Felis ISSN 2398-2950

Benzalkonium chloride toxicity

Synonym(s): Alkyldimethylbenzylammonium chloride, BAC, quarternary ammonium compounds (QAC

Contributor(s): Dominic Barfield, Nicola Bates

Introduction

  • Cause: grooming after exposure to product containing benzalkonium chloride or licking a spill.
  • Signs: hypersalivation, hyperthermia and oral ulceration.
  • Diagnosis: from history of possible exposure following use of product in the home.
  • Treatment: washing; supportive care (analgesia, IV fluids, and nutrition) if required.
  • Prognosis: good.

Pathogenesis

Etiology

  • Ingestion from grooming after walking over surfaces recently cleaned with a benzalkonium chloride Benzalkonium chloride -containing product (often in household disinfectants, antibacterial cleaners, mold removers, hand sanitizers, patio cleaners, etc).
  • Concentrations of household products vary, often between 0.2-5%.
  • Licking up a spill or rubbing against a leaky liquid pot pourri container.
  • Cats are more likely to be exposed than dogs, from grooming behavior following exposure and access to surfaces out of reach of dogs (such as a kitchen countertop).

Predisposing factors

General

  • There are no specific predisposing factors.
  • Clinical signs are likely to be more severe after exposure to a concentrated solution.
  • Cats may be exposed following normal use of products or occasionally after use of a product incorrectly diluted prior to use.

Pathophysiology

  • Benzalkonium chloride (BAC) is a cationic detergent and a quaternary ammonium compound (QAC).
  • It interacts with proteins, lipids and proteins in biological membranes causing irritancy local tissue damage.
  • Hyperthermia is common but the mechanism is unclear.

Timecourse

  • Clinical signs do not appear until hours or even days after exposure.
  • Mean time has been reported approximately 6 hours after exposure to develop clinical signs.
  • Association with use of BAC may not be obviously apparent.
  • Recovery is generally within 4 days but can be a week or more.

Epidemiology

  • House cats are more likely to be exposed.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Addie DD, Boucraut-Baralon C, Egberink H et al (2015) Disinfectant choices in veterinary practices, shelters and households: ABCD guidelines on safe and effective disinfection for feline environments. J Feline Med Surg 17 (7), 594-605 PubMed.
  • Bates N, Edwards N (2015) Benzalkonium chloride exposure in cats: a retrospective analysis of 245 cases reported to the Veterinary Poisons Information Service (VPIS). Vet Rec 176 (9), 229 PubMed.
  • Malik R, Page S W, Finlay-Jones G et al (2015) Benzalkonium chloride intoxication in cats. Vet Rec 176 (9), 226-268 PubMed.
  • Richardson J A (1999) Potpourri hazards in cats. Vet Med 94 (12), 1010-1012 VetMedResource.
  • Bilbrey S A, Dulisch M L, Stallings B (1989) Chemical burns caused by benzalkonium chloride in eight surgical cases. J Am Anim Hosp Assoc 25 (1), 31-34 VetMedResource.
  • Trapani M, Brooks D L, Tillman P C (1982) Quaternary ammonium toxicosis in cats. Lab Anim Sci 32 (5), 520-522 PubMed.

Other sources of information

  • Gwaltney-Brant SM (2013) Miscellaneous indoor toxicants. In: Petersen ME, Talcott PA (eds) Small Animal Toxicology, 3rd Ed. St. Louis, Missouri: Saunders, pp 292-294.

Organisation(s)


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