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(selamectin) ® Topical Parasiticide For Dogs and Cats BRIEF SUMMARY: See package insert for full prescribing information. CAUTION: US Federal law restricts this drug to use by or on the order of a licensed veterinarian. INDICATIONS: Revolution is recommended for use in dogs six weeks of age or older and cats eight weeks of age and older for the following parasites and indications: Dogs: Revolution kills adult fleas and prevents flea eggs from hatching for one month and is indicated for the prevention and control of flea infestations (Cteno cephalides felis), prevention of heartworm disease caused by Dirofilaria immitis, and the treatment and control of ear mite (Otodectes cynotis) infestations. Revolution also is indicated for the treatment and control of sarcoptic mange (Sarcoptes scabiei) and for the control of tick infestations due to Derma centor variabilis. Cats: Revolution kills adult fleas and prevents flea eggs from hatching for one month and is indicated for the preven tion and control of flea infestations (Ctenocephalides felis), prevention of heartworm disease caused by Diro filaria immitis, and the treatment and control of ear mite (Otodectes cynotis) infestations. Revolution is also indicated for the treatment and control of roundworm (Toxocara cati) and intestinal hookworm (Ancylostoma tubaeforme) infections in cats. WARNINGS: Not for human use. Keep out of the reach of children. In humans, Revolution may be irritating to skin and eyes. Reactions such as hives, itching and skin redness have been reported in humans in rare instances. Individuals with known hypersensitivity to Revolution should use the product with caution or consult a health care professional. Revolution contains isopropyl alcohol and the preservative butylated hydroxytoluene (BHT). Wash hands after use and wash off any product in contact with the skin immediately with soap and water. If contact with eyes occurs, then flush eyes copiously with water. In case of ingestion by a human, contact a physician immediately. The material safety data sheet (MSDS) provides more detailed occupational safety information. For a copy of the MSDS or to report adverse reactions attributable to exposure to this product, call 1-888-963-8471. Flammable - Keep away from heat, sparks, open flames or other sources of ignition. Do not use in sick, debilitated or underweight animals (see SAFETY). PRECAUTIONS: Prior to administration of Revolution, dogs should be tested for existing heartworm infections. At the discretion of the veterinarian, infected dogs should be treated to remove adult heartworms. Revolution is not effective against adult D. immitis and, while the number of circulating microfilariae may decrease following treatment, Revolution is not effective for micro- filariae clearance. Hypersensitivity reactions have not been observed in dogs with patent heartworm infections administered three times the recommended dose of Revolution. Higher doses were not tested. ADVERSE REACTIONS: Pre-approval clinical trials: Following treatment with Revolution, transient localized alopecia with or without inflammation at or near the site of application was observed in approximately 1% of 691 treated cats. Other signs observed rarely (≤0.5% of 1743 treated cats and dogs) included vomiting, loose stool or diarrhea with or without blood, anorexia, lethargy, salivation, tachypnea, and muscle tremors. Post-approval experience: In addition to the aforementioned clinical signs that were reported in pre-approval clinical trials, there have been reports of pruritus, urticaria, erythema, ataxia, fever, and rare reports of death. There have also been rare reports of seizures in dogs (see WARNINGS). SAFETY: Revolution has been tested safe in over 100 different pure and mixed breeds of healthy dogs and over 15 different pure and mixed breeds of healthy cats, including pregnant and lactating females, breeding males and females, puppies six weeks of age and older, kittens eight weeks of age and older, and avermectin-sensitive collies. A kitten, estimated to be 5–6 weeks old (0.3 kg), died 8 1 ⁄ 2 hours after receiving a single treatment of Revolution at the recommended dosage. The kitten displayed clinical signs which included muscle spasms, salivation and neurological signs. The kitten was a stray with an unknown history and was malnourished and underweight (see WARNINGS). DOGS: In safety studies, Revolution was administered at 1, 3, 5, and 10 times the recommended dose to six-week-old puppies, and no adverse reactions were observed. The safety of Revolution administered orally also was tested in case of accidental oral ingestion. Oral administration of Revolution at the recommended topical dose in 5- to 8-month-old beagles did not cause any adverse reactions. In a pre-clinical study selamectin was dosed orally to ivermectin-sensitive collies. Oral administration of 2.5, 10, and 15 mg/kg in this dose escalating study did not cause any adverse reactions; how- ever, eight hours after receiving 5 mg/kg orally, one avermectin-sensitive collie became ataxic for several hours, but did not show any other adverse reactions after receiving subsequent doses of 10 and 15 mg/kg orally. In a topical safety study conducted with avermectin-sensitive collies at 1, 3 and 5 times the recommended dose of Revolution, salivation was observed in all treatment groups, including the vehicle control. Revolution also was administered at 3 times the recommended dose to heartworm infected dogs, and no adverse effects were observed. CATS: In safety studies, Revolution was applied at 1, 3, 5, and 10 times the recommended dose to six-week-old kittens. No adverse reactions were observed. The safety of Revolution administered orally also was tested in case of accidental oral ingestion. Oral administration of the recommended topical dose of Revolution to cats caused salivation and intermittent vomiting. Revolution also was applied at 4 times the recommended dose to patent heartworm infected cats, and no adverse reactions were observed. In well-controlled clinical studies, Revolution was used safely in animals receiving other frequently used veterinary products such as vaccines, anthelmintics, antiparasitics, antibiotics, steroids, collars, shampoos and dips. STORAGE CONDITIONS: Store below 30°C (86°F). HOW SUPPLIED: Available in eight separate dose strengths for dogs and cats of different weights (see DOSAGE). Revolution for puppies and kittens is available in cartons containing 3 single dose tubes. Revolution for cats and dogs is available in cartons containing 3 or 6 single dose tubes. NADA 141-152, Approved by FDA Distributed by: Zoetis Inc. Kalamazoo, MI 49007 www.revolutionpet.com 10309504 | THe CanIne SeIzuRe PaTIenT: FouR IMPoRTanT QueSTIonS Today's Veterinary Practice May/June 2014 38 tvpjournal.com epilepticus and acute repetitive seizures in dogs. J Vet Intern Med 2012; 26:334-340. 4. Gullov Ch, Toft n, Baadsager MM, Berendt M. Epilepsy in the Petit Basset Griffon vendeen: Prevalence, semiology, and clinical phenotype. J Vet Intern Med 2011; 25(6):1372-1378. 5. hulsmeyer v, zimmermann r, Brauer C, et al. Epilepsy in border collies: Clinical manifestation, outcome, and mode of inheritance. J Vet Intern Med 2010; 24(1):171-178. 6. Jokinen TS, Metsahonkala L, Bergamasco L, et al. Benign familial juvenile epilepsy in Lagotto romagnolo dogs. J Vet Intern Med 2007; 21(3):464-471. 7. Brauer C, Kastner SB, rohn K, et al. Electroencephalographic recordings in dogs suffering from idiopathic and symptomatic epilepsy: diagnostic value of interictal short time EEG protocols supplemented by two activation techniques. Vet J 2012; 193(1):185- 192. 8. Cuff dE, Bush ww, Stecker MM, et al. use of continuous electroencephalography for diagnosis and monitoring of treatment of nonconvulsive status epilepticus in a cat. JAVMA 2014; 244(6):708-714. 9. deacon C, wiebe S, Blume wT, et al. Seizure identification by clinical description in temporal lobe epilepsy: how accurate are we? Neurology 2003; 61(12):1686-1689. 10. Bush ww, Barr CS, Stecker MM, et al. diagnosis of rapid eye movement sleep disorder with electroencephalography and treatment with tricyclic antidepressants in a dog. JAAHA 2004; 40(6):495-500. 11. Schwartz M, Munana Kr, nettifee-Osborne J. assessment of the prevalence and clinical features of cryptogenic epilepsy in dogs: 45 cases (2003-2011). JAAHA 2013; 242(5):651- 657. 12. Song rB, vite Ch, Bradley Cw, Cross Jr. Postmortem evaluation of 435 cases of intracranial neoplasia in dogs and relationship of neoplasm with breed, age, and body weight. J Vet Intern Med 2013; 27(5):1143-1152. 13. wessmann a, volk ha, Parkin T, et al. Living with canine idiopathic epilepsy: a questionnaire-based evaluation of quality of life. ECVN Abstracts 2012; p 835. 14. Ben-ari Y, Crepel v, represa a. Seizures beget seizures in temporal lobe epilepsies: The boomerang effects of newly formed aberrant kainatergic synapses. Epilepsy Curr 2008; 8(3):68-72. 15. March Pa. Seizures: Classification, etiologies, and pathophysiology. Clin Tech Small Anim Pract 1998; 13(3):119-131. 16. dewey Cw. anticonvulsant therapy in dogs and cats. Vet Clin North Am Small Anim Prac 2006; 36(5):1107-1127. 17. Muñana Kr. Management of refractory epilepsy. Top Companion Anim Med 2013; 28(2):67-71. 18. rossmeisl Jh. alternative anticonvulsants in dogs and cats. Clin Brief 2011; Oct:63-66. 19. Brodie MJ, Kwan P. Staged approach to epilepsy management. Neurol 2002; 58(8):S2-S8. 20. Podell M. Seizures in dogs. Vet Clin North Am Small Anim Pract 1996; 26(4):779-809. 21. dewey Cw, Boothe dM, Berg JM, et al. zonisamide therapy in refractory epilepsy in dogs. JAAHA 2004; (40):285-291. 22. dewey CE, Cerd-Gonzalez S, Levine JM, et al. Pregabalin as an adjunct to phenobarbital, potassium bromide or a combination of phenobarbital and potassium bromide for treatment of dogs with suspected idiopathic epilepsy. JAVMA 2009; 235(12):1442-1449. 23. volk ha, Matiasek La, Feliu-Pascual aL, et al. The efficacy and tolerability of levetiracetam in pharmacoresistant epileptic dogs. Vet J 2008; 176:310-319. 24. Muñana Kr, zhang d, Patterson EE. Placebo effect in canine epilepsy trials. J Vet Intern Med 2010; 24(1):166-170. 25. Muñana Kr, Thomas wB, inzana Kd, et al. Evaluation of levetiracetam as adjunctive treatment for refractory canine epilepsy: a randomized, placebo-controlled, crossover trial. J Vet Intern Med 2012; 26(2):341-348. 26. Bateman Sw, Parent JM. Clinical findings, treatment, and outcome of dogs with status epilepticus or cluster seizures: 156 cases (1990-1995). JAVMA 1999; 215(10):1463-1468. 27. Siato M, Munana Kr, Sharp nJ, Olby nJ. risk factors for development of status epilepticus in dogs with idiopathic epilepsy and effects of status epilepticus on outcome and survival time: 32 cases (1990-1996). JAVMA 2001; 219(5):618-623. 28. howbert JJ, Patterson EE, Stead SM, et al. Forecasting seizures in dogs with naturally occurring epilepsy. PLoS One 2014; 9(1):e81920. 29. Patterson EE, Goel v, Cloyd JC, et al. intramuscular, intravenous and oral levetiracetam in dogs: Safety and pharmacokinetics. J Vet Pharmacol Ther 2008; 31(3):253-258. 30. Tobias KM, Marioni-henry K, wagner r. a retrospective study on the use of acepromazine maleate in dogs with seizures. JAAHA 2006; 42(4):283-289. 31. Platt Sr, randell SC, Scott KC, et al. Comparison of plasma benzodiazepine concentrations following intranasal and intravenous administration of diazepam to dogs. Am J Vet Res 2000; 61(6):651-654. 32. Probst Cw, Thomas wB, Moyers Td, et al. Evaluation of plasma diazepam and nordiazepam concentrations following administration of diazepam intravenously or via suppository per rectum in dogs. Am J Vet Res 2013; 74(4):611. 33. hardy BT, Patterson EE, Cloyd JM. Subcutaneous administration of levetiracetam in healthy dogs (abst). J Vet Intern Med 2011; 25(3):741. 34. dewey Cw, Bailey KS, Boothe dM, et al. Pharmacokinetics of single-dose intravenous levetiracetam administration in normal dogs. J Vet Emer Crit Care 2008; 18(2):153-157. William Bush, VMD, Diplomate ACVIM (Neurol- ogy), serves as a staff neurolo- gist and residency director at Bush Veterinary Neurology Service, which he launched in 2005. His research interests are in electroencephalog- raphy. Dr. Bush received his VMD from University of Pennsylvania, after serving as a naval officer; then completed a rotating internship in medicine and surgery at North Car- olina State University and residency in neurology and neurosurgery at UPenn, where he earned research and teaching awards. TVP_2014-0506_Seizure Patient.indd 38 5/24/2014 10:44:53 AM