Objective: Exposure to ethylene glycol (EG), a common component of antifreeze, is associated with very poor prognosis in cats. Exposure causes renal failure which is reversible with haemodialysis support, both impractical and uncommon in veterinary practice. The objective was to analyse the prevalence and risk factors associated with clinical signs in suspected EG exposure. Methods: Retrospective analysis of suspected EG exposure in cats (with outcome) reported to the VPIS between December 1996 to February 2014. Results: There were 240 cases; 6 cats (2.6%) remained asymptomatic and 234 developed signs (97.5%) including 163 (69.7%) which were euthanised, 42 that died (17.9%), 24 made that recovered (10.3%) and 5 with on-going signs at the time of follow-up (2.1%). Most enquiries were made between October and March (153/240, 64%) peaking in December (32/240, 13%). Enquiries were greatest in male cats (95/150 63.3%) compared to 55/150 (36.7%) females; 90/240 (37.5%) had unspecified sex and in cats aged 1-3 years 97/205 (47.3%) peaking in 2-3 year olds 40/205 (19.5%) – 35/240 (14.6%) had unspecified age. The most common signs were ataxia (83/234, 35.5%), lethargy (78/234, 33.3%), vomiting (73/234, 31.2%) and collapse (73/234, 31.2%). The commonest biochemical abnormalities reported included azotaemia (113/234, 48.3%), hypocalcaemia (82/234, 35%) and hyperglycaemia (47/234, 20.1%). Oxaluria was identified in 32 cases although it was unclear if urinalysis was assessed in every case. Intravenous fluid therapy was administered in most cases (188/240, 78.3%) and ethanol in 66/240 (27.5%). Of those that received the ethanol antidote 49 died and 17 survived. Of those that survived with time to treatment reported ethanol was started within an average of 5.75 hours (median 1.5 hours, n=10) compared to those that died or were euthanized receiving ethanol therapy (21.4 hours average, 24 hours median, n=17). Reasons for euthanasia included poor prognosis (53/163, 32.5%) no response to treatment (26/163, 16%), worsening azotaemia (13/163, 8%), development of anuria (4/163, 2.5%) ,uncontrolled seizures (3/163. 1.8%) and not specified (64/163, 39.3%). Seizures occurred in 18/42 (42.9%) in those that died versus 2/24 (8.3%) that recovered. Conclusion: EG exposure is commonest in younger cats and in male cats. Caution should be taken in winter months especially in animals presenting with ataxia, lethargy, vomiting and collapse. Biochemical abnormalities such as hypocalcaemia, azotaemia and hyperglycaemia can aid diagnosis, however, prognosis is very poor particularly in cats with convulsions. Antidotal therapy is only useful if started in the first few hours after exposure.