Successful treatment of ivermectin overdose in a bearded dragon (Pogona vitticeps) using gastric lavage and intravenous lipid emulsion

J Vet Emerg Crit Care (San Antonio). 2022 Sep;32(5):680-684. doi: 10.1111/vec.13218. Epub 2022 Jun 16.

Abstract

Objective: To describe the clinical signs and outcome following ivermectin overdose in a bearded dragon. This case also describes the novel use of intravenous lipid emulsion (ILE) as a rescue therapy in reptiles, as well as the use of aggressive gastrointestinal decontamination.

Case summary: A 4-year-old female intact bearded dragon (Pogona vitticeps) (0.6 kg) was admitted to the ICU at a specialty hospital following accidental overdose of 40 mg (66.7 mg/kg) of ivermectin enterally. The patient was physically inverted to allow passive reflux of the medication, then sedated for gastric lavage. A 20% ILE was administered intravenously due to the high risk for fatality. Additional treatments included 2 doses of activated charcoal, as well as SC fluids, enteral nutrition, and sucralfate. The patient was profoundly sedate until day 4 when mild improvements in mentation were noted. The patient started ambulating on its own on day 6 and was discharged from the hospital on day 13. The patient was alive 720 days postdischarge.

New or unique information provided: This is the first case report describing the events following ivermectin overdose and the use of ILE therapy and activated charcoal in a bearded dragon. These therapies were tolerated with no adverse effects noted in this patient. This report provides evidence that complete recovery from ivermectin overdose is possible.

Keywords: ILE; decontamination; intoxication; reptile.

Publication types

  • Case Reports

MeSH terms

  • Aftercare
  • Animals
  • Charcoal
  • Drug Overdose* / drug therapy
  • Drug Overdose* / veterinary
  • Fat Emulsions, Intravenous / therapeutic use
  • Female
  • Gastric Lavage / veterinary
  • Ivermectin / therapeutic use
  • Lizards*
  • Patient Discharge
  • Sucralfate

Substances

  • Fat Emulsions, Intravenous
  • Charcoal
  • Sucralfate
  • Ivermectin