Dangers and Veterinary Treatments for Household Battery Ingestion
In today's households, batteries are found in almost every room and can present risks to pets who are exposed to them. Here the ASPCA’s Animal Poison Control Center (APCC) shares important tips for recognizing and treating battery poisoning in pets.
Alkaline batteries contain potassium hydroxide which has a very high pH. Ingestion of alkaline or caustic substances, like the contents of batteries, can cause liquefactive necrosis of tissues.
Liquefactive necrosis affects the fat in the cell membrane causing cell destruction and ultimately deeper penetration into mucosal tissues. Although the degree of damage can vary, the potential for ulceration from batteries is high.
Ulceration can be seen as early as 1-2 hours post exposure, but the full extent of the caustic injury can take up to 24 hours to develop. Clinical signs for oral exposures include dysphagia, hypersalivation, stridor, vomiting, oral and/or abdominal pain, oropharyngeal edema, lethargy, depression, dyspnea and white to grey erosions or ulceration that may slough.
Often the owner will note a liquid or black material leaking from the battery when it has been punctured.
Disc or button batteries can be found in watches, hearing aids, small electronic devices or toys. When chewed open, they have the same caustic injury concern as alkaline batteries.When swallowed intact, they have additional concerns.
Depending on the size of the battery and the size of the patient, obstruction of either the esophagus or trachea (if aspirated) is a possible, but not common, concern. And if a disc battery is retained in the esophagus, it can cause burns due to its ability to emit a small electrical current.
Radiographs may be indicated if whole batteries or large pieces were ingested to determine the location of the battery. Radiographs can also help determine if intact batteries are moving through the GI tract. Anytime there is a battery that can’t be accounted for, radiographs should be taken – make sure to include the neck and chest for disc batteries.
If radiographs show an intact battery in the stomach, give the dog a small meal and induce vomiting to see if the battery can be recovered. If the battery is chewed into pieces, adding extra fiber to the diet and monitoring for the passage of the battery is a reasonable approach. Batteries that are leaking or stuck in the esophagus can either be removed by endoscopy or, if in the stomach, removed via gastrotomy. Activated charcoal is not indicated, as the alkalis work locally and are not absorbed.
Treatment for battery exposures is symptomatic and supportive. If the patient is eating and drinking on his own, is not significantly hyperthermic, or does not have leukocyotosis or leukopenia, he can likely be monitored on an outpatient basis.
Gastroprotectants: Omeprazole and sucralfate slurries are recommended for the treatment of oral, esophageal and GI ulceration.
Fluid therapy: If the patient is unable to drink or is hyperthermic, IV fluids can be very beneficial.
Pain control: To control pain, opioids are recommended. NSAIDs can potentially worsen ulcerations and are not recommended for the treatment of pain in patients exposed to alkalis.
Nutritional support: A gastrotomy tube may be indicated in anorexic patients.
Broad spectrum antibiotics: f there are signs of erosions or ulcerations, administer antibiotics to help prevent secondary bacterial translocation and infection.
There could be a risk for gastrointestinal perforation during the granulation phase of caustic injury, or 3 to 14 days after exposure. There may also be risk for esophageal strictures that can take up to 4-6 weeks to be seen. These complications are not commonly seen in cats and dogs.