January 10, 2019

New Parasiticide Treats Fleas, Ticks, and GI Nematodes

The topical formulation, which is not currently approved in the United States, combines fluralaner with moxidectin for broad-spectrum coverage.
 
By Natalie Stilwell, DVM, MS, PhD
Results of a recent study showed that 12% of cats tested throughout Europe were co-infected with fleas and gastrointestinal nematodes. The European Scientific Counsel Companion Animal Parasites (ESCCAP) currently recommends quarterly nematode prophylaxis for cats with outdoor access.

Bravecto (fluralaner, Merck Animal Health) is a topical product offering 12 weeks of protection against fleas, ticks, and ear mites in feline patients. A new formulation recently approved in Europe and New Zealand, Bravecto Plus, combines fluralaner with moxidectin for added protection against heartworm disease and for treatment of roundworm, hookworm, and lungworm infections.

A recent study published in Parasites & Vectors compared nematode control between Bravecto Plus and another topical product, Profender (emodepside plus praziquantel, Bayer Animal Health).

Methods
The multicenter study, which was conducted in Albania, Bulgaria, Germany, and Hungary and funded by MSD Animal Health, enrolled client-owned and shelter cats. Eligible cats were at least 10 weeks old and 1.2 kg and had positive fecal worm egg counts within 8 days before treatment. Although cats with chronic medical conditions were eligible for the study, parasiticide administration was not allowed within 14 days before or during the study period. Also, pregnant or lactating cats and those with dermatologic conditions were excluded.

Cats were randomly assigned to receive a single dose of 1 of the following products:
  • Bravecto Plus (³40 mg/kg fluralaner plus 2 mg/kg moxidectin)
  • Profender (³3 mg/kg emodepside plus 12 mg/kg praziquantel)

Fecal exam was repeated 10 to 18 days after treatment. Fecal egg counts (FECs) were performed with the modified McMaster method, with an estimated sensitivity of 25 to 50 eggs per gram of feces. Treatment efficacy was then calculated as percent reduction in FEC for each nematode genus or species. The investigators considered a treatment to be effective if at least 10 cats experienced a 90% or greater reduction in a certain nematode species.

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Results
Positive FECs were detected for 273 of 838 screened cats. One hundred eighty-two FEC-positive cats were assigned randomly to the fluralaner plus moxidectin treatment group, and 91 received emodepside plus praziquantel. Cats ranged in age from 11 weeks to 15 years and lived indoors and/or outdoors. Both products were well tolerated, although 2 cats had mild alopecia or hair discoloration at the administration site.

The most frequently identified nematode eggs, belonging to Toxocara cati, were found in about 80% of cats in each treatment group.

Bravecto Plus and Profender were 100% effective after a single dose at eliminating Capillaria spp, hookworm, and Toxascaris spp ova in all previously infected cats. Both drugs also demonstrated greater than 99% efficacy in treating Toxocara cati infection, although a few outlier cats maintained high FECs for T cati after a single dose.

Take-Home Message
Both of the tested products demonstrated efficacy against several nematode species in naturally infected cats. The topical formulations were also well tolerated.

Dr. Stilwell received her DVM from Auburn University, followed by a MS in fisheries and aquatic sciences and a PhD in veterinary medical sciences from the University of Florida. She provides freelance medical writing and aquatic veterinary consulting services through her business, Seastar Communications and Consulting.

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