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用静脉脂质疗法治疗伊维菌素导致失明的一只犬。

Ivermectin-induced blindness treated with intravenous lipid therapy in a dog.

作者信息

Epstein Steven E, Hollingsworth Steven R

机构信息

Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2013 Jan-Feb;23(1):58-62. doi: 10.1111/vec.12016. Epub 2013 Jan 14.

Abstract

OBJECTIVE

To report a case of blindness due to the ingestion of ivermectin and subsequent successful treatment with intravenous lipid (IVL) therapy.

CASE SUMMARY

A female neutered Jack Russell Terrier was examined for acute onset of apparent blindness after being exposed to ivermectin the previous day. The dog appeared to be blind during initial examination. Pupillary light reflex, menace response, and dazzle reflex were not present in either eye. Fundic examination revealed small areas of linear retinal edema. Electroretinography (ERG) showed diminished activity in both eyes. Ivermectin was present in the serum on toxicological assay. Approximately 20 hours after exposure, IVL was infused. Within 30 minutes of initiating the infusion, the pupillary light reflexes returned in both eyes, and by the end of the infusion the patient behaved as if sighted. Fundic examination and ERG were unchanged at this time. The dog was tested for the multidrug resistance gene mutation and was unaffected.

NEW OR UNIQUE INFORMATION PROVIDED

Ivermectin toxicity occurs in dogs with apparent blindness being a common clinical sign. This is the first case report of ivermectin-induced blindness evaluated with ERG before and after treatment with IVL in a dog unaffected by the multidrug resistance gene mutation. Treatment with an infusion of IVL therapy appeared to shorten the clinical course of disease in this patient without affecting ERG results.

摘要

目的

报告一例因摄入伊维菌素导致失明并随后经静脉脂质(IVL)治疗成功的病例。

病例摘要

一只已绝育的雌性杰克罗素梗犬在前一天接触伊维菌素后,因急性发作明显失明而接受检查。在初次检查时,这只狗似乎失明了。双眼均未出现瞳孔对光反射、威胁反应和闪光反射。眼底检查发现视网膜有小面积的线状水肿。视网膜电图(ERG)显示双眼活动减弱。毒理学检测血清中存在伊维菌素。接触后约20小时,输注IVL。在开始输注后30分钟内,双眼瞳孔对光反射恢复,输注结束时,病犬表现得好像恢复了视力。此时眼底检查和ERG未发生变化。对这只狗进行了多药耐药基因突变检测,结果未受影响。

提供的新的或独特信息

伊维菌素中毒在犬类中发生,明显失明是常见的临床症状。这是首例在一只未受多药耐药基因突变影响的犬中,在IVL治疗前后用ERG评估伊维菌素诱导失明的病例报告。在该患者中,输注IVL治疗似乎缩短了疾病的临床病程,且未影响ERG结果。

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