Veterinary Clinics of North America: Small Animal Practice 42, 251-262. (2012) Use of Intravenous lipid emulsions for treating certain poisoning cases in small animals. Journal of American Veterinary Medical Association 237, 1455-1458. (2010) Infusion of a lipid emulsion to treat lidocaine intoxication in a cat. Whelan can be reached at 61, or by e-mailing O’Brien, T.Q. Further research needs to be conducted in a standardized manner in order to determine specifics forILE dosing, most effective time period for administration, length of administration, and which patients are most likely to respond.įor more information about Angell’s Emergency/Critical Care service, please visit Dr. However, it may not always be effective and should be used as an adjunct treatment. Lipids offer an easy potential antidote and can help to accelerate the recovery of the patient. 5 Since there are no current studies evaluating the safety of ILE use in acute toxicities 6, owners should be informed of its off-label use. 3 In another case series, one dog did have swelling and pain from extravasation of the ILE. 2 One study did show that short-term administration of soybean oil-based ILE can decrease neutrophil function in dogs. In addition, hypersensitivity reactions and possible interference with other drugs can be seen. Potential adverse effects mentioned include lipemia which can cause interference with lab tests, lipid emboli in neonates, and secondary pancreatitis. If lipemia is seen, no further administration of ILE should occur. They appear to be relatively safe, and the serum should be monitored about every 2 hours for evidence of lipemia. Lipids are relatively cheap, and easy to administer if you have them on site or can obtain them same day from a local hospital. One case report describes resolution of blindness in a dog that was exposed to an ivermectin horse dewormerand treated with ILE. 6 Regardless of the starting or final dose amount, the neurological or clinical response should guide your therapy. No maximum daily dose has been determined in veterinary patients. 2 Despite the large dosing range ,0.25 ml/kg/min for 30-60 minutes is commonly used. Reported dose ranges in the literature include boluses of 1.5 ml/kg-2.0 ml/kg over 2-15 minutes, then as a CRI 0.06 ml/kg/min to 0.5 ml/kg/min for multiple hours. Aseptic technique should be used when administering ILE to prevent bacterial contamination and secondary sepsis in patients. Lipids are usually given IV in a peripheral catheter, but can be given in a central catheter as well to avoid potential phlebitis. 2 Regardless of its exact mechanism of action, physicians and veterinarians can document their experiences with ILE on the “Lipid Rescue” website ( ). The latter is most favored and supposes that ILE acts as a discrete department in the plasma which prevents the lipophilic compound from reaching its site of action. The exact mechanism of action of ILE is not known but there are two main theories: the metabolic theory and the “lipid sink” effect. 4 Additionally, there have been multiple review articles regarding lipid use in small animal poisoning. A recent article details the use of ILE in the treatment of severe diitiazem toxicosis in a dog along with high-dose insulin therapy. Reports of ILE use in veterinary medicine include use with overdoses of macrocyclic lactones, local anethestics, permethrin, baclofen, and some calcium channel blockers. Lipophilic compounds are those that combine with or dissolve with lipids. In animals, there are many case reports of its use in dogs 3,4,5 and cats 1,6,7 with various toxicities-specifically with lipophilic compounds. However, its use has been reported in humans as adjunct treatment for local anesthetic systemic toxicosis (LAST). Photo courtesy of There are no reported definitive uses of ILE in the human or veterinary literature.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |