A randomized, blinded, controlled, multi-centered field study assessing the treatment of gastrointestinal nematode infections in cats with fluralaner plus moxidectin spot-on solution (Bravecto® Plus).

BACKGROUND: A spot-on formulation containing fluralaner (280 mg/ml) plus moxidectin (14 mg/ml) (Bravecto® Plus) was developed for the treatment of nematode infections as well as providing 12 weeks of protection against insect and acarine parasites in cats. The effectiveness and safety of this product against feline gastrointestinal nematodes was assessed in naturally-infested, client-owned cats under field conditions in Albania, Bulgaria, Germany and Hungary. METHODS: To be eligible for enrollment in this investigator-blinded study cats had to be at least 10 weeks-old, weigh at least 1.2 kg, be clinically healthy, and have a faecal sample testing positive for nematodes no more than eight days prior to treatment. Cats were stratified into blocks of three in order of presentation at each center and randomly allocated in a 2:1 ratio to be treated topically on Day 0 with fluralaner plus moxidectin (minimum dose rates 40 mg/kg and 2 mg/kg, respectively) or emodepside plus praziquantel (minimum dose rates 3 mg/kg and 12 mg/kg, respectively) (Profender®). Faecal samples were collected from cats prior to treatment and 14 ± 4 days later. RESULTS: There were 182 cats randomized to the fluralaner plus moxidectin group, and 91 to the emodepside plus praziquantel group. Prior to treatment the most commonly identified nematode egg was Toxocara cati, found in 79.1 and 82.4% of cats in the fluralaner plus moxidectin and emodepside plus praziquantel groups, respectively. Eggs of Toxascaris leonina were found in 8.2 and 6.6% of cats; of hookworms in 30.8 and 24.2%; and of Capillaria spp. in 7.1 and 4.3%, respectively. After treatment, faecal samples from 98.3% of fluralaner plus moxidectin treated and 96.6% of emodepside plus praziquantel-treated cats were free of nematode ova. Geometric mean faecal egg count reductions for T. cati, the only eggs found in post-treatment faecal samples, were 99.97% and 99.93%, respectively. Treatment with fluralaner plus moxidectin was non-inferior to emodepside plus praziquantel. Both products were safe and well tolerated by cats treated under field conditions. CONCLUSIONS: This field study confirms that, in addition to 12-week extended duration flea and tick control, fluralaner plus moxidectin provides broad spectrum treatment of nematodes in cats.

Characterisation of ecto- and endoparasites in domestic cats from Tirana, Albania.

During 2008 to 2011, faecal samples, ear swabs, and ectoparasites obtained by full body search and total body comb were collected from 252 cats originating from the greater Tirana area. Faecal samples were examined using the McMaster and Baermann techniques, and a subset of 58 samples was tested for Giardia-specific antigen using a coproantigen enzyme-linked immunosorbent assay (ELISA). The ear swabs were examined for the presence of parasitic mites. Overall, almost 93% of the cats were identified harbouring one or more parasites: 59.1% (95% confidence interval (CI), 53.0-65.0) and 86.9% (95% CI, 82.7-91.1) of the cats tested positive for ecto- or endoparasites, respectively; 53.2% of the cats had evidence for concomitant ectoparasite infestation and endoparasite infection. For ectoparasite infestation, prevalence was 52.0% for total fleas (Ctenocephalides felis, 51.2%; Ctenocephalides canis, 2.0%; and Leptopsylla segnis, 0.4%), 8.3% each for Felicola subrostratus and Otodectes cynotis and 4.0 % for Rhipicephalus sanguineus sensu lato. The most prevalent endoparasites were Toxocara ascarids (48.0%), followed by Aelurostrongylus lungworms (39.7%), Capillaria spp. (31.7%), hookworms (32.9%), dipylidiid cestodes (27.8 %), Cystoisospora spp. (23.4%) and taeniid cestodes (2.0%). One animal was found shedding Pseudamphistomum truncatum eggs. Giardia-specific antigen was detected in 29.3% of the 58 cats tested. Mixed infections with up to six endoparasites concurrently (excluding Giardia) and mixed infestations with two or three species of ectoparasites were recorded in 73.1 and 22.8% of the parasite-positive cats, respectively. Cats ≤9 months of age were more frequently tested (p < 0.05) positive for Toxocara and Cystoisospora infections than cats >9 months while these cats tested more often (p < 0.05) Aelurostrongylus-positive compared with the younger cats. The prevalence of infestation with ectoparasites did not differ between the cats of these two age groups. Given the impact that some of the parasites may have upon animal health as well as the zoonotic potential of some of them, measures should be taken to minimise the transmission of these parasites.

Efficacy of a novel topical fipronil, (S)-methoprene, eprinomectin and praziquantel combination against naturally acquired intestinal nematode and cestode infections in cats.

The efficacy of a novel topical combination formulation of fipronil, (S)-methoprene, eprinomectin and praziquantel against naturally acquired intestinal nematode and cestode infections in cats was evaluated in seven negative control, blinded studies. Cats were selected based on a pre-treatment faecal examination indicating a patent infection with at least hookworms (two studies), Toxocara ascarids (one study), taeniid cestodes (two studies) or Dipylidium cestodes (two studies). In each study, cats were assigned randomly to blocks of two animals each, based on decreasing pre-treatment body weight and were randomly allocated to one of two groups of six to 12 cats: untreated (control) or treated with topical fipronil (8.3%, w/v), (S)-methoprene (10%, w/v), eprinomectin (0.4%, w/v) and praziquantel (8.3%, w/v) (BROADLINE(®), Merial) at 0.12 mL/kg body weight (providing a minimum of 10mg fipronil+12 mg S-methoprene+0.5mg eprinomectin+10mg praziquantel per kg body weight). The topical treatment was administered directly on the skin in the midline of the neck in a single spot once on Day 0. For parasite recovery and count, cats were euthanized humanely and necropsied seven or ten days after treatment. A single treatment with the novel topical combination product provided 91% efficacy against Ancylostoma braziliense, ≥ 99% efficacy against Ancylostoma tubaeforme, and >97% efficacy against Toxocara cati. Similarly, excellent efficacy was established against Taenia taeniaeformis, Dipylidium caninum and Diplopylidium spp. as demonstrated by >97% and up to 100% reductions of cestode counts in the treated cats when compared to the untreated controls (P<0.01). All cats accepted the treatment well based on health observations post-treatment and daily health observations. No adverse experiences or other health problems were observed throughout the studies. The results of this series of controlled studies demonstrated high efficacy and excellent acceptability of the novel topical combination formulation of fipronil, (S)-methoprene, eprinomectin and praziquantel against a broad range of feline intestinal nematode and cestode infections.

Principal intestinal parasites of dogs in Tirana, Albania.

From 2004 to 2009, the digestive tracts of 111 dogs from suburban areas around Tirana, Albania, were examined for intestinal helminths. In addition, rectal faecal samples of all dogs were examined for protozoan infections and 48 faecal samples from dogs >6 months of age were processed with the Baermann technique to test for the excretion of lungworm larvae. The heart and pulmonary arteries of 30 dogs >6 months of age also were examined for nematode parasites. The intestinal parasite fauna of the dogs included three protozoan species (Cystoisospora canis, Cystoisospora ohioensis/burrowsi, Sarcocystis spp.), three cestode species (Dipylidium caninum, Taenia hydatigena, Echinococcus granulosus), five nematode species (Ancylostoma caninum, Uncinaria stenocephala, Toxocara canis, Toxascaris leonina, Trichuris vulpis) and one acanthocephalan (Centrorhynchus buteonis). Rates of infection were: 15.3% for C. canis, 31.5% for C. ohioensis/burrowsi, 1.8% for Sarcocystis spp., 65.8% for D. caninum, 16.2% for T. hydatigena, 2.7% for E. granulosus (genotype G1), 13.5% for A. caninum, 64.9% for U. stenocephala, 75.7% for T. canis, 0.9% for T. leonina, 21.6% for T. vulpis and 0.9% for C. buteonis. Up to six species of gastrointestinal parasites were found per dog. The 63 ≤ 6-month-old dogs harboured significantly (p<0.001) fewer gastrointestinal parasite species concurrently (mean 2.65 ± 1.25 species per animal) than the 48 older animals (mean 3.77 ± 1.45 species per animal). Dogs >6 months of age harboured significantly (p<0.05) more D. caninum, T. hydatigena, A. caninum, U. stenocephala and T. vulpis compared to younger dogs. Conversely, the younger dogs harboured significantly (p<0.001) more T. canis than the older ones. There was no difference in the male and female dogs' counts of individual intestinal helminth species apart from T. hydatigena in dogs >6 months of age: Male dogs harboured significantly (p<0.05) more tapeworms than female dogs. Based on faecal examination, there was no indication for lungworm infection; however, two adult heartworms (Dirofilaria immitis) were found in the right ventricle of one dog.