The randomised clinical trial by Peacock et al. Randomised trialĪ statistically significant difference in recovery time (P <0.006) was found among patients treated with soybean oil-based IVLE therapy compared to control patients There were, however, differences in the administration of ClinOleic IVLE therapy after initial exposure (24 hours for case one and nine hours for case two), which could have influenced the time to recovery between both cases. Both cases required additional IVLE doses, which makes it difficult to establish a dosage protocol.īrückner and Schwedes (2012) was the only study that evaluated ClinOleic IVLE therapy administration, with the mean recovery time being 39 hours. Meanwhile, Kuo and Odunayo (2013) found that following initial soybean oil-based IVLE therapy, the mean recovery time in patients with permethrin toxicosis was 14 hours. One of the key limitations of this study was that one case received IVLE therapy 72 hours after the exposure and had a second permethrin exposure once discharged from the hospital, which influenced the overall recovery time. Haworth and Smart (2012) found that three patients showed a clinical improvement after soybean oil-based IVLE therapy with a mean time to recovery of 8.3 hours. Also, different dosages and constant rate infusions (CRI) were used for each patient, which can make it difficult to establish a dosing protocol for this treatment. A limitation is that three patients were treated in another clinic before arriving at the hospital, and information about any previous treatment was not available. (2015) found that four patients had neurological improvement within a mean of five hours after low-dose soybean oil-based IVLE administration. There is no reported correlation between the amount of permethrin exposure and the severity of clinical signs inducedĬeccherini et al. Therefore, this may not lead to significant differences in the time to recovery. The study also reported differences in permethrin product concentration among the evaluated cases however, according to Boland and Angles (2010), there is no reported correlation between the amount of permethrin exposure and the severity of clinical signs induced. An important limitation is that each patient had different treatment protocols, and the study design did not quantify the intrinsic effect of IVLE therapy alone or in combination with other medications (injectable anaesthetics, anticonvulsants). (2018) showed that three patients had neurological improvement after being treated with soybean oil-based IVLE therapy, with a mean time to recovery of 10 hours. Limitations of the studies include low sample sizes, only one study which evaluated ClinOleic therapy and no study directly comparing treatments. The evidenceįive case reports and one randomised clinical trial were critically appraised. You discuss with them two novel intravenous lipid emulsion (IVLE) therapies useful for reducing hospitalisation times: soybean oil-based therapy and ClinOleic therapy. The owners are concerned about their cat’s welfare and the associated costs of treatment.
This scenario is common in emergency rooms as many owners do not know that permethrin-based products intended to control ectoparasites in dogs should not be used in cats and may cause severe clinical signs or death. The owners described the first episode of seizures as occurring almost three hours after applying a permethrin spot-on product designed for dogs directly on their cat’s coat. Imagine this clinical scenario: a four-year-old spayed female domestic short-haired cat is presented to your emergency room with seizures and hypersalivation.
0 kommentar(er)
