Retrospective evaluation of albuterol inhalant exposure in dogs: 36 cases (2007–2017)

Objective To describe the clinical features, clinicopathological features, treatment, and outcome of dogs presented for albuterol exposure. Design Retrospective case series from January 2007 to December 2017. Setting Tertiary veterinary facility. Animals Thirty‐six client‐owned dogs presenting for known or suspected albuterol exposure secondary to chewing on albuterol metered‐dose inhalers (MDIs). Interventions None. Measurements and main results All dogs presented with clinical signs attributable to albuterol exposure. The most common physical examination abnormality was sinus tachycardia, noted in 34 of 36 (94%) dogs. Twenty‐seven patients (75%) were admitted to the hospital for therapy, with a median length of hospitalization of 20.5 hours (16.75–24.5). Thirty‐two of 36 dogs had serum electrolytes evaluated at admission, with 22 of 32 (69%) presenting with hypokalemia ([K+] < 3.62 mmol/L]). Hyperlactatemia ([lactate] > 2.80 mmol/L) was noted in 23 of 28 (82%) dogs. A negative correlation was found between serum lactate and potassium ( r  = –0.64, r 2  = 0.40, P  = 0.0003). Hyperglycemia ([glucose] > 6.44 mmol/L) was noted in 20 of 30 (67%) dogs. Beta antagonist therapy was utilized in 20 of 36 (56%) of dogs. Conclusions Although uncommon, albuterol intoxication can lead to significant clinical and electrolyte abnormalities. Albuterol‐induced hypokalemia and associated tachyarrhythmias can be successfully managed, and albuterol intoxication has an excellent prognosis for survival to discharge. A minimum database should be evaluated in all dogs presenting for suspected albuterol exposure, with lactate and glucose monitored carefully in dogs with moderate or severe hypokalemia given the correlation found.