Discontinue the use
of macrocyclic lactones as a «slow kill» protocol for known heartworm infections; it is NOT recommended by the American Heartworm Society.
Unfortunately, the use of
macrocyclic lactones for generalized demodicosis is considered extralabel, and there is no antidote to the potentially serious and life - threatening side effects.
A single dose of topical moxidectin prior to transport will eliminate most microfilariae.4 - 6 OR Administer an approved
macrocyclic lactone product along with a topical canine insecticide (containing permethrin + dinotefuran + pyriproxyfen) that is labelled to kill and repel mosquitoes.
The «slow kill» therapy sometimes prescribed by veterinarians is never appropriate, as it has been demonstrated that using this modality — repeated
macrocyclic lactone administration over a period of time — increases the proportion of circulating microfilariae that possess resistance markers.
Macrocyclic lactones do not readily cross the mature mammalian blood - brain barrier.17 Safety in mammals is due to the lack of glutamate-gated chloride channels in the peripheral nervous system and the restriction of GABA to the central nervous system.
The new text on the CAPC website states: «Recent work has shown that there are isolates of heartworms that are capable of developing to adults in dogs receiving routine prophylaxis with any of the
available macrocyclic lactones.»
Citing the need to better understand critical issues such as
macrocyclic lactone resistance to heartworm preventives and the role of the immune system in heartworm prevention, the American Heartworm Society (AHS) has announced that it is accepting proposals for new heartworm research studies.
A Complete Interactive Continuing Education Program on Heartworm Disease - Hear the latest information on controversial topics such as «slow kill» and
macrocyclic lactone lack of efficacy investigations.
When using
macrocyclic lactones for generalized demodicosis, the owner must understand its extralabel use and potential for side effects.
The new data shows that blocking transmission from dogs to mosquitoes, and from mosquitoes to dogs, using repellents / insecticides and
macrocyclic lactone preventives is part of a multi-modal approach.
Use microfilaricidal doses
of macrocyclic lactones to reduce transmission from pets receiving adulticidal treatment.
Ivermectin and
the macrocyclic lactones.
If the label protocol proves to be ineffective, it may be more acceptable to use
a macrocyclic lactone instead of extralabel amitraz.
Table 5:
Macrocyclic Lactone Dosages for Generalized Demodicosis in Dogs The ease of oral administration compared with dips makes macrocyclic lactones the first line of therapy for many dermatologists (Table 5).
Selamectin, the active ingredient in Revolution, is
a macrocyclic lactone compound.
But by that time, pharmaceutical companies will probably have other medications than
macrocyclic lactones to prevent and treat heartworms.
More commonly, microfilariae are eventually eliminated, even from non-adulticide-treated dogs, after several months of treatment with prophylactic doses of
the macrocyclic lactones.
The macrocyclic lactones are the safest and most effective microfilaricidal drugs available.
The major class of preventatives include
macrocyclic lactones, including ivermectin, milbemycin, moxidectin, and selamectin).
Until now, however, experts have been careful to avoid using the so - called R word, «resistant,» to describe the strains that appear not to respond as expected to
macrocyclic lactones.
Practitioners diagnosing these unexpected heartworm infections have begun to question the effectiveness of
macrocyclic lactones.
Are heartworms becoming resistant to
macrocyclic lactones?
Recent studies have also demonstrated that administration of
macrocyclic lactones to pets with prepatent infections will actually delay the development of heartworms.
Anecdotal evidence and preliminary scientific studies suggest that some populations of heartworms may behave differently when exposed to
macrocyclic lactones.
We do not have evidence to suggest that higher doses of
macrocyclic lactones or more frequent dosing would provide increased protection.
In recent years veterinarians have made greater use of a group of chemicals known as
macrocyclic lactones.
When definitive adulticidal therapy with melarsomine can not be provided immediately, heartworm - positive dogs should be started on a 4 - week course of doxycycline and a monthly preventive with
a macrocyclic lactone until such treatment can be provided.
This new standard of care means that every dog should be on
a macrocyclic lactone year - round, and Vectra ® 3D, a flea and tick control that doubles as an extra layer of protection against heartworm transmission.
American Heartworm Society guidelines recommend «doxycycline and
a macrocyclic lactone prior to the three - dose regimen of melarsomine... for treatment of heartworm disease in both symptomatic and asymptomatic dogs.
Administering doxycycline and
a macrocyclic lactone during the 1 - month rest period after melarsomine administration eliminates most of the remaining circulating microfilariae, and any remaining adult worms are essentially sterile and die of attrition over time.