JOURNAL OF THE AMERICAN ANIMAL HOSPITAL ASSOCIATION /
www.aahanet.org CHEWABLES
CAUTION: Federal (U.S.A.) law restricts this drug to use by or on the order of a licensed veterinarian.
INDICATIONS: For use in dogs to prevent canine heartworm disease by eliminating the tissue stage of heartworm larvae (Dirofilaria immitis) for a month (30 days) after infection and for the treatment and control of ascarids (Toxocara canis, Toxascaris leonina) and hookworms (Ancylostoma caninum, Uncinaria stenocephala, Ancylostoma braziliense).
DOSAGE: HEARTGARD® Plus (ivermectin/pyrantel) Chewables should be administered orally at monthly intervals at the recommended minimum dose level of 6 mcg of ivermectin per kilogram (2.72 mcg/lb) and 5 mg of pyrantel (as pamoate salt) per kg (2.27 mg/lb) of body weight. The recommended dosing schedule for prevention of canine heartworm disease and for the treatment and control of ascarids and hookworms is as follows:
Weight Per Month Content Content and Carton Up to 25
26 - 50 51 - 100
1 1 1
68 mcg 57 mg 136 mcg 114 mg 272 mcg 227 mg
Green Brown
Blue
HEARTGARD Plus is recommended for dogs 6 weeks of age and older. For dogs over 100 lb use the appropriate combination of these chewables.
ADMINISTRATION: Remove only one chewable at a time from the foil-backed blister card. Return the card with the remaining chewables to its box to protect the product from light. Because most dogs find HEARTGARD Plus palatable, the product can be offered to the dog by hand. Alternatively, it may be added intact to a small amount of dog
food.The chewable should be administered in a manner that encourages the dog to chew, rather than to swallow without chewing. Chewables may be broken into pieces and fed to dogs that normally swallow treats whole.
Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes after administration to ensure that part of the dose is not lost or rejected. If it is suspected that any of the dose has been lost, redosing is recommended.
HEARTGARD Plus should be given at monthly intervals during the period of the year when mosquitoes (vectors), potentially carrying infective heartworm larvae, are active. The initial dose must be given within a month (30 days) after the dog’s first exposure to mosquitoes. The final dose must be given within a month (30 days) after the dog’s last exposure to mosquitoes.
When replacing another heartworm preventive product in a heartworm disease prevention program, the first dose of HEARTGARD Plus must be given within a month (30 days) of the last dose of the former medication.
If the interval between doses exceeds a month (30 days), the efficacy of ivermectin can be reduced. Therefore, for optimal performance, the chewable must be given once a month on or about the same day of the month. If treatment is delayed, whether by a few days or many, immediate treatment with HEARTGARD Plus and resumption of the recommended dosing regimen will minimize the opportunity for the development of adult heartworms.
Monthly treatment with HEARTGARD Plus also provides effective treatment and control of ascarids (T. canis, T. leonina) and hookworms (A. caninum, U. stenocephala, A. braziliense). Clients should be advised of measures to be taken to prevent reinfection with intestinal parasites.
EFFICACY: HEARTGARD Plus Chewables, given orally using the recommended dose and regimen, are effective against the tissue larval stage of
D.immitis for a month (30 days) after infection and, as a result, prevent the development of the adult stage. HEARTGARD Plus Chewables are also effective against canine ascarids (T. canis, T. leonina) and hookworms (A. caninum, U. stenocephala, A. braziliense).
ACCEPTABILITY: In acceptability and field trials, HEARTGARD Plus Chewables were shown to be an acceptable oral dosage form that was consumed at first offering by the majority of dogs.
PRECAUTIONS: All dogs should be tested for existing heartworm infection before starting treatment with HEARTGARD Plus which is not effective against adult D. immitis. Infected dogs must be treated to remove adult heartworms and microfilariae before initiating a program with HEARTGARD Plus.
While some microfilariae may be killed by the ivermectin in HEARTGARD Plus at the recommended dose level, HEARTGARD Plus is not effective for microfilariae clearance. A mild hypersensitivity-type reaction, presumably due to dead or dying microfilariae and particularly involving a transient diarrhea, has been observed in clinical trials with ivermectin alone after treatment of some dogs that have circulating microfilariae.
Keep this and all drugs out of the reach of children. In case of ingestion by humans, clients should be advised to contact a physician immediately. Physicians may contact a Poison Control Center for advice concerning cases of ingestion by humans.
Store at controlled room temperature of 68°F - 77°F (20°C - 25°C). Excursions between 59°F - 86°F (15°C - 30°C) are permitted. Protect product from light.
ADVERSE REACTIONS: In clinical field trials with HEARTGARD Plus, vomiting or diarrhea within 24 hours of dosing was rarely observed (1.1% of administered doses). The following adverse reactions have been reported following the use of HEARTGARD: Depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation.
SAFETY: HEARTGARD Plus has been shown to be bioequivalent to HEARTGARD, with respect to the bioavailability of ivermectin. The dose regimens of HEARTGARD Plus and HEARTGARD are the same with regard to ivermectin (6 mcg/kg). Studies with ivermectin indicate that certain dogs of the Collie breed are more sensitive to the effects of ivermectin administered at elevated dose levels (more than 16 times the target use level) than dogs of other breeds. At elevated doses, sensitive dogs showed adverse reactions which included mydriasis, depression, ataxia, tremors, drooling, paresis, recumbency, excitability, stupor, coma and death. HEARTGARD demonstrated no signs of toxicity at 10 times the recommended dose (60 mcg/kg) in sensitive Collies. Results of these trials and bioequivalency studies, support the safety of HEARTGARD products in dogs, including Collies, when used as recommended.
HEARTGARD Plus has shown a wide margin of safety at the recommended dose level in dogs, including pregnant or breeding bitches, stud dogs and puppies aged 6 or more weeks. In clinical trials, many commonly used flea collars, dips, shampoos, anthelmintics, antibiotics, vaccines and steroid preparations have been administered with HEARTGARD Plus in a heartworm disease prevention program.
In one trial, where some pups had parvovirus, there was a marginal reduction in efficacy against intestinal nematodes, possibly due to a change in intestinal transit time.
HOW SUPPLIED: HEARTGARD Plus is available in three dosage strengths (see DOSAGE section) for dogs of different weights. Each strength comes in convenient cartons of 6 and 12 chewables.
For customer service, please contact Merial at 1-888-637-4251.
1Trone Brand Connections, studies with Pet Owner and Veterinary panels, for the Greenies Company, 2008.
2 Data on file at Merial. 3 Of dogs showing a preference in three studies conducted by independent investigators, dogs preferred HEARTGARD®
(milbemycin oxime) FlavorTabs®
(ivermectin) Chewables over INTERCEPTOR® by a margin of 37 to 1; data on file at Merial.
®HEARTGARD and the Dog & Hand logo are registered trademarks of Merial. ®INTERCEPTOR is a registered trademark of the Novartis Corporation. ®FLAVOR TABS is a registered trademark of Novartis AG. ©2010 Merial Limited, Duluth, GA. All rights reserved. HGD09PBPILLAD.
For the full text of these reports and studies, log on to
www.aahanet.org Trends magazine, November/December 2010
SOFT T ISSUE SURGERY
Comparison of the Carbon Dioxide Laser and the Radiofrequency Unit
for Feline Onychectomies SM Burns, EW Howerth, CA Rawlings, KK Cornell, MG Radlinsky, JW Mauck
ORIGINAL STUDY This study compared the collateral tissue damage and incisional bridging with granulation tissue via histo- pathological examination following feline onychectomy performed by radiofrequency (RF) and carbon dioxide (CO2) laser. Two cats were euthanized, and their digits were harvested for histopathological evaluation on days 1, 3, and 7 post-onychectomy. Each digit was evaluated for total lesion width, total necrosis width, and degree of edema, hemorrhage, and inflammation. This study found few significant differences in collateral tissue damage between RF and CO2 laser, but more incisional bridging by granulation tissue was noted with RF for feline onychectomies. These results indicate that RF for feline onychectomy is a reasonable alternative to CO2 laser in regard to collateral tissue damage and bridging of the incision by granulation tissue. In addition, RF is not accompanied by the strict safety considerations and initial expense of acquisition of a CO2 laser.
EMERGENCY AND CRI T I CAL CARE
Pneumothorax: A Review DR Pawloski, KD Broaddus
REVIEW Pneumothorax is a pathological condition in which air accumulates within the thoracic cavity. Pneumothorax affects animals without sex or age predilections; how- ever, it has been suggested that the Siberian husky breed of dog has a predisposition for spontaneous pneumo- thorax. Pneumothorax occurs as the result of trauma or underlying disease and can present a clinical challenge with regard to diagnostic and therapeutic techniques. Topics reviewed include normal lung physiology; the pathogenesis, diagnosis, treatment, complications, and prognosis of pneumothorax; and current techniques in animals and humans.
Dog Chewables Ivermectin Pyrantel Foil-Backing Color Coding 0n
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