Moxidectin plasma concentrations following topical administration to llamas (Lama glama) and alpacas (Lama pacos)

Pharmacokinetics of a topical application of moxidectin in bare-nosed wombats (Vombatus ursinus)

Sarcoptic mange is a debilitating disease that affects bare-nosed wombats (Vombatus ursinus). One of the drugs currently used for treatment is moxidectin, as it has a relatively high efficacy against endo and ectoparasites and side effects are uncommon in domestic species, thus it is considered a relatively safe drug to use at the recommended doses. Developing further understanding of the pharmacokinetics of moxidectin will aid in developing treatment regimens for sarcoptic mange in wombats. Here we analyzed the pharmacokinetic parameters of using 100 ml of moxidectin (5 g/l) applied topically. We found that mean peak plasma concentration was 0.50 ng/ml and half-life was 8 days. Moxidectin was excreted in scats with the mean peak concentration of 2461.43 ng/g (on a dry matter basis). Our study has provided the pharmacokinetic parameters of a commonly used treatment for sarcoptic mange in wombats. There were no adverse side effects recorded in the wombats after applying moxidectin topically. This study replicated real-world conditions using topical application on free-living wombats. The relatively low plasma concentration suggests the drug is not accumulating in the blood stream and is excreted via scats.

Effective treatment of sarcoptic mange in an alpaca (Vicugna pacos) using fluralaner: a case report

South American Camelids, including alpacas, have gained popularity in Europe as pets and prized wool sources. Skin health concerns, particularly mite infestations, have emerged as a notable problem in these animals. Sarcoptic mange can lead to severe itching, papules, and chronic symptoms such as alopecia, crusts, and emaciation if left untreated. This case report documents a 2-year-old female alpaca suffering from sarcoptic mange. Despite initial treatment with ivermectin, its condition worsened, leading to severe weight loss, abortion, and a continued presence of mites. Considering the lack of effective treatments for sarcoptic mange in alpacas and the unavailability of registered drugs for this species in Italy, fluralaner, a drug previously used in other animal species, has been administered orally at a dosage of 5 mg/kg. Within a week after the treatment with fluralaner, the patient exhibited significant improvement, including the resolution of itching, healing of skin lesions, and an increase in appetite. Follow-up skin scrapings confirmed the absence of mites, and the patient's condition continued to improve. Fluralaner demonstrated to be a highly effective and fast-acting treatment for sarcoptic mange in alpacas, offering potential economic benefits attributed to its single-dose administration.

Free drug percentage of moxidectin declines with increasing concentrations in the serum of marsupials

Moxidectin (MOX) is a macrocyclic lactone used to eliminate endo and ectoparasites in many mammalian species. It is notably the active ingredient of the anti-parasitic drug Cydectin®, manufactured by Virbac, and is frequently used to treat sarcoptic mange in Australian wildlife. Protein binding plays a significant role in the efficacy of a drug, as the unbound/free drug in plasma ultimately reflects the pharmacologically relevant concentration. This study aimed to investigate the free drug percentage of Moxidectin after in vitro spiking into the sera of four sarcoptic mange-susceptible Australian wildlife species; the koala (Phascolarctos cinereus), the bare-nosed wombat (Vombatus ursinus), the eastern grey kangaroo (Macropus giganteus), and the mountain brushtail possum (Trichosurus cunninghami). Three concentration points of MOX were tested for each individual: 20 pg/μL, 100 pg/μL and 500 pg/μL. Serum from five individuals of each species underwent an equilibrium dialysis followed by liquid chromatography tandem mass spectrometry (LC-MS/MS). The results showed an atypical concentration dependent binding across all species, where free drug percentage decreased as MOX concentration increased. In addition, wombats showed significantly lower free drug levels. These findings call for further research into the mechanisms of moxidectin protein binding to help understand MOX pharmacokinetics in marsupials.

Case Report: Successful Treatment of Sarcoptic Mange in European Camelids

Introduction: Members of the Camelidae family are very adaptable mammals, originating from South America. More recently, they have become popular in Europe as pets or wool production farm animals. Their dermatological problems refer mainly to mange, of which sarcoptic mange represent the most clinically relevant form. There is a wide range of molecules effective against sarcoptic mange, but the treatment is very challenging due to the lack of efficiency and absorption.

Methods: Two cases from two different animal populations were described. A female alpaca from Romania with dermatological problems on the ears and two adult llamas, from Italy, both with intense pruritus. Combined treatment with amitraz and subcutaneous eprinomectin was administered for the alpaca, and 2% moxidectin was given to the llamas.

Results: In both cases, the mites were morphologically identified as Sarcoptes scabiei. For the alpaca, negative scrapings were found only after 8 weeks of combined treatment. For the llamas, after four doses of subcutaneous moxidectin, no mites were detected in scrapings and lively hair regrowth of previously alopecic areas was visible.

Conclusion: This paper aimed to present two clinical scenarios of sarcoptic mange in camelids, successfully treated with a combination of ectocides (topical amitraz and subcutaneous eprinomectin) and 2% subcutaneous moxidectin, respectively.

A systematic review of moxidectin as a treatment for parasitic infections in mammalian species

Moxidectin (MOX) is a macrocyclic lactone approved worldwide for the treatment of both endo- and ecto-parasites in many mammalian species. The aim of this study was to assess the efficacy of MOX as a treatment against parasites in a range of mammalian species. An electronic literature search was performed for publications to the 1^st September 2020. A total of 205 papers were retrieved and screened against all required criteria; hence, 35 were papers were reviewed in this study. The level of evidence and methodological quality was analysed, where a total of 13 publications were categorised as a 'randomised control trial', seven were categorised as a 'non-randomised control trial' and 15 as an 'experimental control trial'. The overall methodological quality of the publications was considered low, low to moderate, moderate, moderate to high and high in ten, four, twelve, five and a further four, respectively. We assessed the treatment and possible toxicity of MOX in 13 mammalian species, six investigations reported adverse effects to MOX in a small percentage of individuals. The authors reported observed reactions that were typically mild symptoms that did not require additional therapies, and/or resolved themselves. Further studies are needed to assess the efficacy of MOX treatment in a larger number of species, particularly in wildlife.

Treatment of sarcoptic and chorioptic mange in an alpaca (Vicugna pacos) herd with a combination of topical amitraz and subcutaneous ivermectin

Clinical history: An outbreak of intense pruritus and weight loss in a herd of 40 alpacas (Vicugna pacos) in the south-west of France was investigated after the death of 14 adults. One alpaca was referred to a veterinary teaching hospital for diagnosis and treatment but died soon after and one of the dead alpacas was submitted for necropsy. Clinical findings: The remaining alpacas were intensely pruritic with variably severe and extensive alopecia, erythema, lichenification and crusting on the face, ventral abdomen and distal limbs. Superficial skin scrapes from five animals revealed large numbers of Sarcoptes scabiei mites, and less frequent and numerous Chorioptes bovis mites. Coproscopic examinations revealed a median of 1,350 (min 500, max 8800) strongyle epg. The alpaca admitted for treatment was anaemic and hypoalbuminaemic. Skin scrapes revealed copious S. scabiei and C. bovis mites. The two alpacas examined post-mortem had similar skin lesions to those examined on-farm and were cachexic. One had lung lesions attributed to protostrongylid infestation and its liver contained numerous Dicrocoelium spp. adults. Diagnosis: Sarcoptic and chorioptic mange with secondary superficial bacterial skin infection, associated with severe internal parasitism and underfeeding. Treatment and outcome: All 25 alpacas were treated topically with a 3% chlorhexidine shampoo followed by a 0.025% amitraz wash at the initial visit and then 1, 2, 3, 7 and 9 weeks later. A systemic treatment with S/C 500 µg/kg ivermectin was administered at the initial visit and then 2, 7 and 9 weeks later. The alpacas were treated orally with 50 mg/kg praziquantel to control dicrocoeliosis. Nutritional measures, including increased pasture area and supplemental feeding were simultaneously implemented. Pruritus was reduced 1 week after the start of treatment and had resolved after 2 weeks. After 9 weeks, skin lesions were markedly improved. Six months after the initial visit, skin lesions entirely resolved and superficial skin scrapes, taken from half of the animals, were negative for mites. Clinical relevance: This is the first report of the use of two acaricides combined with a chlorhexidine shampoo to successfully treat simultaneous sarcoptic and chorioptic mange in alpacas.

An assessment of worm control practices used by alpaca farmers in Australia

This study aimed to assess current worm control practices used by Australian alpaca farmers with an online questionnaire survey. The questionnaire contained questions about farm demography and general husbandry practices, farmers' knowledge about gastrointestinal nematodes (GINs) and their importance, the use of worm control strategies and anthelmintics, and grazing management. A link for the questionnaire survey was sent to all (n = 954) registered members of the Australian Alpaca Association in July 2015. The response rate for the questionnaire was 25% (239/954). The majority of respondents were from small (≤ 50 alpacas; 64%, 153/239) followed by medium (50-100 alpacas; 24%, 57/239) and large (>100 alpacas; 12%, 29/239) farms. Findings revealed that the majority of respondents kept Huacaya alpacas to produce high-quality fibre and alpacas were usually kept with other domestic ruminants (e.g. cattle and sheep). Although half of alpaca farmers (114/220) perceived that GINs were an important health problem of alpacas, with Haemonchus spp. being the most common nematode, the majority of them (174/220) used anthelmintics for nematode control. Macrocyclic lactones, a commercial combination of four anthelmintics (abamectin, albendazole, closantel and levamisole) and monepantel were the three most commonly used dewormers by Australian alpaca farmers. Although a significant proportion (166/213) of respondents used a quarantine drench for alpacas, very few respondents were aware of strategic deworming and the issue of anthelmintic resistance. Alpaca farmers mostly used anthelmintics at the dose rate recommended for sheep (47%, 79/167) and cattle (9%, 15/167), though some used 1.5 (31%, 51/167) and 2 (13%, 22/167) times the dose rate recommended for sheep. The majority of small herds used anthelmintics at the dose rate recommended for sheep and cattle while medium and large herds used anthelmintics at 1.5 to 2 times the dose rate recommended for sheep. This study provides invaluable insights into the demography of alpaca farms in Australia, husbandry practices used by alpaca farmers and their knowledge about worms and their control, thereby paving the way for developing guidelines for the control of GINs of alpacas.

Anthelmintic resistance in gastrointestinal nematodes of alpacas (Vicugna pacos) in Australia

Background

Gastrointestinal nematodes (GINs) can cause significant economic losses in alpacas due to lowered production of fibre and meat. Although no anthelmintics are registered for use in alpacas, various classes of anthelmintics are frequently used to control parasitic gastroenteritis in alpacas in Australia and other countries. Very little is known about the current worm control practices as well as the efficacy of anthelmintics used against common GINs of alpacas. This study aimed to assess the existing worm control practices used by Australian alpaca farmers and to quantify the efficacy of commonly used anthelmintics against GINs of alpacas.

Methods

An online questionnaire survey was conducted to assess current worm control practices on 97 Australian alpaca farms, with an emphasis on the use of anthelmintics. Of this group of 97 alpaca farms, 20 were selected to assess the efficacy of eight anthelmintics and/or their combinations (closantel, fenbendazole ivermectin, monepantel, moxidectin and a combination of levamisole, closantel, albendazole, abamectin) using the faecal egg count reduction test (FECRT). A multiplexed-tandem PCR (MT-PCR) was used to identify the prevalent nematode genera/species.

Results

The response rate for the questionnaire was 94% (91/97). Almost half of the respondents kept alpacas with sheep and cattle, and 26% of respondents allowed alpacas to co-graze with these ruminants. Although only 63% respondents perceived worms to be an important health concern for alpacas, the majority of respondents (89%) used anthelmintics to control GINs of alpacas. The commonly used anthelmintics were macrocyclic lactones, monepantel, benzimidazoles, levamisole, closantel and their combinations, and they were typically administered at the dose rate recommended for sheep. The FECRT results showed that a combination of levamisole, closantel, albendazole and abamectin was the most effective dewormer followed by single drugs, including monepantel, moxidectin, closantel, fenbendazole and ivermectin. Haemonchus spp. were the most commonly resistant nematodes followed by Trichostrongylus spp., Camelostrongylus mentulatus, Ostertagia ostertagi and Cooperia spp.

Conclusions

This is the first study aimed at assessing worm control practices and efficacy of commonly used anthelmintics in alpacas in Australia. Our findings document the extent of anthelmintics resistance on Australian alpaca farms and identify those anthelmintics that are still effective against GINs of alpacas.

Electronic supplementary material

The online version of this article (10.1186/s13071-018-2949-7) contains supplementary material, which is available to authorized users.

Pharmacokinetics of moxidectin in alpacas following administration of an oral or subcutaneous formulation

The purpose of this study was to evaluate the pharmacokinetics of moxidectin in alpacas after single subcutaneous injection of a non-aqueous formulation or oral administration of an aqueous drench at 0.2 mg∗kg(-1). Plasma moxidectin concentrations were measured with reverse phase HPLC, and data analyzed using non-compartmental methods. Half-life was longer (p=0.02) after subcutaneous administration than oral (292+/-170 vs 33+/-39 h). The area under the concentration-time curve was greater (p=0.04) following subcutaneous administration (1484.8+/-1049.5 h∗ng∗ml(-1)) than oral (157.6+/-85.9 h∗ng∗ml(-1)). The peak concentration (Cmax) was higher and the after subcutaneous administration, but the difference was not statistically significant (p=0.18). The relative bioavailability of the oral moxidectin to the subcutaneous moxidectin was 11%. The data suggest a higher relative bioavailability following subcutaneous compared to oral administration. Further studies are needed to determine the therapeutic concentrations of moxidectin in alpacas.

[Endo- and ectoparasites of South American camelids and their control]

In a literature review, common endo- and ectoparasites of South American camelids are described, presenting morphological details and clinical signs important for diagnosis. Based on the life cycle of the parasites, possibilities for prophylaxis and therapy are indicated. The review should aid the veterinarian to diagnose and control common parasitic infections in South American camelids.

Llamas and alpacas in Europe: Endoparasites of the digestive tract and their pharmacotherapeutic control

There are distinctive specifications for veterinary medical care of South American camelids (SACs), namely, llamas, alpacas, vicunas and guanacos. Camelids are classified as food-producing animals, but as veterinary medicinal products are often only licensed for domestic food-producing species such as horses, goats, sheep and cattle, treatment of SACs generally requires off-label use of drugs. Endoparasitism is a major health concern in camelids and can result in severe clinical diseases and economic losses. There is still a lack of work on the pharmacokinetics, safety and efficacy for most antiparasitic drugs used in SACs. Even when choosing an appropriate route of administration, several aspects must be considered such as the fact that pour-on formulations are largely ineffective in camelids due to the unique features of llama and alpaca skin and hair that result in extremely low drug bioavailability. This review focuses on the main endoparasites of the digestive tract in llamas and alpacas in Europe and pharmacotherapeutic options based on current knowledge.

Sarcoptic mange in three alpacas treated successfully with amitraz

Sarcoptic mange is a serious skin disease in alpacas that can result in high morbidity and even mortality. Three alpacas were presented with sarcoptic mange that had previously failed to respond to repeated topical applications of eprinomectin, and an injection of doramectin. They were moderately to severely pruritic, had extensive lesions of alopecia, erythema, scaling and crusting, and had lost weight. As no drug is currently licensed for the treatment of sarcoptic mange in alpacas in the UK, they were treated with a topical solution of amitraz (50 mL in 10 L) after initial bathing with antibacterial or keratolytic shampoos. The clinical signs completely resolved with no relapse over a 10-month follow-up period. In this small group of alpacas, amitraz was an effective and well-tolerated treatment for sarcoptic mange.

Efficacy of topical eprinomectin in the treatment of Chorioptes sp. infestation in alpacas and llamas

Chorioptes sp. mite infestation is increasingly recognized as a cause of skin disease in New World camelids and there is a need for an effective treatment protocol to eliminate herd infestation. In this field trial, eprinomectin applied topically at the rate of 0.5 mg kg(-1) weekly for 10 weeks was found to be ineffective in a herd of 12 llamas and 16 alpacas.

Comparative study of the efficacy of eprinomectin versus ivermectin, and field efficacy of eprinomectin only, for the treatment of chorioptic mange in alpacas

The efficacy of eprinomectin versus ivermectin (Study 1: a single-centre, randomised, treatment-controlled, blinded field trial), and the field efficacy of eprinomectin (Study 2: a single-centre, open, un-controlled field trial) for the treatment of chorioptic infestation in naturally infested alpacas were assessed in two studies. Thirty alpacas, all positive for Chorioptes sp. mite, were randomly allocated to two treatment groups in Study 1. Group A received a single topical administration of a 0.5% formulation of eprinomectin at the dose rate of 500mug/kg. Group B received three subcutaneous administrations at 14 days interval of a 1% formulation of ivermectin at the dose rate of 400mug/kg. Response to treatment was assessed by periodic mite count, and skin lesions scored. In Study 2, one group of 19 alpacas received four administrations at weekly interval of topical eprinomectin at the dose rate of 500mug/kg, and response to treatment was monitored by mite counts. No localised or systemic side effects were observed in either trial. There was a statistically significant decrease in mite counts on day 7 (P<0.001) within treatment Groups A and B of Study 1, but mite counts increased again on day 14 and remained high for the duration of the trial in both treatment groups. On day 14 of Study 2, there was a statistically significant reduction in mite counts (P<0.008) and the mite counts remained very low throughout the remainder of the study. The eprinomectin protocol employed in Study 2, consisting of four weekly topical administrations at the dose rate of 500mug/kg of body weight, proved highly effective at reducing the Chorioptes mite burden in alpacas.