Dog Recovers from Insecticide Toxicity with Intravenous Lipid Emulsion

Raisin is a 7-year-old, female spayed, Collie Mix that was referred to us for further treatment after ingestion of a toxic dose of abamectin insecticide (InVict insect paste). This is in the macrolide class of insecticides, and at high doses, crosses the blood-brain barrier, binds to glutamate-gated chloride channels, causes hyperpolarization, prevents nerve conduction, and ultimately can lead to paralysis and death. There is no specific antidote, and traditionally is monitored with supportive care, treatment of seizures, and mechanical ventilation if needed. More recently, intravenous lipid emulsion has become an effective treatment option for animals with toxicities.

Raisin’s clinical signs on presentation included vomiting, hypersalivation, pupil dilation, blindness, mild head tremors, weakness, and mental dullness. In worse cases, dogs can develop seizures and become comatose. We used intravenous lipid emulsion to treat Raisin through her toxicity. She initially received boluses (higher dose over 1 hour), then would relapse clinical signs, so was maintained on a continuous low dose infusion for 40 hours, after which she was weaned off, and had only mild clinical signs. She was discharged 4 days after admit, and on recheck one week later was fully recovered and back to normal.

Intravenous lipid emulsion’s primary mechanism of action is acting as a lipid sink for lipid soluble drugs, drawing them away from the brain into the blood, where they do not exert toxic effects, until the drug can be metabolized/excreted and is below a toxic level. There are other theoretical mechanisms of action. Side effects include lipemia (fat in the blood), and in people, they can develop pancreatitis and fat emboli, but we have not appreciated this to be a clinical problem in dogs and cats.

Raisin is also a special case, due to her genetics, she carries an MDR1 gene mutation, which codes for a protein pump in the brain. This gene mutation makes her particularly more sensitive to drugs that affect the brain, like the macrolides. Although she had a toxic dose of the drug, her genetics made her even more sensitive to the drug. We tested for this in Raisin due to her breed and the known prevalence of this mutation in Collies.

The treatment was a success! The owners were very worried about Raisin when she first presented, and concerned about her long-term expectations, but they are so happy to have Raisin fully normal and back home to her family!

Barbara Maton, DVM, DACVECCBarbara Maton, DVM, DACVECC
Dr. Maton is originally from Florida, where she earned her undergraduate degree in biology from the University of North Florida, and studied veterinary medicine at the University of Florida, obtaining her DVM in 2006. She completed a rotating internship focused on emergency medicine at SouthPaws Veterinary Specialists and Emergency Center in Virginia, then moved to Pittsburgh where she worked as an emergency veterinarian for two years and completed her residency in the specialty in 2012. After helping to start a critical care service at an established veterinary referral hospital in Delaware, she joined NorthStar VETS in 2014. Her clinical and research interests include trauma, electrolyte derangements, anticoagulant therapies and CPR medicine.

The information presented on this web site is not intended to take the place of your family veterinarian’s advice and is not intended to diagnose, treat, cure or prevent any disease. Discuss this information with your own veterinarian to determine what is right for your pet. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. We can not and do not give you medical advice via this blog. The information contained in this online site and emails is presented in summary form only and intended to provide broad understanding and knowledge. The information should not be considered complete and should not be used in place of a visit, call, consultation or advice of your veterinarian. We do not recommend the self-management of your pet’s health problems.

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