Heartworm control in Grenada, West Indies: Results of a field study using imidacloprid 10% + moxidectin 2.5% and doxycycline for naturally-acquired Dirofilaria immitis infections

Paterson, Tara; Fernández, Concepción Páramo; Burnett, PJ; Lessey, L; Hockley, T; Hagen, Ralf Matthias; Coomansingh, C; Sharma, Bhumika; Chandrashekar, R.; Schaper, Roland

doi:10.1016/j.vetpar.2020.109194

Cited by 9 publications

(28 citation statements)

References 30 publications

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“…In summary, the majority of dogs treated with moxi-doxy have shown no to mild respiratory complications, with only a few dogs requiring treatment and one needing brief hospitalization; no HW-associated deaths were reported (9,31,48,52,53,55). This is despite the lack of strict exercise restriction in most cases.…”

Section: Referencesmentioning

confidence: 86%

“…In most surveys, prevalence is markedly greater in dogs with limited or no access to veterinary care than owned dogs likely to have been tested at veterinary visits (12,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) (Figure 1). Owners of heartworm-positive dogs are frequently unable to afford or otherwise access melarsomine treatment (8,9,18,31,32), which is expensive and requires multiple veterinary visits. The cost of treatment was reported by shelters to be the most important challenge for treating HWI (5).…”

Section: Is Perfect the Enemy Of Good When It Comes To Heartworm Treatment?mentioning

confidence: 99%

“…Several studies have now evaluated moxi-doxy for adulticidal treatment, with encouraging results ( Table 1 ) ( 9 , 31 , 48 , 49 , 52 , 53 , 55 ). As yet, no randomized, controlled trial (RCT) has directly compared the safety and efficacy of the current AHS-recommended melarsomine-based protocol and moxi-doxy.…”

Section: Efficacy Of Non-arsenical Adulticide Protocolsmentioning

confidence: 99%

“…All five studies used 10% moxidectin + 2.5% imidacloprid (Advantage Multi® or Advocate®, Elanco). Three of the study protocols administered the product every 30 days for 9 or 10 months ( 9 , 52 , 53 ), with resumption of monthly treatments at 15 months in one ( 9 ). In one study, monthly administration was continued until the study definition for NAD was met ( 49 ).…”

Section: Efficacy Of Non-arsenical Adulticide Protocolsmentioning

confidence: 99%

“…Despite the medical and scientific soundness of this approach, melarsomine treatment remains unattainable for many affected dogs and their caregivers (including many animal shelters) (5,(7)(8)(9)(10). Due to increasing recognition of this problem, expanding pharmaceutical options, and a rapidlygrowing scientific evidence base, practitioners have experimented with non-arsenical treatment protocols with little professional industry guidance.…”

Section: Introductionmentioning

confidence: 99%

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An Accessible Alternative to Melarsomine: “Moxi-Doxy” for Treatment of Adult Heartworm Infection in Dogs

Jacobson

DiGangi

2021

Front. Vet. Sci.

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Canine heartworm infection, caused by the filarial parasite Dirofilaria immitis, represents a serious and expanding animal welfare concern that is expected to increase due to the effects of climate change and the COVID-19 pandemic. A body of evidence has emerged to support the use of a non-arsenical adulticide treatment protocol, using moxidectin and doxycycline to kill adult heartworms over a prolonged period. While a three-dose protocol using the arsenical drug melarsomine is currently the safest and most effective treatment for heartworm infection, this drug is not available in some countries and is inaccessible for many owners and animal shelters. Moxidectin-doxycycline (moxi-doxy) provides a viable alternative to no treatment at all, in cases where arsenical treatment is not possible. Based on current evidence, the most effective non-arsenical treatment regimen is doxycycline 10 mg/kg PO q 12 or 24 h for 28 days, combined with topical moxidectin at label dose. Moxidectin is repeated monthly until no antigen detected (NAD) status is confirmed. Sustained release injectable moxidectin, in combination with doxycycline, may provide an alternative in remote regions or in settings where significant compliance or accessibility concerns exist, but more studies are needed. In moxi-doxy protocols, doxycycline should be repeated annually until NAD. This review summarizes the safety and efficacy of moxi-doxy, addresses controversies surrounding this treatment approach, and provides detailed recommendations for treatment regimens and post-treatment testing.

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Section: Referencesmentioning

confidence: 86%

Section: Is Perfect the Enemy Of Good When It Comes To Heartworm Treatment?mentioning

confidence: 99%

Section: Efficacy Of Non-arsenical Adulticide Protocolsmentioning

confidence: 99%

Section: Efficacy Of Non-arsenical Adulticide Protocolsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An Accessible Alternative to Melarsomine: “Moxi-Doxy” for Treatment of Adult Heartworm Infection in Dogs

Jacobson

DiGangi

2021

Front. Vet. Sci.

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The understanding of heartworm disease: Diagnosis and treatments

Zhang¹

2022

7TH INTERNATIONAL CONFERENCE ON MATHEMATICS: PURE, APPLIED AND COMPUTATION: Mathematics of Quantum Computing

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Further variation of the adulticide protocol for the treatment of canine heartworm infection: can it be even shorter and cost less?

Ward¹,

Jacobson²,

Lacaden³

et al. 2023

Parasites Vectors

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Background This retrospective study evaluated modified three-dose melarsomine treatment protocols in a shelter setting and compared them to the American Heartworm Society (AHS)-recommended protocol. Methods As compared with the AHS protocol, the shelter protocols utilized doxycycline 10 mg/kg once daily (SID) or twice daily (BID), and varied the time from initiation of doxycycline (day 1) to the first melarsomine injection (M1). Dogs were retrospectively grouped based on the shelter’s current protocol (M1 on day 14; Group A) and the AHS protocol (M1 on day 60; Group C), allowing a week on either side of the target M1 day. Treatments that fell outside these ranges formed two additional treatment groups (Groups B and D). Respiratory complications were defined as respiratory signs requiring additional treatment, and were statistically compared for Groups A and C. New respiratory signs and gastrointestinal (GI) signs were compared between dogs receiving SID or BID doxycycline. Results One hundred fifty-seven dogs with asymptomatic or mild heartworm disease at presentation were included. All dogs survived to discharge. There was no statistically significant difference between Groups A (n = 79) and C (n = 27) for new respiratory signs post-melarsomine (P = 0.73). The time to M1 for 14 dogs that developed new respiratory signs was a median of 19 days, compared with 22 days for 143 dogs without new respiratory signs (P = 0.2). Respiratory complications post-melarsomine were uncommon. New respiratory signs post-melarsomine occurred in 10/109 (9.2%) dogs receiving SID doxycycline and 4/48 (8.3%) dogs receiving BID doxycycline (P > 0.999). GI signs prior to M1 were recorded for 40/109 (36.7%) dogs receiving SID doxycycline and 25/48 (52.1%) receiving BID doxycycline (P = 0.08). Forty-four follow-up antigen test results were available; all tests performed > 3 months after the third melarsomine injection were negative. Conclusions This study provided support for initiating melarsomine after 14 days of doxycycline and for a lower doxycycline dose. Shorter and less expensive treatment protocols can increase lifesaving capacity and improve quality of life for shelter dogs by reducing the duration of exercise restriction and length of stay. Graphical Abstract

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Heartworm control in Grenada, West Indies: Results of a field study using imidacloprid 10% + moxidectin 2.5% and doxycycline for naturally-acquired Dirofilaria immitis infections

Cited by 9 publications

References 30 publications

An Accessible Alternative to Melarsomine: “Moxi-Doxy” for Treatment of Adult Heartworm Infection in Dogs

An Accessible Alternative to Melarsomine: “Moxi-Doxy” for Treatment of Adult Heartworm Infection in Dogs

The understanding of heartworm disease: Diagnosis and treatments

Further variation of the adulticide protocol for the treatment of canine heartworm infection: can it be even shorter and cost less?

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