The use of intravenous lipid emulsion as an antidote in veterinary toxicology

Fernández, Alberto Luis; Lee, Justine A.; Rahilly, Louisa J.; Hovda, Lynn R.; Brutlag, Ahna G.; Engebretsen, Kristin M.

doi:10.1111/j.1476-4431.2011.00686.x

Cited by 25 publications

(115 citation statements)

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“…Typically, 1.5–4 ml/kg of a 20 per cent lipid emulsion is given intravenously as a bolus dose, followed by infusion of 0.25 ml/kg/min over 30–60 minutes in dogs (Fernandez and others 2011). Bolus doses of up to 7 ml/kg are also recommended if there is no improvement with this regimen (Fernandez and others 2011). Similar doses have been used in the small number of feline cases reported (O'Brien and others 2010, Pritchard 2010, Haworth and Smart 2012).…”

Section: Discussionmentioning

confidence: 99%

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Lipid infusion in the management of poisoning: a report of 6 canine cases

Bates¹,

Chatterton²,

Robbins³

et al. 2013

Vet Record Case Reports

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Intravenous administration of lipid is a relatively new treatment in the management of toxicity from lipophilic compounds. It is used in human medicine in the treatment of toxicity from lipophilic local anaesthetics and cardiotoxic drugs and can result in dramatic improvement in clinical status. We present six cases of poisoning in dogs successfully treated with lipid infusion after ingestion of ivermectin (3), moxidectin (2) and baclofen (1). The dogs ranged in age from eight weeks to 14 years, and weighed 4–30 kg. Intravenous lipid therapy was started between six and eight hours and 22 hours after ingestion, and all the dogs responded well. In four dogs, there was clinical improvement within one hour; one had improved within two hours and the other within 4.5 hours of lipid administration. The only adverse effect of lipid infusion reported was mild swelling and pain after extravasation in one case which resolved with conservative management. All the dogs were discharged within 24–52 hours after exposure (7–46 hours after the start of lipid administration), and none developed any apparent sequelae.

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Section: Discussionmentioning

confidence: 99%

“…There are also anecdotal reports of its use in animals in the management of toxicity from a variety of toxic drugs (Lee 2010). The use of lipid infusion in veterinary medicine has also been the subject of recent reviews (Fernandez and others 2011, Kaplan and Whelan 2012). …”

mentioning

confidence: 99%

Lipid infusion in the management of poisoning: a report of 6 canine cases

Bates¹,

Chatterton²,

Robbins³

et al. 2013

Vet Record Case Reports

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“…A number of other reviews have covered the use of ILE in veterinary medicine 160 . ‐ 162 In particular, Intralipid has been used extensively to treat ivermectin 77 , 163 ‐ 166 and permethrin 167 ‐ 170 toxicity. In particular, Peacock et al 171 conducted a randomized trial of lipid emulsion in permethrin toxicosis in felines and found a robust rescue effect of the lipid emulsion in comparison to saline.…”

Section: Part Iii: Clinical Futurementioning

confidence: 99%

Past, Present, and Future of Lipid Resuscitation Therapy

Fettiplace

Weinberg

2015

J Parenter Enteral Nutr

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Lipid resuscitation therapy was identified in 1998 as an effective treatment for local anesthetic systemic toxicity in an animal model. Since the original observation, the field has progressed tremendously with successful clinical translation and expansion of use to treatment of other types of drug overdose. Recent work has expanded our understanding of the mechanism of this novel treatment, one that includes both a dynamic scavenging component and direct cardiotonic effect. In this review, we discuss the past, present, and future of lipid resuscitation therapy with a focus on our understanding of the mechanism and directions that the field is moving, both from a clinical and basic research side.

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“…[9][10][11][12][13][14] Recently, a state-of-the-art review by Fernandez et al 9 discussed the recommendations on the use of ILE in veterinary medicine; in this paper, dosage recommendations in veterinary medicine were based on extrapolation from human dosing and the dose used for TPN and PPN administration in veterinary medicine: administration of an initial 20% ILE bolus in the range between 1.5 ml/kg and 4 ml/kg (between 0.3 g/kg and 0.8 g/kg IV over 1 minute), followed by a constant rate infusion (CRI) of 0.25 ml/kg/min (0.05 g/kg/min IV over 30 to 60 minutes) as a generally conservative start in dogs. [9][10][11][12][13][14] Recently, a state-of-the-art review by Fernandez et al 9 discussed the recommendations on the use of ILE in veterinary medicine; in this paper, dosage recommendations in veterinary medicine were based on extrapolation from human dosing and the dose used for TPN and PPN administration in veterinary medicine: administration of an initial 20% ILE bolus in the range between 1.5 ml/kg and 4 ml/kg (between 0.3 g/kg and 0.8 g/kg IV over 1 minute), followed by a constant rate infusion (CRI) of 0.25 ml/kg/min (0.05 g/kg/min IV over 30 to 60 minutes) as a generally conservative start in dogs.…”

Section: Resultsmentioning

confidence: 99%