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THE UK is fortunate to have a Veterinary Poisons Information Service (VPIS). A paper summarised on p 229 of this issue of Veterinary Record by Bates and Edwards (2014) concerning benzalkonium chloride (BAC) exposure in cats is testament to the excellent database analyses VPIS conducts as part of its mission. It is pertinent that during the period studied, only one case of feline BAC intoxication was reported in the adverse drug reaction database of the Center for Veterinary Medicines in the USA, with another single case recorded by the Australian Pesticides and Veterinary Medicines Authority, while the VPIS recorded 245 cases.
Although the paper is retrospective, the data is sufficiently robust to paint an evidence-based clinical picture for both owners and the veterinary team confronted with the management of such patients. The number of cases Bates and Edwards reviewed is huge, reflecting the commonness and importance of this toxicosis, and the excellent record-keeping of this group.
The first question that springs from the paper is ‘Why cats?’ (or, ‘Why not dogs?’). The answer is straightforward, at least in part. The intoxication reflects the behavioural predisposition of cats to groom any abnormal material from their coat or pads. This often gets them into trouble when they share the environment with people who use different chemical agents to clean surfaces on which cats may walk or roll. It is the same reason why cats are at risk of lead intoxication from flaky paint (they groom it off their coat and ingest it) (Knight and Kumar 2003), why flea allergens in the coat can trigger severe secondary eosinophilic granuloma lesions on the lingual surface (Malik 2007), and why cats come to ingest illicit substances that mysteriously find their way onto their coat or paws (Barfield and others …