Efficacia e sicurezza del trattamento con emulsioni lipidiche endovenose a basse dosi nelle intossicazioni del cane e del gatto

Poisonings are one of the most frequent pathologies in veterinary clinical practice. However, only a very small number of toxins have antidotes that are readily available in clinical practice to counteract the related symptoms. Intravenous lipid emulsion (ILE) therapy is an emerging antidote for lipophilic drug toxicities in both veterinary and human medicine. First, a Veterinary University Hospital (VUH) epidemiology study was performed from 2001 to 2017 and all the clinical suspects of intoxications in dogs and cats were evaluated. The most frequent poisonings were identified and lipophilic intoxications were selected for the second part of the study. Cutaneous and enteral intoxications in dogs and cats were evaluated between 2015 and 2017. 303 dogs and cats were selected (77% and 23% respectively). The most frequently identified toxic agents were rodenticides, permethrin and metaldehyde. Treatment with low-dose ILE was performed on 18 animals (11 dogs and 5 cats) between 2015 and 2018. The most common known toxicants were permethrin in cats (3/5 cases) and metaldehyde in dogs (3/11 cases). No adverse effects directly associated with the administration of lipid emulsions were reported immediately or in the follow-up. Low-dose ILE treatment was considered safe, and potentially effective, in the management of the reported cases. Further randomised controlled trials are needed to determine the appropriate dosing, effectiveness and safety of ILE in clinical settings.