{
  "id": "pet-safety/ai-recommends-ivermectin-for-dog-worms-without-checking-mdr1-mutation",
  "signature": "AI recommends ivermectin for heartworm prevention in dogs without warning about MDR1 gene mutation sensitivity",
  "signature_zh": "AI推荐使用伊维菌素进行犬心丝虫预防，未警告MDR1基因突变敏感性风险",
  "regex": "ivermectin.*dog.*heartworm|ivermectin.*collie|heartworm.*prevention.*ivermectin|MDR1.*ivermectin",
  "domain": "pet-safety",
  "category": "life_threatening",
  "subcategory": null,
  "root_cause": "Dogs with MDR1 gene mutation (common in Collies, Australian Shepherds, Shelties) cannot properly efflux ivermectin from the brain, leading to neurotoxicity at standard preventive doses, causing tremors, seizures, and death.",
  "root_cause_type": "generic",
  "root_cause_zh": "携带MDR1基因突变的犬（常见于柯利犬、澳大利亚牧羊犬、喜乐蒂牧羊犬）无法正常将伊维菌素从大脑中排出，标准预防剂量即可导致神经毒性，引起震颤、癫痫和死亡。",
  "versions": [
    {
      "version": "v1.0",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "v2.3",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "v3.1",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "Assuming only Collies are affected — MDR1 mutation occurs in over 10 herding breeds including Australian Shepherds, Shelties, Old English Sheepdogs, and mixed breeds with herding ancestry.",
      "fail_rate": 0.85,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Using a lower dose of ivermectin (e.g., 0.006 mg/kg) thinking it's safe — even low doses can cause toxicity in homozygous MDR1 mutant dogs.",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Relying on breed appearance alone — mixed breed dogs may carry the mutation without showing herding traits; only genetic testing confirms status.",
      "fail_rate": 0.75,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Test for MDR1 mutation before using any ivermectin-based product (Heartgard, Iverhart). Use a cheek swab test from Washington State University VGL or a vet. If mutation positive, choose alternative heartworm prevention (e.g., selamectin, milbemycin oxime, moxidectin).\nExample: Order MDR1 test kit from WSU (https://vgl.vetmed.wsu.edu/). For a positive dog, use Revolution (selamectin) topical monthly or Sentinel (milbemycin oxime + lufenuron) oral monthly. Avoid all ivermectin products.",
      "success_rate": 0.95,
      "how": "Test for MDR1 mutation before using any ivermectin-based product (Heartgard, Iverhart). Use a cheek swab test from Washington State University VGL or a vet. If mutation positive, choose alternative heartworm prevention (e.g., selamectin, milbemycin oxime, moxidectin).\nExample: Order MDR1 test kit from WSU (https://vgl.vetmed.wsu.edu/). For a positive dog, use Revolution (selamectin) topical monthly or Sentinel (milbemycin oxime + lufenuron) oral monthly. Avoid all ivermectin products.",
      "condition": "",
      "sources": []
    },
    {
      "action": "If ivermectin toxicity is suspected (vomiting, ataxia, tremors, seizures), stop the medication immediately. Administer activated charcoal (1-2 g/kg PO) if within 2 hours of ingestion. Seek emergency vet for IV fluids, lipid emulsion therapy, and symptomatic support.\nExample: For a 20-kg Collie showing ataxia after Heartgard, give activated charcoal 20-40 g PO, transport to ER. Vet may administer intralipid 20% at 1.5 mL/kg IV over 30 minutes to bind lipophilic ivermectin.",
      "success_rate": 0.85,
      "how": "If ivermectin toxicity is suspected (vomiting, ataxia, tremors, seizures), stop the medication immediately. Administer activated charcoal (1-2 g/kg PO) if within 2 hours of ingestion. Seek emergency vet for IV fluids, lipid emulsion therapy, and symptomatic support.\nExample: For a 20-kg Collie showing ataxia after Heartgard, give activated charcoal 20-40 g PO, transport to ER. Vet may administer intralipid 20% at 1.5 mL/kg IV over 30 minutes to bind lipophilic ivermectin.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Test for MDR1 mutation before using any ivermectin-based product (Heartgard, Iverhart). Use a cheek swab test from Washington State University VGL or a vet. If mutation positive, choose alternative heartworm prevention (e.g., selamectin, milbemycin oxime, moxidectin).\nExample: Order MDR1 test kit from WSU (https://vgl.vetmed.wsu.edu/). For a positive dog, use Revolution (selamectin) topical monthly or Sentinel (milbemycin oxime + lufenuron) oral monthly. Avoid all ivermectin products.",
    "If ivermectin toxicity is suspected (vomiting, ataxia, tremors, seizures), stop the medication immediately. Administer activated charcoal (1-2 g/kg PO) if within 2 hours of ingestion. Seek emergency vet for IV fluids, lipid emulsion therapy, and symptomatic support.\nExample: For a 20-kg Collie showing ataxia after Heartgard, give activated charcoal 20-40 g PO, transport to ER. Vet may administer intralipid 20% at 1.5 mL/kg IV over 30 minutes to bind lipophilic ivermectin."
  ],
  "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-IVERMECTIN-MDR1-001",
  "verification_tier": "ai_generated",
  "confidence": 0.9,
  "fix_success_rate": 0.9,
  "resolvable": "true",
  "first_seen": "2023-09-05",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}