Efficacy of oral, topical and extended-release injectable formulations of moxidectin combined with doxycycline in Dirofilaria immitis naturally infected dogs

BACKGROUND

Several studies in both experimentally and naturally infected dogs have reported the adulticide effect of a combination of macrocyclic lactones and doxycycline against Dirofilaria immitis, showing that these protocols can be used as an alternative to melarsomine. The present study evaluated the efficacy of oral, topical and extended-release injectable formulations of moxidectin when combined with doxycycline in dogs naturally infected with D. immitis from a shelter located in southern Italy.

METHODS

Thirty dogs with naturally acquired D. immitis infection were divided in three groups (G) and treated with oral moxidectin (G1) once a month for 9 consecutive months, topical moxidectin (G2) once a month for 9 consecutive months or extended release moxidectin injectable (G3) at enrolment and again at 6 months (Day 180). All treatment groups received doxycycline for the first 30 days. Microfilarial concentrations in 1 ml (mff/ml) blood were determined monthly for 9 months with the modified Knott's test. A clinical scoring system was employed for each dog enrolled in the study based on thoracic radiography and cardiac ultrasound (CU) examinations performed at Day - 15 (before treatment) and at Day 180.

RESULTS

Results from the present study suggest that the majority of dogs from all treatment groups became antigen negative, as evaluated at Day 270: 9/10 dogs (90.0%) from G1, 6/10 dogs (60.0%) from G2 and 8/10 dogs (80.0%) from G3. Improvement of radiographic alterations was observed in all treatment groups, and almost all dogs were cleared of pulmonary abnormalities by 6 months from the beginning of treatment (P = 0.000). Cardiac ultrasound examination showed a progressive improvement of cardiac function in a limited number of animals (4/30).

CONCLUSIONS

The combination of doxycycline and three different formulations of moxidectin leads to antigen-negative status in naturally infected dogs.

Aspects in controlled drug delivery for topical applications in veterinary medicine

The controlled release of drugs is an appealing area of research as it provides numerous benefits in veterinary and human medicine. In this paper we attempt to analyze certain aspects related to topical drug delivery systems, their successes and failures, and their place in veterinary medicine. Some emphasis is given to the pharmaceutical aspects of the delivery systems, where the material available made it possible. Purely topical devices, such as cattle ear tags and various collars, as well as some topically administered bioavailable delivery systems are discussed. Special attention is given to hitherto under-evaluated delivery systems, such as topical varnishes. A carefully selected bibliography aims to lead the reader easily to the facts, without providing overwhelming data of varying quality. We believe that the paper may be of interest to practicing veterinarians as well as to pharmaceutical scientists working or considering practice in the area.

Efficacy of topically administered fluralaner or imidacloprid/moxidectin on dogs with generalised demodicosis

Background

Canine demodicosis is classified as localised or generalised according to the extent of the disease. Chronic generalised demodicosis is a difficult skin disease to treat and unlikely to resolve without therapy. This laboratory study compared the efficacy of two topical spot-on medications, fluralaner or a combination of imidacloprid and moxidectin, against naturally acquired generalised demodicosis in dogs.

Methods

Sixteen client-owned dogs with naturally acquired generalised demodicosis were randomly allocated to 1 of 2 study groups consisting of 8 dogs each. On Day 0, dogs in 1 group were treated once with fluralaner spot-on solution. Dogs in the other group were treated with the imidacloprid/moxidectin spot-on solution on 3 occasions (Days 0, 28 and 56) or weekly in severe cases. Mites were counted in skin scrapings and demodectic lesions were evaluated on each dog before treatment, and at 28-day intervals over the 12-week period. Deep skin scrapings were made from the same 5 sites on each dog at each examination.

Results

After administration of fluralaner, miticidal efficacy was 99.7% at Day 28, > 99.9% at Day 56 and 100% at Day 84. Efficacy in dogs treated topically with the imidacloprid and moxidectin combination, was 9.8% at Day 28, 45.4% at Day 56 and 0% at Day 84, and was significantly (P < 0.01) lower than the fluralaner treated group at each post-treatment time point.

Conclusions

A single topical administration of fluralaner eliminated Demodex sp. mites on dogs with generalised demodicosis. Topical imidacloprid/moxidectin combination treatment administered 3 times at 28-day intervals, or more frequently, did not eliminate mites from most treated dogs.

Efficacy of fluralaner plus moxidectin (Bravecto® Plus spot-on solution for cats) against Otodectes cynotis infestations in cats

Background

The efficacy of the fixed combination of fluralaner plus moxidectin for the treatment of Otodectes cynotis infestations was evaluated in cats after topical application.

Methods

Sixteen cats experimentally infested with O. cynotis were allocated randomly to two groups of 8 cats each. One group was treated topically with the fixed combination of fluralaner plus moxidectin at the minimum dose rate of 40 mg fluralaner and 2 mg moxidectin/kg body weight. The other group was treated with physiological saline solution. Before and 14 and 28 days after treatment the ears of all cats were examined otoscopically for live mites and for the amount of debris and cerumen. Twenty-eight days after treatment, the cats were sedated and had both ears flushed to obtain the total number of live mites per animal. Efficacy was calculated, based on the results of the ear flushing, by comparing mean live mite counts in the fluralaner plus moxidectin treated group versus the saline group.

Results

A single topical application of the fixed combination of fluralaner plus moxidectin to cats reduced the mean mite counts by 100% (P < 0.001) by 28 days after treatment. No mites were visible during otoscopic examination at either 14 or 28 days after treatment. All fluralaner plus moxidectin treated cats had less ceruminous exudate 28 days after treatment compared to pre-treatment and 14 days after treatment. No treatment related adverse events were observed in any cats enrolled in the study.

Conclusions

Single topical application of the fixed combination of fluralaner plus moxidectin was highly effective against O. cynotis infestations in cats.

Investigation of the efficacy of fluralaner spot-on (Bravecto®) against infestations of Ixodes holocyclus on cats

BACKGROUND

Infestation of cats with the Australian paralysis tick, Ixodes holocyclus continues to be a threat because of the paralysis that can result from attachment of just a single tick. The outcome can be fatal, particularly if tick removal and treatment is not initiated soon after the onset of paralysis. However, there are no published studies to guide veterinarians and owners on preventive measures. A study was therefore initiated to determine the efficacy of a systemically-acting, spot-on formulation of fluralaner (Bravecto®) for cats against existing I. holocyclus infestations, and to investigate the duration of protection following a single administration.

METHODS

Healthy domestic cats, short or long-hair, immunized against holocyclotoxin, were randomly allocated to two groups of 10 cats per group, to receive either a single topically applied fluralaner treatment or no treatment. Fluralaner treatments were administered on Day 0 at a dose rate of 40 mg/kg. All cats were infested with 10 adult unfed female I. holocyclus on Day -1 and on Days 14, 28, 42, 56, 70 and 84. Ticks were assessed at 24 and 48 h after fluralaner treatment and 24, 48 and 72 hours after each subsequent re-infestation. Ticks were counted but not removed at the 24- and 48-h post-challenge assessments and were removed following the 72-h counts.

RESULTS

The efficacy of fluralaner spot-on against an existing I. holocyclus infestation was 100% at 48 h post treatment. Following re-infestations, efficacy remained at 100% at the 72-h assessments for all challenges from Day 14 to Day 84. Differences between mean live tick counts on treated versus control cats were significant at all time points from the first post-treatment assessment (t-test: t(18) = 23.162; P < 0.0001) through the final challenge on Day 84 (t-test: t(18) = 21.153; P < 0.0001). No treatment-related adverse events were observed and there were no abnormal observations at the product application sites.

CONCLUSIONS

A single treatment of fluralaner spot-on was well tolerated and provided 100% efficacy against I. holocyclus ticks for at least 84 days. Fluralaner spot-on can be a valuable tool to prevent tick infestation in cats, and to control the risk of I. holocyclus-induced paralysis.

Prevention of transmission of Babesia canis by Dermacentor reticulatus ticks to dogs after topical administration of fluralaner spot-on solution

Background

The preventive effect of fluralaner spot-on solution against transmission of Babesia canis by Dermacentor reticulatus ticks was evaluated.

Findings

Sixteen dogs, tested negative for B. canis by polymerase chain reaction (PCR) and immunofluorescence assay test (IFAT), were allocated to two study groups. On day 0, dogs in one group (n = 8) were treated once topically with fluralaner spot-on solution (Bravecto™ Spot-on Solution) according to label recommendations and dogs in the control group (n = 8) remained untreated. On days 2, 28, 56, 70 and 84, all dogs were infested with 50 (±4) D. reticulatus ticks harbouring B. canis, with tick in situ thumb counts 48 ± 4 h after each infestation. On day 90, ticks were removed from all dogs and counted. Prior to each infestation, the presence of B. canis in the respective tick batch was confirmed by PCR, and 12–16 % of ticks were found to be infected with B. canis. Efficacy against ticks was 99.5 and 99.3 % on days 4 and 58 after treatment, respectively and 100 % on all other days. Replacement dogs were included for any B. canis infected control dog (in total 19). All control dogs (n = 27) became infected with B. canis, as confirmed by PCR, performed every 7 days, and by IFAT, performed every 14 days after treatment. None of the eight treated dogs became infected with B. canis, as they were tested negative by PCR and IFAT throughout the study until day 112. By comparing infected dogs in the treated group with infected dogs in the untreated control group, a 100 % preventive effect against B. canis transmission was demonstrated.

Conclusions

A single topical administration of fluralaner spot-on solution effectively prevented the transmission of B. canis by infected D. reticulatus ticks over a 12-week period.

Evaluation of the efficacy of selamectin spot-on in cats infested with Aelurostrongylus abstrusus (Strongylida, Filariodidae) in a Central Italy cat shelter

In recent years Aelurostrongylus abstrusus has often been reported in Italy. This lungworm is very common in cat colonies due to its route of transmission. Deciding a therapeutic approach can be difficult in such colonies, because there is no certainty whether oral medicines administered with food, or with what dose, will be taken. In this field study, stool samples were taken from 42 cats and analysed for A. abstrusus L1 larvae with Baermann technique. Ten cats testing positive were treated with a spot-on formulation of selamectin 45 mg. Clinical examinations and laboratory tests, repeated four times in two months, demonstrated the success of the treatment in 9 of the 10 cats. Improvements in respiratory signs and general clinical condition were reported after treatment.