![]() Signs generally occur within 30 to 60 minutes of administration and may include depression, ataxia, vomiting, diarrhea (often bloody), tachycardia or bradycardia, pallor, weakness, tetany, tachypnea and seizures. Clinical signs of toxicosis often occur when a retention enema is given or when the enema is given orally. Phosphate enema toxicosis is more likely in cats and small dogs, although marked signs have been reported in large-breed dogs. Hyperglycemia is thought to occur due to stress-induced release of catecholamines.2 Dehydration and hypotension may occur secondary to GI upset. Sodium phosphate enemas are also hypertonic, which can cause fluid and electrolyte shifts as well as hyperosmolality. Hyperphosphatemia can lead to hypocalcemia, tetany, muscle stiffness or weakness. Phosphate enemas are used in people to relieve occasional constipation and for bowel cleansing prior to a colonoscopy.1 Because phosphate enemas are hypertonic, they cause water to move into the colon and increase the water content of the stool, resulting in evacuation of the bowel within five to 10 minutes.Įxcessive absorption of sodium and phosphorus can lead to hypernatremia and hyperphosphatemia. In healthy children, the half-life of phosphates is 4.8 to 10.6 hours with renal insufficiency, the half-life increases to 17 hours.1 Phosphates are primarily excreted renally (90 percent). ![]() Although we don't know the bioavailability in dogs and cats, in humans it is 60 percent. Sodium and phosphorus from the enema are absorbed quickly from the gastrointestinal (GI) tract. The biggest concerns for toxicosis in dogs and cats are in situations in which a pet has underlying health conditions that predispose the pet to toxicosis, is given an enema orally, or does not defecate after being given the enema rectally. Typically, pets are exposed due to outdated veterinary recommendations or because the owners are trying at-home treatments. But they are not typically recommended any more because of the risk of side effects and the availability of safer and effective alternatives, such as dioctyl sodium sulfosuccinate (DSS) enemas and softgels. Historically, these were used in veterinary medicine to treat the signs of megacolon in cats and chronic constipation in dogs and cats. They are used for bowel cleansing before a colonoscopy and to alleviate occasional constipation in people. Hypertonic phosphate enemas (Fleet Enema-Fleet, and generic) contain sodium phosphate and other phosphates, typically at a concentration of 25 to 60 mg/ml, per the package label.
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