Equine Pergolide Toxicity: A Case Series.
Abstract: Veterinary medication exposure may result in human toxicity, with approximately 6,000 exposures to veterinary-only medications reported to poison centers in 2022. There is a paucity of literature on the management of poisoned patients secondary to pharmaceuticals intended for equine use. Pergolide is a dopamine and serotonin receptor agonist and is currently approved to treat equine Cushing's disease. It was previously approved in the United States (US) to treat Parkinson's disease in humans; however, it was withdrawn from the market in 2007 due to its association with valvular heart disease. We report two cases of pergolide toxicity in horse owners following unintentional ingestions. Both patients experienced similar clinical presentations resulting from their unintentional pergolide ingestions. Veterinary medication ingestion presents a unique challenge to clinicians as the drug may have limited human toxicity data and/or recommended animal dosing may differ greatly from human dosing. Case reports of human toxicity may assist with anticipating the clinical course and guiding medical decision-making.
Copyright © 2024, Ebeling-Koning et al.
Publication Date: 2024-07-10 PubMed ID: 39130979PubMed Central: PMC11315443DOI: 10.7759/cureus.64265Google Scholar: Lookup
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Summary
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The research paper focuses on human toxicity caused by exposure to equine medication, specifically Pergolide, resulting from unintentional ingestion and the challenges it poses to clinicians due to limited human toxicity data.
Study Purpose
- This research intends to shed light on a relatively unexplored area – toxicity in humans caused by ingestion of veterinary pharmaceuticals, particularly Pergolide, a drug used to manage equine Cushing’s disease.
- The authors aim to enhance understanding of this issue to aid clinicians anticipate the clinical trajectory and improve decision-making.
Context of the Study
- The authors note that approximately 6,000 instances of human exposure to veterinary-only medications were registered in 2022 in Poison Centers.
- However, they also underscore the overall lack of extensive literature regarding the management of human toxicity resulting from equine pharmaceutical consumption.
Role of Pergolide
- Pergolide, the focus of the study, is a dopamine and serotonin receptor agonist employed mainly for treating equine Cushing’s disease.
- While Pergolide was once approved for treating Parkinson’s disease in humans in the United States, it was withdrawn in 2007 due to its link with valvular heart disease.
Case Study Findings
- The authors examine two cases of Pergolide toxicity in horse owners who unintentionally ingested the medication.
- Both cases show parallels in their clinical representations, indicating consistency in the symptomatic manifestations of Pergolide toxicity in humans.
Challenges for Clinicians
- The paper underlines a pivotal difficulty for clinicians dealing with such cases – the paucity of human toxicity data for such veterinary medications.
- It also emphasizes an additional complication: the disparity between animal and human dosage guidance, which could potentially lead to severe repercussions if a human consumes the animal-prescribed dose.
Value of Human Toxicity Report Cases
- The authors suggest that case reports depicting human toxicity can be instrumental in forecasting the clinical course in such instances, helping to steer appropriate medical decisions.
Cite This Article
APA
Ebeling-Koning NE, Fowler JT, DelBianco JD, Surmaitis RM.
(2024).
Equine Pergolide Toxicity: A Case Series.
Cureus, 16(7), e64265.
https://doi.org/10.7759/cureus.64265 Publication
Researcher Affiliations
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Allentown, USA.
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Allentown, USA.
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Allentown, USA.
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Allentown, USA.
Conflict of Interest Statement
Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
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