If you have one of the breeds affected by the MDR1 mutation, it’s best to have them tested. Ivermectin is not the only drug that can cause a problem.
“Approximately three of every four Collies in the United States have the mutant MDR1 gene. The frequency is about the same in France and Australia, so it is likely that most Collies worldwide have the mutation. The MDR1 mutation has also been found in Shetland Sheepdogs (Shelties). Australian Shepherds, Old English Sheepdogs, English Shepherds, German Shepherds, Long-haired Whippets, Silken Windhounds, and a variety of mixed breed dogs.”
"Drugs that have been documented to cause problems in dogs with the MDR1 mutation include:
Acepromazine (tranquilizer and pre-anesthetic agent). In dogs with the MDR1 mutation, acepromazine tends to cause more profound and prolonged sedation. We recommend reducing the dose by 25% in dogs heterozygous for the MDR1 mutation (mutant/normal) and by 30-50% in dogs homozygous for the MDR1 mutation (mutant/mutant).
Butorphanol (analgesic and pre-anesthetic agent). Similar to acepromazine, butorphanol tends to cause more profound and prolonged sedation in dogs with the MDR1 mutation.We recommend reducing the dose by 25% in dogs heterozygous for the MDR1 mutation (mutant/normal) and by 30-50% in dogs homozygous for the MDR1 mutation (mutant/mutant).
Emodepside (Profender�)-is a deworming drug approved for use in cats only in the U.S., but is approved for use in dogs in some other countries. Use of this drug in dogs with the MDR1 mutation has resulted in neurological toxicity.
Erythromycin. Erythromycin may cause neurological signs in dogs with the MDR1 mutation. A mutant/mutant collie exhibited signs of neurological toxicity after receiving erythromycin. After withdrawal of the drug, the dogs neurological signs resolved. There were no other potential causes of neurological toxicity identified in the dog.
Ivermectin (antiparasitic agent). While the dose of ivermectin used to prevent heartworm infection is SAFE in dogs with the mutation (6 micrograms per kilogram), higher doses, such as those used for treating mange (300-600 micrograms per kilogram) will cause neurological toxicity in dogs that are homozygous for the MDR1 mutation (mutant/mutant) and can cause toxicity in dogs that are heterozygous for the mutation (mutant/normal).
Loperamide (ImodiumTM; antidiarrheal agent). At doses used to treat diarrhea, this drug will cause neurological toxicity in dogs with the MDR1 mutation. This drug should be avoided in all dogs with the MDR1 mutation.
Selamectin, milbemycin, and moxidectin (antaparasitic agents). Similar to ivermectin, these drugs are safe in dogs with the mutation if used for heartworm prevention at the manufacturer’s recommended dose. Higher doses (generally 10-20 times higher than the heartworm prevention dose) have been documented to cause neurological toxicity in dogs with the MDR1 mutation.
Vincristine, Vinblastine, Doxorubicin (chemotherapy agents). Based on some published and ongoing research, it appears that dogs with the MDR1 mutation are more sensitive to these drugs with regard to their likelihood of having an adverse drug reaction. Bone marrow suppression (decreased blood cell counts, particulary neutrophils) and GI toxicity (anorexia, vomiting, diarrhea) are more likely to occur at normal doses in dogs with the MDR1 mutation. To reduce the likelihood of severe toxicity in these dogs, MDR1 mutant/normal dogs should have their dose reduced by 25% while MDR1 mutant/mutant dogs should have their dose reduced by a full 50%. These patients should be closely monitored for adverse effects. "