A Review of the Application of Intravenous Lipid Emulsion Therapy in Ivermectin Toxicosis in dogs

Background: Ivermectin is a macrolide antibiotic used to treat external parasites and heartworms in dogs. Although the marginal safety of this drug is wide among the treated cases, number of ivermectin toxicoses have been raised (multiple cases from ۱۹۹۸ to ۲۰۲۵). certain breeds of dogs are more susceptible to ivermectin toxicosis such as border collie, German shepherd, etc. Severe CNS defects such as ataxia, blindness, and seizures have been seen in ivermectin toxicosis, and if it progresses, it may cause respiratory depression and death. (۹% mortality among clinical cases). So, there is a reasonable need for therapeutic intervention for these cases. Methods: This review is based on some peer-reviewed articles that we found in the literature. Data included species, dosage, ILE regimen, and clinical outcome. Results: ILE therapy (application of intra-venous lipid emulsion for detoxifying lipophilic drugs) demonstrated neurologic or visual recovery within hours to days, with no major adverse side effects. Regimens varied (۱.۵–۲ mL/kg bolus; ۰.۰۰۸–۰.۲۵ mL/kg/min CRI), and the pharmacokinetics of ivermectin showed quick* clearance. Conclusion: These studies suggested IV lipid emulsion (ILE) as a low-risk and fast adjunctive therapy for ivermectin toxicosis in veterinary practice particularly in cases with neurologic symptoms which often results in rapid neurologic/visual improvement within minutes to hours. It is claimed that the underlying mechanism is “lipid sink” (post-ILE serum drug rise). ILE has been demonstrated to be a safe and effective adjunctive therapy for dogs suffering from lipophilic toxicosis through several recent studies. Adverse effects due to IVLE are infrequent but include lipemia, hypertriglyceridemia, and rare hypersensitivity reactions.

کلیدواژه ها:

IVLE ، Ivermectin toxicosis ، CNS defects ، neurologic improvement