Survival of formalin intoxication in a 13-year-old Thoroughbred gelding.

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dc.citation.issue3
dc.citation.volume56
dc.contributor.authorLovett A
dc.contributor.authorVokes J
dc.contributor.authorLoghides N
dc.contributor.authorJohnstone L
dc.contributor.authorSykes B
dc.coverage.spatialUnited States
dc.date.accessioned2024-08-18T23:41:56Z
dc.date.available2024-08-18T23:41:56Z
dc.date.issued2024-04-05
dc.description.abstractBACKGROUND: Formalin intoxication via the gastrointestinal route has not been previously reported in the horse. Whereas ingestion of formalin in humans, although rare, is well documented. Majority of human cases are either accidental, suicidal or homicidal and often lead to fatality, with a reported lethal formaldehyde dose equating to 0.12 - 0.16 g/kg bwt. OBJECTIVES: To describe a single case report of the clinical management of an adult horse referred to a veterinary teaching hospital following accidental administration of 10% formalin via nasogastric tube. METHODS: A 13-year-old Thoroughbred gelding originally presented to the referring veterinarian for colic where 1.8 L of 10% formalin was accidentally administered instead of mineral oil via nasogastric intubation, a potentially lethal dose of formaldehyde (0.12 g/kg bwt). Approximately 20-hours following 10% formalin administration the horse was admitted to the referral hospital with moderate tachycardia, occasional ectopic beats, tacky and hyperaemic mucous membranes, delayed capillary refill time, reduced borborygmi, and pronounced digital pulses. Diagnostic investigations included laboratory blood analysis, urinalysis, electrocardiogram, abdominal ultrasound, palpation per rectum and gastroscopy. RESULTS: Patient assessment found evidence of toxicity to the gastrointestinal tract, hypovolaemia and risk for laminitis. Intensive care included fluid and electrolyte therapy, anti-inflammatories and analgesia, continuous digital cryotherapy, gastro-protectants and other methods of gastrointestinal support. The horse was discharged from hospital on day 14 with no long-term complications and the client-veterinarian relationship was preserved. DISCUSSION: In human cases of ingestion, gastrointestinal injury is typically accompanied by severe metabolic acidosis and multiple organ dysfunction syndrome due to toxicity of other body systems that can contribute to non-survival. Formaldehyde toxicity in the present case predominantly affected the gastrointestinal tract, most likely a direct result of the route of administration. Aside from gastrointestinal injury, primary toxicity of other body systems was not confirmed. To prevent this medical error recurring, the referring veterinary clinic revised their labelling and storage of 10% formalin. CONCLUSION: This is the first report of systemic formalin intoxication in the horse. Following a high dose of 10% formalin (0.12 g/kg bwt formaldehyde) enterally, the horse survived having received intensive supportive care based on human guidelines for ingested formalin.
dc.description.confidentialfalse
dc.edition.editionMay 2024
dc.format.pagination494-502
dc.identifier.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/37587652
dc.identifier.citationLovett A, Vokes J, Loghides N, Johnstone L, Sykes B. (2024). Survival of formalin intoxication in a 13-year-old Thoroughbred gelding.. Equine Vet J. 56. 3. (pp. 494-502).
dc.identifier.doi10.1111/evj.13982
dc.identifier.eissn2042-3306
dc.identifier.elements-typejournal-article
dc.identifier.issn0425-1644
dc.identifier.urihttps://mro.massey.ac.nz/handle/10179/71331
dc.languageeng
dc.publisherJohn Wiley and Sons, Inc.
dc.publisher.urihttps://beva.onlinelibrary.wiley.com/doi/10.1111/evj.13982
dc.relation.isPartOfEquine Vet J
dc.rights(c) 2023 The Author/s
dc.rightsCC BY 4.0
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectformaldehyde
dc.subjectformate
dc.subjecthorse
dc.subjectmedical error
dc.subjecttoxicity
dc.subjectHumans
dc.subjectMale
dc.subjectAnimals
dc.subjectHorses
dc.subjectHospitals, Animal
dc.subjectHospitals, Teaching
dc.subjectFormaldehyde
dc.subjectColic
dc.subjectHorse Diseases
dc.subjectRespiratory Hypersensitivity
dc.titleSurvival of formalin intoxication in a 13-year-old Thoroughbred gelding.
dc.typeJournal article
pubs.elements-id479837
pubs.organisational-groupOther
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