Acute ethylene glycol (EG) intoxication is a life-threatening medical emerg
ency characterized by hyperosmolality, profound high anion gap metabolic ac
idosis, and oliguric or anuric renal failure. Toxic effects and associated
clinical signs of this syndrome are caused by both EG and its metabolites,
particularly glycolate; however, there is confusion in the medical (human a
nd veterinary) literature regarding the various metabolites of EG and their
putative roles in the pathophysiology of this devastating syndrome.