Intralipid emulsion therapy for ivermectin toxicity in a dog

Therapeutic management of ivermectin overdose in a Shih Tzu dog using intravenous administration of intravenous lipid emulsion (ILE).

A 3-year-old female Shih Tzu dog weighing 2.5 kg was presented to a veterinary clinic in Tehran with ataxia, tremors, incoordination, negative PLR and menace reflex, bradycardia and salivation. The patient was treated with a 10 mg ivermectin tablet with the brand name Medimect in the last 12 h. Following the diagnosis of ivermectin intoxication, treatment with ILE was initiated. ILE was administered as a bolus of 1.5 mL/kg in 1 min, followed by a dose of 0.25 mL/kg/min for 30 min as a CRI. The neurological symptoms of the patient began to decrease 2.5 h after the ILE therapy. Twenty-four hours later, the patient was resuscitated, and all symptoms were resolved.

The current paper reports the successful treatment of ivermectin toxicity with ILE therapy in Iran. The education of veterinarians regarding the beneficial and varied roles of ILE therapy in different clinical settings is warranted, particularly in terms of the potential for ILE therapy to reverse the toxicities of various lipophilic drugs.