Successful treatment of 5‐fluorouracil toxicosis with hemodialysis

Abstract

To describe the successful treatment of lethal dose 5-fluorouracil (5-FU) toxicosis using hemodialysis. A 4-month-old intact female Golden Retriever was presented to the emergency department after ingesting 20g of 5% 5-FU cream. The puppy developed refractory seizures and became comatose with uncontrolled tonic-clonic convulsions. Because of the low molecular weight and minimal protein binding of 5-FU, a single hemodialysis treatment was employed for detoxification. The puppy improved clinically posttreatment and was successfully discharged 3days after admission. Postingestion leukopenia and neutropenia occurred but were responsive to treatment with filgrastim. The puppy is neurologically normal and has no lasting effects 1 year postingestion. To the authors' knowledge, this is the first reported case in veterinary medicine of a potentially fatal 5-FU ingestion that has been treated with intermittent hemodialysis.