Use of 20% intravenous lipid emulsion for the treatment of loperamide toxicosis in a Collie homozygous for the ABCB1‐1∆ mutation

Abstract

ILE was successful in the treatment of loperamide toxicosis in a Collie with the ABCB1-1∆ mutation. ILE may be of benefit for treatment of other intoxications in dogs with ABCB1-1Δ mutations.

Use of Intravenously Lipid Emulsion for Treatment of Baclofen Toxicosis in a Cat

“…In dogs, ILE was used for management of ivermectin, moxidectin, diltiazem, loperamide, ibuprofen and baclofen intoxications. In cats, ILE was described in lidocaine, permethrin and ivermectin toxicosis (Kidwell et al, 2014;Long et al, 2017;Robben and Dijkman, 2017). The exact mechanism of ILE remains incompletely elucidated.…”

Loperamide-induced cardiac toxicity and lipid emulsion treatment

“… 3 Moreover, 20% lipid emulsion was able to treat neurologic symptoms caused by loperamide (highly lipid soluble p-glycoprotein substrate) toxicity in a dog with a p-glycoprotein defect due to an adenosine triphosphate-binding cassette transporter gene mutation. 5 Considering previous reports, the putative underlying mechanism of lipid emulsion treatment for highly-lipid soluble loperamide-induced cardiac toxicity is as follows ( Figure 1 ): 2 , 3 Lipid emulsion may absorb loperamide from the heart, and lipid emulsion containing loperamide may be delivered to liver, muscle, and adipose tissue, leading to recovery from Torsade de Pointes and myocardial depression through less inhibition of cardiac sodium and hERG potassium channels, and positive inotropic effect.…”