Pharmacokinetics and anthelmintic efficacy of injectable eprinomectin in goats.

The objective of this study was to assess the pharmacokinetics and the anthelmintic efficacy of eprinomectin (Eprecis® 20mg/mL) following subcutaneous administration to goats. Forty non-lactating female Alpine goats aged between one and three years and weighing between 32.7 and 59.5kg, were randomly allocated to one of the following groups (8 animals per group): two groups were not infected and were treated at a dose of either 0.2 or 0.4mg/kg BW of eprinomectin, two groups were experimentally infected with nematodes and treated at 0.2 or 0.4mg/kg BW of eprinomectin similarly and one group was infected and left untreated (control). Infection consisted in a single and simultaneous administration of 5000 Haemonchus contortus and 12,500 Trichostrongylus colubriformis infective larvae. No local or general adverse reaction was visually observed whatever the dose rate. The maximal plasma concentrations (Cmax) were 20.68±12.85 vs 39.79±17.25µg/L and the plasma bioavailabilities (AUC) 83.45±34.75 vs 169.37±43.44µg*d/L for 0.2 vs 0.4mg/kg respectively. The efficacy against H. contortus and T. colubriformis was 97.8 and 98.7% at 0.2mg/kg and 98.4% and >99.9% at 0.4mg/kg respectively. The differences in worm burdens between the two dose rates were only significant for T. colubriformis. These results indicate that injectable eprinomectin is a potent anthelmintic against the two major gastrointestinal nematodes in goats. Additional information is needed regarding pharmacokinetics in lactating goats and milk residues.

Influence of Pluronic 85 and ketoconazole on disposition and efficacy of ivermectin in sheep infected with a multiple resistant Haemonchus contortus isolate.

Non-specific mechanisms involving ATP-binding cassette drug efflux transporters may play an important role in xenobiotic clearance in ovine gastro-intestinal nematodes. By using transporter inhibitors, the aim of this trial was to assess the possibility of increasing drug bioavailability in the host in an attempt to improve treatment efficacy. Thirty-six lambs were infected with 5000 multiple-drug resistant Haemonchus contortus third stage larvae and separated into six groups (n=6): ivermectin alone (IVM; 0.2 mg/kg body-weight, BW), ketoconazole alone (KET; 10 mg/kg BW), Pluronic 85 alone (P85; 4 mg/kg BW), IVM+KET, IVM+P85 or untreated control. Ivermectin was administered once on day 28 post-infection for all appropriate groups, whereas KET and P85 were administered as five separate doses on day 26-30 post-infection inclusive. The resultant data showed that concomitant administration of KET or P85 with IVM induced increases in plasma and tissue concentrations of IVM in treated animals, resulting in a two-fold increase in the area under the time-concentration curve (p<0.05). Faecal egg counts and worm burdens of the IVM+KET and IVM+P85 groups were lower than in the untreated, KET and P85 alone control animals. Worm burdens were reduced by between 16% and 51% with IVM+KET and IVM+P85 respectively compared to untreated control animals. The co-administration of P85 with IVM increased the efficacy by 34%, compared with IVM alone, in terms of worm count reduction of the multi-resistant isolate of H. contortus.

Doramectin resistance in Haemonchus contortus on an alpaca farm in Belgium.

Parasitism by gastrointestinal nematodes is a health concern in New World Camelids (NWC) worldwide, and anthelmintic treatment is often needed for parasite control. Although anthelmintic resistance has been reported in ruminants worldwide, data in NWC are only scarce. In the present study, a case of suspected doramectin resistance in alpacas was examined. A field efficacy study was conducted for the evaluation of two different dosages of doramectin using a faecal egg count reduction test. A group of 8 alpacas was treated with a subcutaneous injection of doramectin at 0.2mg/kg bodyweight. Individual faecal samples were collected before treatment and 7 days after treatment. The faecal egg counts indicated a treatment efficacy of only 68%. To determine whether the treatment failure was caused by true anthelmintic resistance or suboptimal dosage in this animal species, a group of 4 alpacas was subsequently treated at 0.3mg/kg bodyweight. Faecal egg counts 7 days post treatment were reduced by only 41%, indicating that the treatment failure was more likely to be caused by the presence of resistant parasites on this farm. Coprocultures of faecal samples collected after treatment indicated the presence of 98.5% Haemonchus contortus and a small percentage of Cooperia oncophora (<1.5%). A controlled efficacy trial in sheep, for which the optimal dosage of doramectin is known, was conducted to ensure that this truly was a case of resistant parasites. Infective larvae collected from the faeces of these alpacas were used to infect eight nematode-free lambs. These lambs were assigned to one of two groups based on faecal egg counts post infection. One group was treated with doramectin injectable at 0.2mg/kg bodyweight, the other group served as a non treated control group. Pharmacokinetics indicated that the doramectin treatment was adequate, yet an efficacy of only 16% was determined on day 7 after treatment. Identification of the larvae after treatment revealed 100% H. contortus. On day 7 after treatment, H. contortus worm counts were only reduced by 8% in the treated lambs. The results of the present study report for the first time a case of doramectin resistance in alpacas, mainly in H. contortus.

Plasma disposition and fecal elimination of doramectin after oral or intramuscular administration in horses.

A study was done to compare plasma disposition kinetics and the fecal elimination profile of doramectin (DRM) after oral or intramuscular (IM) administration in horses. Ten clinically healthy horses, 328-502 kg body weight (bw), were assigned to 2 experimental groups of 5 horses each. Group 1 was treated with an oral dose of 0.2 mg DRM/kg bw, while Group 2 was treated with 0.2 mg DRM/kg bw by IM route. Blood and fecal samples were collected at different times between 0.5h and 60 days post-treatment. After plasma and fecal drug extraction and derivatization, samples were analysed by high performance liquid chromatography (HPLC). A non-compartmental kinetic analysis was performed. Results were expressed as mean+/-standard deviation and were compared using Mann-Whitney U-test. The parent molecule was detected in plasma between 30 min and either 30 (oral) or 60 (IM) days post-treatment. Peak plasma concentrations (C(max)) of 51.6+/-22.2 and 33.3+/-10.5 ng/mL were obtained after oral administration and IM route, respectively. Differences between administration route were not statistically significant (P=0.42). The value for the area under the concentration-time curve (AUC) was 178.6+/-53.7 and 393.6+/-66.6 ng day/mL for Group 1 and Group 2, respectively. These differences were significant (P<0.0079). The averages for mean residence time (MRT) values were 7.7+/-0.9 and 13.2+/-4.5 days for oral and IM treated groups, respectively. In horses treated using the oral route, the peak fecal concentration (F C max) was 2295+/-593 ng/g observed at 1.9+/-0.5 days after oral treatment. Whereas, for those treated by IM route, the F C max was lower (162+/-26 ng/g) (P<0.0079) and it was observed at 5.6+/-2.9 days. The results of this study showed that the administration route affects plasma disposition kinetics, bioavailability and fecal elimination of DRM.

P-glycoprotein interfering agents potentiate ivermectin susceptibility in ivermectin sensitive and resistant isolates of Teladorsagia circumcincta and Haemonchus contortus.

P-glycoprotein (P-gp) homologues, belonging to the ATP Binding Cassette (ABC) transporter family, are thought to play an important role in the resistance of gastro-intestinal nematode parasites against macrocyclic lactones. The aim of this study was to investigate the influence of various P-gp interfering compounds on the efficacy of ivermectin (IVM) in sensitive and resistant nematode isolates. The feeding of IVM resistant and sensitive Teladorsagia circumcincta and Haemonchus contortus first-stage larvae (L1) was assessed using a range of IVM concentrations (0.08-40 nm) with or without P-gp inhibitors: valspodar, verapamil, quercetin, ketoconazole and pluronic P85. The P-gp inhibitors were selected on the basis of their ability to interfere with P-gp transport activity in an epithelial cell line over-expressing murine P-gp. In the presence of P-gp interfering agents, the in vitro susceptibility to IVM of both sensitive and resistant isolates of T. circumcincta and H. contortus was increased. These results show that compounds interfering with P-gp transport activity could enhance IVM efficacy in sensitive isolates, and also restore IVM sensitivity in resistant nematodes. These results support the view that ABC transporters can play an important role in resistance to IVM, at least in the free-living stages of these economically important gastro-intestinal nematodes.

Interaction of macrocyclic lactones with the multidrug transporters: the bases of the pharmacokinetics of lipid-like drugs.

Like most drugs, macrocyclic lactone endectocides (MLs) exert their antiparasitic effects within the defined target tissues where parasites are located, and whose drug concentrations correlate with those in the plasma compartment. The process of drug distribution to the active site constitutes the link in the pharmacokinetic/pharmacodynamic relationship. In the past few years it has become evident that transporter proteins play a major role in regulating the distribution, elimination and metabolism of the antiparasitic macrocyclic lactones. The efflux transporter P-glycoprotein (P-gp) has received the most attention with regards to its strong interaction with ivermectin and other MLs. P-gp has been reported to be involved in restricting the absorption of these drugs, in enhancing their intestinal elimination, in the protection against their neurotoxicity and in the ML resistance mechanisms in parasites. This review focuses on the interaction of MLs with P-glycoprotein and with other multidrug resistance transporters. Given the structural and physicochemical diversity of these drugs, they constitute models of interest to study the major molecular determinants for the interaction with transporters. We will discuss the consequences of such interactions on ML pharmacokinetics and the possibility of benefiting from of drug/drug interaction to reverse multidrug resistance in several therapeutic fights such as against parasites and tumors.

A comparative kinetic study of doramectin and moxidectin in zebu Gobra cattle (Bos indicus).

The plasma kinetics of doramectin and moxidectin were evaluated in zebu Gobra under field conditions after subcutaneous administration of 0.2 mg kg(-1) of commercially available formulations for cattle. The results indicate that the absorption of moxidectin from the site of injection was significantly faster (absorption half-life [t1/2ab] = 0.7 day) than that of doramectin (t1/2ab = 3.1 days). Moxidectin peak plasma concentration (Cmax) was reached significantly earlier (tmax = 0.4 day) compared with that of doramectin (tmax = 5.3 days). No differences in Cmax values were observed; the area under the concentration-time curve was higher for doramectin (475 ng day ml(-1)) compared with moxidectin (198 ng day ml(-1)), while the mean residence time was longer for moxidectin (13.4 days) compared with doramectin (9.4 days). These results obtained give interesting information on doramectin and moxidectin pharmacokinetics in zebu Gobra, which show a similar pharmacokinetic profile as in other cattle.

Experimental selection for ivermectin resistance in Ostertagia ostertagi in cattle.

Recent reports of suspected ivermectin (IVM) resistance in Ostertagia ostertagi have highlighted the need for research into the mechanisms of IVM resistance. However, there are no reports of resistant field isolates of O. ostertagi, which have been characterized for molecular research. Therefore, an anthelmintic susceptible O. ostertagi population was selected for IVM resistance by repeatedly exposing the population to subtherapeutic and therapeutic levels of IVM over 10 generations. In each selection round, a group of calves was infected with the progeny of the previous IVM-selected O. ostertagi population. In the last selection round a therapeutic IVM dose (0.2 mg/kg BW) only reduced the faecal egg counts by 57% and 65% on days 7 and 14 after treatment, respectively. In contrast, the therapeutic IVM dose was 100% effective at eliminating the parental IVM-susceptible isolate.

Estimation of absolute oral bioavailability of moxidectin in dogs using a semi-simultaneous method: influence of lipid co-administration.

Moxidectin is a long-acting anthelmintic drug for which little is known about its kinetic behaviour in dogs and its oral absolute bioavailability has never been reported. We studied the pharmacokinetics of moxidectin in dogs, with a special emphasis on oral bioavailability and the influence of lipid co-administration, by using a semi-simultaneous method of administration. Ten Beagle dogs were dosed orally and then intravenously (i.v.) with 0.2 mg/kg moxidectin. The oral application was conducted with or without corn oil co-administration. Moxidectin concentration-time profiles in plasma were analysed using a compartmental modelling approach, designed to fit the oral and i.v. kinetic disposition curves simultaneously. In contrast to what happens in other species, our study indicates that the bioavailability of orally given moxidectin in dogs is nearly total (90.2 +/- 7.4%), and is not enhanced by lipid co-administration. The clearance, the volume of distribution, the mean residence time and the terminal half-life were similar to what was already described for other species. Finally our trial suggests that the body condition (degree of obesity) is likely to be a major determinant of moxidectin kinetics in dogs because of its modulation of the volume of distribution that indirectly controls the terminal half-life of the drug.

Environmental risk assessment of veterinary pharmaceuticals: development of a standard laboratory test with the dung beetle Aphodius constans.

The environmental risk assessment of veterinary pharmaceuticals for dung beetles is required if the substance is an anti-parasiticide for the treatment of pasture animals. However, the demonstration of the environmental safety of those substances for dung fauna is hampered by the fact that no standardized laboratory test system is currently available. Here a test system using the temperate dung beetle species Aphodius (Agrilinus) constans (Scarabaeidae: Aphodiinae) Duftschmidt is described. The survival of first instar larvae of A. constans exposed to a model substance, dimethoate, spiked into formulated (i.e. dried, formulated and re-wetted) or fresh dung was measured over a period of three weeks. Larvae performed better in formulated dung which also proved to be more suitable for mixing-in test substances homogenously. Dimethoate caused significant larval mortality with LC50 values within a range of 1.3-2.8 mg a.s./kg dung (d.w.), depending on the dung type. Based on the data presented here, it is recommended to incorporate this new test system in the risk assessment process for veterinary pharmaceuticals. However, an international ringtest should to be performed beforehand to ensure adequate validation of the method.

Pharmacokinetics assessment of moxidectin long-acting formulation in cattle.

The plasma kinetics disposition of moxidectin following a subcutaneous administration with a long-acting formulation (Cydectin) 10%, Fort Dodge Animal Health, France) at the recommended dose of 1 mg kg(-1) body weight was evaluated in Charolais cattle breed (five females weighing 425-450 kg) for 120 days. Furthermore, its concentration was measured in hair for the same period. After plasma extraction and derivatization, samples were analysed by HPLC with fluorescence detection. Moxidectin was first detected at 1 h after treatment for plasma (2.00+/-1.52 ng ml(-1)) and at 2 days for hair (446.44+/-193.26 ng g(-1)). The peak plasma concentration (C(max)) was 55.71+/-15.59 ng ml(-1) and 444.44+/-190.45 ng g(-1) for plasma and hair, respectively. The mean calculated time of peak occurrence (T(max)) was 3.40+/-3.36 and 2 days for plasma and hair, respectively. The mean residence time (MRT) was 28.93+/-2.87 and 13.32+/-2.48 days for plasma and hair cattle. The area under concentration-time curve (AUC) was 1278.95+/-228.92 ng day ml(-1) and 2663.82+/-1096.62 ng day g(-1) for plasma and hair, respectively. At the last sampling time (120 days), the concentration was 1.91+/-0.26 ng ml(-1) and 0.69+/-0.52 ng g(-1) for plasma and hair, respectively. The bioavailability of this long-acting formulation of moxidectin is similar to that registered after subcutaneous administration of moxidectin in cattle at 0.2 mg kg(-1) body weight. For the first time the moxidectin pharmacokinetics parameters in hair after a subcutaneous administration was described. The moxidectin profile concentrations in hair reflected that registered in plasma. The previous studies of efficacy have to be correlated to the extended period of absorption and distribution by the LA formulation due to the fivefold higher dose rate in comparison with the 1% injectable formulation (0.2 mg kg(-1) body weight).

Ivermectin in senegalese peulh sheep: influence of sex on plasma disposition.

The plasma disposition kinetics of ivermectin following a single subcutaneous administration of 0.2 mg/kg was investigated in male and female Senegalese Peulh sheep. Ten clinically healthy animals (5 males and 5 females) weighing 38-45 kg were used in this trial. Blood samples were collected by jugular puncture at different times between 0.5 h and 30 days post treatment. After plasma extraction and derivatization, samples were analysed by HPLC with fluorescence detection. Computerized kinetic analysis was carried out and mean parameters were statistically compared with the Mann-Whitney U-test. The area under the concentration-time curve (AUC) was significantly higher (p < 0.0027) in females than in males. Although the differences in maximum concentration (C (max)), mean residence time (MRT) and half-life of elimination (t (1/2el)) between males and females did not achieve statistical significance, values tended to be higher in females. Sex differences may be parallel with the level of storage in fat. Further investigations are required to improve the use of ivermectin in Senegalese sheep and findings may be used to predict optimal anthelmintic strategies for management of African species depending on the parasites present in a production system.

Fumagillin, a new P-glycoprotein-interfering agent able to modulate moxidectin efflux in rat hepatocytes.

We have tested the ability of two compounds licensed in veterinary medicine: fumagillin and diminazene diaceturate to increase intracellular moxidectin quantity in rat hepatocytes. These compounds significantly increased the quantity of 14C-moxidectin (expressed as area under the time curve concentrations) in cultured rat hepatocytes by 44% and 65% for diminazene and fumagillin treatments respectively. In addition, we have tested these drugs for their interference with P-glycoprotein (P-gp) function in porcine kidney epithelial cells transfected with murine mdr1a (Mdr1a-LLCPK1). We examined the intracellular accumulation of rhodamine 123 (Rho 123) as a functional test to evaluate the effects of these two drugs on P-gp activity. In this model, only fumagillin led to a marked intracellular accumulation of Rho 123. After transforming the data to express the results as a percentage of the accumulation in the presence of the P-gp inhibitor valspodar (VSP), the maximal Rho 123 accumulation was 47% of that with VSP for 100 microm fumagillin. The EC50, the concentration needed to determine 50% of the maximal effect was 34 microm. Fumagillin interacts with P-gp function and appears as a promising compound among registered drugs available, which may optimize the therapeutic use of macrocyclic lactones (MLs).

The interaction between moxidectin and MDR transporters in primary cultures of rat hepatocytes.

The interaction of moxidectin (a macrocyclic lactone, ML) with P-glycoprotein (P-gp), multidrug resistance associated proteins (MRPs) and breast cancer resistance protein (BCRP) was studied in primary cultures of rat hepatocytes by measuring the intracellular accumulation of [14C]-moxidectin over 72 h in the presence of specific inhibitors: for P-gp, verapamil (10 microM); for MRPs, MK571 (100 microM), indomethacin (10 microM) and probenecid (3.8 mM); and for BCRP, fumitremorgin C (5 microM). The P-gp and MRP inhibitors increased significantly (P < 0.01) by 48.7%, 49.8%, 49.9% and 57.2% the area under the time-intracellular concentration curve (AUC) of moxidectin in rat hepatocytes, while the BCRP inhibitor, fumitremorgin C, had no effect on the AUC compared with the control. In addition, the mRNAs of all the drug transporters studied were detected in rat hepatocytes from 0 to 72 h. Using this cellular model it has been shown that MRP inhibitors increase moxidectin intracellular concentrations to a similar extent as the P-gp inhibitor. The identification of all the transporters that interact with MLs remains a challenge, which currently concerns several important therapeutic fields.

Efficacy of eprinomectin pour-on in naturally Oestrus ovis infested merino sheep in Extremadura, South-West Spain.

The aim of this study is to evaluate the efficacy of the eprinomectin pour-on in naturally Oestrus ovis-infested sheep. To carry out this trial, 14 naturally infected sheep from the same flock were used. The animals were randomly distributed in three groups: group 1 (non-treated sheep), group 2 treated with 0.5 mg/kg bodyweight and group 3 treated with 1 mg/kg bodyweight of eprinomectin. The sheep were slaughtered 15 days after treatment and their heads were sectioned to count and identify larvae instar. The following results were obtained: Group 1: the average was 34 live and 0.75 dead larvae per sheep. Group 2: the efficacy of the eprinomectin was 83.5% against O. ovis group 3: the efficacy of the eprinomectin pour-on was 100%. Drug analysis was made to determine plasma eprinomectin concentration 9 days after treatment and the average concentrations in groups 2 and 3 were 1.23 and 3.04 ng/ml, respectively. The statistical study showed a significant difference between the efficacy and the dose used, and there was correlation between the plasma concentration of eprinomectin and the dose. The efficacy and easy application allow us to take into account this endectocide as an alternative method in the integral control of parasites in sheep.

Eprinomectin in dairy zebu Gobra cattle (Bos indicus): plasma kinetics and excretion in milk.

The pharmacokinetics and mammary excretion of eprinomectin were determined in zebu Gobra following topical administration of 0.5 mg kg(-1). The kinetics of plasma and milk was analysed using a one-compartment model. The maximum plasma concentration of 8.83+/-2.15 ng ml(-1) occurred 1.30 days post-administration. The area under the plasma concentration-time curve was 30.63+/-5.56 ng day(-1) ml(-1) and the mean residence time was 3.38+/-0.60 days. Eprinomectin was detected in milk at the first sampling time and thereafter for at least 8 days. The systemic availability of eprinomectin was significantly lower than that for other breeds of cattle. Comparison of the milk and plasma data demonstrated the parallel disposition of the drug in the milk and plasma with a milk/plasma ratio of 0.094. The very low extent of mammary excretion supports the permitted use of eprinomectin in lactating zebu Gobra.

Effect of parasitism on the pharmacokinetic disposition of ivermectin in lambs.

The aim of this study was to investigate the effect of parasitism on plasma availability and pharmacokinetic behaviour of ivermectin (IVM) in lambs. Fourteen greyface Suffolk lambs (26.8 +/- 2.2 kg body weight) were selected for this study. Seven pairs of lambs were allocated into two groups in order to obtain an approximately even distribution. Group I (non-parasitized) was pre-treated by three repeated administrations of 5 mg/kg of fenbendazole (Panacur), in order to maintain a parasite-free condition. The lambs in group II (parasitized) did not receive any anthelmintic treatment and the natural infection was sustained by an oral inoculation of infective stages of nematode parasites. After the 85-day pre-treatment period both groups of animals were treated with IVM (200 microg/kg, Ivomec) by subcutaneous injection in the shoulder area. Both groups of animals were maintained under similar conditions of feeding and management. Blood samples were collected by jugular puncture at different times between 0.5 h and 25 days post-treatment. After plasma extraction and derivatization, samples were analysed by high-performance liquid chromatography with fluorescence detection. A computerized kinetic analysis was performed and data were compared using the unpaired Student's t-test. The parent molecule was detected in plasma between 30 min and either 12 (parasitized) or 20 (no parasitized) days post-IVM treatment. The area under the curve values of the parasitized group (75.2 +/- 15.5 ng x d/ml) were significantly lower that those observed in the parasite-free group (134.3 +/- 15.7 ng x d/ml). The mean residence time (MRT) of the parasitized group (2.93 +/- 0.16 days) was significantly lower than the MRT of healthy group (3.93 +/- 0.29 days). The results of this study have shown that a change in body condition followed by a parasitic infection is associated with significant changes in plasma disposition of IVM when it is administered subcutaneously to parasitized lambs. Therefore, variations in the condition induced by parasitism should be considered when these anthelmintics are used for treating parasitized animals.

Pharmacokinetics of ivermectin in zebu Gobra (Bos indicus).

Plasma disposition kinetics of ivermectin was evaluated in a West African cattle breed. Five clinically healthy zebu Gobra cattle (Bos indicus) weighing 220-270 kg were treated (0.2 mg kg-1) with a commercially available ivermectin formulation for cattle. Blood samples were collected by jugular puncture at different times between 0.5 h and 40 days post-treatment. After plasma extraction and derivatization, samples were analysed by HPLC with fluorescence detection. Ivermectin was detected in plasma between 30 min and 20 days post-treatment. The observed peak plasma concentration (Cmax) was 46.3+/-13.8 ng ml-1 and the time to reach Cmax (t(max)) was 0.9+/-0.2 day. The values for the absorption half-life (t1/2ab) and the elimination half-life (t1/2el) were 0.3+/-0.2 and 2.8+/-0.7 days, respectively. The calculated area under the concentration-time curve (AUC) was 185.2+/-12.1 ng day ml-1 and the mean residence time (MRT) was 4.2+/-1.3 days. The availability of ivermectin is low in zebu Gobra in comparison to other breeds cattle but equivalent to that reported in the yak and is likely to be due to physiological characteristics of this breed.

Pharmacokinetics of selamectin in dogs after topical application.

Some pharmacokinetic parameters of selamectin were determined in male (n = 5) and female (n = 5) Beagle dogs following a topical application at a dose rate of 6 mg/kg. The plasma concentration versus time data for the drug were analysed using a one-compartment model. The maximum plasma concentrations of 12.72 +/- 5.13 ng/ml for males and 22.65 +/- 11.95 ng/ml for females occurred around 5 days after administration. The area under the concentration-time curve (AUC) was 192.08 +/- 63.85 ng.day/ml for males and 370.97 +/- 146.87 ng.day/ml for females. The mean residence time was the same in males and females (12.55 days). This study reveals a sex-influence on the disposition of selamectin in the plasma of dogs, which implies that further information will be needed for correlation with efficacy studies in dogs.