Abstract
Objective: To describe the outcome of 3 cases of ivermectin toxicosis in dogs homozygous for the ABCB1-1Δ gene mutation treated with intravenous fat emulsion (IFE). Series Summary: One Australian Shepherd and 2 Miniature Australian Shepherds were treated for naturally occurring ivermectin toxicosis with IFE. All 3 dogs were homozygous for the ABCB1-1Δ gene mutation. Serum ivermectin concentrations confirmed ivermectin exposure in each case. All 3 dogs exhibited tremors, ptyalism, and central nervous system depression, which progressed over several hours to stupor in 2 dogs, and to a comatose state requiring mechanical ventilation in the remaining dog. A 20% formulation of IFEa was administered as an IV bolus (1.5 mL/kg) followed by a slow IV infusion (7.5-15 mL/kg [0.25-0.5 mL/kg/m], over 30 minutes). No change was observed in the neurologic status of any patient. Lipemia visible upon blood sampling persisted for 36 hours in 1 dog however, no other adverse effects were noted. Flumazenil (0.01 mg/kg IV), followed by a constant rate infusion(CRI) of 0.01 mg/kg/h IV was administered in 1 case, without any apparent clinical benefit or adverse effect. New or Unique Information Provided: IFE was ineffective in the treatment of ivermectin toxicosis in these ABCB1-1Δ homozygous mutant dogs. Further investigation is necessary to determine why IFE treatment was unsuccessful in these cases and whether its use can be optimized to yield better results.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 666-672 |
| Number of pages | 7 |
| Journal | Journal of Veterinary Emergency and Critical Care |
| Volume | 21 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 2011 |
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Keywords
- Central nervous system depressants
- Neurotoxicity
- P-glycoprotein
ASJC Scopus subject areas
- veterinary(all)
- Medicine(all)
Cite this
Intravenous fat emulsion as treatment for ivermectin toxicosis in three dogs homozygous for the ABCB1-1Δ gene mutation. / Wright, Heather M.; Chen, Annie V.; Talcott, Patricia A.; Poppenga, Robert H; Mealey, Katrina L.
In: Journal of Veterinary Emergency and Critical Care, Vol. 21, No. 6, 12.2011, p. 666-672.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intravenous fat emulsion as treatment for ivermectin toxicosis in three dogs homozygous for the ABCB1-1Δ gene mutation
AU - Wright, Heather M.
AU - Chen, Annie V.
AU - Talcott, Patricia A.
AU - Poppenga, Robert H
AU - Mealey, Katrina L.
PY - 2011/12
Y1 - 2011/12
N2 - Objective: To describe the outcome of 3 cases of ivermectin toxicosis in dogs homozygous for the ABCB1-1Δ gene mutation treated with intravenous fat emulsion (IFE). Series Summary: One Australian Shepherd and 2 Miniature Australian Shepherds were treated for naturally occurring ivermectin toxicosis with IFE. All 3 dogs were homozygous for the ABCB1-1Δ gene mutation. Serum ivermectin concentrations confirmed ivermectin exposure in each case. All 3 dogs exhibited tremors, ptyalism, and central nervous system depression, which progressed over several hours to stupor in 2 dogs, and to a comatose state requiring mechanical ventilation in the remaining dog. A 20% formulation of IFEa was administered as an IV bolus (1.5 mL/kg) followed by a slow IV infusion (7.5-15 mL/kg [0.25-0.5 mL/kg/m], over 30 minutes). No change was observed in the neurologic status of any patient. Lipemia visible upon blood sampling persisted for 36 hours in 1 dog however, no other adverse effects were noted. Flumazenil (0.01 mg/kg IV), followed by a constant rate infusion(CRI) of 0.01 mg/kg/h IV was administered in 1 case, without any apparent clinical benefit or adverse effect. New or Unique Information Provided: IFE was ineffective in the treatment of ivermectin toxicosis in these ABCB1-1Δ homozygous mutant dogs. Further investigation is necessary to determine why IFE treatment was unsuccessful in these cases and whether its use can be optimized to yield better results.
AB - Objective: To describe the outcome of 3 cases of ivermectin toxicosis in dogs homozygous for the ABCB1-1Δ gene mutation treated with intravenous fat emulsion (IFE). Series Summary: One Australian Shepherd and 2 Miniature Australian Shepherds were treated for naturally occurring ivermectin toxicosis with IFE. All 3 dogs were homozygous for the ABCB1-1Δ gene mutation. Serum ivermectin concentrations confirmed ivermectin exposure in each case. All 3 dogs exhibited tremors, ptyalism, and central nervous system depression, which progressed over several hours to stupor in 2 dogs, and to a comatose state requiring mechanical ventilation in the remaining dog. A 20% formulation of IFEa was administered as an IV bolus (1.5 mL/kg) followed by a slow IV infusion (7.5-15 mL/kg [0.25-0.5 mL/kg/m], over 30 minutes). No change was observed in the neurologic status of any patient. Lipemia visible upon blood sampling persisted for 36 hours in 1 dog however, no other adverse effects were noted. Flumazenil (0.01 mg/kg IV), followed by a constant rate infusion(CRI) of 0.01 mg/kg/h IV was administered in 1 case, without any apparent clinical benefit or adverse effect. New or Unique Information Provided: IFE was ineffective in the treatment of ivermectin toxicosis in these ABCB1-1Δ homozygous mutant dogs. Further investigation is necessary to determine why IFE treatment was unsuccessful in these cases and whether its use can be optimized to yield better results.
KW - Central nervous system depressants
KW - Neurotoxicity
KW - P-glycoprotein
UR - http://www.scopus.com/inward/record.url?scp=84861428751&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84861428751&partnerID=8YFLogxK
U2 - 10.1111/j.1476-4431.2011.00687.x
DO - 10.1111/j.1476-4431.2011.00687.x
M3 - Article
C2 - 22316260
AN - SCOPUS:84861428751
VL - 21
SP - 666
EP - 672
JO - Journal of Veterinary Emergency and Critical Care
JF - Journal of Veterinary Emergency and Critical Care
SN - 1479-3261
IS - 6
ER -