# Intravenous Lipid Emulsion (ILE): veterinary dose and monograph > Intravenous Lipid Emulsion (ILE) is a veterinary drug. A sterile soybean-oil/egg-phospholipid fat emulsion (the same product used for parenteral nutrition) that has become a valuable ANTIDOTE/RESCUE for poisoning by LIPID-SOLUBLE (lipophilic) toxins — it creates an intravascular "LIPID SINK"… Indications include local-anaesthetic systemic toxicity (bupivacaine/lidocaine cardiotoxicity) — the original indication; lipophilic toxicoses: permethrin (cats), ivermectin/moxidectin (macrocyclic lactones), baclofen, calcium-channel blockers, some NSAIDs, antidepressants and other fat-soluble drugs; adjunct rescue in severe lipophilic-drug overdose unresponsive to standard care. This monograph lists 2 reference doses for dogs and cats, each with route, frequency and source. Source: https://vetmasterji.com/drugs/lipid-emulsion · Last reviewed: 2026-10-01 ## At a glance - **Drug class:** Veterinary drug - **Also known as:** ILE, 20% Intralipid, Lipid rescue, IV fat emulsion - **Species with doses:** Dogs and Cats - **Routes:** IV - **Last reviewed:** 1 October 2026 ## Indications - Local-anaesthetic systemic toxicity (bupivacaine/lidocaine cardiotoxicity) — the original indication - Lipophilic toxicoses: permethrin (cats), ivermectin/moxidectin (macrocyclic lactones), baclofen, calcium-channel blockers, some NSAIDs, antidepressants and other fat-soluble drugs - Adjunct rescue in severe lipophilic-drug overdose unresponsive to standard care ## Intravenous Lipid Emulsion (ILE) dose by species Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them. ### Dogs *Intravenous Lipid Emulsion (ILE) doses for dogs* | Indication | Dose | Route | Frequency | Duration | | --- | --- | --- | --- | --- | | Lipophilic toxicosis (lipid rescue) | 20% ILE 1.5 mL/kg IV over 1–3 min, then 0.25–0.5 mL/kg/min for 30–60 min | IV | bolus then CRI; repeat if signs recur | — | - Lipophilic toxicosis (lipid rescue): Plumb’s (Fat Emulsion, Intravenous): regimen extrapolated from human medicine (Jamaty 2010), aiming not to exceed 8 mL/kg/day; if signs persist, 1.5 mL/kg IV over 30 min q4–6h for 24–36 h or a CRI of 0.5 mL/kg/h (Lee 2010). Papich 5e (ivermectin toxicosis): 1.5 mL/kg bolus of 20% emulsion. Use a dedicated sterile catheter; check for lipaemia before repeating. Adjunct to decontamination and supportive care. ### Cats *Intravenous Lipid Emulsion (ILE) doses for cats* | Indication | Dose | Route | Frequency | Duration | | --- | --- | --- | --- | --- | | Permethrin / lipophilic toxicosis (lipid rescue) | 20% ILE 1.5 mL/kg IV over 1–3 min, then 0.25–0.5 mL/kg/min for 30–60 min | IV | bolus then CRI; repeat if signs recur | — | - Permethrin / lipophilic toxicosis (lipid rescue): Plumb’s (Fat Emulsion, Intravenous): general regimen, not cat-specific; aim not to exceed 8 mL/kg/day. Adjunct to methocarbamol, decontamination (bathing) and supportive care in permethrin toxicosis. ## Contraindications Known hypersensitivity to egg/soy components. Fat-overload conditions; severe lipaemia-sensitive conditions (e.g. pancreatitis — relative). Use as a substitute for standard decontamination/supportive care (it is an ADJUNCT). Total doses beyond recommended (fat-overload syndrome). Use only for lipophilic toxins (no benefit for water-soluble poisons). ## Species-specific warnings > **Caution:** Cats: A valuable adjunct in severe/refractory permethrin toxicosis — combine with decontamination, methocarbamol, cooling and supportive care; monitor for lipaemia/fat overload. ## Adverse effects - Usually well tolerated - Fat-overload syndrome with repeated/large doses (lipaemia, haemolysis, organ dysfunction) - Hypersensitivity (egg/soy); interference with some lab assays (lipaemic sample) - Theoretical worsening of pancreatitis; phlebitis ## Drug interactions - Lipophilic drugs: sequestered (the therapeutic effect) — but this can also sequester concurrently needed lipophilic drugs (e.g. reduce efficacy of lipophilic medications) - Laboratory assays: lipaemic samples interfere with many tests - No specific adverse pharmacologic interactions ## Pregnancy and lactation Used in life-threatening toxicosis when needed (it is a nutritional lipid product); maternal benefit prioritised. ## Monitoring - Clinical response of the toxicosis (cardiac/neurologic signs) - Serum lipaemia clearance before any repeat dose; PCV (haemolysis) - Total lipid dose (avoid fat overload) - Continue standard decontamination/supportive care alongside ## Toxicity and overdose Generally safe; the main concern is FAT-OVERLOAD SYNDROME with excessive/repeated dosing — hyperlipaemia, haemolysis, hepatosplenomegaly, coagulopathy and organ dysfunction. Hypersensitivity (egg/soy), phlebitis, and interference with laboratory assays can occur. There is theoretical concern about precipitating/worsening pancreatitis. Management: Stop further lipid; supportive care. For fat-overload syndrome, discontinue and provide supportive treatment (monitor lipaemia clearance, PCV for haemolysis, organ function). Limit total dose and do not re-bolus until the serum has cleared of visible lipaemia. ## Clinical pearls - A genuine "lipid rescue" for LIPOPHILIC poisonings — the original use is local-anaesthetic (bupivacaine) cardiotoxicity, but it is now a key adjunct for permethrin (cats), ivermectin/moxidectin, baclofen, calcium-channel blockers and other fat-soluble toxins - Give a bolus then a CRI; only repeat once the serum has cleared of lipaemia, and don't exceed recommended total doses (fat overload) - It is an ADJUNCT — keep doing decontamination, methocarbamol (for tremors), and full supportive care - It can also sequester lipophilic medications you want to work — bear that in mind in mixed scenarios ## Mechanism of action The leading explanation is the "lipid sink": the infused intravascular lipid phase sequesters highly lipophilic drug molecules, pulling them out of target tissues (heart, brain) and lowering the free, active concentration. Additional proposed mechanisms include providing fatty-acid energy substrate to the myocardium and direct positive cardiotonic/membrane effects. The net effect is reduced toxicity from fat-soluble drugs as the toxin partitions into the emulsion and is redistributed/eliminated. ## Formulations and products - 20% lipid emulsion (Intralipid/Lipofundin) — 200 mg/mL - Intralipid / Lipofundin 20% — 20% (200 mg/mL) emulsion, IV emulsion (human-label) ## Storage Emulsion: 15–25 °C (some refrigerated), do not freeze; discard if the emulsion has cracked/separated (oil droplets). Use aseptically; dedicated line. ## Before you use this dose > **Caution:** Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision. ## Other hormones, emergency drugs, supplements and other drugs - [Hydroxyzine](https://vetmasterji.com/drugs/hydroxyzine) - [Hypertonic Saline (7.2–7.5% NaCl)](https://vetmasterji.com/drugs/hypertonic-saline) - [Imepitoin](https://vetmasterji.com/drugs/imepitoin) - [Insulin](https://vetmasterji.com/drugs/insulin) - [Iron Dextran](https://vetmasterji.com/drugs/iron-dextran) - [Leflunomide](https://vetmasterji.com/drugs/leflunomide) - [Leucovorin (Folinic Acid)](https://vetmasterji.com/drugs/leucovorin) - [Levetiracetam](https://vetmasterji.com/drugs/levetiracetam) ## Frequently asked questions ### What is the dose of Intravenous Lipid Emulsion (ILE) for dogs? Reference doses for Intravenous Lipid Emulsion (ILE) in dogs: 20% ILE 1.5 mL/kg IV over 1–3 min, then 0.25–0.5 mL/kg/min for 30–60 min IV bolus then CRI; repeat if signs recur (Lipophilic toxicosis (lipid rescue)). Confirm against the label and the patient before use. ### What is the dose of Intravenous Lipid Emulsion (ILE) for cats? Reference doses for Intravenous Lipid Emulsion (ILE) in cats: 20% ILE 1.5 mL/kg IV over 1–3 min, then 0.25–0.5 mL/kg/min for 30–60 min IV bolus then CRI; repeat if signs recur (Permethrin / lipophilic toxicosis (lipid rescue)). Confirm against the label and the patient before use. ### When should Intravenous Lipid Emulsion (ILE) not be used? Known hypersensitivity to egg/soy components. Fat-overload conditions; severe lipaemia-sensitive conditions (e.g. pancreatitis — relative). Use as a substitute for standard decontamination/supportive care (it is an ADJUNCT). Total doses beyond recommended (fat-overload syndrome). Use only for lipophilic toxins (no benefit for water-soluble poisons). ### What are the side effects of Intravenous Lipid Emulsion (ILE) in animals? Usually well tolerated; Fat-overload syndrome with repeated/large doses (lipaemia, haemolysis, organ dysfunction); Hypersensitivity (egg/soy); interference with some lab assays (lipaemic sample); Theoretical worsening of pancreatitis; phlebitis. ## Sources - Plumb's Veterinary Drug Handbook - Merck Veterinary Manual, 11th edition - Papich, Papich Handbook of Veterinary Drugs, 5th edition --- VetMasterJi is a clinical decision-support and education platform for veterinary professionals and students. It does not provide veterinary advice, diagnosis or treatment for specific animals. All drug doses, calculators and differentials are references that must be independently verified before clinical use; the attending registered veterinarian remains solely responsible for every clinical decision.