Intravenous lipid emulsion therapy in 20 cats accidentally overdosed with ivermectin

Abstract

Our series describes the treatment of accidental ivermectin parenteral overdose in 20 cats with early initiation of IVLE therapy. An early bolus followed by a 30-minute constant rate infusion of IVLE appeared to mitigate the signs of ivermectin toxicosis in cats compared to a single treatment bolus. Our observations also suggest that cats with a low BCS given only a bolus of IVLE treatment were more likely to develop signs of ivermectin intoxication and require a greater amount of IVLE for the resolution of clinical signs. Based on our observations, BCS appears to influence the severity of ivermectin toxicity with a low BCS being associated with more severe signs of ivermectin toxicity.

Chewing the fat on veterinary toxicology: The path to discovery

“…Additional observations included that body condition scores (a measure of body fat) may influence the risk for developing clinical signs associated with ivermectin toxicity and that an initial bolus followed by a 30-minute infusion of intravenous lipid may reduce the risk of toxicity. 7 Although these findings need to be confirmed with carefully designed prospective controlled studies, this clinical report makes a compelling case that this protocol is worth considering.…”

“…The interesting observations were that asymptomatic cats that were treated with a bolus followed by a 30‐minute infusion ( n = 4) appeared to be “protected” from the toxic effects of the ivermectin overdose, as compared to 6 of 16 cats treated with an initial single bolus of intravenous lipid that went on the development clinical signs and require further treatment. Additional observations included that body condition scores (a measure of body fat) may influence the risk for developing clinical signs associated with ivermectin toxicity and that an initial bolus followed by a 30‐minute infusion of intravenous lipid may reduce the risk of toxicity . Although these findings need to be confirmed with carefully designed prospective controlled studies, this clinical report makes a compelling case that this protocol is worth considering.…”

“…The administration of intravenous lipid therapy to prevent or mitigate the development of toxic signs as opposed to treatment following the development of clinical signs is debatable as all interventions carry some risks. Offering some potential insights or perhaps an opportunity to refine our questions, the case study by Jourdan et al does allows us to explore this point, albeit with various limitations. Although one would probably not design a prospective study in this manner, the authors faced a unique clinical situation whereby 20 cats from a cattery were simultaneously presented following accidental 20‐fold overdose of ivermectin.…”

Electroretinographic changes after intravenous lipid emulsion therapy in a dog and a foal with ivermectin toxicosis

“…Ivermectin toxicosis typically occurs after accidental overdose, with animals exhibiting central nervous system signs including depression, ataxia, mydriasis, blindness, tremors, and hypersalivation . Current treatment of ivermectin toxicosis generally includes supportive care based on clinical signs, but in recent years, administration of intravenous lipid emulsion (ILE) has been successfully used in multiple species . Ivermectin‐induced blindness has been previously reported in dogs, cats, equids, and an African lion .…”

Evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning

“…A total of 56 studies were included in the update, from which eleven were animal reports, two regarding LA and nine non-LA poisonings. [33][34][35][36][37][38][39][40][41][42][43]. Forty-five human reports, eight regarding LA and 37 non-LA were included.…”