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      Efficacy of a novel topical combination of esafoxolaner, eprinomectin and praziquantel for the prevention of heartworm disease in cats Translated title: Efficacité d’une nouvelle association topique d’esafoxolaner, d’éprinomectine et de praziquantel pour la prévention de la dirofilariose chez les chats

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          Abstract

          NexGard ® Combo is a novel topical endectoparasiticide formulation for cats combining the insecticide/acaricide esafoxolaner, the nematodicide eprinomectin and the cestodicide praziquantel. The efficacy of this novel formulation for the prevention of heartworm disease in cats was tested in two experimental studies using an induced infection model and a randomized, blinded, placebo-controlled study design, and two USA isolates of Dirofilaria immitis. In each study, 20 naïve cats were each inoculated sub-cutaneously with 100 third-stage larvae of D. immitis 30 days before treatment. Following randomization to two treatment groups of ten cats, each cat was treated topically once, either with the minimum recommended dose of the novel formulation, or with an identical volume of placebo. Five months after treatment (6 months after infections), the cats were humanely euthanized for parasite recovery and count. Efficacy was calculated by comparison of the numbers of adult D. immitis recovered in the control and in the novel formulation groups. In the control groups of each study, D. immitis were recovered in seven and nine cats (respective worm counts ranges 1–7 and 1–16, respective geometric means 1.6 and 5.1). In both studies, none of the treated cats harbored any D. immitis at necropsy and the calculated efficacy of the novel formulation was 100%. There were no adverse reactions related to treatment with the novel formulation. The results of these two studies demonstrate that a topical NexGard ® Combo application at the minimum label dose is well-tolerated and efficacious in preventing heartworm disease in cats.

          Translated abstract

          NexGard ® Combo est une nouvelle formulation d’endectoparasiticide topique pour chats combinant l’insecticide/acaricide esafoxolaner, le nématodicide éprinomectine et le cestodicide praziquantel. L’efficacité de cette nouvelle formulation pour la prévention de la maladie du ver du cœur (dirofilariose) chez les chats a été testée dans deux études expérimentales utilisant un modèle d’infection induite et une conception d’étude randomisée, en aveugle et contrôlée par placebo, et deux isolats américains de Dirofilaria immitis. Dans chaque étude, vingt chats naïfs ont chacun été inoculés par voie sous-cutanée avec 100 larves de troisième stade de D. immitis 30 jours avant le traitement. Après randomisation dans deux groupes de traitement de dix chats, chaque chat a été traité par voie topique une fois, soit avec la dose minimale recommandée de la nouvelle formulation, soit avec un volume identique de placebo. Cinq mois après le traitement (6 mois après les infections), les chats ont été euthanasiés sans cruauté pour la récupération et le dénombrement des parasites. L’efficacité a été calculée en comparant les nombres de D. immitis adultes collectés dans le groupe contrôle et dans le groupe ayant reçu la nouvelle formulation. Dans les groupes témoins de chaque étude, D. immitis a été trouvé chez sept et neuf chats (les nombres de vers respectifs variaient de 1 à 7 et de 1 à 16, les moyennes géométriques respectives étaient 1,6 et 5,1). Dans les deux études, aucun des chats traités ne présentait de D. immitis lors de l’autopsie et l’efficacité calculée de la nouvelle formulation était de 100%. Il n’y a eu aucun effet indésirable lié au traitement avec la nouvelle formulation. Les résultats de ces deux études démontrent qu’une application topique de NexGard ® Combo à la dose minimale indiquée sur l’étiquette est bien tolérée et efficace pour prévenir la dirofilariose chez les chats.

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          Heat treatment prior to testing allows detection of antigen of Dirofilaria immitis in feline serum

          Background Diagnosis of Dirofilaria immitis infection in cats is complicated by the difficulty associated with reliable detection of antigen in feline blood and serum samples. Methods To determine if antigen-antibody complex formation may interfere with detection of antigen in feline samples, we evaluated the performance of four different commercially available heartworm tests using serum samples from six cats experimentally infected with D. immitis and confirmed to harbor a low number of adult worms (mean = 2.0). Sera collected 168 (n = 6), 196 (n = 6), and 224 (n = 6) days post infection were tested both directly and following heat treatment. Results Antigen was detected in serum samples from 0 or 1 of 6 infected cats using the assays according to manufacturer’s directions, but after heat treatment of serum samples, as many as 5 of 6 cats had detectable antigen 6–8 months post infection. Antibodies to D. immitis were detected in all six infected cats by commercial in-clinic assay and at a reference laboratory. Conclusions These results indicate that heat treatment of samples prior to testing can improve the sensitivity of antigen assays in feline patients, supporting more accurate diagnosis of this infection in cats. Surveys conducted by antigen testing without prior heat treatment of samples likely underestimate the true prevalence of infection in cats.
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            Heartworm biology, treatment, and control.

            This article is a review of the systematics, taxonomy, biology, prevention, control, and treatment of the canine heartworm, Dirofilaria immitus. This filarioid parasite remains one of the most important and dangerous diseases of the dog throughout the United States. The geographic range of the parasite is expanding, and in many parts of the country it has emerged as a threat to canine welfare only in the last 50 or so years. The article also discusses the pathophysiological mechanisms behind the disease induced, the means for diagnosing the disease, and the means of assessing the success of therapy. The treatment of potential complications of heartworm infection, such as post-adulticide thromboembolism, eosinophilic granulomatous pneumonitis, and caval syndrome, is also discussed.
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              Understanding feline heartworm infection: disease, diagnosis, and treatment.

              Feline heartworm disease is a very different clinical entity from canine heartworm disease. In cats, the arrival and death of immature heartworms in the pulmonary arteries can cause coughing and dyspnea as early as 3 months postinfection. Adult heartworms suppress the function of pulmonary intravascular macrophages and thus reduce clinical disease in chronic feline heartworm infection. Approximately 80% of asymptomatic cats self-cure. Median survival time for symptomatic cats is 1.5 years, or 4 years if only cats living beyond the day of presentation are considered. Aberrant worm migration is more frequent than it is in dogs, and sudden death can occur with no prior clinical signs. The bacterial endosymbiont Wolbachia likely contributes to the inflammatory pathology of heartworm disease, but its role is not yet fully clear. Unfortunately, the diagnosis, treatment, and management of feline heartworm disease are far from simple. Antemortem diagnosis is hampered by low worm burdens, the frequency of all-male infections, and nonspecific radiographic lesions. It is up to the veterinarian to determine the correct index of suspicion and choose the right combination of diagnostic tests to achieve an answer. Treatment is symptomatic because adulticide therapy is risky and does not increase survival time. Despite the dangers of feline heartworm disease, less than 5% of cats in the United States are on chemoprophylaxis. It is important for veterinarians to take a proactive preventive stance because heartworm infection in cats is a multisystemic disease that has no easy cure. Copyright © 2010 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Parasite
                Parasite
                parasite
                Parasite
                EDP Sciences
                1252-607X
                1776-1042
                2021
                02 April 2021
                : 28
                : ( publisher-idID: parasite/2021/01 )
                Affiliations
                [1 ] Boehringer-Ingelheim Animal Health 1730 Olympic Drive Athens 30601 GA USA
                [2 ] TRS Labs Inc. 215 Paradise Blvd Athens 30607-1151 GA USA
                [3 ] ClinVet USA 1479 Talmadge Hill Rd S Waverly 14892 NY USA
                [4 ] Boehringer-Ingelheim Animal Health 29 Avenue Tony Garnier 69007 Lyon France
                [5 ] College of Veterinary Medicine, Cornell University Ithaca 14850 NY USA
                Author notes
                Article
                parasite200152 10.1051/parasite/2021026
                10.1051/parasite/2021026
                8019556
                © C. Baker et al., published by EDP Sciences, 2021

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 36, Pages: 6
                Categories
                Research Article
                Special Issue – NexGard ® Combo (esafoxolaner, eprinomectin, praziquantel): A new endectocide spot-on formulation for cats. Invited Editor: Frédéric Beugnet

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