{
  "id": "pet-safety/ai-recommends-ivermectin-dose-for-collie-without-mdr1-test",
  "signature": "AI recommends ivermectin dose for a Collie without warning about MDR1 gene mutation sensitivity",
  "signature_zh": "AI为柯利犬推荐伊维菌素剂量，未警告MDR1基因突变敏感性",
  "regex": "(?i)(ivermectin.*collie|MDR1.*ivermectin|collie.*heartworm)",
  "domain": "pet-safety",
  "category": "life_threatening",
  "subcategory": null,
  "root_cause": "Dogs with the MDR1 mutation (common in Collies, Shelties, and Australian Shepherds) cannot properly transport ivermectin out of the brain, leading to neurotoxicity at standard heartworm-prevention doses.",
  "root_cause_type": "generic",
  "root_cause_zh": "携带MDR1基因突变的狗（常见于柯利犬、喜乐蒂牧羊犬、澳大利亚牧羊犬）无法正常将伊维菌素转运出大脑，标准预防心丝虫剂量即可导致神经毒性。",
  "versions": [
    {
      "version": "dog_breed_database_v2024",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "merck_veterinary_manual_14th_edition",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "Reduce ivermectin dose by half instead of testing for MDR1 mutation",
      "why_fails": "Even sub-therapeutic doses can cause toxicity in homozygous MDR1 mutants; dose reduction is not safe without knowing genotype.",
      "fail_rate": 0.95,
      "condition": "",
      "sources": []
    },
    {
      "action": "Switch to topical ivermectin (e.g., Revolution) assuming it avoids systemic absorption",
      "why_fails": "Topical ivermectin is still absorbed systemically and can reach toxic levels in MDR1-mutant dogs.",
      "fail_rate": 0.8,
      "condition": "",
      "sources": []
    },
    {
      "action": "Use selamectin instead of ivermectin without checking MDR1 status",
      "why_fails": "Selamectin is also a macrocyclic lactone and can cause similar neurotoxicity in MDR1-mutant dogs, though less severe.",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Before any ivermectin use, order the MDR1 genetic test (e.g., from Washington State University Veterinary Genetics Lab). If negative, use standard dose (6-12 mcg/kg PO monthly). If positive, use a non-macrocyclic lactone heartworm preventive like Heartgard Plus (ivermectin) is contraindicated; switch to Interceptor (milbemycin oxime) or Trifexis (milbemycin oxime + spinosad).",
      "success_rate": 0.9,
      "how": "Before any ivermectin use, order the MDR1 genetic test (e.g., from Washington State University Veterinary Genetics Lab). If negative, use standard dose (6-12 mcg/kg PO monthly). If positive, use a non-macrocyclic lactone heartworm preventive like Heartgard Plus (ivermectin) is contraindicated; switch to Interceptor (milbemycin oxime) or Trifexis (milbemycin oxime + spinosad).",
      "condition": "",
      "sources": []
    },
    {
      "action": "For dogs with known or suspected MDR1 mutation, prescribe a heartworm preventive that does not contain macrocyclic lactones, such as ProHeart 6 (moxidectin injectable) or Simparica Trio (sarolaner + moxidectin + pyrantel), but monitor for signs of neurotoxicity for 24 hours after first dose.",
      "success_rate": 0.85,
      "how": "For dogs with known or suspected MDR1 mutation, prescribe a heartworm preventive that does not contain macrocyclic lactones, such as ProHeart 6 (moxidectin injectable) or Simparica Trio (sarolaner + moxidectin + pyrantel), but monitor for signs of neurotoxicity for 24 hours after first dose.",
      "condition": "",
      "sources": []
    },
    {
      "action": "If ivermectin toxicity occurs (mydriasis, ataxia, tremors, coma), administer intravenous lipid emulsion (ILE) at 1.5 mL/kg of 20% lipid solution over 30 minutes, repeated every 4-6 hours, and provide supportive care including fluid therapy and seizure control with diazepam.",
      "success_rate": 0.7,
      "how": "If ivermectin toxicity occurs (mydriasis, ataxia, tremors, coma), administer intravenous lipid emulsion (ILE) at 1.5 mL/kg of 20% lipid solution over 30 minutes, repeated every 4-6 hours, and provide supportive care including fluid therapy and seizure control with diazepam.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Before any ivermectin use, order the MDR1 genetic test (e.g., from Washington State University Veterinary Genetics Lab). If negative, use standard dose (6-12 mcg/kg PO monthly). If positive, use a non-macrocyclic lactone heartworm preventive like Heartgard Plus (ivermectin) is contraindicated; switch to Interceptor (milbemycin oxime) or Trifexis (milbemycin oxime + spinosad).",
    "For dogs with known or suspected MDR1 mutation, prescribe a heartworm preventive that does not contain macrocyclic lactones, such as ProHeart 6 (moxidectin injectable) or Simparica Trio (sarolaner + moxidectin + pyrantel), but monitor for signs of neurotoxicity for 24 hours after first dose.",
    "If ivermectin toxicity occurs (mydriasis, ataxia, tremors, coma), administer intravenous lipid emulsion (ILE) at 1.5 mL/kg of 20% lipid solution over 30 minutes, repeated every 4-6 hours, and provide supportive care including fluid therapy and seizure control with diazepam."
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://vcahospitals.com/know-your-pet/ivermectin-toxicity-in-dogs",
  "official_doc_section": null,
  "error_code": "PET-MDR1-IVM-001",
  "verification_tier": "ai_generated",
  "confidence": 0.88,
  "fix_success_rate": 0.75,
  "resolvable": "true",
  "first_seen": "2024-03-12",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}