Treatment for insecticide toxicosis in cats

Haworth MD and Smart L. Use of intravenous lipid therapy in three cases of feline permethrin toxicosis. J Vet Emerg Crit Care. 2012; 22: 697-702.

Permethrin is a synthetic pyrethroid insecticide and acaricide commonly used for flea and tick control in dogs. Permethrin toxicosis in cats usually occurs when owners inadvertently apply over-the-counter spot-on flea insecticides intended for dogs to their cats or when cats are exposed secondarily to the product used on dogs that share the same environment. Permethrin exerts its toxic effect on ectoparasite and host by modulating sodium ion channels, causing them to remain open longer, resulting in repetitive excitable cell discharge. While this leads to paralysis and death of the parasite, toxicosis in the host manifests primarily as central nervous system effects including tremors, hyperesthesia, ataxia, mydriasis, pyrexia, seizures, and possibly death. Cats are highly susceptible to permethrin toxicity possibly due to their innate deficiency in glucoronyl transferase and slower hepatic detoxification of the compound.
 
No antidote exists for permethrin toxicosis, therefore treatment is aimed at decontamination and control of neurological symptoms while allowing time for the toxin to be metabolized and excreted. Clinical signs typically last from 1 to 3 days. Mortality rates vary from 5-45%. Lengthy hospitalization times and cost often contribute to an owner’s decision for euthanasia.

Intravenous lipid emulsion (IVLE) has shown promise as an emerging adjuvant treatment for certain lipophilic toxicants such as ivermectin, local anesthetics, and permethrin. Although the exact mechanism of action of IVLE is unknown, it has been postulated that the lipid creates a “sink” for fat-soluble drugs, decreasing their tissue availability. This report describes treatment of 3 cats with permethrin toxicosis with IVLE administration in addition to standard treatment. All 3 cats appeared to show accelerated resolution of clinical signs following lipid administration. The authors suggest that lipid administration may also reduce hospitalization time and cost, and possibly prevent the decision to euthanize. A prospective, controlled clinical trial to confirm these findings is warranted. In circumstances where euthanasia, or death is imminent, the use of IVLE is justified. [GO]

See also: Bruckner M and Schwedes CS. Successful treatment of permethrin toxicosis in two cats with an intravenous lipid administration. Tierarztl Prax Ausg K Kleintiere Heimtiere. 2012; 40: 129-34. 

Malik R, Ward MP, Seavers A, et al. Permethrin spot-on intoxication of cats: Literature review and survey of veterinary practitioners in Australia. J Feline Med Surg. 2010; 12: 5-14.

Related blog articles:
Feline permethrin toxicity (March 2010)
Cats and permethrin toxicity (February 2009)
Feline permethrin spot-on toxicity (May 2008)


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Winn Feline Foundation Library
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Haworth MD and Smart L. Use of intravenous lipid therapy in three cases of feline permethrin toxicosis. J Vet Emerg Crit Care. 2012; 22: 697-702.

Permethrin is a synthetic pyrethroid insecticide and acaricide commonly used for flea and tick control in dogs. Permethrin toxicosis in cats usually occurs when owners inadvertently apply over-the-counter spot-on flea insecticides intended for dogs to their cats or when cats are exposed secondarily to the product used on dogs that share the same environment. Permethrin exerts its toxic effect on ectoparasite and host by modulating sodium ion channels, causing them to remain open longer, resulting in repetitive excitable cell discharge. While this leads to paralysis and death of the parasite, toxicosis in the host manifests primarily as central nervous system effects including tremors, hyperesthesia, ataxia, mydriasis, pyrexia, seizures, and possibly death. Cats are highly susceptible to permethrin toxicity possibly due to their innate deficiency in glucoronyl transferase and slower hepatic detoxification of the compound.
 
No antidote exists for permethrin toxicosis, therefore treatment is aimed at decontamination and control of neurological symptoms while allowing time for the toxin to be metabolized and excreted. Clinical signs typically last from 1 to 3 days. Mortality rates vary from 5-45%. Lengthy hospitalization times and cost often contribute to an owner’s decision for euthanasia.

Intravenous lipid emulsion (IVLE) has shown promise as an emerging adjuvant treatment for certain lipophilic toxicants such as ivermectin, local anesthetics, and permethrin. Although the exact mechanism of action of IVLE is unknown, it has been postulated that the lipid creates a “sink” for fat-soluble drugs, decreasing their tissue availability. This report describes treatment of 3 cats with permethrin toxicosis with IVLE administration in addition to standard treatment. All 3 cats appeared to show accelerated resolution of clinical signs following lipid administration. The authors suggest that lipid administration may also reduce hospitalization time and cost, and possibly prevent the decision to euthanize. A prospective, controlled clinical trial to confirm these findings is warranted. In circumstances where euthanasia, or death is imminent, the use of IVLE is justified. [GO]

See also: Bruckner M and Schwedes CS. Successful treatment of permethrin toxicosis in two cats with an intravenous lipid administration. Tierarztl Prax Ausg K Kleintiere Heimtiere. 2012; 40: 129-34. 

Malik R, Ward MP, Seavers A, et al. Permethrin spot-on intoxication of cats: Literature review and survey of veterinary practitioners in Australia. J Feline Med Surg. 2010; 12: 5-14.

Related blog articles:
Feline permethrin toxicity (March 2010)
Cats and permethrin toxicity (February 2009)
Feline permethrin spot-on toxicity (May 2008)


More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

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Feline Permethrin Toxicity

Boland LA, Angles JM: Feline permethrin toxicity: retrospective study of 42 cases, J Feline Med Surg 12:61, 2010.

This study was a retrospective review of 42 cases of feline permethrin toxicity treated at a referral hospital in Australia. Most of the cases had a canine permethrin spot-on (PSO) flea product directly applied to the affected cats. Approximately half of the cases developed toxicity following a PSO product purchased from a supermarket. Most of the cases occurred in the summer. Cats are particularly sensitive to the effects of permethrin. Tremors and muscle fasciculations were the most common clinical sign exhibited in 86% of cats affected followed by twitches, hyperesthesia, seizures, pyrexia, ptyalism, ataxia, mydriasis, and temporary blindness. The clinical onset of signs was from a few hours up to 24-72 hours after application of the PSO. There was no correlation between the amount of permethrin applied and the severity of clinical signs induced. In this study, treatment involved decontamination, anticonvulsants, and supportive care. Methocarbamol was not used. Hypothermia was the most common complication found during treatment, followed by electrolyte abnormalities. One cat had to be euthanized during treatment. Results of this study suggest that the lack of availability of methocarbamol for treatment should not preclude treatment of permethrin toxicity. [VT]

Related articles:
Sutton NM, Bates N, Campbell A: Clinical effects and outcome of feline permethrin spot-on poisonings reported to the Veterinary Poisons Information Service (VPIS), London, J Feline Med Surg 9:335, 2007.

Dymond NL, Swift IM: Permethrin toxicity in cats: a retrospective study of 20 cases, Aust Vet J 86:219, 2008.

More on cat health: Winn Feline Foundation Library
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Boland LA, Angles JM: Feline permethrin toxicity: retrospective study of 42 cases, J Feline Med Surg 12:61, 2010.

This study was a retrospective review of 42 cases of feline permethrin toxicity treated at a referral hospital in Australia. Most of the cases had a canine permethrin spot-on (PSO) flea product directly applied to the affected cats. Approximately half of the cases developed toxicity following a PSO product purchased from a supermarket. Most of the cases occurred in the summer. Cats are particularly sensitive to the effects of permethrin. Tremors and muscle fasciculations were the most common clinical sign exhibited in 86% of cats affected followed by twitches, hyperesthesia, seizures, pyrexia, ptyalism, ataxia, mydriasis, and temporary blindness. The clinical onset of signs was from a few hours up to 24-72 hours after application of the PSO. There was no correlation between the amount of permethrin applied and the severity of clinical signs induced. In this study, treatment involved decontamination, anticonvulsants, and supportive care. Methocarbamol was not used. Hypothermia was the most common complication found during treatment, followed by electrolyte abnormalities. One cat had to be euthanized during treatment. Results of this study suggest that the lack of availability of methocarbamol for treatment should not preclude treatment of permethrin toxicity. [VT]

Related articles:
Sutton NM, Bates N, Campbell A: Clinical effects and outcome of feline permethrin spot-on poisonings reported to the Veterinary Poisons Information Service (VPIS), London, J Feline Med Surg 9:335, 2007.

Dymond NL, Swift IM: Permethrin toxicity in cats: a retrospective study of 20 cases, Aust Vet J 86:219, 2008.

More on cat health: Winn Feline Foundation Library
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Follow us on Twitter
New for 2010: subscribe to our e-newsletter

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Cats and Permethrin Toxicity

Dymond NL, Swift IM. Permethrin toxicity in cats: a retrospective study of 20 cases. Aust Vet J. Jun 2008;86(6):219-223.

Researchers in Australia completed a retrospective study of 20 cases of permethrin toxicity in cats. The cats were presented to an emergency clinic in Brisbane, Australia from October 2004 to June 2005. Permethrin is present in many topical flea control products used for small animals. Cats are particularly susceptible to the toxic effects of permethrin, which occurs when cats are accidentally exposed to products made for use on dogs. The history of recent exposure plus typical clinical signs of permethrin poisoning including tremors, muscle fasciculations, and seizures were the primary means for diagnosis. Treatment included decontamination of the product and patient support with drug therapy to control muscle tremors and seizures. Researchers noted that rapid intervention lead to good outcomes of treatment in 19 of 20 cats. One kitten died when there was a 24-hour delay in treatment. All recovered cats were reported to have no complications when a 4-month follow-up was performed. Education of owners regarding the risks of permethrin use on cats plus clear, appropriate labeling of products to help decrease the number of future cases were the conclusions drawn by the study.
>> PubMed Abstract

Related articles:
Sutton NM, Bates N, Campbell A. Clinical effects and outcome of feline permethrin spot-on poisonings reported to the Veterinary Poisons Information Service (VPIS), London. J Feline Med Surg. Aug 2007;9(4):335-339.
>> PubMed Abstract

Linnett PJ. Permethrin toxicosis in cats. Aust Vet J. Jan-Feb 2008;86(1-2):32-35.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Dymond NL, Swift IM. Permethrin toxicity in cats: a retrospective study of 20 cases. Aust Vet J. Jun 2008;86(6):219-223.

Researchers in Australia completed a retrospective study of 20 cases of permethrin toxicity in cats. The cats were presented to an emergency clinic in Brisbane, Australia from October 2004 to June 2005. Permethrin is present in many topical flea control products used for small animals. Cats are particularly susceptible to the toxic effects of permethrin, which occurs when cats are accidentally exposed to products made for use on dogs. The history of recent exposure plus typical clinical signs of permethrin poisoning including tremors, muscle fasciculations, and seizures were the primary means for diagnosis. Treatment included decontamination of the product and patient support with drug therapy to control muscle tremors and seizures. Researchers noted that rapid intervention lead to good outcomes of treatment in 19 of 20 cats. One kitten died when there was a 24-hour delay in treatment. All recovered cats were reported to have no complications when a 4-month follow-up was performed. Education of owners regarding the risks of permethrin use on cats plus clear, appropriate labeling of products to help decrease the number of future cases were the conclusions drawn by the study.
>> PubMed Abstract

Related articles:
Sutton NM, Bates N, Campbell A. Clinical effects and outcome of feline permethrin spot-on poisonings reported to the Veterinary Poisons Information Service (VPIS), London. J Feline Med Surg. Aug 2007;9(4):335-339.
>> PubMed Abstract

Linnett PJ. Permethrin toxicosis in cats. Aust Vet J. Jan-Feb 2008;86(1-2):32-35.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Read More

Feline Permethrin Spot-On Toxicity

Sutton, N. M., N. Bates, et al. (2007). "Clinical effects and outcome of feline permethrin spot-on poisonings reported to the Veterinary Poisons Information Service (VPIS), London." J Feline Med Surg 9(4): 335-9.

Permethrin is a pyrethroid insecticide used in topically applied spot-on flea treatments for dogs. Cats are very sensitive to the toxic effects of permethrin. These products are readily available and are often less expensive than other flea control products. Cats may be affected when the product is applied directly to them, or through contact with a treated animal. Data from 286 cases of permethrin toxicity in cats from the Veterinary Poisons Information Service in the United Kingdom is reviewed. The majority of the cats (96.9%) experienced clinical signs of toxicosis. The most common clinical signs were twitching, tremors, muscle fasciculations, and seizures. The duration of clinical signs was long, with seizures lasting an average of 38 hours and tremors lasting an average of 32 hours. Some cats took up to 1 week to recover. Death occurred in 10.5% of cases, some of which were euthanized due to reasons such as respiratory failure, or uncontrollable seizures. It is very important for cat owners to avoid using spot-on flea products containing permethrin on cats, and cats should not have contact with other animals treated with these products.
>> PubMed abstract

Related articles:
Linnett, P. J. (2008). "Permethrin toxicosis in cats." Aust Vet J 86(1-2): 32-5.
>> PubMed abstract

More on cat health: Winn Feline Foundation Library

Sutton, N. M., N. Bates, et al. (2007). "Clinical effects and outcome of feline permethrin spot-on poisonings reported to the Veterinary Poisons Information Service (VPIS), London." J Feline Med Surg 9(4): 335-9.

Permethrin is a pyrethroid insecticide used in topically applied spot-on flea treatments for dogs. Cats are very sensitive to the toxic effects of permethrin. These products are readily available and are often less expensive than other flea control products. Cats may be affected when the product is applied directly to them, or through contact with a treated animal. Data from 286 cases of permethrin toxicity in cats from the Veterinary Poisons Information Service in the United Kingdom is reviewed. The majority of the cats (96.9%) experienced clinical signs of toxicosis. The most common clinical signs were twitching, tremors, muscle fasciculations, and seizures. The duration of clinical signs was long, with seizures lasting an average of 38 hours and tremors lasting an average of 32 hours. Some cats took up to 1 week to recover. Death occurred in 10.5% of cases, some of which were euthanized due to reasons such as respiratory failure, or uncontrollable seizures. It is very important for cat owners to avoid using spot-on flea products containing permethrin on cats, and cats should not have contact with other animals treated with these products.
>> PubMed abstract

Related articles:
Linnett, P. J. (2008). "Permethrin toxicosis in cats." Aust Vet J 86(1-2): 32-5.
>> PubMed abstract

More on cat health: Winn Feline Foundation Library

Read More