title: Use of 20% intravenous lipid emulsion for the treatment of loperamide toxicosis in a Collie homozygous for the ABCB1-1∆ mutation.
abstract: OBJECTIVE
  To describe the successful treatment of loperamide toxicosis in a dog using intravenous lipid emulsion (ILE).
  
  
  METHODS
  An 8-month-old male neutered Rough Collie weighing 20.0 kg was given a total dose of 0.75 mg/kg loperamide over 3 days as treatment for diarrhea. The dog was subsequently evaluated for signs of dull mentation, anxiety, ptyalism and ataxia, thought to be a result of loperamide intoxication. The dog was treated with a 1.5 mL/kg IV bolus of 20% ILE solution followed by 0.25 mL/kg/min of the same solution for 2 hours. The dog's mentation improved rapidly following ILE infusion, and he was neurologically normal 3 hours after initiation of ILE treatment. The dog was subsequently found to be homozygous for the ATP-binding cassette (ABC) transporter gene (ABCB1-1∆) mutation. There were no adverse effects noted during or following ILE infusion.
  
  
  CONCLUSIONS
  ILE was successful in the treatment of loperamide toxicosis in a Collie with the ABCB1-1∆ mutation. ILE may be of benefit for treatment of other intoxications in dogs with ABCB1-1Δ mutations.
authors.affiliation: Angell Animal Medical Center, 350 South Huntington Avenue, Boston, MA, 02130.
authors.forename: Whitney M
authors.initials: WM
authors.lastname: Long
authors.affiliation: Angell Animal Medical Center, 350 South Huntington Avenue, Boston, MA, 02130.
authors.forename: Virginia B
authors.initials: VB
authors.lastname: Sinnott
authors.affiliation: Angell Animal Medical Center, 350 South Huntington Avenue, Boston, MA, 02130.
authors.forename: Kiko
authors.initials: K
authors.lastname: Bracker
authors.affiliation: Angell Animal Medical Center, 350 South Huntington Avenue, Boston, MA, 02130.
authors.forename: Danielle
authors.initials: D
authors.lastname: Thomas
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics*; D000818:Animals; D000930:Antidiarrheals / Q000009:adverse effects*; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000188:drug therapy / Q000662:veterinary; D004283:Dog Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D004285:Dogs; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary*; D004630:Emergencies / Q000662:veterinary; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D008139:Loperamide / Q000009:adverse effects*; D008297:Male; D009154:Mutation
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000930:Antidiarrheals; D005217:Fat Emulsions, Intravenous; D008139:Loperamide
keywords: P-glycoprotein; antidote; central nervous system; mutation; neurotoxicosis