Hypertriglyceridemia and transient corneal lipidosis in a cat following intravenous lipid therapy for permethrin toxicosis.

An 8-year-old male neutered domestic shorthair cat developed corneal lipidosis and marked hypertriglyceridemia approximately 36 hours after intravenous lipid therapy (IVLT) for the treatment of permethrin toxicosis. The cat's ocular changes resolved approximately 72 hours after IVLT without treatment. This study reports a rare complication of IVLT.

Hypertriglycéridémie et lipidose cornéenne transitoire chez un chat après une lipidothérapie intraveineuse pour une toxicose à la perméthrine. Un chat commun mâle stérilisé âgé de 8 ans a développé une lipidose cornéenne et une hypertriglycéridémie marquée environ 36 heures après une lipidothérapie intraveineuse (LTI) pour le traitement de la toxicose à la perméthrine. Les changements oculaires du chat se sont résorbés sans traitement environ 72 heures près la LTI. Cette étude signale une complication rare de la LTI.(Traduit par Isabelle Vallières).

Efficacy of naringenin against permethrin-induced testicular toxicity in rats.

Permethrin (PM), a synthetic pyrethroid insecticide, has broad toxicity spectra. We aimed to investigate the effects of PM on the testes of adult albino rats, examine the recovery response and evaluate the efficacy of naringenin (NG) supplementation. Adult male albino rats were randomly assigned to five groups of six each: control, NG (50 mg/kg), PM (70 mg/kg), recovery (after subsequent withdrawal of PM) and NG-PM group. All treatments were given by oral gavage for 6 weeks and another 3 weeks for the recovery group. At the time of sacrifice, each testis was weighed. Biochemical analysis of epididymal sperm count and serum testosterone level was performed. Testes were processed for histological, ultrastructural and c-Kit immunohistochemical study. PM toxicity was evidenced by a highly significant decrease in testicular weight, epididymal sperm count and serum testosterone level compared to control. Furthermore, testicular structure abnormalities and reduced c-Kit immunoreactions were observed. Stoppage of PM in the recovery group partially reversed PM-induced changes. There was a mild decrease in testicular weight and biochemical parameters compared to control. The structure of seminiferous tubules was partially retained. The NG-PM group showed an overall improvement in testicular weight and biochemical alterations which were confirmed by light and electron microscopic examination. In conclusion, PM induced testicular toxicity, which was ameliorated by NG co-administration. However, stoppage of PM exposure was associated with partial recovery.

Persistent gross lipemia and suspected corneal lipidosis following intravenous lipid therapy in a cat with permethrin toxicosis.

OBJECTIVE: To describe the observation of persistent gross lipemia and suspected corneal lipidosis following intravenous lipid therapy (IVLT) in a cat with permethrin toxicosis. CASE SUMMARY: A 5-year-old, spayed female, domestic short-haired cat with permethrin toxicosis was treated with a high dose of IVLT as an adjunct treatment when it remained severely obtunded following traditional supportive care. The cat received intravenous 20% lipid emulsion as a 1.5 mL/kg bolus given over 10 minutes followed by a constant rate infusion of 0.25 mL/kg/min for 2 hours. The cat developed gross lipemia that persisted at least 48 hours after the single dose of IVLT. Changes consistent with corneal lipidosis were observed and resolved within 1 week after IVLT. NEW OR UNIQUE INFORMATION PROVIDED: This is the first report documenting the complications of persistent gross lipemia and suspected corneal lipidosis in a cat following IVLT. This report underscores the off-label, experimental nature of IVLT as a treatment for intoxication in cats.

A randomized, controlled clinical trial of intravenous lipid emulsion as an adjunctive treatment for permethrin toxicosis in cats.

OBJECTIVE: To assess for any clinical benefit of intravenous lipid emulsion (ILE) for permethrin toxicosis in cats by comparing the progression of clinical signs of cats before and after treatment with ILE to cats treated with a saline control. To accomplish this objective, a clinical staging system for cats with permethrin toxicosis was developed and validated. DESIGN: Prospective, multicenter, randomized, controlled clinical trial. SETTING: University veterinary teaching hospital and 12 private veterinary emergency hospitals. ANIMALS: Thirty-four client-owned cats with permethrin toxicosis. INTERVENTIONS: A clinical staging system was designed based on abnormalities found on physical examination of cats with permethrin toxicosis. The clinical staging system had 6 stages, ranging from Stage A for cats with no abnormalities to Stage F for cats with grand mal seizures. The system was validated for intraviewer and interviewer variability. Cats in the clinical trial were randomized to receive 15 mL/kg of either intravenous 0.9% saline (control) or 20% ILE over 60 minutes. For each cat, a clinical stage was recorded at set time points before and after the randomized treatment was administered. The distribution of clinical stage stratified over time was compared across treatment groups. MEASUREMENTS AND MAIN RESULTS: The clinical staging system showed excellent repeatability (P = 1.0) and reliability (P = 1.0). In the clinical trial, there was a significant difference in the distribution of clinical stages over time (P < 0.001) and from presentation stage to Stage B (P = 0.006), with ILE-treated cats (n = 20) having lower clinical stages earlier than control cats (n = 14). There was no significant difference in signalment, body weight, or supportive treatment between the groups. CONCLUSIONS: The clinical staging system was repeatable and reliable. Clinical stages of permethrin toxicosis in ILE-treated cats improved earlier compared to control cats, suggesting ILE may be a useful adjunctive therapy in the treatment of permethrin toxicosis in cats.

[Vigilance for veterinary medicinal products: reports of adverse reactions in the year 2012]. / Vigilance der Tierarzneimittel: Gemeldete unerwünschte Wirkungen im Jahr 2012.

197 adverse reactions of Swissmedic-authorized veterinary medicinal products were reported during the year 2012 (2011: 167). Species and drug classes remain unchanged over the years: most of the reports related to reactions following the use of antiparasitic products (37.6 %), antiinfectives (15.7 %) or non-steroidal antiinflammatory drugs (11.7 %) in companion animals (94 dogs and 53 cats) followed by cattle/calves (29). Additionally, 45 cases transmitted by the Swiss Toxicological Information Centre in Zürich were processed. We discuss a paradoxical reaction under the potential influence of acepromazine as well as a modified protocol for treating permethrin intoxication in cats. Finally, the vaccinovigilance program received 95 declarations following the application of various vaccines, mainly to dogs or cats.

En 2012, on a enregistré 197 annonces de réactions après application de médicaments vétérinaires autorisés par Swissmedic (2011: 167). La répartition de ces annonces, tant en ce qui concerne les espèces que les classes de médicaments, est inchangée par rapport aux années précédentes: on a annoncé le plus souvent des réactions à des produits antiparasitaires (37.6 %), antiinfectieux (15.7 %) ou antiinflammatoires (11.7 %) chez les petits animaux (94 annonces concernaient des chiens, 53 des chats) suivis par les bovins (29 annonces). En outre 45 cas annoncés par le Centre suisse d'information toxicologique de Zürich dans le cadre de ses activités de conseil ont été étudiés. Une réaction paradoxale d'agressivité sous l'effet possible de l'acépromazine et un protocole modifié pour le traitement des intoxications à la perméthrine chez le chat sont présentés. Pour ce qui est de la vaccinovigilance effectuée par l'IVI, on a enregistré 95 annonces de réactions après l'application de divers vaccins, principalement chez des chiens et des chats.

Adjunctive therapy with intravenous lipid emulsion and methocarbamol for permethrin toxicity in 2 cats.

OBJECTIVE: To describe the use of an intravenous lipid emulsion (ILE) as an adjunctive therapy in 2 cats with permethrin toxicity. CASE SERIES SUMMARY: Two cats that presented with severe permethrin toxicity were treated with ILE as part of their treatment regimens. Both cats improved dramatically following therapy with decontamination, ILE, methocarbamol, and supportive care. NEW OR UNIQUE INFORMATION PROVIDED: This is the first reported use of ILE as an adjunctive treatment for cats with permethrin toxicity. Outcome was favorable in both cats and no adverse effects were noted from the ILE.

Successful treatment of permethrin toxicosis in two cats with an intravenous lipid administration.

The present work describes successful treatment of permethrin toxicosis in two cats with a novel therapy of intravenous lipid administration. Two cats presented in lateral recumbency and with generalized tremor after they had been incidentally treated with permethrin for flea control by their owners. Initial therapy consisted of diazepam, propofol, bathing, and intravenous fluids. After an initial bolus of 2mg/kg BW pentobarbital a pentobarbital continuous rate infusion (CRI) was started. Both cats received an emulsion of 20% soybean oil and 80% olive oil, commonly used as fat component of total parenteral nutrition in humans, later in the course of therapy. A bolus of 2 ml/kg BW of the emulsion followed by a CRI of 4 ml/kg BW/h for 4 hours was administered via a jugular catheter as reported previously. One cat received two cycles of therapy with intravenous lipid whereas the other cat needed just one application. Both cats recovered completely without requiring any further treatment. In conclusion, administration of intravenous lipids for permethrin toxicosis in cats is a novel treatment approach which seems to be highly effective in shortening the recovery time for permethrin toxicosis and possibly other fat-soluble toxins.

Pesticide use modifies the association between genetic variants on chromosome 8q24 and prostate cancer.

Genome-wide association studies have identified 8q24 region variants as risk factors for prostate cancer. In the Agricultural Health Study, a prospective study of licensed pesticide applicators, we observed increased prostate cancer risk with specific pesticide use among those with a family history of prostate cancer. Thus, we evaluated the interaction among pesticide use, 8q24 variants, and prostate cancer risk. The authors estimated odds ratios (OR) and 95% confidence intervals (95% CI) for interactions among 211 8q24 variants, 49 pesticides, and prostate cancer risk in 776 cases and 1,444 controls. The ORs for a previously identified variant, rs4242382, and prostate cancer increased significantly (P<0.05) with exposure to the organophosphate insecticide fonofos, after correction for multiple testing, with per allele ORnonexposed of 1.17 (95% CI, 0.93-1.48), per allele OR(low) of 1.30 (95% CI, 0.75-2.27), and per allele ORhigh of 4.46 (95% CI, 2.17-9.17; P-interaction=0.002, adjusted P-interaction=0.02). A similar effect modification was observed for three other organophosphate insecticides (coumaphos, terbufos, and phorate) and one pyrethroid insecticide (permethrin). Among ever users of fonofos, subjects with three or four risk alleles at rs7837328 and rs4242382 had approximately three times the risk of prostate cancer (OR, 3.14; 95% CI, 1.41-7.00) compared with subjects who had zero risk alleles and never used fonofos. We observed a significant interaction among variants on chromosome 8q24, pesticide use, and risk of prostate cancer. Insecticides, particularly organophosphates, were the strongest modifiers of risk, although the biological mechanism is unclear. This is the first report of effect modification between 8q24 and an environmental exposure on prostate cancer risk.

Permethrin spot-on intoxication of cats Literature review and survey of veterinary practitioners in Australia.

UNLABELLED: SURVEY AIMS: A questionnaire was sent to veterinarians in Australia to determine the approximate number of cats presenting for permethrin spot-on (PSO) intoxication over a 2-year period. FINDINGS: Of the 269 questionnaires returned, 255 were eligible for analysis. A total of 207 respondents (81%) reported cases of PSO intoxication in cats over the previous 2 years. In total, 750 individual cases were reported, with 166 deaths. While all deaths were generally attributable to intoxication, 39 cats were euthanased because owners were unable to pay the anticipated treatment costs. Brands of PSO implicated included Exelpet Flea (and Tick) Liquidator (Mars Australia) (146 respondents), Bayer Advantix (48), Purina Totalcare Flea Eliminator Line-On (19), Troy Ease-On (six) and Duogard Line-On (Virbac) (four); 67 respondents were not able to identify a specific product. Permethrin spot-on formulations were most commonly obtained from supermarkets (146 respondents), followed by pet stores (43), veterinary practices (16), and a range of other sources including produce stores and friends. The majority of intoxication cases reported involved PSOs labelled for use in dogs with specific label instructions such as 'toxic to cats'. Owners applied these PSO products to their cats accidentally or intentionally. In some cases, exposure was through secondary contact, such as when a PSO product was applied to a dog with which a cat had direct or indirect contact. RECOMMENDATIONS: In the authors' view, because of the likelihood of inappropriate use and toxicity in the non-labelled species, over-the-counter products intended for use in either dogs or cats must have a high margin of safety in all species. Furthermore, PSOs should only be available at points of sale where veterinary advice can be provided and appropriate warnings given. As an interim measure, modified labelling with more explicit warnings may reduce morbidity and mortality.

Feline permethrin toxicity: retrospective study of 42 cases.

Forty-two cases of feline permethrin toxicity treated at a referral hospital in Sydney, Australia were retrospectively reviewed. In most cases canine permethrin spot-on (PSO) flea products had been directly applied to affected cats. Most presented during summer and there was an increase in cases during the 2007/2008 period. Clinical signs included; tremors/muscle fasciculations (86%), twitches (41%), hyperaesthesia (41%), seizures (33%), pyrexia (29%), ptyalism (24%), ataxia (24%), mydriasis (19%) and temporary blindness (12%). Treatment involved decontamination, anticonvulsants and supportive care. Methocarbamol was not used. Complications occurred in 33% of cats and included: hypothermia (29%), electrolyte abnormalities (26%), aspiration pneumonia (12%), hypoproteinaemia (12%), anaemia (5%), apnoea (7%), respiratory arrest (5%), cardiorespiratory arrest (2%), pleural effusion (2%), urinary tract infection (2%) and corneal ulceration (2%). One cat was euthanased. Feline permethrin toxicity may result in severe clinical signs requiring intensive treatment. Despite prominent label warnings, cases of feline permethrin toxicity continue to occur in Australia and may be fatal.

Uptake of permethrin from impregnated clothing.

In order to examine exposure and health risks which can arise from permethrin-impregnated clothing, a controlled trial was conducted. In a study group consisting of 187 volunteers in total, a subgroup of 86 persons was equipped with permethrin-impregnated battle dress uniforms (BDU) for 28 days. One hundred and one persons served as a control group, wearing non-impregnated BDUs throughout the entire study period of 56 days. Internal exposure of all participants was assessed by determination of urinary permethrin metabolites (cis-DCCA, trans-DCCA and 3-PBA) on day 0, 14 and 28 of the wearing period and 28 days after termination of wearing. Exposure levels in the control group ranged within background exposure of the general German population at all four dates of sampling (medians Sigma DCCA+3-PBA were 0.09, 0.13, 0.23 and 0.10mug/l, respectively). For the group equipped with impregnated BDUs this applied to day 0 (0.31mug/l) only, while the following measurements revealed considerably higher metabolite concentrations (31.39, 22.01 and 1.44mug/l, respectively), especially while wearing impregnated clothing. Due to these results a substantial uptake of permethrin from impregnated BDUs has to be assumed. However, since calculations reveal a maximum permethrin uptake clearly below the acceptable daily intake (ADI), health impairments are rather unlikely.

Permethrin toxicity in cats: a retrospective study of 20 cases.

OBJECTIVE: Permethrin is a synthetic pyrethroid widely used in flea control products for small animals. Accidental toxicity can occur with off-label usage, and cats are particularly susceptible. METHODS: Retrospective study of 20 cases of permethrin toxicity in cats treated at an emergency clinic in Brisbane, Queensland from October 2004 to June 2005. RESULTS: The diagnosis of permethrin toxicity was made on the basis of a history of exposure and characteristic clinical signs, including seizures, muscle fasciculations, and tremors. Decontamination and appropriate seizure or muscle fasciculation control were the basis of treatment. The outcome was good after rapid intervention and 19 of the 20 cats were successfully treated, with the only death occurring in a kitten for which treatment was delayed for 24 h. No long-term complications were reported by the cats' owners at 4-month follow-up after discharge from hospital. CONCLUSIONS: Owner education, together with more appropriate product labelling, may help eliminate this problem in the future.

Permethrin toxicosis in cats.

A retrospective analysis of all adverse experience reports received by the Australian Pesticides and Veterinary Medicines Authority's Adverse Experience Reporting Program for veterinary medicines since 1995, showed that permethrin toxicity in cats usually occurred after the owner applied a canine permethrin-containing product, typically a spot-on. Cats are also at risk from grooming or being in direct contact with recently treated dogs. This paper reviews permethrin toxicosis and its treatment in cats, incorporating information from the Australian and selected overseas veterinary pharmacovigilance programs.