Efficacy of a novel topical combination of esafoxolaner, eprinomectin and praziquantel in cats against Toxocara cati and Dipylidium caninum.

NexGard® Combo, a novel topical antiparasitic product for cats, combines the insecticide/acaricide esafoxolaner with the nematocide eprinomectin and cestodicide praziquantel. The efficacy of this combination product was evaluated against two common endoparasites of global occurrence in cats, the nematode Toxocara cati and the cestode Dipylidium caninum, in five controlled studies using naturally or experimentally infected cats with parasites of North American, South African or European origin. Cats evaluated in these studies harbored patent infection of the target parasite confirmed through a pre-treatment fecal examination. In each study, cats were allocated randomly to two groups of equal size (8 or 10 cats per group per study), one group treated with a placebo (mineral oil) and the other with NexGard® Combo. Both treatments were administered once as a spot-on at 0.12 mL per kg body weight to deliver the minimum label dosage (1.44 mg/kg esafoxolaner, 0.48 mg/kg eprinomectin, and 10.0 mg/kg praziquantel) to the NexGard® Combo-treated cats. To determine efficacy, geometric mean parasite counts seven to 12 days after treatment of placebo-treated (control) cats and NexGard® Combo-treated cats were compared. The efficacy of NexGard® Combo was 98.8% and 100% against adult T. cati in two studies; and 98.0%, 98.3% and 93.2% against D. caninum in three studies. No adverse events related to treatment were observed throughout the studies. These studies demonstrate high efficacy against these major feline endoparasites and excellent acceptability of the novel topical antiparasitic combination of esafoxolaner, eprinomectin and praziquantel.

TITLE: Efficacité d'une nouvelle association topique d'esafoxolaner, d'éprinomectine et de praziquantel chez le chat contre Toxocara cati et Dipylidium caninum. ABSTRACT: NexGard® Combo, un nouveau produit antiparasitaire topique pour chats combine l'insecticide/acaricide esafoxolaner avec le nématocide éprinomectine et le cestodicide praziquantel. L'efficacité de ce produit d'association a été évaluée contre deux endoparasites communs d'occurrence mondiale chez le chat, le nématode Toxocara cati et le cestode Dipylidium caninum, dans cinq études contrôlées utilisant des chats naturellement ou expérimentalement infectés par des parasites d'origine nord-américaine, sud-africaine ou européenne. Les chats évalués dans ces études présentaient une infection patente du parasite cible confirmée par un examen fécal avant le traitement. Dans chaque étude, les chats ont été répartis au hasard en deux groupes de taille égale (8 ou 10 chats par groupe et par étude), un groupe traité avec un placebo (huile minérale) et l'autre avec NexGard® Combo. Les deux traitements ont été administrés une fois par spot-on à 0,12 mL par kg de poids corporel pour délivrer la dose minimale indiquée sur l'étiquette (1,44 mg/kg d'esafoxolaner, 0,48 mg/kg d'éprinomectine et 10,0 mg/kg de praziquantel) pour les chats du groupe traité par NexGard® Combo. Pour déterminer l'efficacité, les nombres moyens géométriques de parasites sept à 12 jours après le traitement des chats traités par placebo (témoins) et des chats traités par NexGard® Combo ont été comparés. L'efficacité de NexGard® Combo était de 98,8 % et de 100 % contre T. cati adulte dans deux études, et de 98,0 %, 98,3 % et 93,2 % contre D. caninum dans trois études. Aucun événement indésirable lié au traitement n'a été observé tout au long des études. Ces études démontrent la grande efficacité contre ces principaux endoparasites félins et l'excellente acceptabilité de la nouvelle combinaison antiparasitaire topique d'esafoxolaner, d'éprinomectine et de praziquantel.

Efficacy against nematode infections and safety of afoxolaner plus milbemycin oxime chewable tablets in domestic dogs under field conditions in Europe.

Afoxolaner (AFX) plus milbemycin oxime (MO) combination chewable tablets (NexGard Spectra®, Merial) were evaluated for safety and efficacy against naturally acquired nematode infections in domestic dogs in a multi-centre, positive control, blinded field study using a randomized block design based on the order of presentation for allocation. In total, 408 dogs confirmed positive for naturally acquired infections of intestinal nematodes by pre-treatment faecal examination were studied in ten countries in Europe (Albania, Austria, Bulgaria, France, Germany, Hungary, Italy, Lithuania, Romania and Slovakia). Pre-treatment faecal examination revealed Toxocara, Toxascaris, hookworm, Trichuris and/or Capillaria nematode infections in 134, 30, 223, 155 and 14 dogs, respectively. Dogs were allocated to one of two treatment groups in a ratio of 1, AFX + MO chewables (≥2.5 mg AFX + ≥0.5 mg MO per kg body weight, according to dose bands; 207 dogs), and 1, MO plus praziquantel (PRZ) chewables (Milbemax®, Novartis; ≥0.5 mg MO + ≥5 mg PRZ per kg body weight, according to the manufacturer's instructions; 201 dogs) and treated once. For evaluation of efficacy based on reduction of faecal nematode egg counts, two faecal samples, one collected prior to treatment and one collected 9 to 21 days after treatment, were examined using modified McMaster techniques. For evaluation of systemic safety, dogs were examined by a veterinarian before treatment administration and at study end, and dog owners observed the health status of their dogs until the end of the study and reported any abnormal observation. For dogs treated with AFX + MO chewables, the efficacy was 99.7, 99.7, 97.2, 99.7 and 99.7 % for Toxocara, Toxascaris, hookworm, Trichuris and Capillaria, respectively; and the efficacy was 99.5, 99.4, 94.3, 99.9 and 98.0 %, respectively, for the MO + PRZ-treated dogs (p ≤ 0.002 for all nematodes and both treatments). For Toxocara, hookworm and Trichuris, non-inferiority analysis demonstrated that the efficacy of AFX + MO chewable tablets was equal to or better than that of MO + PRZ. In spite that both treatments were ≥98 % efficacious against Toxascaris and Capillaria, a hypothesis of non-inferiority for both genera could not be established due to the low number of dogs infected with these parasites. No treatment-related adverse experiences were observed throughout the study. For both treatments, all dogs were given a systemic safety score of 'excellent' apart from one dog in each treatment group which received a score of 'acceptable'. AFX + MO combination chewables were shown to be safe and demonstrated a high level of efficacy when administered once to dogs infected with a broad range of parasitic nematodes under field conditions.

Parasites and vector-borne diseases in client-owned dogs in Albania: infestation with arthropod ectoparasites.

To establish the diversity and seasonality of ectoparasite infestation in client-owned dogs in Albania, 602 dogs visiting four small animal clinics in Tirana from March 2010 to April 2011 inclusive were examined for ectoparasites by full body search and total body comb. In addition, ear swab specimens collected from all dogs and scrapings taken from skin lesions suspicious of mite infestation were examined for parasitic mites. Overall, 93 dogs (15.4 %, 95%CI 12.6-18.6) were demonstrated to be infested, and nine species of ectoparasites were identified: Ixodes ricinus, 0.8 %; Rhipicephalus sanguineus s. l., 8.1 %; Demodex canis, 0.2 %; Sarcoptes scabiei, 0.7 %; Otodectes cynotis, 2.8 %; Ctenocephalides canis, 4.8 %; Ctenocephalides felis, 3.0 %; Pulex irritans, 0.2 %; and Trichodectes canis, 0.2 %. Single and multiple infestations with up to four species of ectoparasites concurrently were recorded in 67 (11.1 %, 95%CI 8.7-13.9) and 26 dogs (4.3 %, 95%CI 2.8-6.3), respectively. On univariate analysis, the category of breed (pure breed dogs vs. mixed-breed dogs), the dog's purpose (pet, hunting dog, working dog), the housing environment (mainly indoors/indoors with regular outside walking vs. yard plus kennel/run), the history of ectoparasiticide treatment and the season of examination were identified as significant (p < 0.05) factors predisposing dogs to various ectoparasites, while the variables dog's age, gender, the dog's habitat (city, suburban, rural) and the presence/absence of other pets were not significant predictors. Multivariate logistic regression analysis for factors associated with overall ectoparasitism revealed that dogs treated with ectoparasiticides at least once per year (odds ratio [OR] = 0.24; p < 0.001) had a significantly lower risk of infestation compared with dogs not treated against ectoparasite infestation. Dogs examined during spring, summer and autumn (OR = 7.08, 7.43 and 2.48, respectively; all p < 0.001) had a significantly higher risk of infestation than dogs examined during winter. By providing basic data on the infestation with ectoparasites in client-owned, veterinary-cared-for dogs from Albania for the first time, the results of this survey should emphasize the need of an increase of attention to ectoparasites in dogs by both veterinarians and dog owners.

Parasites and vector-borne pathogens in client-owned dogs in Albania. Blood pathogens and seroprevalences of parasitic and other infectious agents.

Knowledge on the epidemiology of parasitic and vector-borne infections is still very limited for Albania, a country located in the Balkan Peninsula in southeast Europe. Recent publications indicated prevalence rates of up to 52% for vector-borne infections in less-cared dogs in Albania. To provide data on the epidemiological situation in dogs under veterinary care, a total of 602 client-owned dogs presented to four small animal clinics between March 2010 and April 2011 in Tirana, Albania, were screened by examination of Giemsa-stained blood smears, PCR, and serological methods for the presence of arthropod-borne infections, as well as Neospora caninum and Toxoplasma gondii. Eight different pathogens, namely Babesia vogeli, Hepatozoon canis, Leishmania infantum, Dirofilaria immitis, Anaplasma phagocytophilum, Anaplasma platys, Ehrlichia canis, and Mycoplasma haemocanis, were detected by direct methods with prevalence rates ranging from 1 to 9%. Seroprevalence for Babesia spp., L. infantum, Anaplasma spp., and E. canis were 6.6, 5.1, 24.1, and 20.8%, respectively. Dogs >1 year of age were positive for vector-borne infections significantly more often than younger dogs (p = 0.003). More than half (51.7%) of the dogs were seroreactive to T. gondii and 18.3% to N. caninum. This is the first report on the detection of A. phagocytophilum, A. platys, E. canis, and M. haemocanis by PCR as well as the serological confirmation of exposure of dogs to N. caninum and T. gondii in Albania. The spectrum of pathogens and the seroprevalences for N. caninum and T. gondii in client-owned dogs from Tirana, Albania, are comparable to that reported in other countries in the Mediterranean Basin. The prevalence rates of vector-borne pathogens are at the lower range of that reported in studies from this geographical region. This is probably due to increased awareness of the owners of pet dogs, including better husbandry conditions and ectoparasiticidal treatment, thus limiting exposure of dogs to vectors.

Parasites and vector-borne diseases in client-owned dogs in Albania. Intestinal and pulmonary endoparasite infections.

From March 2010 to April 2011 inclusive, feces from 602 client-owned dogs visiting four small animal clinics in Tirana, Albania, were examined using standard coproscopical techniques including Giardia coproantigen ELISA and immunofluorescent staining of Giardia cysts. Overall, samples of 245 dogs (40.7 %, 95 % CI 36.6-45.6) tested positive for at least one type of fecal endoparasite (protozoan and/or helminth and/or pentastomid) stage, of which 180 (29.9 %, 95 % CI 26.3-33.7) and 129 (21.9 %, 95 % CI 18.2-24.9) tested positive for protozoan or nematode endoparasites, respectively. Fecal forms of at least 14 endoparasites were identified. The most frequently identified stages were those of Giardia (26.4 %), Trichuris (9.5 %), Toxocara (8.0 %), hookworms (7.1 %), Cystoisospora ohioensis (4.3 %), and Cystoisospora canis (3 %). For the first time for dogs in Albania, fecal examination indicated the occurrence of Hammondia/Neospora-like (0.2 %), Angiostrongylus lungworm (0.3 %), capillariid (2.8 %), and Linguatula (0.2 %) infections. Single and multiple infections with up to seven parasites concurrently were found in 152 (25.2 %, 95 % CI 21.8-28.9) and 93 dogs (15.4 %, 95 % CI 12.7-18.6), respectively. On univariate analysis, the dog's age, the dog's purpose (pet, hunting dog, working dog), the dog's habitat (city, suburban, rural), and environment (mainly indoors, indoors with regular outside walking, yard, kennel/run), presence/absence of other dogs and/or cats, history of anthelmintic use, and season of examination were identified as significant (p < 0.05) factors predisposing dogs to various types of endoparasitism while the variables breed (pure breed dogs vs. mixed-breed dogs), gender, and type of food were not significant predictors. Multivariate logistic regression analysis for factors associated with overall endoparasitism revealed that dogs >1 year of age (odds ratio [OR] = 0.64), dogs dewormed at least once per year (OR = 0.35), and dogs tested during spring, summer, and autumn (OR = 0.51, 0.15, and 0.20, respectively) had a significantly lower risk compared with ≤1 year old dogs, dogs not dewormed, or dogs tested during winter. The odds of a dog to be diagnosed positive for endoparasites was 1.56 times higher for dogs living together with other pets than that for a dog without other dogs or cats.

Efficacy of Broadline against Capillaria aerophila lungworm infection in cats.

Capillaria aerophila is a globally distributed parasite of the respiratory system of carnivores and can be considered the second most common lungworm after Aelurostrongylus abstrusus in domestic cats in the northern hemisphere. To evaluate the efficacy of Broadline (Merial), a combination of fipronil 8.3% w/v, (S)-methoprene 10% w/v, eprinomectin 0.4% w/v and praziquantel 8.3% w/v against C. aerophila, a controlled study with 20 naturally infected cats was conducted. Following blocking by body weight, cats were allocated randomly to two groups of ten animals each: control (untreated) or treated once with Broadline according to the label instructions. For evaluation of efficacy, faeces were examined for capillarid egg shedding prior to and weekly for 3 weeks after treatment, when the cats were necropsied for C. aerophila recovery. Following single topical administration of Broadline, faecal capillarid egg counts were significantly reduced by 93.5 to 99.1% (p < 0.01) compared to the controls. Cats treated harboured significantly fewer C. aerophila lungworms compared to the untreated controls (efficacy 82.4%, p = 0.016). Results of this study demonstrate that Capillaria lungworm burdens can be markedly reduced and that faecal egg shedding can be substantially lowered or eliminated following a single treatment with Broadline.

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 combination of fipronil, (S)-methoprene, eprinomectin and praziquantel against feline urinary bladder worm (Capillaria plica) infection.

Infection with urinary capillarid bladder worms has been observed in cats worldwide. Although considered as generally causing no or little harm, infection with urinary capillarids may be associated with clinical disease which requires an appropriate treatment including the use of anthelmintics. Therefore, the efficacy of a novel topical combination formulation of fipronil 8.3% (w/v), (S)-methoprene 10% (w/v), eprinomectin 0.4% (w/v), and praziquantel 8.3% (w/v) (BROADLINE(®), Merial) was evaluated against urinary capillarids in naturally infected cats. Sixteen European Short Hair cats (5 male, 11 female) with capillarid eggs in their urine pre-treatment were included in the study. At the time of treatment, the cats were approximately ten months to eight years old and weighed 1.6-3.6 kg. Cats were ranked based on decreasing bodyweight and then randomly allocated within replicates of two animals to one of the treatment groups. Each cat in the treated group received one topical application of the combination product at the minimum therapeutic dose of 0.12 mL/kg body weight delivering 10mg fipronil+12 mg (S)-methoprene+0.5mg eprinomectin+10mg praziquantel per kilogram of body weight while the cats allocated to the control group remained untreated. For parasite recovery, identification and count, cats were euthanized humanely 14 days after treatment. All untreated cats harboured Capillaria plica in their urinary bladders (range 4-12), while no capillarids were recovered from the eight treated cats. Thus, the efficacy of the novel topical combination against C. plica was 100%. All cats accepted the treatment well based on post-treatment observations and daily observations thereafter. No adverse events or other health problems were observed during the study.

Survey of Toxoplasma gondii and Neospora caninum, haemotropic mycoplasmas and other arthropod-borne pathogens in cats from Albania.

BACKGROUND: Albania is a country on the western part of the Balkan Peninsula. The Mediterranean climate is favourable for the stable development of many arthropod species, which are incriminated as vectors for various agents. Recently, several papers have reported on epidemiological aspects of parasitic diseases including vector-borne disease agents of dogs with zoonotic characteristics in Albania. However, data on the epidemiology of feline parasitic and bacterial agents in Albania is scarce. METHODS: Serum and EDTA-blood samples collected from 146 domestic cats from Tirana during 2008 through 2010 were examined for exposure to Toxoplasma gondii, Neospora caninum, Leishmania infantum, and Anaplasma spp. with IFAT, for infection with L. infantum, A. phagocytophilum, Bartonella spp. and haemotropic mycoplasmas with conventional PCR and real-time PCR and for Dirofilaria immitis with antigen ELISA. Additionally blood smear microscopy was carried out for detection of blood-borne pathogens. RESULTS: Antibodies to T. gondii (titre ≥1:100) were demonstrated in 91 cats (62.3%). Antibodies to N. caninum (titre ≥1:100), L. infantum (titre ≥1:64) and Anaplasma spp. (titre ≥1:100) were found in the serum of 15 (10.3%), 1 (0.7%) or 3 (2.1%) cats, respectively. DNA of haemotropic mycoplasmas was detected in the blood of 45 cats (30.8%), namely Candidatus Mycoplasma haemominutum (21.9%), Mycoplasma haemofelis (10.3%), and Candidatus Mycoplasma turicensis (5.5%), with ten cats harbouring co-infections of two mycoplasmas each; blood from one cat was PCR positive for Bartonella henselae. No DNA of Leishmania spp. and A. phagocytophilum or circulating D. immitis antigen was detected in any cat sample. The overall prevalence of haemotropic mycoplasmas was significantly higher in male compared to female cats (40.6% vs. 24.1%, p = 0.0444); and age was associated positively with the prevalence of antibodies to T. gondii (p = 0.0008) and the percentage of haemotropic mycoplasma infection (p = 0.0454). CONCLUSIONS: With the broad screening panel including direct and indirect methods applied in the present study, a wide spectrum of exposure to or infection with parasitic or bacterial agents was detected.

Rickettsia felis and Bartonella spp. in fleas from cats in Albania.

Fleas can serve as vectors for bacterial pathogens like Bartonella and Rickettsia species, which have been isolated worldwide. However, the knowledge of the epidemiology of vector-borne diseases in general and thus on flea-borne diseases in Albania is limited. Therefore, from 78 free-roaming cats in Tirana, Albania, fleas (371 Ctenocephalides felis and 5 Ctenocephalides canis) were collected to examine them for the presence of Rickettsia and Bartonella species. Ten of the 371 C. felis (2.7%) were positive for Rickettsia felis, and 24 (6.5%) for Bartonella spp. (B. henselae and B. clarridgeiae). In total, fleas from 15 cats (19.2%) were positive for either one or the other of the pathogens. The results of this study provided evidence for the presence of R. felis (causing flea-borne spotted fever) and Bartonella spp. (causing cat scratch disease) in Albania. Thus, these infectious diseases should be considered as differential diagnoses when febrile symptoms are presented, especially after contact with cats or their fleas.