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.
| PUBLISHER'S MEMO
highly qualified veterinary professionals for free due to revenue from the advertisements published in each issue. While advertisers are not allowed to influence editorial, topical advertisements can provide an opportunity to learn more about products and services that can help keep your practice on the cutting edge in both patient care and efficiency. Between our supportive
advertisers and goal of gaining qualified subscriptions, we are able and will continue to be able to provide free print subscriptions to a wide variety of veterinary professionals. This fulfills our mission of "providing veterinary professionals with practical, peer-reviewed, state-of- the-art information on pertinent clinical topics in veterinary medicine, as well as exploring all aspects of veterinary practice and business development, resulting in better health for both patients and practices."
Thanks to Our Contributors After three successful issues, I'd like to thank the authors who contributed important articles; the Editorial Review Board who diligently vetted the articles; our Editorial Advisory Board who lent their wisdom in planning our editorial calendar, Dr. Lesley King for her tireless efforts in making sure we provide the most accurate, up-to-date information; and, of course, our staff that pulled it all together. The quality of each issue speaks to these efforts.
Thanks to Our Readers We at VetMed Communications consider it an honor to be warmly welcomed into the veterinary community. We will do our utmost to be worthy of your trust and uphold the highest standards of veterinary medical publishing. As we start a new year, we are sure it will be great one!
Nick Paolo, Publisher January/February 2012 Today's Veterinary Practice 11
TRIFEXIS™ (spinosad + milbemycin oxime) Chewable Tablets
Before using TRIFEXIS chewable tablets, please consult the product insert, a summary of which follows:
Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian.
Indications: TRIFEXIS is indicated for the prevention of heartworm disease ( ¿ÈÅŰ·ȿ· ¿ÃÿʿÉƻƔ
ÆȻ̻ÄÊ¿ÅÄ ·Äº ÊÈ»·ÊûÄÊ Å¼ Ų»· ¿Ä¼»ÉÊ·Ê¿ÅÄÉ ƺ Ê»ÄŹ»Æ¾·Â¿º»É ¼»Â¿É), and the treatment and control of adult hookworm ( ĹÏÂÅÉÊÅ÷ ¹·Ä¿ÄËÃ), adult roundworm ( ÅÎŹ·È· ¹·Ä¿É and Åηɹ·È¿É »ÅÄ¿Ä·) and adult whipworm ( È¿¹¾ËÈ¿É ÌËÂÆ¿É) infections in dogs and puppies 8 weeks of age or older and 5 pounds of body weight or greater.
Contraindications: There are no known contraindications to the use of TRIFEXIS Chewable Tablets.
Warnings: Not for human use. Keep this and all drugs out of the reach of children.
Serious adverse reactions have been reported following concomitant extra-label use of ivermectin with spinosad alone, one of the components of TRIFEXIS Chewable Tablets (see ADVERSE REACTIONS).
Precautions: Treatment with fewer than 3 monthly doses after the last exposure to mosquitoes may not provide complete heartworm prevention (see EFFECTIVENESS).
¾¿Â» ʾ» ÄËø»È ż ¹¿È¹Ë·ʿĽ ÿ¹ÈÅŰ·ȿ·» Ã·Ï º»¹È»·É» ¼ÅÂÂÅͿĽ ÊÈ»·ÊûÄÊƑ
¿É ÄÅÊ »Ů»¹Ê¿Ì» ·½·¿ÄÉÊ ·ºËÂÊ
Prior to administration of TRIFEXIS, dogs should be tested for existing heartworm infection. At the discretion of the veterinarian, infected dogs should be treated with an adulticide to remove adult ¾»·ÈÊÍÅÈÃÉƔ
Ɣ ¿ÃÿʿÉ.
clearance. Mild, transient hypersensitivity reactions manifested as labored respiration, vomiting, salivation and lethargy, have been noted in some dogs treated with milbemycin oxime carrying · ¾¿½¾ ÄËø»È ż ¹¿È¹Ë·ʿĽ ÿ¹ÈÅŰ·ȿ·»Ɣ ¾»É» È»·¹Ê¿ÅÄÉ ·È» presumably caused by release of protein from dead or dying ÿ¹ÈÅŰ·ȿ·»Ɣ
¿É ÄÅÊ ¿Äº¿¹·Ê»º ¼ÅÈ Ã¿¹ÈÅŰ·ȿ·»
Use with caution in breeding females. The safe use of TRIFEXIS in breeding males has not been evaluated. Use with caution in dogs with pre-existing epilepsy. Puppies less than 14 weeks of age may experience a higher rate of vomiting.
Adverse Reactions: Ä · Í»ÂÂƖ¹ÅÄÊÈÅ»º Ű»Âº ÉÊ˺ÏƑ ;¿¹¾ ¿Ä¹Â˺»º · ÊÅʷ ż 352 dogs (176 treated with TRIFEXIS chewable tablets and 176 treated with an active control), no serious adverse reactions were attributed to administration of TRIFEXIS chewable tablets. All reactions were regarded as mild.
Reactions that occurred at an incidence >2% (average monthly rate) within any of the 6 months of observation are presented in the following table:
Average Monthly Rate (%) of Dogs With Adverse Reactions Adverse
Reaction Vomiting Pruritus Lethargy Diarrhea
a
a single mild seizure 2½ hours after receiving the second monthly dose. The dog remained enrolled and received four additional monthly doses after the event and completed the study without further incident.
n=176 dogs Ä Ê¾»
Ű»Âº ÉÊ˺ÏƑ ÅÄ» ºÅ½ ·ºÃ¿Ä¿ÉʻȻº
TRIFEXIS Chewable Tabletsa
6.13 4.00 2.63 2.25
3.08 4.91 1.54 1.54
»Îƻȿ»Ä¹»º
Active Control Tabletsa
Á¿ÂÂÉ Ų»·É ·Äº ¿É ¿Äº¿¹·Ê»º ¼ÅÈ Ê¾»
Following concomitant extra-label use of ivermectin with spinosad alone, a component of TRIFEXIS, some dogs have experienced the following clinical signs: ÊȻø¿ĽƭÊͿʹ¾¿Ä½Ƒ ɷ¿̷ʿÅÄƭºÈÅÅ¿ĽƑ É»¿ÐËÈ»ÉƑ ·Ê·Î¿·Ƒ ÃϺȿ·É¿ÉƑ ¸Â¿ÄºÄ»ÉÉ ·Äº º¿ÉÅÈ¿»ÄÊ·Ê¿ÅÄ. Spinosad alone has been shown to be safe when administered concurrently with heartworm preventatives at label directions.
Ä ·Äº ËÈÅÆ»·Ä Ű»Âº ÉÊ˺¿»ÉƑ ÄÅ ºÅ½É »Îƻȿ»Ä¹»º É»¿ÐËÈ»É when dosed with spinosad alone at the therapeutic dose range of 13.5-27.3 mg/lb (30-60 mg/kg), including 4 dogs with pre-existing epilepsy. Four epileptic dogs that received higher than the maximum recommended dose of 27.3 mg/lb (60 mg/kg) experienced at least one seizure within the week following the É»¹Åĺ ºÅÉ» ż ÉÆ¿ÄÅÉ·ºƑ ¸ËÊ ÄÅ É»¿ÐËÈ»É ¼ÅÂÂÅͿĽ ʾ» ŰÈÉÊ ·Äº ʾ¿Èº ºÅÉ»ÉƔ ¾» ¹·ËÉ» ż ʾ» É»¿ÐËÈ»É Å¸É»ÈÌ»º ¿Ä ʾ» Ű»Âº ÉÊ˺¿»É could not be determined.
For technical assistance or to report an adverse drug reaction, call 1-888-545-5973. Additional information can be found at www.TRIFEXIS.com. Ů»¹Ê¿Ì»Ä»ÉÉƓ
In a well-controlled laboratory study, TRIFEXIS was 100% »Ů»¹Ê¿Ì» ·½·¿ÄÉÊ ¿ÄºË¹»º ¾»·ÈÊÍÅÈà ¿Ä¼»¹Ê¿ÅÄÉ Í¾»Ä ·ºÃ¿Ä¿ÉʻȻº for 3 consecutive monthly doses. Two consecutive monthly doses º¿º ÄÅÊ ÆÈÅÌ¿º» ʸʷʷ̈ »Ů»¹Ê¿Ì»Ä»ÉÉ ·½·¿ÄÉÊ ¾»·ÈÊÍÅÈà ¿Ä¼»¹Ê¿ÅÄƔ In another well-controlled laboratory study, a single dose of Í·É ʸʷʷ̈ »Ů»¹Ê¿Ì» ·½·¿ÄÉÊ ¿ÄºË¹»º ¾»·ÈÊÍÅÈÃ
»·ÈÊÍÅÈà Ȼ̻ÄÊ¿ÅÄƓ
¿Ä¼»¹Ê¿ÅÄÉƔ Ä · Í»ÂÂƖ¹ÅÄÊÈÅ»º É¿ÎƖÃÅÄʾ Ű»Âº ÉÊËºÏ ¹Åĺ˹ʻº with TRIFEXIS, no dogs were positive for heartworm infection as determined by heartworm antigen testing performed at the end of the study and again three months later.
In a well-controlled laboratory study, TRIFEXIS demonstrated ʸʷʷ̈ »Ů»¹Ê¿Ì»Ä»ÉÉ ÅÄ Ê¾» ŰÈÉÊ º·Ï ¼ÅÂÂÅͿĽ ÊÈ»·ÊûÄÊ ·Äº ʸʷʷ̈ »Ů»¹Ê¿Ì»Ä»ÉÉ ÅÄ ·Ï ˝ʷƔ Ä · Í»ÂÂƖ¹ÅÄÊÈÅ»º ·¸ÅÈ·ÊÅÈÏ ÉÊ˺ÏƑ ÉÆ¿ÄÅÉ·ºƑ · ¹ÅÃÆÅÄ»ÄÊ Å¼
»· È»·ÊûÄÊ ·Äº Ȼ̻ÄÊ¿ÅÄƓ
30 minutes after administration and demonstrated 100% »Ů»¹Ê¿Ì»Ä»ÉÉ Í¿Ê¾¿Ä ʻ ¾ÅËÈÉƔ Ä Ű»Âº ÉÊ˺¿»É ¹Åĺ˹ʻº ¿Ä ¾ÅËÉ»¾ÅÂºÉ Í¿Ê¾ »Î¿ÉʿĽ Ų»· ¿Ä¼»ÉÊ·Ê¿ÅÄÉ Å¼ Ì·ÈϿĽ ɻ̻ȿÊÏƑ Ų»· reductions of 98.0% to 99.8% were observed over the course of ˝ ÃÅÄʾÂÏ ÊÈ»·ÊûÄÊÉ Í¿Ê¾ ÉÆ¿ÄÅÉ·º ·ÂÅÄ»Ɣ
Ƒ ¸»½·Ä ÊÅ Á¿Â Ų»·É
allergy dermatitis showed improvement in erythema, papules, scaling, alopecia, dermatitis/pyodermatitis and pruritus as a direct È»ÉËÂÊ Å¼ »Â¿Ã¿Ä·Ê¿Ä½ ʾ» Ų»·ÉƔ
Å½É Í¿Ê¾ É¿½ÄÉ Å¼ Ų»·
»Ů»¹Ê¿Ì» ¿Ä È»ÃÅ̿Ľ Ä·ÊËÈ·ÂÂÏ ·Äº »ÎƻȿûÄÊ·ÂÂÏ ¿ÄºË¹»º ·ºËÂÊ roundworm, whipworm and hookworm infections.
È»·ÊûÄÊ ·Äº ÅÄÊÈÅ ż ÄÊ»ÉÊ¿Ä·Â »Ã·Êź» ļ»¹Ê¿ÅÄÉƓ Ä Í»ÂÂƖ¹ÅÄÊÈÅ»º ·¸ÅÈ·ÊÅÈÏ ÉÊ˺¿»ÉƑ
NADA #141-321, Approved by the FDA
Manufactured for Elanco Animal Health A Division of Eli Lilly & Co. Lilly Corporate Center, Indianapolis, IN 46285
Trifexis™ is a trademark of Eli Lilly and Company PA9945DEAMX (V01-12-2010)
Í·É ̟ ˀʷ̈