Intravenous fat emulsion as treatment for ivermectin toxicosis in three dogs homozygous for the ABCB1-1Δ gene mutation

Heather M. Wright, Annie V. Chen, Patricia A. Talcott, Robert H Poppenga, Katrina L. Mealey

Research output: Contribution to journalArticle

17 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)666-672
Number of pages7
JournalJournal of Veterinary Emergency and Critical Care
Volume21
Issue number6
DOIs
StatePublished - Dec 2011

Fingerprint

Intravenous Fat Emulsions
Ivermectin
ivermectin
emulsions
poisoning
Dogs
mutation
Mutation
dogs
lipids
Genes
genes
Therapeutics
adverse effects
Stupor
Flumazenil
blood sampling
Tremor
hyperlipidemia
Coma

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 journalArticle

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