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Adverse Reactions:
Adverse reactions in fluralaner-treated dogs were evaluated in studies evaluating its use for flea and
tick control and were uncommon to rare. Transient gastrointestinal-related signs including vomiting and anorexia have been reported in 2% of dogs. Fluralaner can be used without additional risk for collies and other sensitive herding breeds that have the MDR1 mutation. No adverse events were observed subsequent to fluralaner treatment of ABCB1 (-/-) Collies at three times the highest expected clinical dose. Fluralaner seems to be an effective, safe and convenient treatment option for all breeds of dogs with generalized demodicosis.
Sarolaner (Simparica®)
Sarolaner (1-(5’-((5S)-5-(3,5-dichloro-4-fluorophenyl)- 5-(trifluoromethyl)-4,5-dihydroisoxazol-3-yl)-3’-H- spiro(azetidine-3,1’-(2) benzofuran)-1-yl)-2-(methylsulfonyl) ethanone) has a very similar spectrum of activity, efficacy, pharmacokinetics and safety to the other isoxazoline molecules.
Demodex:
In a recent study, 16 dogs with generalised demodicosis were treated either with monthly oral sarolaner at 2mg/kg or with a spot-on containing imidacloprid and moxidectin (Advocate®) every 7 days. The sarolaner- treated dogs and the dogs treated with the spot-on
had a reduction of over 99% and 96% in mite numbers after one month and negative scrapings after one month and after 11 weeks respectively. There were
no treatment-related adverse events observed. The excellent response of the dogs in this study receiving the weekly spot-on suggests that these dogs may not be comparable to the dogs presented with generalised demodicosis in Europe or North America. (Six 2016)
Isoxazolines and Demodicosis
With the advent of these new treatments for demodicosis, as well as chronic use of these treatments as flea and tick preventatives, come new concerns about their impact on normal canine cutaneous Demodex populations. Demodex mites are considered part
of the microbiota of most mammals, including dogs. Under normal circumstances, they appear to live as commensals, feeding on their host’s sebum and are only opportunistically pathogenic.
A recent study, however to investigate if healthy dogs treated with the isoxazolines, afoxolaner and fluralaner at the labelled dose for flea and tick prevention maintain a normal population of Demodex mites as part of their cutaneous microbiota demonstrated that after 30 and 90 days of treatment, healthy dogs have continued presence of Demodex mites in numbers similar to
the population of healthy dogs not receiving these treatments. (Zewe 2017)
These conclusions suggest that dogs on isoxazoline treatment maintain Demodex populations as part of their cutaneous microbiota, despite the apparent ability of these medications to resolve clinical demodicosis. Tested isoxazolines at the labelled dose do not
appear to completely eradicate Demodex mites from the skin, but simply reduce Demodex populations to normal numbers in affected dogs. To date, no studies have been performed to detect Demodex DNA post- treatment in dogs with demodicosis. More studies are needed to characterise the response of the Demodex populations in dogs with clinical disease to isoxazolines, independently and in comparison to other treatments for demodicosis.
References
Beugnet F, Halos L, Larsen D, et al. Efficacy of oral afoxolaner for the treatment of
canine generalised demodicosis. Parasite. 2016 23: 14.
Carithers D, Crawford J, de Vos C, Lotriet A, Fourie J. Assessment of afoxolaner efficacy against Otodectes cynotis infestations of dogs. Parasit Vectors. 2016 9(1):635.
Chavez F. Case report of afoxolaner treatment for canine demodicosis in four dogs naturally infected with Demodex canis. Intern J Appl Res Vet Med. 2016 14: 123-127.
Duangkaew L, Larsuprom L, Anakkul P, et al. Efficacy of oral fluralaner for the treatment of generalized demodicosis in dogs from Bangkok, Thailand. North American Veterinary Dermatology Forum. 2017;432.
Fourie JJ, Liebenberg JE, Horak IG, et al. Efficacy of orally administered fluralaner (Bravecto) or topically applied imidacloprid/moxidectin (Advocate(R)) against generalized demodicosis in dogs. Parasit Vectors 2015; 8: 187.
Karas-Tecza J, Dawidowicz J. Efficacy of fluralaner for the treatment of canine demodicosis. Veterinary Dermatology 2015. 26: 307.
Karaś-Tęcza J. Update on the diagnosis and treatment of canine demodicosis. World Congress Veterinary Dermatology 8. Bordeaux, France, 2016 Demodex Workshop report
Mueller RS, Shipstone MA. Update on the diagnosis and treatment of canine demodicosis. Advances in Veterinary Dermatology 2017. 206-209.
Six RH, Becskei C, Mazaleski MM, et al. Efficacy of sarolaner, a novel oral isoxazoline, against two common mite infestations in dogs: Demodex spp. and Otodectes cynotis. Vet Parasitol. 2016 222: 62-66.
Taenzler J, Liebenberg J, Roepke RK, Frénais R, Heckeroth AR. Efficacy of fluralaner administered either orally or topically for the treatment of naturally acquired Sarcoptes scabiei var. canis infestation in dogs. Parasit Vectors. 2016 9(1):392.
Taenzler J, de Vos C, Roepke RK, Frénais R, Heckeroth AR. Efficacy of fluralaner against Otodectes cynotis infestations in dogs and cats. Parasit Vectors. 2017 10(1):30.
Zewe CM, Altet L, Lam AT, Ferrer L. Afoxolaner and fluralaner treatment do not impact on cutaneous Demodex populations of healthy dogs. Veterinary Dermatology. 2017 28:1
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