Field clinical study evaluating the efficacy and safety of an oral formulation containing milbemycin oxime/praziquantel (Milbemax®, Novartis Animal Health) in the chemoprevention of the zoonotic canine infection by Dirofilaria repens

The long-distance relationship between Dirofilaria and the UK: case report and literature review

Over the last two decades, vector-borne pathogens (VBPs) have changed their distribution across the globe as a consequence of a variety of environmental, socioeconomic and geopolitical factors. Dirofilaria immitis and Dirofilaria repens are perfect exemplars of European VBPs of One Health concern that have undergone profound changes in their distribution, with new hotspots of infection appearing in previously non-endemic countries. Some areas, such as the United Kingdom, are still considered non-endemic. However, a combination of climate change and the potential spread of invasive mosquito species may change this scenario, exposing the country to the risk of outbreaks of filarial infections. Only a limited number of non-autochthonous cases have been recorded in the United Kingdom to date. These infections remain a diagnostic challenge for clinicians unfamiliar with these "exotic" parasites, which in turn complicates the approach to treatment and management. Therefore, this review aims to (i) describe the first case of D. repens infection in a dog currently resident in Scotland, (ii) summarise the available literature on Dirofilaria spp. infections in both humans and animals in the United Kingdom and (iii) assess the suitability of the United Kingdom for the establishment of these new VBPs.

Novel anti-Wolbachia drugs, a new approach in the treatment and prevention of veterinary filariasis?

Filarial nematodes are tissue-dwelling parasitic worms that can cause a range of disfiguring pathologies in humans and potentially lethal infections of companion animals. The bacterial endosymbiont, Wolbachia, is present within most human and veterinary filarial pathogens, including the causative agent of heartworm disease, Dirofilaria immitis. Doxycycline-mediated drug targeting of Wolbachia leads to sterility, clearance of microfilariae and gradual death of adult filariae. This mode of action is attractive in the treatment of filariasis because it avoids severe host inflammatory adverse reactions invoked by rapid-killing anthelmintic agents. However, doxycycline needs to be taken for four weeks to exert curative activity. In this review, we discuss the evidence that Wolbachia drug targeting is efficacious in blocking filarial larval development as well as in the treatment of chronic filarial disease. We present the current portfolio of next-generation anti-Wolbachia candidates discovered through phenotypic screening of chemical libraries and validated in a range of in vitro and in vivo filarial infection models. Several novel chemotypes have been identified with selected narrow-spectrum anti-Wolbachia specificity and superior time-to-kill kinetics compared with doxycycline. We discuss the opportunities of developing these novel anti-Wolbachia agents as either cures, adjunct therapies or new preventatives for the treatment of veterinary filariasis.

Occurrence of canine and feline extra-intestinal nematodes in key endemic regions of Italy

Extra-intestinal nematodes of companion animals are of growing concern in veterinary medicine for their pathogenic potential and the current expansion throughout Europe. The present study has evaluated the occurrence of major canine and feline extra-intestinal nematodes in regions of Italy having epidemiological relevance. Associations of various recorded parameters related to the examined animals have been statistically evaluated, along with a comparative analysis with the most recent epidemiological data. Overall, 1055 dogs and 1000 cats were tested. Among extra-intestinal nematodes Angiostrongylus vasorum was the most common in dogs followed by Capillaria aerophila and Dirofilaria spp.; Aelurostrongylus abstrusus was the most recorded parasite in cats, followed by C. aerophila and Troglostrongylus brevior. The statistical analysis revealed that outdoor access is associated with A. vasorum, A. abstrusus and T. brevior infections, that were also more prevalent in animals with cardio-respiratory signs. Moreover, cats aged less than 12 months had more chances to be infected by lungworms. The data herein presented confirm the occurrence and the possible risk of expansion of different extra-intestinal parasitoses of dogs and cats in Italy, underlining the importance of a constant epidemiologic vigilance and of appropriate control methods.

Recent advances on Dirofilaria repens in dogs and humans in Europe

Dirofilaria repens is a nematode affecting domestic and wild canids, transmitted by several species of mosquitoes. It usually causes a non-pathogenic subcutaneous infection in dogs and is the principal agent of human dirofilariosis in the Old World. In the last decades, D. repens has increased in prevalence in areas where it has already been reported and its distribution range has expanded into new areas of Europe, representing a paradigmatic example of an emergent pathogen. Despite its emergence and zoonotic impact, D. repens has received less attention by scientists compared to Dirofilaria immitis. In this review we report the recent advances of D. repens infection in dogs and humans, and transmission by vectors, and discuss possible factors that influence the spread and increase of this zoonotic parasite in Europe. There is evidence that D. repens has spread faster than D. immitis from the endemic areas of southern Europe to northern Europe. Climate change affecting mosquito vectors and the facilitation of pet travel seem to have contributed to this expansion; however, in the authors' opinion, the major factor is likely the rate of undiagnosed dogs continuing to perpetuate the life-cycle of D. repens. Many infected dogs remain undetected due to the subclinical nature of the disease, the lack of rapid and reliable diagnostic tools and the poor knowledge and still low awareness of D. repens in non-endemic areas. Improved diagnostic tools are warranted to bring D. repens diagnosis to the state of D. immitis diagnosis, as well as improved screening of imported dogs and promotion of preventative measures among veterinarians and dog owners. For vector-borne diseases involving pets, veterinarians play a significant role in prevention and should be more aware of their responsibility in reducing the impact of the zoonotic agents. In addition, they should enhance multisectorial collaboration with medical entomologists and the public health experts, under the concept and the actions of One Health-One Medicine.

The 3Rs Concept: Time to Change How We Evaluate the Efficacy of Anthelmintics in Companion Animals

Experimental infections are required by current guidelines for investigating the efficacy of anthelmintics in dogs and cats. Recently, alternatives to experimental infections and the sacrificing of research dogs and cats have been evaluated, and novel conceptual investigations and methods of examination have been explored. Several of these approaches could potentially be used in efficacy studies for anthelmintics in dogs and cats. Here, we provide food for thought towards using new tools for evaluating the efficacy of anthelmintics in companion animals, for promoting the value of field trials, and for updating the existing guidelines for the efficacy testing of anthelmintics in dogs and cats.

Aberrant peritoneal localization of Dirofilaria repens in a dog

Subcutaneous dirofilariosis is a widely spread vector-borne zoonotic disease caused by Dirofilaria repens. In the last years, a rise of human and animal cases of infection by D. repens has been reported in different European countries. The disease may be subclinical or characterized by different skin conditions. This report describes an unusual ectopic localization of D. repens in a naturally infected dog. The six-year old Pit Bull mixed breed dog presented dysorexia, exercise intolerance, orchialgia and moderate abdominal effusion. The abdominal ultrasound examination revealed multiple linear tubular structures with writhing and undulating movements within the peritoneal effusion. The microscopic examination of the peritoneal effusion revealed many larvae microscopically and molecularly identified as D. repens. This is the first case of peritoneal localization of D. repens in a dog. Epidemiological implications are discussed.

Efficacy of fipronil combined with permethrin commercial spot on (Effitix) preventing Culex pipiens from feeding on dogs

A controlled clinical trial was carried out to assess the adulticidal and anti-feeding effectiveness of a spot-on combining fipronil and permethrin (Effitix, Virbac, Carros, France) in preventing Culex pipiens from feeding on dogs. Twelve dogs with equal sensitivity to mosquitoes were included in the study and divided into two groups of six dogs: an untreated control group and a group treated with Effitix. All dogs were challenged with 80 females C. pipiens for 90 ± 5 min on days -7, 1, 7, 14, 21, and 28 (day 0 being treatment day). The number of engorged, dead, and live mosquitoes was determined after each exposure to treated and untreated dogs. Dead mosquitoes were also counted 24 h after exposure. The anti-feeding effect of the spot-on formulation was 100, 99.5, 97.7, 98.3, and 96.7% on days 1, 7, 14, 21, and 28, respectively. The mortality effect was 66.6, 55.9, 38, 17.2, and 12.3% on days 1, 7, 14, 21, and 28, respectively. At each challenge point, the mortality and anti-feeding effects on mosquitoes were significantly different between the control and treated group (p < 0.05). The results indicate that a combination of permethrin and fipronil could be used as an effective mosquito control strategy in dogs and is therefore recommended for use in a dirofilariasis prevention program.

Comparative palatability of two veterinary dewormers (Milpro(®) and Milbemax(®)): a blinded randomised crossover cat study

Background

The combination of milbemycin oxime–praziquantel is widely used against the most common tapeworms and roundworms affecting cats. New veterinary presentations of this combination have recently been approved.

Objective

The objective of this study was to compare the palatability of two products using this combination, Milpro^® and Milbemax^®.

Methods

In all, 20 adult cats and 20 kittens were offered each product according to a randomisation table using a blinded crossover design. Prehension from the bowl, prehension from the hand and total consumption were assessed.

Results

Both presentations were very well tolerated in adult cats and kittens. Total prehension in adult cats and kittens was 100 and 45 per cent, respectively, for Milpro^®, and 95 and 30 per cent, respectively, for Milbemax^®. The percentages of adult cats and kittens which swallowed the pill after taking it into their mouth (total spontaneous consumption) were respectively 40 and 45 per cent for Milpro^®, and 35 and 20 per cent for Milbemax^®.

Conclusion

In this study, both presentations were highly attractive to cats and their respective coatings successfully covered the unpleasant odour of praziquantel, which usually repels cats. These results indicate that the palatability of Milpro^® is at least as good as Milbemax^® and both tablets are well accepted by adult cats and kittens.