Treatment of a case of feline baclofen toxicosis with intravenous lipid therapy

Abstract

Baclofen (γ-amino-β-[p-chlorophenyl]-butyric acid) is a centrally acting skeletal muscle relaxant that is frequently used in people. Baclofen toxicosis has previously been successfully treated in cats via supportive therapy alone, whereas administration of an intravenous lipid emulsion (ILE) has been reported as an adjunct to supportive therapy in dogs with baclofen toxicosis. This case report presents a cat that became severely stuporous following ingestion of baclofen (10 mg/kg) and was successfully treated with administration of ILE without any apparent side effects. The cat received a 1.5 ml/kg bolus of a 20 per cent lipid emulsion intravenously followed by a constant rate infusion (CRI) of 15 ml/kg/hour. Approximately one hour following initiation of the CRI, the cat became acutely more responsive. Intravenous lipid therapy may be a useful adjunct to conventional treatment in cases of feline baclofen toxicosis and other lipophilic drug toxicoses.

Common questions in veterinary toxicology

“…Off‐label use of intravenous lipids (Intralipid® 20%, Fresenius Kabi, is most commonly used) have a place in the management of compounds that are lipophilic or cardiotoxic. Most veterinary cases reported involve permethrin (Brückner & Schwedes , Haworth & Smart , Kuo & Odunayo , DeGroot ) or macrocyclic lactones such as moxidectin and ivermectin (Crandall & Weinberg , Bates et al , Kidwell et al ), but lipid infusion has also been successful in the treatment of toxicity with other compounds such as lidocaine (O'Brien et al ), diltiazem (Maton et al ), baclofen (Bates et al , Edwards et al ) and ibuprofen (Bolfer et al ); the list continues to grow.…”

Intravenous lipid emulsion therapy in 20 cats accidentally overdosed with ivermectin

“…Indeed, in the last decade, there has been an increasing amount of evidence supporting its use in the management of lipophilic drugs intoxication. In veterinary medicine, 3 recent reviews [13][14][15] and case reports have described the use of IVLE for the management of toxicity due to various lipophilic drugs: ivermectin, [16][17][18][19] moxidectin, 16,20 diltiazem, 21 and baclofen 16 in dogs; ivermectin, 7,10 lidocaine, 22 baclofen, 23 and permethrin [24][25][26][27] in cats.…”

Formulation and Evaluation of Baclofen-Meloxicam Orally Disintegrating Tablets (ODTs) Using Co-Processed Excipients and Improvement of ODTs Performance Using Six Sigma Method

“…10,11 Baclofen is a good candidate for ODT formulations as it is water soluble with a suitable log p-value (1.3), small molecular weight, dose less than 20 mg, suitable half-life. 12,13 Meloxicam partially fulfills the ODT formulation requirement as it possesses a small molecular weight, long half-life, dose less than 20 mg, but possesses a poor water solubility. Meloxicam is classified under class II of the Biopharmaceutics Classification System (BCS), having good permeability but low water solubility.…”