Nematode control in eventer horses

BEVA primary care clinical guidelines: Equine parasite control

BACKGROUND

There is a lack of consensus on how best to balance our need to minimise the risk of parasite-associated disease in the individual horse, with the need to limit the use of anthelmintics in the population to preserve their efficacy through delaying further development of resistance.

OBJECTIVES

To develop evidence-based guidelines utilising a modified GRADE framework.

METHODS

A panel of veterinary scientists with relevant expertise and experience was convened. Relevant research questions were identified and developed with associated search terms being defined. Evidence in the veterinary literature was evaluated using the GRADE evidence-to-decision framework. Literature searches were performed utilising CAB abstracts and PubMed. Where there was insufficient evidence to answer the research question the panel developed practical guidance based on their collective knowledge and experience.

RESULTS

Search results are presented, and recommendation or practical guidance were made in response to 37 clinically relevant questions relating to the use of anthelmintics in horses.

MAIN LIMITATIONS

There was insufficient evidence to answer many of the questions with any degree of certainty and practical guidance frequently had to be based upon extrapolation of relevant information and the panel members' collective experience and opinions.

CONCLUSIONS

Equine parasite control practices and current recommendations have a weak evidence base. These guidelines highlight changes in equine parasite control that should be considered to reduce the threat of parasite-associated disease and delay the development of further anthelmintic resistance.

Equine parasite control and the role of national legislation - A multinational questionnaire survey

Experts recommend a change in the control of equine parasites across the world in order to adopt a surveillance-based approach utilizing parasite faecal egg counts (FEC). Several European countries have implemented prescription-only restrictions of anthelmintic usage by law, which is in stark contrast to US, where all anthelmintic products continue to be available over the counter. This study aimed to describe and compare equine parasite control strategies employed in Germany, Austria, the Netherlands, US, and Denmark. An invitation to participate in an online questionnaire survey was published on a large equine news website in each of the participating countries. The main focus of the study was on usage of FEC and anthelmintic treatment intensity in three different equine age groups; foals, 1-3 year-olds and >3 years old. A total of 3092 respondents participated in the study. Danish respondents used significantly more faecal analyses in their parasite control strategies than participants from the other four countries (p < 0.0001). Similarly, Danish participants administered significantly fewer anthelmintic treatments per horse per year (p < 0.0001) independent of the age of the horse, and had been using a selective treatment strategy for a significantly longer time period than their counterparts in other countries (p < 0.0001). Only minor differences were found between respondents from the other four countries. This is remarkable as both Austria and Germany have had prescription-only restrictions for 3-4 decades. Yet, their parasite control strategies were more similar to those employed by American respondents. The Netherlands had only recently introduced prescription-only restrictions by the time this survey was conducted which can explain why Dutch respondents were also similar to their American counterparts. Taken together, this study illustrates substantially different worm control strategies practiced in Denmark, and this difference cannot be explained by legislation alone.

A survey on parasite control in sport horses of Argentina and other regional countries

Strategies for parasite control have undergone major changes in recent years, especially in Europe and the United States, replacing traditional approaches by schemes based on surveillance and selective therapy. A first step in helminth control planning is to understand and demonstrate how horse owners or trainers currently control nematodes. The aim of this study was to collect information, through a survey, about important aspects of routine anthelmintic strategies in sport horses in Argentina and other regional countries. A total of 100 surveys were sent. Sixty nine were responded, 53% of the surveys were answered by veterinarians and 47% by managers. The majority of the respondents (58%) worked in Thoroughbred studs, followed by Throroughbred farms (23%), Horse Riding Centers (10%) and other types of centers (9%). Most respondents treated horses at fixed time every 3 months (48%). Twenty-two percent of them did it at fixed time every 6 months, 16% at fixed time every 4 months and 6% at fixed time every 12 months; 6% dewormed on individual basis while 4% did not treat at all; 2% dewormed every two months. When asked about the rationale for deworming, the majority (41%) did so based on the time elapsed since the last treatment, followed by the time of the year (22%), according to the age of the animals (15%), according to previous diagnosis (12%), 9% treated for no particular reason and 1% when the horses reached the stud. Almost half of respondents (48%) did not rotate anthelmintic drug on. In a smaller proportion, others did it every 3 months (26%), every 12 months (11%), every 6 months (9%) and finally every 4 months (6%). Half of the respondents (50%) treated horses 4 times a year, 32% did 2 times a year, 15% 3 times and 3% did not deworm at all. Regarding making a diagnosis prior to treatment, 76% of the respondents answered negatively, while 24% did so. Only 20% of respondents performed the anthelmintic efficacy test. It can be concluded that there is little participation and planning of the veterinary professional regarding the control of internal parasites in horses of Argentina. Performing coprologic tests are practices not usual in our region. Practices of parasite management seem to be reduced almost exclusively to the administration of anthelmintic drugs at fixed times, often indiscriminately.

A questionnaire study of equine gastrointestinal parasite control in Scotland

REASONS FOR PERFORMING STUDY

Anthelmintic resistance in equine gastrointestinal nematodes is a threat to equine health and welfare. Detailed knowledge of anthelmintic use and parasite control methods is a prerequisite to identification of potential risk factors for resistance.

OBJECTIVES

To identify parasite control practices employed by equine owners in Scotland and investigate management factors associated with anthelmintic resistance.

STUDY DESIGN

Questionnaire study of equine parasite control in Scotland.

METHODS

Questionnaires were available electronically, distributed at a conference and mailed to clients. Key areas explored included general background, grazing management, anthelmintic treatment practices and use of diagnostic tests.

RESULTS

A total of 193 responses detailing information on parasite control programmes of 993 equids were analysed. Moxidectin (MOX) and ivermectin or related combination products were the most commonly administered anthelmintics in the preceding 12 months. Treatments licensed for use against cyathostomin encysted larvae and tapeworms were administered by 80% and 90% of respondents, respectively. This was often achieved through indiscriminate use of MOX and MOX-praziquantel products. Faecal egg count (FEC) analysis had been performed on 62% of yards and regular use of FECs reduced annual anthelmintic treatment frequency. Veterinarians had the greatest influence on control practices. While 40% of respondents believed that they practised targeted dosing, this was not associated with delaying treatment beyond the egg reappearance period of the anthelmintic used.

CONCLUSIONS

Responses indicated increasing veterinary involvement and use of FECs. The majority of respondents administered anthelmintics licensed against cyathostomin encysted larvae and tapeworms. However, responses suggested that owners did not understand the definition of 'targeted' dosing regimens.

POTENTIAL RELEVANCE

The high frequency of MOX use represents a potential risk factor for macrocyclic lactone resistance. As veterinarians were the most influential factor in anthelmintic choice, awareness of macrocyclic lactone resistance and potential risk factors for its development and spread should be incorporated into client advice.

Resistance to avermectin/milbemycin anthelmintics in equine cyathostomins - current situation

Avermectins and milbemycins (AM) are potent compounds against all major nematode parasites, but their continuous usage has led to the development of widespread resistance in many of the important species of ruminant and equine parasites. The exception to this has been the cyathostomins, where AM resistance was recently first reported only after decades of drug exposure. Data from a Brazilian study suggests that AM resistance has developed in cyathostomins and reports of shortened egg reappearance periods after ivermectin treatment have been published recently from USA and Germany. Thus, AM resistance in cyathostomins is an emerging worldwide concern, but there is only limited amount data on the extent of this problem. To limit the development and spread of AM-resistant cyathostomins the equine industry must implement new strategies for worm control, and the veterinary parasitology community must develop and validate improved protocols for detecting anthelmintic resistance in the field.

Restrictions of anthelmintic usage: perspectives and potential consequences

Given the increasing levels of anthelmintic resistance in equine parasites, parasitologists now recommend traditional treatment approaches to be abandoned and replaced by more sustainable strategies. It is of crucial importance to facilitate veterinary involvement to ensure that treatment decisions are based on parasitic knowledge. Despite recommendations given for the past two decades, strategies based on the selective therapy principle have not yet been implemented on a larger scale in equine establishments. In contrast, treatment regimens appear to be derived from recommendations originally given in 1966. The province of Quebec in Canada, and an increasing number of European countries, have implemented prescription-only restrictions on anthelmintic drugs. Denmark introduced this legislation ten years ago, and some evidence has been generated describing potential consequences. It is without dispute that Danish veterinarians are now deeply involved with parasite management in equine establishments. However, little is known about the impact on levels of anthelmintic resistance and the risk of parasitic disease under these circumstances. In addition, the legislation makes huge demands on diagnosis and parasite surveillance. No data have been published evaluating fecal egg count techniques and larval culture methods as clinical diagnostic tools, and very little is known about potential correlations with actual worm burdens. This article provides a general review of anthelmintic strategies currently used in equine establishments and outlines the recommendations now given for parasite control. Preliminary experience with prescription-only restrictions in Denmark is presented and current research needs to further evaluate this approach are discussed.

Parasite control practices on Swedish horse farms

BACKGROUND

Virtually all horses are infected with helminth parasites. For some decades, the control of parasites of Swedish horses has been based on routine treatments with anthelmintics, often several times per year. Since anthelmintic resistance is becoming an increasing problem it is essential to develop more sustainable control strategies, which are adapted to different types of horse management. The aim of this study was to obtain information on practices used by Swedish horse owners for the control of endoparasites.

METHODS

A questionnaire with 26 questions about management practices and parasite control routines was posted to 627 randomly selected horse establishments covering most types of horse management in Sweden.

RESULTS

The response rate was good in all categories of respondents (66-78%). A total of 444 questionnaires were used in the analyses. It was found that virtually all horses had access to grazing areas, usually permanent. Generally, pasture hygiene was infrequently practiced. Thirty-six percent of the respondents clipped or chain harrowed their pastures, whereas weekly removal of faeces from the grazing areas was performed by 6% of the respondents, and mixed or rotational grazing with other livestock by 10%. The number of anthelmintic treatments per year varied from 1-8 with an average of 3.2. Thirty-eight percent considered late autumn (Oct-Dec) to be the most important time for deworming. This finding, and an increased use of macrocyclic lactones in the autumn, suggests a concern about bot flies, Gasterophilus intestinalis. Only 1% of the respondents stated that faecal egg counts (FEC) were performed on a regular basis. The relatively high cost of FEC analyses compared to purchase of anthelmintics was thought to contribute to the preference of deworming without a previous FEC. From the study it was evident that all categories of horse owners took advice mainly from veterinarians.

CONCLUSION

The results show that routines for endoparasite control can be improved in many horse establishments. To increase the knowledge of equine endoparasite control and follow the recommendations for how to reduce the spread of anthelmintic resistance, a closer collaboration between parasitologists and veterinary practitioners is desirable.

Will technology provide solutions for drug resistance in veterinary helminths?

Drug resistance in veterinary helminths affects a growing number of livestock producers on a global basis. The parasites infecting the major species of livestock are presently showing resistance in varying degrees to the commonly used classes of anthelmintics. The degree and extent of this problem especially with respect to multidrug resistance (MDR) in nematode populations is likely to increase. Finding solutions to the spread of resistance requires knowledge of the drugs' modes of action and mechanisms of resistance. This knowledge can then be applied to detect and monitor the state of resistance. Here we present a brief overview of resistance mechanisms and some of the technologies being used to study them. We also discuss some of the strategies for slowing the spread of resistance. The issue of reversal of drug resistance is analysed under consideration of recent progress in the field of MDR reversal in non-infectious diseases. Finally, we propose an application of currently available technologies that could assist in the detection and monitoring of anthelmintic resistance. Taking into account the significant complexity of the genetic mechanism of anthelmintic resistance in and between the various species, we suggest to undertake a co-ordinated effort to systematically identify anthelmintic-related single nucleotide polymorphisms (SNPs) in the most important helminth parasites. Monitoring the state of resistance in field populations could be achieved with a SNP-based protocol for genotyping the many genes known or suspected to contribute to the modes of action or mechanisms of resistance to the various classes of anthelmintics. If significant associations between genotypes and phenotypes exist within a species, then a single test with sufficient SNPs could potentially have universal applicability. These could then be explored for the development of new molecular diagnostic procedures. New classes of anthelmintics are needed, but until they are developed and available to the producers, technology can assist to achieve the goal of better sustainability in anthelmintic usage.

Helminth control used by trainers of thoroughbreds in England

A telephone survey was conducted of the methods used to control parasitic worms at 106 thoroughbred training yards. Most of the horses were allowed access to grass and were therefore at risk of infection. The control methods relied primarily on the use of anthelmintics and appeared reasonably successful because only 44 per cent of trainers reported observing clinical signs of nematode infections. They dosed their horses frequently, 40 per cent treating every four to six weeks and 25 per cent treating every seven to eight weeks. New arrivals on yards were usually treated with anthelmintic but the strategies used would be unlikely to prevent the introduction of anthelmintic-resistant nematodes on most yards or to deal with encysted cyathostomes. Trainers were responsible for the design of most control schemes, and only 42 per cent of them based their choice of anthelmintic on veterinary advice.

The future of veterinary parasitology

Current evidence suggests research in veterinary parasitology is in decline despite its importance. This is particularly true in the UK where research funds have been diverted into BSE. Decline in interest in veterinary parasitology is at least in part due to the success of major pharmaceutical companies in producing a range of effective and safe anti-parasitic drugs. Research is needed because of the effects of parasites on animal welfare and the economic costs of parasites. However, there is little information on the actual costs of animal parasites. Another major reason for research is the development of drug resistance in protozoa, helminths and arthropods of veterinary importance. This is a serious problem particularly for sheep and goats in the southern hemisphere. A prioritised list of research requirements is suggested: (i) new drugs; (ii) resistance management; (iii) vaccines; (iv) breeding for resistance; (v) improved diagnostics; (vi) zoonoses; (vii) global warming and parasites. There is a major political challenge to raise the profile of veterinary parasitology and thus the funding essential for its advancement and the continued welfare and productivity of animals.