title: Moxidectin toxicosis in a puppy successfully treated with intravenous lipids.
abstract: OBJECTIVE
  To describe successful treatment of canine moxidectin toxicosis with the novel therapy of IV lipid administration.
  
  
  METHODS
  A 16-week-old female Jack Russell Terrier was presented with acute onset of seizures followed by paralysis and coma shortly following suspected exposure to an equine formulation of moxidectin. Moxidectin toxicity was later confirmed. Initial therapy consisted of diazepam, glycopyrrolate, and IV fluids. Mechanical ventilation and supportive nursing care were provided as needed. An emulsion of 20% soybean oil in water, commonly used as the fat component of parenteral nutrition, was administered intravenously as a bolus of 2 mL/kg followed by 4 mL/kg/h for 4 hours beginning 10 hours after exposure and was administered again at a rate of 0.5 mL/kg/min for 30 minutes beginning 25.5 hours post-exposure. Mild improvement was seen after the first dose, and dramatic improvement was noted within 30 minutes of the second dose. The puppy's neurologic status returned to normal within 6 hours of the second administration, with no relapses.
  
  
  CONCLUSIONS
  IV lipid therapy is a novel treatment approach for moxidectin toxicity. Its use is supported by recent research and case studies involving IV lipid administration for bupivacaine and other fat-soluble toxins. Lipid administration appeared to reverse the signs of toxicity and may prove to be a highly effective therapy for moxidectin and other fat-soluble toxins.
authors.affiliation: Veterinary Emergency Clinic and Referral Center, 920 Yonge Street, Toronto, ON M4W 3C7, Canada. dcrandelldvm@vectoronto.com
authors.forename: Dawn E
authors.initials: DE
authors.lastname: Crandell
authors.forename: Guy L
authors.initials: GL
authors.lastname: Weinberg
mesh_terms: D000818:Animals; D000969:Antinematodal Agents / Q000633:toxicity*; D004283:Dog Diseases / Q000139:chemically induced* / Q000188:drug therapy; D004285:Dogs; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D005260:Female; D018942:Macrolides / Q000633:toxicity
chemical_list: D000969:Antinematodal Agents; D005217:Fat Emulsions, Intravenous; D018942:Macrolides; C027837:moxidectin