LipidRescue™ Resuscitation

To the group,
I was wondering if any veterinary practitioners (especially @ teaching hospitals) are using lipid emulsion rescue as a regular protocol. If so for what types of cases, when in the course of treatment and what have the outcomes been?

Thanks
Kit Kelly, DVM
Resident in Anesthesia

I am concerned about using this in veterinary medicine. I was a believer and gave the intralipids to a dog having tremors due to an assumed but unknown medication overdose. The tremors stopped within minutes of giving the lipids but the dog developed an acute, severe pancreatitis. She is terribly painful in her abdomen and she was normal before this according to the owners. I am very curious, I know the skeptics were concerned that this could be a potiential problem along with fatty embolus, but is there any report of pancreatitis being linked to intralipids? I couldnt find any data, but there is always a first time I guess. If it isnt reported, and the tests come back conclusive for pancreatitis we may try to publish this case report.

I believe that may be the case as well. The rseident feels that the animal may have presented with an acute abdomen that was hidden by the tremors but I can not explain why the tremors stopped with the intralipids. I did the research on it, presented it to my clinic and now we have it in stock and I was still impressed by the way it worked. I did give Diazepam as well, but it took an hour after that before the tremors stopped and diazepam should have worked quicker than that if it was going to. Dose-1.5ml/kg bolus then 0.25ml/kg/min over 60 min. Unfortunately the owners ran out of money and the dog was unable to eat or drink due to the inflammation in her abdomen so we euthanized her. She may have even suffered a small perforation that went undetected on rads or ultrasound. No one here is trying to blame the intralipids but just tyring to get more information. I ran a urine drug screen (something else I am researching and presenting in a week) and it was negative for all drugs. Doesnt explain why she got better either. Organphosphates can cause acute pancreatitis and yes, it definately could have been something she got into. Other thought was that she presented with pancreatitis and the intralipids didnt help things, but no quick and dirty test for this on ER. Thanks for your information. This case has us scratching our heads.

I guess i should answer the first post. Yes, veterinarians are using this. My clinic has implemented this and aside from this weird case, has been successful One was a baclofen intoxication and one was an ivermectin overdose where the dog went blind. Both have recovered and are doing well. Michigan state is alos using this and they have had good results. Any medication that is lipid soluble has the potential top be helped by Intralipids. And when it works, it is incredible. We can get them out of the hospital so much sooner than before and with a better prognosis.