Conventional treatment of a metaldehyde-intoxicated cat with additional use of low-dose intravenous lipid emulsion

Abstract

Case summary An adult male intact domestic shorthair cat was presented for acute onset of generalised tremors, stupor, horizontal nystagmus, anisocoria and bilateral absence of pupillary light and palpebral reflexes. Response to intravenous (IV) administration of benzodiazepines was minimal; thus, the induction of general anaesthesia with propofol, midazolam and dexmedetomidine was necessary to control clinical signs. Following a clinical suspicion of neurotoxicosis, a low-dose constant rate infusion (CRI) of IV lipid emulsion (ILE) was started. Phenobarbital and a low-dose CRI of ketamine were also used for neuroprotective purposes. Metaldehyde intoxication was confirmed by qualitative faecal toxicological analysis after discharge. Anaesthetic drugs were progressively tapered and stopped after 28 h and extubation was possible after 44 h. The cat was discharged 8 days after admission with a complete recovery of the clinical signs. Relevance and novel information To the authors’ knowledge, this is the first report to describe a case of metaldehyde toxicosis in a cat treated with intensive supportive care and an additional low-dose CRI of ILE.

Intravenous lipid emulsion for the treatment of poisonings in 313 dogs and 100 cats (2016–2020)

“…Assuming that metaldehyde is of rather low lipophilicity (with log p = 0.12), administration of ILE would presumably be ineffective with metaldehyde poisoning. Nevertheless, a beneficial effect has been reported in canine and feline metaldehyde poisoning for ILE combined with other supportive measures ( 44 , 45 ). In this study, central nervous system signs were not improved after administration of several anticonvulsants but treatment including ILE led to a remarkable improvement of the tonic–clonic activity and complete resolution of the clinical sign ( 44 ).…”

“…In cats, most authors follow the typical dose in dogs of 1.5 mL/kg (bolus) with a CRI of 0.25 mL/kg/min over 30–60 min ( 1 , 9 , 43 , 47 , 48 ). However, low-dose ILE treatment strategies (1.5 mL/kg bolus followed by 0.25 mL/kg/min over 3 min, 0.025 mL/kg/min over 360 min, or 1.5 mL/kg followed by 0.025 mL/kg over 3–9 h) are also reported to be ineffective or potentially effective ( 45 , 49 ), but were not effective within 2–12 h in our study. Two to six different ILE administrations were mostly given 12 h apart (52/95, 54.7%).…”

Case Report: Successful Intravenous Lipid Emulsion Therapy for Canine Amphetamine Toxicosis

“…Hyperlipidemia is an unavoidable consequence of IVLE use and there is concern for precipitating pancreatitis in animals, even though it is yet to be proven in the acute setting with IVLE therapy. Numerous veterinary reports of successful treatment with IVLE for lidocaine, naproxen, carprofen, ibuprofen, vitamin D, bromethalin, and several other toxicoses have been published (11)(12)(13)(14)(15)(16)(17)(18).…”

Metaldehyde-Mediated Genotoxicity in Allium Cepa (L.) Root Meristem Cells

“…Weight gain decreased by 16%, 26%, 40% and 60%, respectively, from the group treated with the lowest dose of metaldehyde (MA-20 ppm) to the group treated with the highest dose (MA-20 ppm), compared to the control. Although there are many studies in the literature on the toxicity of metaldehyde in non-target organisms such as ducklings, dogs, cats and macroinvertebrates (Wei et al 2020;Botelho et al 2020;Bergamini et al 2020;Gething et al 2020), to the best of our knowledge this is the rst study to reveal metaldehyde toxicity in A. cepa. On the other hand, Ester and Nijenstein (1996) mentioned that metaldehyde application to perennial ryegrass (Lolium perenne) at rates exceeding 320 g per kg seed had a phytoxic effect by reducing germination.…”