Attributes, knowledge, beliefs, and behaviors relating to prevention of heartworm in dogs among members of a national hunting dog club

A review of moxidectin vs. other macrocyclic lactones for prevention of heartworm disease in dogs with an appraisal of two commercial formulations

Macrocyclic lactones (MLs) are the only drug class currently licensed for heartworm disease prophylaxis. Macrocyclic lactones kill third- and fourth-stage larvae of Dirofilaria immitis, thus preventing the development of adult worms in dogs, which are responsible for heartworm disease, a potentially life-threatening condition. Despite considerable overlap in terms of endectocide spectrum, several important differences distinguish moxidectin from other MLs. Moxidectin has beneficial pharmacokinetic characteristics, such as a longer half-life and greater tissue distribution compared to ivermectin. Additionally, moxidectin has a greater margin of safety compared to ivermectin in dogs with ABCB1 (previously MDR1) gene-defect, which is commonly recognized in collies and other breeds. Multiple laboratory studies have shown that moxidectin is more effective than other commonly used heartworm preventives against resistant strains of D. immitis. This improved efficacy benefits individual dogs and helps reduce the risk of spreading resistant strains within the community. Despite the presence of proven resistant strains in the United States, non-compliance with preventive measures remains a major factor contributing to the diagnosis of heartworm disease in dogs. In retrospective analyses, the oral moxidectin combination product Simparica Trio® (sarolaner, moxidectin, and pyrantel) was associated with increased compliance, resulting in more time of protection compared to dogs receiving flea/tick and heartworm preventive products separately. Compliance with the extended-release moxidectin injectables ProHeart® 6 and ProHeart® 12 was higher than with monthly heartworm preventives, as they provide 6 months or a full year of protection with one single injection, respectively, and revenues remain in the veterinary clinics as injectable moxidectin cannot be sourced through online retailers.

Factors associated with heartworm preventative use in the golden retriever lifetime study

Introduction

Heartworm disease is preventable with use of heartworm preventatives, but the reported prevalence of heartworm preventative use in the United States is low, some estimates falling around 50% of dogs. However, there are very few estimates of prevalence and its associated factors.

Methods

We aimed to estimate prevalence and evaluate factors, including vaccination status, demographics, lifestyle, physical conditions, medications and supplements, and environment and living conditions, for their association with heartworm preventative use in a large dataset from the Golden Retriever Lifetime Study (N = 2,998). Due to the large number of predictors evaluated, we built a bootstrapped elastic net logistic regression model, which is robust to overfitting and multicollinearity. Variables were evaluated by calculating covariate stability (>80%) and statistical significance (p<0.02).

Results

In our sample, the prevalence of heartworm use was 39.5%. In our elastic net model, receiving vaccinations (rabies, Bordetella, or any other vaccine), being located in the Southern U.S., being altered, having an infectious disease or ear/ nose/throat system disease diagnosis, being on heartworm preventatives in the past, currently being on tick preventative, having sun exposure in an area with concrete flooring, living in a house with more rooms with carpeted floors, and spending time on hardwood flooring inside were associated with greater odds of heartworm preventative use. Supplementation use and being in the top quartile of height were associated with lower odds of heartworm preventative use.

Discussion

The explanatory factors we identified can be used to improve client communication. In addition, target populations for educational interventions and outreach can be identified. Future studies can validate the findings in a more diverse population of dogs.

CANINE HEARTWORM INFECTION AND PROPHYLAXIS USE AMONG PET CARETAKERS FROM THE CUMBERLAND GAP REGION OF TENNESSEE, USA

The prevalence of infection with canine heartworm (CHW), Dirofilaria immitis, continues to increase across the United States, regardless of the availability of effective and affordable prophylactic products. Current reports of CHW prevalence as estimated by the Companion Animal Parasite Council (CAPC) are thought to under-represent the true magnitude of the issue because pet dogs that do not receive regular veterinary care are often excluded. This study estimated the prevalence of CHW in pet dogs and associated prophylaxis use in pet dogs in the Cumberland Gap Region with a combined doorstep diagnostic testing approach and caretaker survey. Dogs tested (n = 258) during the summers of 2018 and 2019 revealed a 2.3% (6/258) prevalence in the pet dog population with 33% (2/6) being microfilaremic. Questionnaire data from caretaker interviews revealed that 41.8% (108/258) of the dogs were not receiving CHW prophylaxis. Significant predictors of CHW prophylaxis use identified through logistic regression included pet caretaker awareness of CHW as an important health issue and the use of veterinary services in the year preceding participation in the survey. These results underscore the importance of veterinary-mediated client interaction to create risk awareness of CHW disease and association with prophylaxis compliance.

Hunting Dogs

Herding and hunting dogs are intense, high-drive dogs that work, and often live, outdoors and in constant or repeated close contact with domestic and wild animals. These dogs are at increased risk for injury and exposure to infectious diseases, toxic substances, and environmental threats. The common practice of feeding or allowing access to raw meat from farm or game animals enhances disease transmission risk. These dogs can be affected by infectious diseases and injurious agents that are rarely encountered in other groups of dogs. In addition, their extreme work ethic may lead to delays in diagnosis.

Pharmacoeconomic Analysis of Heartworm Preventive Compliance and Revenue in Veterinary Practices in the United States

Background: Heartworm disease (HWD) is a potentially fatal condition caused by the nematode Dirofilaria immitis. It is endemic in North America, and the American Heartworm Society recommends that owned dogs be on a Food and Drug Administration-approved HWD preventive year-round. The objective of this study was to compare the 12-month HWD preventive purchase compliance rates of injectable moxidectin (ProHeart® 6) and the dose equivalent in monthly HWD preventives and their associated economic value to the veterinary hospital.

Methods: This study used retrospective anonymized transactional data of 7,926,392 unique dogs from 3,737 companion animal practices across the US for the period 2014–2017. Compliance was defined using American Heartworm Society guidelines. Comparisons were purchases of a 6-month moxidectin injection or six doses of any monthly HWD or HWD combination preventive product, tracked for the next preventive purchase 5–7 months later. Total revenue, HWD prevention cost, 12-month repurchase compliance, and patient retention were calculated. Data were expressed on an annualized basis. Compliance comparisons were calculated based on proportion analysis with the SAS ProbNorm function (SAS 9.4, Cary, NC), using a two-sided t-test, at the 5% level of significance (P < 0.05).

Results: At 51.7%, annual compliance with injectable moxidectin was higher than the dose equivalent in monthly HWD preventives, which was 24.4% (P = 0.0001). Eighty-five percent of patients on injectable moxidectin recorded additional transactions during the first visit (average invoice of $161), compared with only 55% of pet owners who purchased monthly HWD prevention (average invoice $141) or monthly HWD combination (average invoice of $171). The average costs of 6 months of HWD preventives were as follows: injectable moxidectin, $48 (29.7% of the total visit invoice); monthly HWD prevention, $45 (31.0% of the total invoice); and monthly HWD combination, 95 (55.6% of the total visit invoice). Finally, dogs receiving injectable moxidectin had a higher proportion of patients with repeat injections within 12 months between 2014 and 2017, with 68% retention rate after 4 years. In comparison, the six-dose monthly HWD cohort retention rate dropped to 55% by 2017.

Conclusions: Dogs receiving injectable moxidectin had higher HWD preventive compliance, generated more practice revenue, and had a higher rate of practice retention compared with monthly HWD products.

Protecting dogs and cats against the Australian paralysis tick, Ixodes holocyclus (Acari: Ixodidae): A review of the Australian acaricide registration process

Tick control is mainly achieved through the use of effective ectoparasiticides that can be either dermally or systemically distributed in/on the host. Before any acaricide can be legally made available to veterinarians and pet owners, it must demonstrate efficacy in a series of well-designed dose confirmation studies. The data generated during these studies are then reviewed by government regulators and used for the registration of the acaricide. In Australia, the most significant tick species is the Australian paralysis tick, Ixodes holocyclus. This three-host tick produces a potent neurotoxin (holocyclotoxin) that induces a rapidly ascending flaccid paralysis that can be fatal to companion animals and larger mammals such as cattle and horses. The Australian Pesticides and Veterinary Medicines Authority (APVMA) is the national Australian regulator which sets the data requirements for the registration of acaricides. This paper reviews the requirements set by the APVMA and puts them in direct context with the biology, distribution and reported acaricide susceptibility of I. holocyclus. An overview of acaricides currently registered in Australia for the control of I. holocyclus in dogs and cats, their reported efficacy data and the conduct of I. holocyclus efficacy trials are also provided.

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A review of the requirements for the conduct of acaricide efficacy trials for Ixodes holocyclus was undertaken.

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The requirements of the Australian government regulator were put in direct context with the biology of the species.

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The need for the inclusion of Far North Queensland ticks into tick studies needs to be further assessed.

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At present, there is no evidence of acaricide resistance in Ixodes holocyclus.

Systematic review of the factors affecting cat and dog owner compliance with pharmaceutical treatment recommendations

The aim of this systematic review is to describe and assess the quality of the existing evidence base concerning factors that influence the compliance of cat and dog owners to pharmaceutical and specifically polypharmacy treatment recommendations. PubMed, CAB Abstracts and Google were searched to identify relevant literature and search results were filtered according to predetermined inclusion and exclusion criteria. Standardised data extraction and critical appraisal were carried out on each included study, and a Centre for Evidence-Based Medicine level of evidence grading was applied. Of the 8589 studies, eight studies were included in the review. Majority (five of eight) of the included studies were examining compliance with short-term antimicrobial therapies and none examined polypharmacy. Multiple definitions of compliance, methods of measurement and different factors potentially affecting compliance were used. Factors reported to have affected compliance in at least one study were dosing regimen, discussion of dosing regimen in light of owners' circumstances, consultation time, disease, month of consultation/treatment, physical risk, social risk and method of administration. The evidence available regarding factors affecting client compliance with pharmaceutical treatment recommendations in cats and dogs is scarce and of poor quality.

Future challenges for parasitology: vector control and 'One health' in Europe: the veterinary medicinal view on CVBDs such as tick borreliosis, rickettsiosis and canine leishmaniosis

The medical as well as the veterinary importance of parasitic arthropods or ectoparasites in general terms, is characterized by the primary or secondary impact on the health of humans and companion animals alike. The parasitic arthropods addressed here are those ectoparasites belong to the class of insects, such as fleas and sand flies, or the subclass of acarids, such as ticks. These parasitic arthropods interact intensively with their hosts by blood feeding. Fleas, sand flies and ticks hold the vector capacity to transmit pathogens such as virus, bacteria or protozoa to cats, dogs and humans. The diseases caused by these pathogens are summarized under the terms canine vector-borne diseases (CVBD), feline vector-borne diseases (FVBD) or metazoonoses. In small animal practice, it is important to understand that the transmitted pathogen may either lead to a disease with clinical signs, or more often to asymptomatic, clinically healthy, or silent infections. Blocking of the vector-host interactions, the blood feeding and subsequently the transmission of pathogens during blood feeding is a key element of CVBD control. The focus of this review is on the current knowledge of the epidemiology of parasitic vectors and three important CVBDs they transmit; rickettsiosis, tick borreliosis and canine leishmaniosis from a European perspective, and how veterinary medicine may contribute to the challenges of CVBDs and their control. Prevention of CVBDs is fundamentally based on ectoparasite control. Ectoparasite management in cats and dogs is important not only for the health and well-being of the individual companion animal but for public health in general and is therefore a perfect example of the 'One health' approach.

The synergistic action of imidacloprid and flumethrin and their release kinetics from collars applied for ectoparasite control in dogs and cats

Background

The control of tick and flea burdens in dogs and cats has become essential to the control of important and emerging vector borne diseases, some of which are zoonoses. Flea worry and flea bite hypersensitivity are additionally a significant disease entity in dogs and cats. Owner compliance in maintaining the pressure of control measures has been shown to be poor. For these reasons efforts are continuously being made to develop ectoparasiticides and application methods that are safe, effective and easy to apply for pet owners. A new polymer matrix collar has recently been developed which is registered for 8 months use in cats and dogs. The basic properties of this collar have been investigated in several in vitro and in vivo studies.

Methods

The effects of imidacloprid, flumethrin and the combination were evaluated in vitro by means of whole cell voltage clamp measurement experiments conducted on isolated neuron cells from Spodoptera frugiperda. The in vitro efficacy of the two compounds and the combination against three species of ticks and their life stages and fleas were evaluated in a dry surface glass vial assay. The kinetics of the compounds over time in the collar were evaluated by the change in mass of the collar and measurement of the surface concentrations and concentrations of the actives in the collar matrix by HPLC. Hair clipped from collar treated dogs and cats, collected at various time points, was used to assess the acaricidal efficacy of the actives ex vivo.

Results

An in vitro isolated insect nerve model demonstrated the synergistic neurotoxic effects of the pyrethroid flumethrin and the neonicotinoid imidacloprid. An in vitro glass vial efficacy and mortality study against various life stages of the ticks Ixodes ricinus, Rhipicephalus sanguineus and Dermacentor reticulatus and against the flea (Ctenocephalides felis) demonstrated that the combination of these products was highly effective against these parasites. The release kinetics of these actives from a neck collar (compounded with 10% imidacloprid and 4.5% flumethrin) was extensively studied in dogs and cats under laboratory and field conditions. Acaricidal concentrations of the actives were found to be consistently released from the collar matrix for 8 months. None of the collar studies in dogs or cats were associated with any significant collar related adverse event.

Conclusion

Here we demonstrated the synergism between the pyrethroid flumethrin and the neonicotinoid imidacloprid, both provided in therapeutically relevant doses by a slow release collar matrix system over 8 months. This collar is therefore a convenient and safe tool for a long-term protection against ectoparasites.