Collie with severe reaction to butorphanol pain medicine

Abstract

Certain dog breeds, particularly herding breeds like Collies, are predisposed to drug sensitivity due to the(previously known as) mutation, which disrupts P-glycoprotein (P-gp) function. This mutation impairs drug efflux at the blood-brain barrier, leading to increased susceptibility to neurotoxic effects. While adverse reactions to P-gp substrate drugs such as macrocyclic lactones and chemotherapeutics are well documented, opioid sensitivity remains poorly understood. This case report documents a Collie that developed severe neurotoxicity, including profound sedation, ataxia, hypersalivation, and seizures, following a single 0.2 mg/kg dose of butorphanol. Symptoms persisted despite supportive care, requiring continuous naloxone administration for approximately 40 h before significant improvement. Neurotoxicological effects may have been exacerbated by metoclopramide and maropitant, known P-gp substrates. This case underscores the need for further research into opioid pharmacokinetics inmutant dogs and highlights the importance of genetic screening in veterinary practice. To enhance patient safety, integration of automated alerts within electronic medical record systems is recommended to flag high-risk drugs for at-risk breeds, providing real-time warnings, dosing adjustments, and monitoring guidance. These measures could reduce adverse drug reactions and improve clinical outcomes in genetically susceptible dogs.