Barium sulfate is a substance that’s commonly utilized in contrast radiology in both animals and people. There are other options available these days, especially since barium sulfate comes with a share of side effects.
In today’s article, we’re looking at barium poisoning in dogs – how it happens, its clinical signs, if and how it can be treated, and whether or not it can be prevented.
What is barium sulfate?
Barium sulfate is a contrast substance that can be used for performing x-rays. It is most effective for examining the integrity and the contents of the gastrointestinal system.
It can be administered in two main ways – orally, so through a dog’s mouth, or rectally, meaning through their anus. It proves its worth in both ways, but it reveals different sections of the gastrointestinal system.
For example, when given orally, it can highlight the esophagus, the stomach, the duodenum, and perhaps a part of the jejunum, the next section of the small intestine. On the other hand, when it is administered rectally, it mostly highlights the large intestine without reaching the further parts of the small one.
Although it might seem like a rather primitive procedure, using a contrast substance in diagnostic imaging is extremely helpful. For example, if a dog or a cat sustains an intestinal puncture on account of them having ingested something sharp, the barium sulfate solution can reveal the location of the leak and depending on the object, its location, too.
As you can imagine, this can come in handy for the veterinary surgeon, who will then perform the operation based on the information gathered from the x-ray.
Causes of barium poisoning in dogs
Cases of barium poisoning are extremely rare in both dogs and humans, so they are usually due to an individual sensitivity to the substance that the patient has and that no one is aware of.
Barium sulfate does have a series of adverse reactions and can cause some health concerns even several weeks following its administration.
So, in this situation, the cause isn’t necessarily a too high dose of barium – it’s simply a dog’s sensitivity to the substance per se.
Symptoms of barium poisoning in dogs
If your dog is unlucky enough to be allergic to barium, they will develop several signs of an allergic reaction, such as hives, swelling in the face, difficulty breathing, and other signs they might be on their way to suffering an anaphylactic shock.
On the other hand, if your dog is merely sensitive to barium sulfate, they might experience vomiting or diarrhea, or they could become constipated for several days.
If there is a constriction somewhere in the large intestine, the barium sulfate solution might make it worse, so time is of the essence when it comes to surgery. In that case, the dog would be in abdominal pain, would strain to defecate without being able to, and might also have additional symptoms such as a lack of appetite for food or water.
Other dogs have the following symptoms:
These are clinical signs that can only be seen in dogs that have received massive doses of barium sulfate, as those commonly used in veterinary diagnostic imaging typically do not lead to such a clinical picture.
What else can happen?
There is another significant risk when it comes to the oral administration of barium sulfate, and it consists of aspiration pneumonia. Since most pets aren’t really keen on gulping down the contrast solution without them being coaxed by the vet, the risk of them breathing barium sulfate does exist.
Consequently, some dogs can develop breathing difficulties and may have to be treated for respiratory pathologies for a long time. Aspiration pneumonia can be life-threatening if the amount of barium sulfate that ends up in the respiratory system is not low.
There is always the option for the vet to use an orogastric tube, which would make the procedure a lot safer. In this case, the barium sulfate solution would end up directly in the stomach and would continue its trajectory from there.
However, the downside to this method is that it would basically leave the esophagus unrevealed unless the person performing the procedure manages to insert only a small portion of the tube into the organ.
Barium sulfate should always be administered gradually, in up to three or four doses. These are called boluses, and they are necessary in order for the solution not to accumulate in a specific part of the gastrointestinal system and lay there (potentially producing an issue later on).
How can barium poisoning in dogs be treated?
Although rare, barium poisoning can lead to fatal hypokalemia, which means that supportive treatment is of utmost importance. The dog should receive fluids and electrolytes intravenously so as to increase potassium levels.
Dogs that have arrhythmias may also have to receive magnesium and calcium also intravenously along with specific heart medications.
Most cases resolve in a couple of hours with the appropriate therapy.
Barium poisoning in dogs is very rare, and that’s because there are protocols in place when it comes to the usage of contrast substances in this species and others.
Vets know how much barium sulfate they should give to a dog depending on their size and can calculate the appropriate dose in case they don’t have it in a manual.
Most barium toxicosis cases are acute when it comes to the cardiovascular imbalances they can cause or hypokalemia.
There are long-term digestive effects of using this solution, although it is perhaps one of the most effective ones when it comes to diagnosing pathologies of the gastrointestinal tract.
Barium toxicosis in a dog, Fiona H. Adam et al, 2010: https://pubmed.ncbi.nlm.nih.gov/20807132/#:~:text=Barium%20toxicosis%20can%20cause%20life,hypokalemia%20and%20appropriate%20clinical%20signs.
Handbook on the Toxicology of Metals (Fifth Edition), Volume II: Specific Metals, Chapter 4 – Barium, Agneta Oskarsson, 2022: https://www.sciencedirect.com/science/article/pii/B9780128229460000039