event that electrolytes need to be given, they should be administered in an IV to ensure that the correct amount is being given. This will re-hydrate your dog while flushing the toxins from his body. 

Treating the Symptoms

Many of the symptoms of sodium phosphate enema toxicity can cause extreme suffering in your dog. While the toxicity levels are still high in your dog’s system, your veterinarian will treat the symptoms to help give him some relief. Seizures will be treated with an anti-seizure medication, hypotension will be treated with IV fluids and a broad spectrum antibiotic may also be given.

Sodium phosphate enema toxicity is a serious condition and can be life threatening. For dogs that are healthy, the recovery time will be significantly less than older or infirmed dogs. Dogs that have pre-existing renal disease or heart disease will have a harder time pulling through and could have long-term effects that may affect their quality of life.

Once your veterinarian has done a full assessment and begun supportive care, she will have a more definitive prognosis for your dog. All treatments should be followed explicitly and all follow up visits and tests should be done.