Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.
Issue link: http://todaysveterinarypractice.epubxp.com/i/891985
HEARTWORM HOTLINE 14 AHS HEARTWORM HOTLINE • Would a different regimen of doxycycline be more effective in the adulticidal regimen? • Does a regimen of doxycycline increase the efficacy of melarsomine administration? Answering these questions will advance our knowledge of the practical applications of doxycycline in the heartworm treatment protocol. Even without these answers, we know that Wolbachia are a significant contributor to pathology in dogs infected with heartworm. Because doxycycline can eliminate Wolbachia and reduce inflammation and PTEs, it should be used whenever possible in the treatment of heartworm-infected animals. Don't let a heartworm-positive dog leave the clinic without it. References 1. McTier TL, McCall JW, Dzimianski MT, et al. Use of melarsomine dihydrochloride (RM 340) for adulticidal treatment of dogs with naturally acquired infections of Dirofilaria immitis and for clinical prophylaxis during reexposure for 1 year. Vet Parasitol 1994;55(3):221-233. 2. Kramer L, Grandi G, Leoni M, et al. Wolbachia and its influence on the pathology and immunology of Dirofilaria immitis infection. Vet Parasitol 2008;158(3):191-195. 3. Bandi C, Anderson TJ, Genchi C, et al. Phylogeny of Wolbachia in filarial nematodes. Proc Biol Sci 1998;265(1413):2407-2413. 4. Bandi C, Trees AJ, Brattig NW. Wolbachia in filarial nematodes: evolutionary aspects and implications for the pathogenesis and treatment of filarial diseases. Vet Parasitol 2001;98(1-3):215-238. 5. Kozek WJ. What is new in the Wolbachia/Dirofilaria interaction? Vet Parasitol 2005;133(2-3):127-132. 6. Voronin D, Bachu S, Shlossman M, et al. Glucose and glycogen metabolism in Brugia malayi is associated with Wolbachia symbiont fitness. PLoS One 2016;11(4):e0153812. 7. McCall JW, Genchi C, Kramer L, et al. Heartworm and Wolbachia: therapeutic implications. Vet Parasitol 2008;158(3):204-214. 8. Kramer LH, Tamarozzi F, Morchon R, et al. Immune response to and tissue localization of the Wolbachia surface protein (WSP) in dogs with natural heartworm (Dirofilaria immitis) infection. Vet Immunol Immunopathol 2005;106(3-4):303-308. 9. Kramer L, Simon F, Tamarozzi F, et al. Is Wolbachia complicating the pathological effects of Dirofilaria immitis infections? Vet Parasitol 2005;133(2- 3):133-136. 10. Grandi G, Quintavalla C, Mavropoulou A, et al. A combination of doxycycline and ivermectin is adulticidal in dogs with naturally acquired heartworm disease (Dirofilaria immitis). Vet Parasitol 2010;169(3-4):347-351. 11. American Heartworm Society. Current canine guidelines for the diagnosis, prevention, and management of heartworm (Dirofilaria immitis) infection in dogs. 2014. heartwormsociety.org/veterinary-resources/american-heartworm- society-guidelines. Accessed May 2017. 12. Kramer L, Grandi G, Passeri B, et al. Evaluation of lung pathology in Dirofilaria immitis-experimentally infected dogs treated with doxycycline or a combination of dox ycycline and ivermectin before administration of melarsomine dihydrochloride . Vet Parasitol 2011;176(4):357-360. 13. McCall JW, Kramer L, Genchi C, et al. Effects of dox ycycline on heartworm embryogenesis, transmission, circulating microfilaria, and adult worms in microfilaremic dogs. Vet Parasitol 2014;206(1-2):5-13. 14. Savadelis MD, Ohmes CM, Hostetler JA, et al. Assessment of parasitological findings in heartworm-infected beagles treated with Advantage Multi(R) for dogs (10% imidacloprid + 2.5% moxidectin) and doxycycline. Parasites Vectors 2017;10(1):245. 15. Townson S, Tagboto S, McGarry HF, et al. Onchocerca parasites and Wolbachia endosymbionts: evaluation of a spectrum of antibiotic types for activity against Onchocerca gutturosa in vitro. Filaria J 2006;5:4. 16. Papich MG. Considerations for using minocycline vs doxycycline for treatment of canine heartworm disease. Parasit Vectors [In press, 2017]. Chewable Tablets Brief Summary: Please consult full package insert for more information. INDICATIONS: Tri-Heart ® Plus chewable tablets are indicated for use in prevention of canine heartworm caused by Dirofilaria immitis and for the treatment and control of ascarids (Toxocara canis, Toxascaris leonina) and hookworms (Ancylostoma caninum, Uncinaria stenocephala, Ancylostoma braziliense) in dogs and in puppies 6 weeks of age and older. PRECAUTIONS: All dogs should be tested for existing heartworm infection before starting treatment with Tri-Heart ® Plus chewable tablets. A mild hypersen- sitivity-type reaction, presumably due to dead or dying microfilariae and particularly involving a transient diarrhea has been observed in clinical trials with ivermectin alone after treatment of some dogs that have circulating microfilariae. Keep this and all drugs out of the reach of children. In case of ingestion by humans, clients should be advised to contact a physician immediately. Physicians may contact a Poison Control Center for advice concerning cases of ingestion by humans. ADVERSE REACTIONS: The following adverse reactions have been reported following the use of ivermectin at the recommended dose: depression/ lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation. Caution: Federal (U.S.A.) law restricts this drug to use by or on the order of a licensed veterinarian. HOW SUPPLIED: Tri-Heart ® Plus chewable tablets are available in three dosage strengths for dogs of different weights. Each strength comes in convenient packs of 6 chewable tablets. Store at controlled room temperature of 59-86˚ F (15-30˚ C). Protect product from light. For Technical Assistance, call Merck Animal Health: 1-800-224-5318 Manufactured for: Intervet Inc. a subsidiary of Merck & Co. Inc., Summit, NJ 07901 Manufactured by: Diamond Animal Health, Inc., a wholly owned subsidiary of Heska Corporation, Des Moines, IA 50327 ©2013 Heska Corporation. All rights reserved. 02260-1 ANADA 200-338, Approved by FDA 2016