Focus on Toxocara

Toxocara Inside features...

Foreword by Ian Wright introduces why we need to keep a close eye on Toxocara Toxocara canis life cycle is overviewed to highlight migration pathways

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 1

19/04/2013 15:22

Focus On Toxocara

Keeping Toxocara in (and out of) the public eye Foreword by Ian Wright

I

There are two common misconceptions about Toxocarosis that we, as veterinary surgeons, need to address; firstly, that contact with fresh dog faeces poses a threat of transmission. Freshly passed Toxocara eggs pose no risk as they require at least a few days to reach the infective embryonated stage. Embryonated eggs may be ingested Toxocara is an intestinal nematode of dogs from soil (geophagia), contaminated objects (T. canis) and cats (T. cati). It is the most such as toys (pica) and contaminated fruit and common nematode seen in small animal vegetables. It is now known that eggs may practice and the one most likely to be also embryonate in the coats of dogs. This recognised by name, by the general public. risk from petting dogs has not been quantified Its notoriety has not come from the disease it and was highly publicised by the press when causes in pets but from its zoonotic potential, first discovered. While currently not thought however, this does not mean that people are to be a high risk, dogs (and possibly cats) well informed about the should be assumed to be risk of zoonotic disease or ...it is likely that some carrying infective eggs and how it is transmitted. cases go undiagnosed good hygiene maintained It is our role as vets and around them. nurses to better educate each year, due to the the public and address wide variety of clinical The second misconception is that owning a dog is their concerns. Recent presentations. undesirable due to the news articles have risk of Toxocarosis. We, as vets, want to increased awareness of Toxocara and, as a celebrate the joy of owning a cat or dog result, vets in practice are likely to be asked and the wonderful positive mental and about the risks of human infection. physical health benefits a pet can bring. The Human Toxocarosis (also known as risks of Toxocarosis can be safely managed Toxocariasis) is a syndrome caused by the by discouraging geophagia and pica, good migration of Toxocara spp. larvae (T. canis hygiene after playing outside or cuddling pets, in dogs and T. cati in cats) through the thorough washing of fruit and vegetables lungs and liver (visceral larval migrans), the and by regular worming of pets. It is our eye (ocular larval migrans) and nervous responsibility as vets to ensure that owners system (neurological larval migrans). This are worming at the right frequency and with can lead to a wide range of clinical signs in effective products to minimise infective risk. people including lethargy, seizures, pruritus Many people say that Toxocarosis is a and progressive loss of vision. Although rare disease and that vets scaremonger it has been proposed that people can be or promote dog aversion by talking about infected by eating the undercooked meat of it. I say that 30 cases a year of an easily paratenic hosts such as wild game, the most preventable disease that can cause blindness common route of human infection is by the or debilitating illness is 30 cases too many. ingestion of embryonated eggs. Although The only way to reduce this number is to between 2-31% of people have antibodies continue to educate the public. to the parasite, incidence of clinical disease is fortunately relatively low.1 Currently, Let’s keep Toxocara in (and out of) approximately 2 cases per million2 people the public eye! are reported in the UK each year, however it is likely that some cases go undiagnosed each year, due to the wide variety of clinical presentations. n my ten years as a vet and 16 years as a parasitologist I have seen different parasites rise and fall in terms of their prevalence in the UK but also in the publicity surrounding them. One parasite however, that is common and has maintained a high public profile, is Toxocara.

After completing a Masters degree in Veterinary Parasitology at the Liverpool School of Tropical Medicine in 1997, Ian went on to qualify as a Veterinary Surgeon from Glasgow in 2002. Since then, Ian has continued research in parasitology while practising companion animal medicine and has been published in several peer-reviewed journals.

Ian also gives lectures to vets and vet nurses on a variety of parasite related topics and is a member of the European Scientific Council of Companion Animal Parasites (ESCCAP UK and Ireland)

Toxocarosis also known as Toxocariasis

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 2

19/04/2013 15:22

Focus On Toxocara

Life cycle of Toxocara canis Toxocara canis is a nematode which causes disease in dogs, mainly puppies. Below details the complex life cycle of this common roundworm.

T

oxocara canis eggs are not immediately infective when they are passed in the faeces of dogs. They must first undergo a maturation phase, whereby cell division occurs and they become embryonated. This process takes approximately two weeks and the eggs are then infective (containing L3 larvae).

Once ingested by a dog, the embryonated eggs hatch in the duodenum and the larvae then follow one of two distinct migratory pathways, either tracheal or somatic: Tracheal migration – the hatched L3 larvae penetrate the duodenal wall and pass via the lymph vessels, hepatic portal vein, heart and pulmonary artery to the lungs. A proportion of these larvae then leave the bloodstream and ascend the respiratory tract via the alveoli, bronchioles and trachea. They are then coughed up and swallowed. Further development to L4 takes place and on reaching the small intestine, these larvae mature into immature adults and then adults, subsequently producing eggs which are passed with the dog’s faeces.

Somatic migration – after penetrating the duodenal wall the L3 larvae remain in the blood and are distributed throughout the tissues of the body; in particular, they target muscle tissues.

The distribution of larvae between these alternative pathways depends on the age and sex of the host. In young pups, virtually all newly hatched larvae will proceed via the tracheal route to reach the intestines.

Toxocara canis worms coiled up in the intestine

In the adult dog, and increasingly as the pup grows older, most larvae take a somatic route to the tissues.

Somatic larvae remain dormant, only completing their life cycle under certain circumstances. Typically this occurs in a bitch that becomes pregnant or during a false pregnancy. After about the sixth week of gestation, a proportion of the dormant larvae re-enter the circulation and cross the placenta to develop in the foetus; thus the puppies are infected with T. canis before they are born. A residual population of dormant larvae may remain in the somatic tissues of the bitch and will become activated during a subsequent pregnancy. Within the foetus the L3 larvae reach the liver and at birth these are present in the lungs where they remain for the first week or so of post-natal life.

These larvae undergo tracheal migration to be coughed up and swallowed. By the end

of the second to fifth week, they become adult worms in the intestine, the first eggs appearing in the faeces of pups as young as three weeks of age.

As well as passing to the foetus during pregnancy, activated third stage larvae reach the bitch’s mammary glands. They are passed to the suckling pup via the milk and develop directly to adult worms in the puppies’ intestines. This passage of larvae in the milk may continue until the puppies are 3-4 weeks old. Whether acquired prenatally, during suckling or by ingesting eggs from the environment, adult worms are usually expelled by the time the pups are 12-16 weeks old.

In addition, embryonated eggs in the environment may be ingested by other animals such as mice or birds. If these paratenic hosts are eaten by a dog, the larvae will develop directly into adults in the small intestine.

It is important to remember that T. canis is a zoonotic parasite. If a human ingests embryonated eggs they can contract Human Toxocarosis. This can produce a variety of signs such as impaired vision or even blindness, following ocular larval migration.

Toxocara canis worms

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 3

Toxocara eggs pass out in dog faeces

19/04/2013 15:22

Focus On Toxocara

Public Enemy Number 2 Spreading happiness is what dogs do best – but they are also pretty good at circulating something that is a lot less appealing.

It is estimated there are around 10 million dogs in Britain, producing up to 1,000 tons of excrement every single day,3 much of which gets deposited on our pavements, parks and play areas. Dog faeces are not just an unpleasant experience for anyone unfortunate enough to tread in them, they are also a potentially hazardous material.

In a study in 2007,4 15 percent of the dogs tested positive for Toxocara canis via faecal

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 4

examination. Infected dogs actively shed the parasite’s eggs through their faeces.

A study between 2001-03 to estimate the extent of toxocaral soil contamination in public parks found that overall, the percentage of positive samples was 18 percent from open parkland, 17.8 percent from enclosed play areas, and 30 percent from non-enclosed play areas.5 If embryonated eggs are accidentally ingested by a human, they can develop into a larval stage which may cause a number of health problems, including damage to the eye. Between 50 and 100 cases are diagnosed each year6 in the UK in which people suffer partial loss of vision due to Toxocarosis.

Sadly, the majority of those cases are in children, who are more likely to come into contact with infective eggs while playing.

Toddlers that have a habit of eating soil have been shown to be particularly at risk.

Everybody has seen the signs in the street, warning that failure to pick up the mess

19/04/2013 15:22

Focus On Toxocara

left by your dog is a breach of the by-laws introduced by local authorities all over the country. Dog owners therefore have both a legal and moral duty to dispose of their pet’s waste products yet some people still choose to ignore them. When 1,000 pet owners were questioned last year,7 less than half (44 percent) of those surveyed said they regularly pick up their pet’s faeces when walking together. Even more remarkably, 59 percent of those asked admitted to leaving their pet’s faeces in the garden. As the eggs are there long after faeces have disappeared and can remain viable for up to three years, this lack of awareness may expose the owner’s children to a serious but readily preventable disease.

‘Bagging and binning’ is a simple and highly effective way to minimise the chances that a parasite lurking in a dog’s digestive system could pose a threat to anyone else, but it won’t entirely eliminate the risk. That is because the owner may not always be there to act when their pet passes faeces and even when they are, it isn’t always possible to clean up the mess, so it is essential that good hygiene is backed up with appropriate veterinary treatment.

Pet owners also need to understand that the risk of infection with Toxocara canis is not the same for every animal. Puppies and nursing bitches are particularly prone to carrying a heavy worm burden and so it is essential for their health and welfare that they receive regular appropriate anthelmintic treatments.

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 5

Using Advocate monthly not only treats against fleas and mites, and prevents lungworm in dogs, but also interrupts the Toxocara life cycle and helps to reduce the risk of Toxocara eggs being shed into the environment. If tapeworms are an issue, Advocate should be combined with products such as Drontal, Profender or Droncit at regular intervals. However, not all pet owners are the same, so for further information on how the Bayer parasite range can be effectively tailored to suit your individual customer’s needs, visit jungleforvets.co.uk.

Monthly worming helps to...

• Interrupt the parasite life cycle reducing the risk of eggs being shed into the environment.

• Rid pets of existing parasites and remove parasites before they reproduce – helping to reduce further environmental contamination.

• Keep pets worm-free and reduce the risk of parasitic zoonoses to pet owners and families.

19/04/2013 15:22

Focus On Toxocara

Break the Toxocara life cycle with Advocate® a zoonotic health risk

Toxocarosis is a serious human health risk

• One T. canis worm is able to produce up to 84,754 eggs a day8

• Toxocarosis can cause blindness in humans • In an Irish study, 9.7 definite and strongly suspected cases of Toxocarosis were found per 100,000 school children10

• Worming every three months may not be enough to prevent egg shedding • As the pre-patent period for Toxocara spp. is a little over four weeks, monthly treatment will minimise the risk of patent infections establishing9

25%

• Not only children are affected, Toxocarosis is a threat to adults too • Eggs can be found in the environment and on the pet’s coat

Evidence of Toxocara canis eggs in dogs’ coats:11

75%

Present

Not Present

Use Advocate to treat Toxocara

• Monthly spot-on worming, provides broad-spectrum coverage of intestinal nematodes • Effective at eliminating adult stages of T. canis and T. cati • Treats the L4 and immature adult stages, further disrupting the life cycles of these parasites

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 6

19/04/2013 15:22

Focus On Toxocara

Highly effective against intestinal nematode worms USE MONTHLY

100

A. tubaeforme

T. cati

T. vulpis

U. stenocephala

A. caninum

40

T. leonina

60

T. canis

% Efficacy

80

20

Roundworm

Fleas

Hookworm

Flea Larvae

Whipworm*

Ear Mites

Heartworm

Biting Lice*

0 Dogs

Cats

Efficacy Range

Im p o rt a n t t o re m e m b e r. ..

When using Advocate as a monthly flea and worm treatment, you are also preventing Angiostrongylus vasorum in dogs.

Prevention from the first dose.

(D. immitis)

Fox Lungworm* (C. vulpis)

Demodex*

Lungworm*

Sarcoptes*

(A. vasorum)

* Dogs only

Ticks and Tapeworm an issue? Advocate速 can be effectively combined with a range of Bayer products, visit jungleforvets.co.uk

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 7

19/04/2013 15:22

Focus On Toxocara

Toxocara and Tapeworm?

Give their dog a bone!

With its broad spectrum of activity against roundworms,12 hookworms, whipworms and tapeworms, Drontal is the only wormer that kills every type of intestinal worm commonly found in UK cats and dogs.

FOR DOGS

bone shaped tablets

• Effective against all intestinal worms commonly found in UK dogs (including Uncinaria stenocephala)

This exciting product innovation is the result of extensive research with dog owners and veterinary professionals.

• Can be used in pregnant and lactating bitches

• Looks like a treat

• Can be used in puppies from 2 weeks of age

• Perceived to be easier to administer

bo

ogs

Actual size

rd

• Suitable and appealing size

dy

• NFA-VPS

• Easy to split

17mm

han

• Contains praziquantel, pyrantel embonate and febantel

ailable in Av

n e s h a p e fo

FOR CATS • Effective against all intestinal worms commonly found in UK cats • Can be used in lactating queens • Can be used in kittens from 6 weeks of age

USE MONTHLY / QUARTERLY

• Contains praziquantel and pyrantel embonate • NFA-VPS

Use Drontal as part of your regular parasite protection plan • If using Advocate monthly – remember to use Drontal or Droncit at least quarterly for Tapeworm control.

Roundworm

Whipworm

Hookworm

Tapeworm

Other parasites an issue? Drontal® can be effectively combined with a range of Bayer products, visit jungleforvets.co.uk

• If using another flea product such as Seresto, Drontal provides comprehensive cover for intestinal worms and can even be used monthly to break the Toxocara life cycle.

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 8

19/04/2013 15:23

Focus On Toxocara

Simple and certain cat worming Profender is effective against every type of intestinal worm commonly found in UK cats. It is the broadest spot-on cat wormer available. It successfully treats:

Toxocara cati

Toxascaris leonina

Ancylostoma tubaeforme

Taenia taeniaeformis

Dipylidium caninum

Echinococcus multilocularis

The only cat wormer licensed to kill potentially harmful larval stages of cat nematodes.

Toxocara cati L3 larvae

Profender® Spot-on Milbemycin oxime & praziquantel

L4 larvae

Immature adult

Toxascaris leonina Adult

L4 larvae

Immature adult

Adult

Ancylostoma tubaeforme L4 larvae

Immature adult

Adult

✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✗ ✗ ✓ ✓ ✗ ✗ ✗ ✗ ✓ ✓

CAT OWNERS

66% 75%

of those already using spot-on wormers worm their cat at least quarterly, compared to 29% of cat owners using tablets.

would prefer to worm their cat with Profender® spot-on rather than their existing cat wormer.

USE monthly / quarterly

Roundworm

Hookworm

Insight Track report, May 2007

Tapeworm

Use Profender as part of your regular parasite protection plan • Profender spot on is a great choice for convenient and simple worming

Other parasites an issue? Profender® can be effectively combined with a range of Bayer products, visit jungleforvets.co.uk

• Should be used at least quarterly or can be used monthly depending on the individual cat’s lifestyle and associated risks

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 9

19/04/2013 15:23

Focus On Toxocara

CASE STUDY: Nadine Nash – Toxocarosis Romford, UK Queens Hospital and a series of operations, the parasite, which had lain dormant for over 20 years, caused problems again in 2001, when Nadine’s vision worsened after developing serious glaucoma. Nadine underwent immediate treatment at Whipps Cross Hospital, in an attempt to salvage her vision.

M

other of two, Nadine Nash, 35, lost her eye 30 years after contracting the Toxocarosis parasite as a primary school pupil, but that hasn’t changed her love of dogs, just her understanding of the responsibility of being a dog owner.

“I can’t tell you exactly how I caught the Toxocarosis parasite, but we think it was whilst I was out in a park,” says Nadine.

“I experienced no real problems for 20 years, but started getting really bad glaucoma about 10 years ago. I had to have a string of operations on my eye but they made no improvement and my sight continued to deteriorate.”

The problem was first discovered during an eye exam at her school, after Nadine’s teachers noticed deterioration in her vision.

She was treated with steroids immediately at Oldchurch Hospital in Romford for a period of two weeks. However, despite ongoing visits to the specialist eye unit at

“At one point, unable to focus properly with my remaining eye and in considerable pain, I couldn’t even get out of bed. The decision to remove my eye actually came as a relief and four months later I received my prosthetic eye.

I am lucky to have perfect vision in my remaining eye, allowing me to still see the beautiful smiling faces of my children. I appreciate the beauty in everyday life more than ever now, after coming so close to losing my sight entirely.”

Nadine is helping alert dog and cat owners to the dangers of parasites, and the importance of cleaning up after their pets and regular worming – the Toxocara parasite can live in the soil for months, long after the dog mess has been washed away. She is also running the 2013 London Marathon to support the Guide Dogs for the Blind charity.

“I had never heard of this condition before but, although it is rare, I am proof that it can happen to anyone. Responsible owners should take the time to learn the various parasites that can be carried by their pets, most of which are completely preventable. Children are particularly at risk because they will often touch an object out of curiosity and do not always wash their hands afterwards.

I am proof of how debilitating this condition can be. Despite this I still own a dog, which is thoroughly wormed and treated – I would urge all pet owners to do the same.”

Every case is individual. Below Carlos explains how Toxocarosis may typically affect people.

Toxocara canis is usually acquired by accidental ingestion of eggs shed in dogs’ faeces. Eggs may remain dormant in the soil for extended periods of time and once ingested will release small larvae, which will gain access to the blood stream and will reach the eye by chance.

Once in the eye it will induce an inflammatory response, clinically called uveitis. This can affect the central part of the retina, resulting in immediate reduction in vision, or the periphery, which is less noticeable initially, but may also lead to signifciant reduction in vision over time. It happens more in children simply because they are more exposed, playing on the ground and putting things in their mouth all the time. In children, it may not be diagnosed initially because they are unlikely to complain about visual loss when only one eye is affected, this is often what happens in Toxacarosis.

Immediate treatment of the inflammation with local (drops, injections) or sytemic therapy (tablets) is essential to reduce damage and preserve vision.

Surgery may be required in a few cases to correct problems induced by the inflammation.

Carlos Pavesio Consultant Ophthalmologist at Moorfields Eye Hospital, London

If you know of any other Toxocarosis cases, please let us know on 01635 563699 or email us at animal.health@bayer.com

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 10

19/04/2013 15:23

Focus On Toxocara

Comprehensive control of companion animal parasites PARASITE

3

3 3 3 3

Tapeworm Hookworm Whipworm (D. immitis)

Fleas Flea Larvae Dogs

F.A.D. Lungworm

(A. vasorum and C. vulpis)

Biting Lice

3 3 3

3 3 3

3

3 3

Ticks

3 3 3

Otodectes Sarcoptes Demodex

Sand Flies Stable Flies Roundworm

3

Tapeworm Hookworm Heartworm (D. immitis) Cats

3 3 3

3 3 3

Mosquitoes

Fleas Flea Larvae F.A.D. Otodectes

3 3 3 3 3 3

3 3 3

NOT FOR USE IN CATS

Heartworm

3 3 3 3 3 3 3 3

3

NOT FOR USE IN DOGS

Roundworm

3 3 3

3 3 3

3 3 3 3

Ferrets

Rabbits

Ticks NOT FOR USE IN RABBITS

Fleas

Fleas Heartworm

(D. immitis)

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 11

3 3

3

NOT FOR USE IN RABBITS

NOT FOR USE IN FERRETS

19/04/2013 15:23

Focus On Toxocara

Our optimal plan for dogs Protection plan covering parasites found in the UK and Ireland.

For dog owners who ‘want it all’.

Fleas Whipworm

Ear Mites

Heartworm✖

Lungworm

(D. immitis)

(A. vasorum)

MONTHLY Biting Lice

Hookworm

+ OR

QUARTERLY

+ Demodex

Roundworm

ANNUALLY

Sarcoptes

Tapeworm

Fox Lungworm

Ticks✪

(C. vulpis)

Flea Larvae

This partnership uses Advocate monthly to treat fleas, GI nematodes (roundworm, whipworm and hookworm, including Uncinaria stenocephala) and to prevent lungworm (Angiostrongylus vasorum); Drontal or Droncit quarterly to treat tapeworm and Seresto annually for 8 months’ tick control during the tick season.

6

Prevention only. Not endemic in the UK or Ireland. J Ixodes ricinus, Rhipicephalus sanguineus, Dermacentor reticulatus.

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 12

19/04/2013 15:23

Focus On Toxocara

Our optimal plan for cats Protection plan covering parasites found in the UK and Ireland.

For cat owners who ‘want it all’.

Fleas

Ear Mites

Hookworm

MONTHLY

+ OR

Heartworm✖

Ticks❈

(D. immitis)

MONTHLY / QUARTERLY

+ ANNUALLY

Flea Larvae

Tapeworm

Roundworm

This partnership uses Advocate monthly to treat fleas and roundworm, Profender or Drontal monthly or quarterly to treat tapeworm and Seresto annually for 8 months’ tick control during the tick season.

6

Prevention only. Not endemic in the UK or Ireland. ❈ Ixodes ricinus, Rhipicephalus turanicus.

When using two different spot-on products they should not be applied at the same time, it is generally advised to allow a minimum interval of 48 hours.

When using Profender please note: Co-treatment with emodepside and macrocyclic lactones could give rise to pharmacokinetic drug interactions; the potential clinical consequences of such interactions have not been investigated. See full datasheet for further information.

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 13

19/04/2013 15:23

Advocate Spot-on Solution Incorporating the data sheets for the following products: Advocate 40 mg + 4 mg spot-on solution for small cats and ferrets, Advocate 80 mg + 8 mg spot-on solution for large cats, Advocate 40 mg + 10 mg spot-on solution for small dogs, Advocate 100 mg + 25 mg spot-on solution for medium dogs, Advocate 250 mg + 62.5 mg spot-on solution for large dogs, Advocate 400 mg + 100 mg spot-on solution for extra-large dogs.

Presentation: Advocate spot-on solution for cats and ferrets is a clear yellow to brownish solution containing 100 mg/ml imidacloprid and 10 mg/ml moxidectin with benzyl alcohol and Butylhydroxytoluene 1 mg/ml (E 321 as an antioxidant). Each pipette of the small cat and ferret contains 0.4 ml (40 mg imidacloprid, 4 mg moxidectin), the large cat contains 0.8 ml (80 mg imidacloprid, 8 mg moxidectin). Advocate spot-on solution for dogs is a clear yellow to brownish solution containing 100 mg/ml imidacloprid and 25 mg/ml moxidectin with benzyl alcohol and Butylhydroxytoluene 1 mg/ml (E321 as an antioxidant). Each pipette of the dog contains either 0.4 ml (40 mg imidacloprid, 10 mg moxidectin), 1.0 ml (100 mg imidacloprid, 25 mg moxidectin), 2.5 ml (250 mg imidacloprid, 62.5 mg moxidectin) or 4.0 ml (400 mg imidacloprid, 100 mg moxidectin).

Uses: For use in cats, ferrets and dogs suffering from, or at risk from, mixed parasitic infections: For cats: For the treatment and prevention of flea infestation (Ctenocephalides felis), treatment of ear mite infestation (Otodectes cynotis), prevention of heartworm disease (L3 and L4 larvae of Dirofilaria immitis) and treatment of infections with gastrointestinal nematodes (L4 larvae, immature adults and adults of Toxocara cati and Ancylostoma tubaeforme). The product can be used as part of a treatment strategy for flea allergy dermatitis (FAD).

For ferrets: For the treatment and prevention of flea infestation (Ctenocephalides felis) and the prevention of heartworm disease (L3 and L4 larvae of Dirofilaria immitis).

For dogs: For the treatment and prevention of flea infestation (Ctenocephalides felis), treatment of biting lice (Trichodectes canis), treatment of ear mite infestation (Otodectes cynotis), sarcoptic mange (caused by Sarcoptes scabiei var. canis), demodicosis (caused by Demodex canis), prevention of heartworm disease (L3 and L4 larvae of Dirofilaria immitis) and angiostrongylosis (L4 larvae and immature adults of Angiostrongylus vasorum), treatment of Angiostrongylus vasorum and Crenosoma vulpis and treatment of infections with gastrointestinal nematodes (L4 larvae, immature adults and adults of Toxocara canis, Ancylostoma caninum and Uncinaria stenocephala, adults of Toxascaris leonina and Trichuris vulpis). The product can be used as part of a treatment strategy for flea allergy dermatitis (FAD).

Dosage and administration: The recommended minimum doses for cats are 10 mg/kg body weight imidacloprid and 1.0 mg/kg body weight moxidectin, equivalent to 0.1 ml/kg body weight Advocate for cats. Dosage schedule for ferrets: one pipette of Advocate spot-on solution for Small Cats and Ferrets (0.4 ml) should be administered per animal. Do not exceed the recommended dose. The recommended minimum doses for dogs are 10 mg/kg body weight imidacloprid and 2.5 mg/kg body weight moxidectin, equivalent to 0.1 ml/kg body weight Advocate for dogs. The treatment schedule for all species should be based on the local epidemiological situation. Flea treatment and prevention (Cats and Dogs) One treatment prevents future flea infestation for 4 weeks. Existing pupae in the environment may emerge for 6 weeks or longer after treatment is initiated, depending upon climatic conditions.

Therefore, it may be necessary to combine Advocate treatment with environmental treatments aimed at breaking the flea life cycle in the surroundings. This can result in a more rapid reduction in the household flea population.

The product should be administered at monthly intervals when used as part of a treatment strategy for flea allergy dermatitis. Flea treatment and prevention (Ferrets) One treatment prevents future flea infestation for 3 weeks. Under heavy flea pressure it may be necessary to repeat the dose after 2 weeks. Treatment of ear mite infestation (Otodectes cynotis) (Cats & Dogs) A single dose of the product should be administered. In dogs, loose debris should be gently removed from the external ear canal at each treatment. For both cats and dogs, a further veterinary examination 30 days after treatment is recommended as some animals may require a second treatment. Do not apply directly to the ear canal. Treatment of biting lice (Trichodectes canis) (Dogs) A single dose should be administered. A further veterinary examination 30 days after treatment is recommended as some animals may require a second treatment.

Treatment of sarcoptic mange (caused by Sarcoptes scabiei var. canis) (Dogs) A single dose should be administered twice 4 weeks apart. Treatment of demodicosis (caused by Demodex canis) (Dogs) The administration of a single dose every 4 weeks for 2 to 4 months is efficacious against Demodex canis and leads to a marked improvement of clinical signs particularly in mild to moderate cases. Especially severe cases may require more prolonged and more frequent treatment. To achieve the best possible response in these severe cases, at the discretion of the veterinarian, Advocate can be applied once a week and for a prolonged time. In all cases it is essential that the treatment should be continued until skin scrapings are negative on at least 2 consecutive monthly occasions. Treatment should be stopped in dogs that show no improvement or do not respond in mite count after 2 months treatment. Alternative treatment should be administered. Seek the advice of your veterinarian. As demodicosis is a multifactorial disease, where possible, it is advisable to also treat any underlying disease appropriately. Heartworm prevention (Cats, Ferrets & Dogs) Cats, ferrets and dogs in areas endemic for heartworm, or those which have travelled to endemic areas, may be infected with adult heartworms. Therefore prior to treatment with Advocate, the advice provided in Contra-indications and Warnings etc should be considered. For prevention of heartworm disease, the product must be applied at regular monthly intervals during the time of the year when mosquitoes (the intermediate hosts which carry and transmit heartworm larvae) are present. The product may be administered throughout the year or at least 1 month before the first expected exposure to mosquitoes. Treatment should continue at regular monthly intervals until 1 month after the last exposure to mosquitoes. To establish a treatment routine, it is recommended that the same day or date be used each month. When replacing another heartworm preventative product in a heartworm prevention programme, the first treatment with Advocate must be given within 1 month of the last dose of the former medication. In nonendemic areas there should be no risk of animals having heartworm. Therefore they can be treated without special precautions. Roundworm and hookworm treatment (Cats) In areas endemic for heartworm, monthly treatment may significantly reduce the risk of reinfection caused by the respective roundworms and hookworms.

In areas nonendemic or heartworm, the product can be used as part of a seasonal prevention programme against fleas and gastrointestinal nematodes. Roundworm, hookworm and whipworm treatment (Dogs) In areas endemic for heartworm, monthly treatment may significantly reduce the risk of reinfection caused by the respective round, hook and whipworms. In areas nonendemic for heartworm, the product can be used as part of a seasonal prevention programme against fleas and gastrointestinal nematodes. Studies have shown that monthly treatment of dogs will prevent infections caused by Uncinaria stenocephala. Treatment and Prevention of Angiostrongylus vasorum (Dogs) A single dose should be administered. A further veterinary examination 30 days after treatment is recommended as some animals may require a second treatment. In endemic areas regular four weekly application will prevent angiostrongylosis and patent infection with Angiostrongylus vasorum. Treatment of Crenosoma vulpis (Dogs) A single dose should be administered.

Method of Administration: For external use only. Remove one pipette from the package. Then hold the pipette in an upright position, and twist and pull off the cap. Reverse the cap and use it to twist and remove the seal from the pipette. Cats and Ferrets Part the fur on the animal’s neck at the base of the skull until the skin is visible. Place the tip of the pipette on the skin and squeeze the pipette firmly several times to empty its contents directly onto the skin. Application at the base of the skull will minimise the opportunity for the animal to lick the product. Apply only to undamaged skin. For dogs up to 25 kg With the dog in a standing position, part the coat between the shoulder

blades until the skin is visible. Wherever possible apply to undamaged skin. Place the tip of the pipette on the skin and squeeze the pipette firmly several times to empty its contents directly onto the skin. For dogs of more than 25 kg For easy application the dog should be standing. The entire contents of the pipette should be applied evenly as 3 or 4 spots along the top of the back, from between the shoulders to the base of the tail. At each spot, part the coat until the skin is visible. Wherever possible apply to undamaged skin. Place the tip of the pipette on the skin and gently squeeze the pipette to expel a portion of its contents directly onto the skin. Do not apply an excessive amount of solution at any one spot, as that could cause some of the product to run down the animal’s side.

Use During Pregnancy and Lactation: The safety of the veterinary medicinal product has not been established during pregnancy and lactation. Laboratory studies with either imidacloprid or moxidectin in rats and rabbits have not produced any evidence of teratogenic, foetotoxic or maternotoxic effects. Use only according to the risk-benefit assessment by the responsible veterinarian.

Contra-indications, warnings, etc: Do not use in kittens under 9 weeks of age. Do not use in puppies under 7 weeks of age. Treatment of cats or dogs weighing less than 1 kg, and ferrets weighing less than 0.8 kg should be based on a risk-benefit assessment. Do not use in the case of hypersensitity to the active substances or to any of the excipients. There is limited experience on the use of the product in sick and debilitated animals, thus the product should only be used based on a risk-benefit assessment for these animals. For cats, the corresponding “Advocate spot-on Solution for Cat” product, which contains 100 mg/ml imidacloprid and 10 mg/ml moxidectin, must be used.

For ferrets: Do not use Advocate for Large Cats (0.8 ml) or Advocate for Dogs (any size), only “Advocate for Small Cats and Ferrets” (0.4 ml) must be used. The product’s efficacy has not been tested in ferrets weighing over 2 kg and therefore the duration of effect might be shorter in these animals. For dogs, the corresponding “Advocate for Dog” product, which contains 100 mg/ml imidacloprid and 25 mg/ml moxidectin, must be used. The product tastes bitter. Salivation may occasionally occur if the animal licks the application site immediately after treatment. This is not a sign of intoxication and disappears within some minutes without treatment. Correct application will minimize licking of the application site. In case of accidental oral uptake, symptomatic treatment should be administered. There is no known specific antidote. The use of activated charcoal may be beneficial. After accidental oral ingestion (i.e. licking at the site of application), or overdose, neurological signs (most of which are transient) such as ataxia, generalised tremors, ocular signs (dilated pupils, little pupillary reflex, nystagmus), abnormal respiration, salivation and vomiting may be observed in very rare cases. The use of the product may result in transient pruritus in the animal. On rare occasions greasy fur, erythema and vomiting can occur. These signs disappear without further treatment. The product may, in rare cases cause local hypersensitivity reactions. The product may in very rare cases cause at the application site a sensation resulting in transient behavioural changes such as lethargy, agitation, and inappetence.

Care should be taken that the content of the pipette or the applied dose does not come into contact with the eyes or mouth of the recipient and/or other animals. Do not allow recently treated animals to groom each other. When the product is applied in 3 to 4 separate spots in larger dogs, specific care should be taken to prevent the animal licking the application sites. Oral uptake by Collies, Old English Sheepdogs and related breeds or crossbreeds should be prevented. During treatment with Advocate no other antiparasitic macrocyclic lactone should be administered. This product contains moxidectin (a macrocyclic lactone), therefore special care should be taken with Collies, Old English Sheepdogs and related breeds or crossbreeds, to correctly administer the product as described above. In particular, oral uptake by the recipient and/or other animals in close contact should be prevented. Ivermectinsensitive Collie dogs tolerated up to 5 times the recommended dose repeated at monthly intervals without any adverse effects, but the safety of application at weekly intervals has not been investigated in ivermectinsensitive Collie dogs. When 40% of the unit dose was given orally, severe neurological signs were observed. Oral administration of 10% of the recommended dose produced no adverse effects. Up to 10 times the recommended dose was tolerated in adult dogs with no evidence of adverse effects or undesirable clinical signs. Five times the recommended minimum dose applied at weekly intervals for 17 weeks was investigated in dogs aged over 6 months and tolerated with no evidence of adverse effects or undesirable clinical signs. Up to 10 times the recommended dose was tolerated in cats with no evidence of adverse effects or undesirable clinical signs. The product was administered to kittens and puppies at up to 5 times the recommended dose, every 2 weeks for 6 treatments, and there were no serious safety concerns.

Transient mydriasis, salivation, vomiting and transient rapid respiration were observed. The product was administered to ferrets at 5 times the recommended dose, every 2 weeks for 4 treatments, and there was no evidence of adverse effects or undesirable clinical signs. It is recommended that cats and ferrets living in, or travelling to areas endemic for heartworm are treated monthly with the product to protect them from heartworm disease. Whilst the accuracy of diagnosis of heartworm infection is limited, it is recommended that attempts be made to check the heartworm status of any cat and ferret aged over 6 months, before beginning prophylactic treatment, as use of the product on cats or ferrets which have adult heartworms may cause serious adverse effects, including death. If adult heartworm infection is diagnosed, the infection should be treated in accordance with current scientific knowledge. Although the product may be safely administered to dogs infected with adult heartworms, it has no therapeutic effect against adult Dirofilaria immitis. It is therefore recommended that all dogs 6 months of age or more, living in areas endemic for heartworm, should be tested for existing adult heartworm infection before being treated with the product. Dogs infected with adult heartworms tolerated up to 5 times the recommended dose, every 2 weeks for 3 treatments, without any adverse effects. No interactions between Advocate and routinely used veterinary medicinal products or medical or surgical procedures have been observed. Brief contact of the animal with water on one or two occasions between monthly treatments is unlikely to significantly reduce the efficacy of the product. However, frequent shampooing or immersion of the animal in water after treatment may reduce the efficacy of the product. Parasite resistance to any particular class of anthelmintic may develop following frequent, repeated use of an anthelmintic of that class. The solvent in Advocate may stain or damage certain materials including leather, fabrics, plastics and finished surfaces.

Allow the application site to dry before permitting contact with such materials.

User Safety: Avoid contact with skin, eyes or mouth. Do not eat, drink or smoke during application. Wash hands thoroughly after use. In case of accidental spillage onto skin, wash off immediately with soap and water. After application do not stroke or groom animals until the application site is dry. People with a known hypersensitivity to benzyl alcohol, imidacloprid or moxidectin should administer the product with caution. In very rare cases the product may cause skin sensitisation or transient skin reactions (for example numbness, irritation or burning/tingling sensation).

In very rare cases the product may cause respiratory irritation in sensitive individuals.. If the product accidentally gets into eyes, they should be thoroughly flushed with water. If skin or eye symptoms persist, or the product is accidentally swallowed, seek medical attention and show the package insert to the physician.

Environmental Safety: Advocate should not be allowed to enter surface waters as it has harmful effects on aquatic organisms: moxidectin is highly toxic to aquatic organisms. Dogs should not be allowed to swim in surface waters for 4 days after treatment. Any unused product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.

Pharmaceutical precautions: Do not store above 30°C. Shelf-life of the veterinary medicinal product as packaged for sale: 3 years Legal category: POM-V

Drontal Cat/ XL Film-coated Tablets Presentation: Drontal Cat Film-coated Tablets are white to yellowish, scored, coated tablets that can be divided into equal halves. Each tablet contains 230 mg pyrantel embonate and 20 mg praziquantel with 1.8 mg Titanium Dioxide (E171). Drontal Cat XL Film-coated Tablets are unscored coated white to yellowish, ellipsoid, biconvex tablets, each containing 345 mg pyrantel embonate and 30 mg praziquantel with 2.6 mg Titanium Dioxide (E171).

Uses: For the treatment of gastrointestinal roundworms and tapeworms of cats: Toxocara cati, Toxascaris leonina, Dipylidium caninum, Taenia taeniaeformis (see ‘Further information’).

Dosage and administration: Dosage The recommended dose rates are 57.5 mg/kg pyrantel embonate and 5 mg/ kg praziquantel. This is equivalent to one Drontal Cat Film-coated Tablet per 4 kg body weight and 1 Drontal Cat XL Film-coated Tablet per 6 kg body weight. Administration and Duration of Treatment For single oral administration.

The tablets should be given directly to the animal, but if necessary can be disguised in food.

Use During Pregnancy and Lactation: Not to be used during pregnancy but may be used during lactation.

Contra-indications, warnings, etc: Not intended for use in kittens less than 6 weeks of age. Do not use simultaneously with piperazine compounds.Until sufficient studies have been performed with this combination, do not use during pregnancy.

User Safety: In the interests of good hygiene, persons administering the tablets directly to a cat, or by adding them to the cat’s food, should wash their hands afterwards. For animal treatment only. Keep out of the reach of children.

Environmental Safety: Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.

Pharmaceutical precautions: Do not store above 25°C. Do not remove tablets from strip packing until required for use. Any part used tablets should be discarded. Drontal Cat Film-coated Tablets: Shelf-life of the veterinary medicinal product as packaged for sale: 5 years. Drontal Cat XL Film-coated Tablets: Shelf-life of the veterinary medicinal product as packaged for sale: 4 years.

Legal category: NFA-VPS

effects of both pyrantel (spastic paralysis) and piperazine (neuromuscular paralysis) may be antagonised when the two drugs are used together. Doses of up to 5 times the therapeutic level of the product have been administered to puppies and young dogs without clinical signs of intolerance arising. At 10 times the recommended dose the first sign of intolerance – vomiting – was evident.

User Safety: Wash hands after use. Avoid direct contact with the skin and eyes. In case of accidental spillage wash the affected area immediately with clean running water.

Environmental safety: Any unused product or waste materials should be disposed of in accordance with national requirements.

Pharmaceutical precautions: This unopened veterinary medicinal product does not require any special storage conditions. After opening, store the product at a temperature not exceeding 25 ºC. Do not use after expiry date.

Shelf-life of the veterinary medicinal product as packaged for sale: 5 years. Shelf-life after first opening the immediate packaging: 12 weeks.

Legal category: NFA-VPS

Drontal Oral Suspension for Puppies Presentation: A pale red suspension for oral administration. Each ml of suspension contains 5.0 mg Pyrantel (as pyrantel embonate 14.4 mg) and 15 mg febantel. The product also contains 2.05 mg sodium benzoate (E211), 2.05 mg sodium propionate (E281) and 0.25 mg Ponceau 4R (E124).

Uses: For the treatment of roundworm infections in puppies and young dogs up to one year of age caused by: Ascarids Toxocara canis, Toxascaris leonina Hookworm Ancylostoma caninum, Uncinaria stenocephala Whipworm Trichuris vulpis Dosage and administration: The dose is 1 ml suspension/kg body weight (equivalent to 14.4 mg/kg pyrantel embonate and 15 mg/kg febantel). Administration is by the oral route. The product may be given directly to the animal or mixed with the feed. No special dietary measures are necessary. Mix the product by inversion of the container before withdrawing the required dose. Through intrauterine and transmammary infection, ascarid infestation may occur in dogs at a very early age. For some animals, especially in case of severe infections, elimination of ascarids may be incomplete, and a potential risk of infections to humans can not be excluded. Where epidemiologically appropriate, it is recommended that treatment should be started at 2 weeks of age and should be performed repeatedly at suitable intervals (for example every two weeks) until weaning. Otherwise treatment should be based upon confirmed infection, for example the results of faecal examinations.

Use During Pregnancy and Lactation: This product is contraindicated for pregnant and lactating bitches.

Contra-indications, warnings, etc: Do not use simultaneously with compounds containing piperazine. Parasite resistance to any particular class of anthelmintic may develop following frequent repeated use of an anthelmintic of that class. The safety of the product has not been assessed in puppies younger than 2 weeks and weighing less than 0.6 kg. In very rare cases mild transient digestive tract signs (e.g., vomiting, diarrhoea) may occur. The anthelmintic

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 14

Drontal Plus Flavour Bone Shaped Tablets Presentation: Drontal Plus Flavour Bone Shaped Tablets are pale brown to brown flavoured bone shaped tablets scored on both sides for oral administration to dogs, containing 50 mg praziquantel, 144 mg pyrantel embonate and 150 mg febantel as active constituents and 116.5 mg Artificial beef flavour irradiated.

Uses: For the control of the following roundworms and tapeworms in dogs and puppies: Ascarids Toxocara canis, Toxascaris leonina (adult and late immature forms).

Hookworms Uncinaria stenocephala, Ancylostoma caninum (adults).

Whipworms Trichuris vulpis (adults).

Tapeworms Echinococcus species, Taenia species, Dipylidium caninum (adults and immature forms).

Dosage and administration: For oral administration only. Dosage The recommended dose rates are: 15 mg/kg body weight febantel, 14.4 mg/kg pyrantel and 5 mg/kg praziquantel. This is equivalent to 1 tablet per 10 kg body weight. Administration and Duration of Treatment Oral administration, the tablet(s) can be given directly to the dog or disguised in food. Access to normal diet does not need to be limited before or after treatment. Puppies should be treated at 2 weeks of age and every 2 weeks until 12 weeks of age. Thereafter they should be treated at 3 month intervals. It is advisable to treat the bitch at the same time as the puppies. Not for use in dogs weighing less than 3 kg. For the control of Toxocara, nursing bitches should be dosed 2 weeks after giving birth and every 2 weeks until weaning. For routine control adult dogs should be treated every 3 months. In the event of a heavy roundworm infection, a repeat dose should be given after 14 days.

Use During Pregnancy and Lactation: Consult a veterinary surgeon before treating pregnant animals for roundworms. The product may be used during lactation. Do not exceed the stated dosage when treating pregnant bitches.

Contra-indications, warnings, etc: Do not use simultaneously with piperazine compounds Any part used tablets should be discarded. Benzimidazoles possess a wide safety margin. Pyrantel is not absorbed systemically to any extent. Praziquantel has a wide safety margin of up to five times the normal dose User Safety: In the interests of good hygiene, persons administering the tablets directly to the dog, or by adding them to the dog’s food, should wash their hands afterwards.

Environmental safety: Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal product should be disposed of in accordance with local requirements.

Pharmaceutical precautions: Do not store above 25ºC. Shelf-life of the veterinary medicinal product as packaged for sale: 5 years Legal category: NFA-VPS

19/04/2013 15:23

Drontal Plus Flavour Tablets / Drontal Plus XL Flavour Tablets Presentation: Drontal Plus Flavour Tablets are a light brown to brown, round tablet, cross scored on one side for oral administration to dogs, containing 50 mg praziquantel, 144 mg pyrantel embonate and 150 mg febantel as active constituents and 116.5 mg Artificial beef flavour irradiated. Drontal Plus XL Flavour Tablet is a pale brown to brown oval-shaped divisible tablet scored on both sides containing 175 mg praziquantel, 504 mg pyrantel embonate and 525 mg febantel as active constituents and 408.0 mg Artificial beef flavour irradiated.

Uses: For the control of the following gastrointestinal roundworms and tapeworms of dogs and puppies.

Ascarids Toxocara canis, Toxascaris leonina (adult and late immature forms).

Hookworms Uncinaria stenocephala, Ancylostoma caninum (adults).

Whipworms Trichuris vulpis (adults).

Tapeworms Echinococcus species, Taenia species, Dipylidium caninum (adults and immature forms).

Dosage and administration: For oral administration only. The recommended dose rates are: 15 mg/kg body weight febantel, 14.4 mg/kg pyrantel and 5 mg/kg praziquantel. 1 Drontal Plus Flavour Tablet per 10 kg (22 lbs) body weight. 1 Drontal Plus XL Flavour Tablet per 35 kg body weight. Drontal Plus Flavour Tablets should be used to achieve accurate dosing in dogs weighing less than 17.5 kg. The dose is equivalent to 1 tablet per 10 kg. The tablets can be given directly to the dog or disguised in food. No starvation is needed before or after treatment. For routine treatment a single dose is recommended. Puppies should be treated at 2 weeks of age and every 2 weeks until 12 weeks of age. Thereafter they should be treated at 3 month intervals. It is advisable to treat the bitch at the

same time as the puppies. Not for use in dogs weighing less than 3 kg. For the control of Toxocara, nursing bitches should be dosed 2 weeks after giving birth and every two weeks until weaning. For routine control adult dogs should be treated every 3 months. For routine treatment a single dose is recommended. In the event of heavy roundworm infection a repeat dose should be given after 14 days.

Use During Pregnancy and Lactation: Consult a veterinary surgeon before treating pregnant animals for roundworms. The product may be used during lactation. Do not exceed recommended dose when treating pregnant bitches.

Contra-indications, warnings, etc: Do not use simultaneously with piperazine compounds. The product is well tolerated in dogs. In safety studies doses of 5 x or greater gave rise to occasional vomiting.

User Safety: In the interests of good hygiene, persons administering the tablets directly to the dog, or by adding them to the dog’s food, should wash their hands afterwards.

Environmental safety: Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal product should be disposed of in accordance with local requirements.

Pharmaceutical precautions: Do not store above 25°C. Any part used tablets should be discarded. Drontal Plus Flavour Tablets: Shelf-life of the veterinary medicinal product as packaged for sale: 5 years. Drontal Plus XL Flavour Tablets: Shelf-life of the veterinary medicinal product as packaged for sale: 3 years.

Legal category: NFA-VPS

Profender Spot-on Solution for small cats / Profender Spot-on Solution for medium cats / Profender Spot-on Solution for large cats Presentation: Profender spot-on solution for cats is a clear yellow to brown solution containing 21.4 mg/ml emodepside and 85.8 mg/ml praziquantel, with 5.4 mg/ml butylhydroxyanisole (E320) as antioxidant. The product is presented in a single use plastic tube for dermal ( spot-on) application. Profender spot-on solution for small cats is a 0.35 ml tube containing 7.5 mg emodepside and 30 mg praziquantel. Profender spot-on solution for medium cats is a 0.70 ml tube containing 15 mg emodepside and 60 mg praziquantel. Profender spot-on solution for large cats is a 1.12 ml tube containing 24 mg emodepside and 96 mg praziquantel.

Uses: For cats suffering from, or at risk from, mixed parasitic infections caused by roundworms and tapeworms of the following species: Roundworms (Nematodes); Toxocara cati (mature adult, immature adult, L4 and L3) Toxascaris leonina (mature adult, immature adult and L4) Ancylostoma tubaeforme (mature adult, immature adult and L4): Tapeworms (Cestodes); Dipylidium caninum (adult) Taenia taeniaeformis (adult) Echinococcus multilocularis (adult).

Dosage and administration: Dosage and Treatment Schedule See Table 1. The recommended minimum doses are 3 mg emodepside/kg body weight and 12 mg praziquantel/kg body weight, equivalent to 0.14 ml Profender/kg body weight. A single administration per treatment is effective. Method of Administration For external use only. Remove one pipette from package. Hold pipette in upright position, twist and pull off cap and use the opposite end of the cap to break the seal. Part the fur on the cat’s neck at the base of the skull until the skin is visible. Place the tip of the pipette on the skin and squeeze firmly several times to empty the contents directly onto the skin. Application on the base of the skull will minimise the ability of the cat to lick the product off.

Use During Pregnancy and Lactation: Profender can be used during pregnancy and lactation.

Contra-indications, warnings, etc: Do not use in kittens under 8 weeks of age or weighing less than 0.5 kg. Apply only to the skin surface and on intact skin. Do not administer orally or parenterally. Avoid the treated cat or other cats in the household licking the site of application while it is wet. Salivation, vomiting and neurological signs (tremor) were observed occasionally when the product was administered at up to 10 times the recommended dose in adult cats and up to 5 times the recommended dose in kittens. These symptoms were thought to occur as a result of the cat licking the application site. The symptoms were completely reversible. There is no known specific antidote. In very rare cases following administration of Profender transient alopecia, pruritus and/or inflammation were observed at the application site. Emodepside is a substrate for Pglycoprotein.

Cotreatment with other drugs that are Pglycoprotein substrates/inhibitors (for example, ivermectin and other antiparasitic macrocyclic lactones, erythromycin, prednisolone and cyclosporine) could give rise to pharmacokinetic drug interactions. The potential clinical consequences of such interactions have not been investigated. Shampooing or immersion of the animal in water directly after treatment may reduce the efficacy of the product. Treated animals therefore should not be bathed until the solution has dried. There is limited experience on the use of the product in sick and debilitated animals, thus the product should only be used based on a benefit-risk assessment for these animals. Parasite resistance to any particular class of anthelmintic may develop following frequent, repeated use of an anthelmintic of that class. The solvent in this product may stain certain materials including leather, fabrics, plastics and finished surfaces. Allow the application site to dry before permitting contact with such materials.

User Safety: Read the package insert before use. Do not smoke, eat or drink during application. Avoid direct contact with application area while it is wet. Keep children away from treated animals during that time. Wash hands after use. In case of accidental spillage onto skin, wash off immediately with soap and water. If the product accidentally gets into eyes, they should be thoroughly flushed with plenty of water. If skin or eye symptoms persist, or in case of accidental ingestion, seek medical advice and show the package insert or the label to the physician. Care should be taken not to allow children to have prolonged intensive contact (for example, by sleeping) with treated cats during the first 24 hours after application of the product. Frequent users of the product (for example, veterinarians, professional cat breeders) should wear disposable gloves when administering the product. Although the product was well tolerated by pregnant cats, studies performed in rats and rabbits suggest that emodepside may interfere with embryofoetal development. Therefore, women of childbearing potential should avoid contact with, or wear disposable gloves when administering, the product.

Environmental Safety: Profender should not be allowed to enter surface water as emodepside has shown harmful effects on aquatic organisms. Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.

Pharmaceutical precautions: Store in the original package in order to protect from moisture. Shelf-life of the veterinary medicinal product as packaged for sale: 3 years.

Legal category: POM-V

Droncit Spot-On 20 Mg Solution Presentation: A clear, colourless to slightly reddish solution for spot-on use containing 20 mg praziquantel per 0.5 ml tube with butylated hydroxytoluene.

Uses: For the treatment of tapeworms of cats. The product is effective against mature and immature forms of Dipylidium caninum and Taenia species. The product is also effective against Echinococcus multilocularis.

Dosage and administration: The minimum dose rate is 8 mg/kg bodyweight, which equates to 1 tube per 2.5 kg bodyweight.Method of Administration Remove one tube from the package. Hold the tube in an upright position, twist and pull off cap. Use reversed cap to twist and remove seal from tube. Part the hair on the cat’s neck at the base of the skull until the skin is visible. Place the tip of the tube on the skin and squeeze firmly several times to empty the contents directly onto the skin. Application at the base of the skull will minimise the opportunity for the cat to lick the product. To minimise the possibility of runoff after application of more than one pipette, it is advised that the applications should be performed slowly to allow absorption and that it may be advisable to allow the contents of the previous pipette to be absorbed before applying another. Tapeworm infection is certain to reoccur unless control of the intermediate hosts such as fleas, mice, etc, is undertaken. Flea control Flea infestations can be controlled by the regular use of effective flea control remedies. Mice control If cats roam and hunt, contact with, and consumption of, mice and subsequent reinfestationwith Taenia taeniaeformis is impossible to prevent. It is recommended to reapply Droncit spot-on when signs of tapeworm infection reappear or at monthly intervals.

Use During Pregnancy and Lactation: There are no contra-indications against use during pregnancy and lactation.

Contra-indications, warnings, etc: Do not use on cats weighing less than 1 kg body weight. Do not allow recently treated animals to groom each other. Care should be taken to avoid the contents of the tube coming into contact with the eyes or mouth of the recipient animal. For external use only. Occasionally a transient local reaction such as scurf or mild exudation may be observed at the application site following treatment. The product is bitter tasting and salivation may occasionally occur if the cat licks the application site immediately after treatment. This is not a sign of intoxication and disappears after a short time without treatment. No incompatibility has been observed between this product at the recommended dose and a range of common veterinary treatments. Overdosing can lead to slight skin reactions which disappear without treatment within a few days. Withdrawal period(s) Not applicable as the product is not indicated for the treatment of food producing animals.

User Safety: This product can be irritant to the skin and eyes. Care should be taken to prevent contact of the solution with the skin or eyes. If contact with the skin occurs, wash off any skin contamination with soap and water immediately. If accidental contact occurs with the eyes, flush the affected eyes thoroughly with clean fresh water.

In the event of skin or eye contact, seek medical advice if irritation persists and show the Doctor this package. Do not stroke or groom animals until area of application is dry (typically around 1 hour after application).Wash hands thoroughly after use. Do not eat, drink or smoke during application. Store away from food, drink or animal feeding stuffs.

Environmental safety: Any unused product or waste material should be disposed of in accordance with national requirements.

Pharmaceutical precautions: Store away from food, drink and animal feeding stuffs. Do not use after expiry date. Shelf-life of the product as packaged for sale: 5 years Shelf-life after dilution or reconstitution: Not applicable,

the product is presented in a ready-to-use solution. Shelf-life after first opening the container: Not applicable, once opened, the entire contents of the tube is applied to the animal’s skin.

Legal category: AVM-GSL

Seresto Presentation: A grey, odour free collar containing the following active substances: Seresto 1.25 g + 0.56 g, collar for cats: 38 cm (12.5 g) containing 1.25 g imidacloprid and 0.56 g flumethrin, Seresto 1.25 g + 0.56 g, collar for dogs ≤ 8 kg: 38 cm (12.5 g) containing 1.25 g imidacloprid and 0.56 g flumethrin, Seresto 4.50 g + 2.03 g, collar for dogs >8 kg: 70 cm (45 g) containing 4.5 g imidacloprid and 2.03 g flumethrin The collar also contains the following excipients: Titanium dioxide (E 171) Iron oxide black (E 172) Uses: For cats use Seresto 1.25 g + 0.56 g, collar for cats For dogs ≤ 8 kg use Seresto 1.25 g + 0.56 g, collar for dogs ≤ 8 kg For dogs > 8 kg use Seresto 4.50 g + 2.03 g, collar for dogs > 8 kg Cats: For the treatment and prevention of flea (Ctenocephalides felis) infestation for 7 to 8 months. Efficacy against fleas starts immediately after application of the collar.

Protects the animal’s immediate surroundings against flea larvae development for 10 weeks. Seresto can be used as part of a treatment strategy for the control of Flea Allergy Dermatitis (FAD). The product has persistent acaricidal (killing) efficacy (Ixodes ricinus, Rhipicephalus turanicus) and repellent (antifeeding) efficacy against tick infestations (Ixodes ricinus) for 8 months. It is effective against larvae, nymphs and adult ticks. Ticks already on the cat prior to treatment may not be killed within 48 hours after collar application and may remain attached and visible. Therefore removal of ticks already on the cat at the time of application is recommended. The prevention of infestations with new ticks starts within two days after application of the collar. Ideally, the collar should be applied before the beginning of the flea or tick season. Dogs: For the treatment and prevention of flea (Ctenocephalides felis) infestation for 7 to 8 months. Efficacy against fleas starts immediately after application of the collar. Protects the animal’s immediate surroundings against flea larvae development for 8 months. Seresto can be used as part of a treatment strategy for the control of Flea Allergy Dermatitis (FAD). The product has persistent acaricidal (killing) efficacy against tick infestations (Ixodes ricinus, Rhipicephalus sanguineus, Dermacentor reticulatus) and repellent (antifeeding) efficacy against tick infestations (Ixodes ricinus, Rhipicephalus sanguineus) for 8 months. It is effective against larvae, nymphs and adult ticks. Ticks already on the dog prior to treatment may not be killed within 48 hours after collar application and may remain attached and visible. Therefore removal of ticks already on the dog at the time of application is recommended. The prevention of infestations with new ticks starts within two days after application of the collar. For treatment of biting/chewing lice (Trichodectes canis) infestation. Ideally, the collar should be applied before the beginning of the flea or tick season.

Dosage and administration: Cutaneous use. One collar per animal to be fastened around the neck. Cats receive one collar of 38 cm length. Small dogs up to, and including, 8 kg body weight receive one Seresto collar of 38 cm length. Dogs above 8 kg receive one Seresto collar for dogs > 8 kg of 70 cm length. For external use only. Remove collar from protective bag directly before use. Unroll collar and make sure that there are no remnants from the plastic connectors inside the collar. Adjust the collar around the animal’s neck without tightening it too tight (as a guide, it should be possible to insert 2 fingers between the collar and the neck). Pull excess collar through the loop and cut off any excess length extending beyond 2 cm. The collar should be worn continuously for the 8 month protection period and should be removed after the treatment period. Check periodically and adjust fit if necessary, especially when puppies and kittens are rapidly growing. Cats: This collar is designed with a safety closure mechanism. In the unlikely event of a cat being trapped, the cat’s own strength is sufficient to widen the collar to allow for quick release.

Contra-indications, warnings, etc: Do not treat kittens less than 10 weeks of age. Do not treat puppies less than 7 weeks of age. Do not use in the case of known hypersensitivity to the active substances or to any of the

excipients. Ticks will be killed and fall off the host within 24 to 48 hours after infestation without having had a blood meal, as a rule. An attachment of single ticks after treatment cannot be excluded. For this reason, a transmission of infectious diseases by ticks cannot be completely excluded if conditions are unfavourable. As in all long term topical products, periods of excessive seasonal hair shedding may lead to transient slight reduction of efficacy by loss of hair-bound portions of the active ingredients. Replenishment from the collar starts immediately so that full efficacy will be reestablished without any additional treatment or collar replacement. For optimum control of flea problems in heavily infested households it may be necessary to treat the environment with a suitable insecticide.

The product is water resistant; it remains effective if the animal becomes wet. However, prolonged, intense exposure to water or extensive shampooing should be avoided as the duration of activity may be reduced. Studies show that monthly shampooing or water immersion does not significantly shorten the 8 months efficacy duration for ticks after redistribution of the active substances in the coat whereas the product’s flea efficacy gradually decreased, starting in the 5th month. Occasionally slight pruritus and/or erythema may be observed in animals that are not used to wearing collars on the first few days after fitting. Ensure that the collar is not fitted too tightly. Slight hair loss and mild skin reactions may occur at the application site, which usually recover within 1 to 2 weeks without the need for collar removal. In single cases, a temporary collar removal may be recommended until the symptoms have disappeared. Cats: Initially, slight and transient reactions as depression, change of food intake, salivation, vomiting and diarrhoea might occur in rare cases. As in other topical applications, allergic contact dermatitis might occur in hypersensitive animals. Laboratory studies with either flumethrin or imidacloprid in rats and rabbits have not produced any effects on fertility or reproduction and showed no teratogenic or foetotoxic effects. However, the safety of the veterinary medicinal product has not been established in target animals during pregnancy and lactation and in the absence of available data, the product is therefore not recommended in pregnant and lactating bitches or queens. Due to the nature of the collar, overdosage is unlikely and signs of overdosage are not to be expected.

An overdosage of 5 collars around the neck was investigated in adult cats and dogs for an 8 month period, and in 7 week old puppies and 10 week old kittens for a 6 month period and no other adverse effects were observed than those already described in this section. In the unlikely event of the animal eating the collar mild gastrointestinal symptoms (e.g. loose stool) may occur.

User Safety: Keep the bag with the collar in the outer packaging until use. As with any veterinary medicinal products, do not allow small children to play with the collar, or to put it into their mouths. Pets wearing the collar should not be allowed to sleep in the same bed as their owners, especially children. People with known sensitivity to the ingredients of the collar should avoid contact with the collar. Immediately dispose of any remnants or cutoffs of the collar (see Dosage and administration section). Wash hands with cold water after fitting the collar.

Environmental Safety: Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements. This product should not enter water courses as it may be dangerous for fish and other aquatic organisms.

Pharmaceutical precautions: Shelf-life of the veterinary medicinal product as packaged for sale: 30 months.

This veterinary medicinal product does not require any special storage conditions.

Legal category: POM-V

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 15

Droncit Tablets 50 mg Presentation: A white round tablet scored on one side containing 50 mg praziquantel.

Uses: For the treatment of adult tapeworms in dogs and cats. The tablets are effective against both immature and mature forms of adult tapeworms in both dogs and cats. The product is a highly effective treatment against all the common species of tapeworm infecting dogs and cats in the United Kingdom and Ireland including Echinococcus granulosus, Taenia ovis, Taenia pisiformis, Taenia multiceps, Taenia hydatigena, Taenia taeniaeformis, and Dipylidium caninum. Droncit is also effective against Echinococcus multilocularis (see Contra-indications, warnings, etc).

Dosage and administration: The recommended dosage rate is 5 mg/kg body weight. This corresponds to 1 tablet per 10 kg body weight. Oral administration The tablets are administered by opening the animal’s mouth and pushing the tablet over the back of the tongue so that it cannot be rejected. Alternatively, a tablet can be wrapped in a piece of meat or butter and offered to the animal or crushed and mixed with the food. A single dose is all that is required. However, for dogs in rural areas and for packs of hounds this dose should be repeated every four weeks to ensure that newly acquired tapeworms are destroyed before reaching maturity. Dosing must be associated with strict control of the dog’s diet to ensure that uncooked offal is not eaten.

Use during pregnancy and lactation: The product may be administered to pregnant females. It is safe to the female herself, to the unborn foetus and to the newborn young.

Contra-indications, warnings, etc: Do not administer to dogs weighing less than 2.5 kg. Do not administer to unweaned puppies and kittens, as such animals are rarely infected with tapeworms. Fleas serve as intermediate hosts for one common type of tapeworm Dipylidium caninum. To avoid reinfection with this parasite, flea control of the animal and its housing should be carried out at the same time. Unless flea control is complete an infected flea population may survive: i.e. retreatment of the animal may be necessary. As a precautionary measure to prevent the establishment of Echinococcus multilocularis in the UK and Ireland, it is recommended that all dogs and cats entering the country be treated with praziquantel.

User Safety: In the interests of good hygiene, persons administering the tablets directly to the animal, or by adding them to the animal’s food, should wash their hands afterwards.

Environmental safety: Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal product should be disposed of in accordance with local requirements.

Pharmaceutical precautions: Do not store above 25°C. Store in a dry place. Any part used tablets should be discarded. Shelf-life of the veterinary medicinal product as packaged for sale: 5 years Legal category: AVM-GSL

19/04/2013 15:23

Advantage Incorporating the data sheets for the following products: Advantage 40 mg spot-on Solution for Small Cats, Small Dogs and Pet Rabbits, Advantage 80 mg spot-on Solution for Large Cats and Pet Rabbits, Advantage 100 spot-on Solution for Dogs, Advantage 250 spot-on Solution for Dogs, Advantage 400 spot-on Solution for Dogs.

Presentation: A clear yellow to slightly brownish solution containing as active substance imidacloprid. Each tube contains 0.4 ml (40 mg imidacloprid), 0.8 ml (80 mg imidacloprid), 1 ml (100 mg imidacloprid), 2.5 ml (250 mg imidacloprid) and 4.0 ml (400 mg imidacloprid) respectively as listed above. The product also contains benzyl alcohol and butylhydroxytoluene (E321) as an antioxident.

Uses: For the prevention and treatment of flea infestations on cats and dogs, and for the treatment of biting lice (Trichodectes canis) on dogs. For the treatment of flea infestations on pet rabbits. Fleas are killed within one day following treatment. One treatment prevents further flea infestation for up to four weeks on dogs, three to four weeks on cats and up to one week on pet rabbits. The product can be used as part of a treatment strategy for Flea Allergy Dermatitis (FAD) in the cat and the dog, where this has been previously diagnosed by a veterinary surgeon.

Dosage and administration: Treatment should be repeated after four weeks. Treatment of nursing bitches and queens controls flea infestations on both dam and offspring. Fleas are killed within one day following treatment. One treatment prevents further flea infestation on dogs and cats for up to four weeks and on rabbits for up to one week.

Should retreatment be necessary earlier than four weeks, do not treat more frequently than weekly. Reinfestation from emergence of new fleas in the environment may continue to occur for six weeks or longer after treatment is initiated. More than one treatment may therefore be required, depending on the level of fleas in the environment. To aid reduction in environmental challenge, the additional use of a suitable environmental treatment against adult fleas and developing stages is recommended. In order to reduce further the environmental challenge, it is recommended that all cats, dogs and rabbits in the household are treated. The product remains effective if the animal becomes wet, for example after exposure to heavy rain or after swimming (dogs). However, retreatment may become necessary, depending on the presence of fleas in the environment. In these cases do not treat more frequently than once weekly.

In the case of biting louse infestation in dogs, a veterinary examination 30 days after treatment is recommended as some animals may require a second treatment.

Method of Administration: Remove one tube from the package. Hold the tube in an upright position, twist and pull off cap. Use reversed cap to twist and remove seal from tube. Administration to the Cat/Rabbit Part the hair on the pet’s neck at the base of the skull until the skin is visible. Place the tip of the tube on the skin and squeeze firmly several times to empty the contents directly onto the skin. See Figure 2. Correct application will minimise the opportunity for the animal to lick off the product. Apply only to undamaged skin. Do not allow recently treated animals to groom each other. For dogs of less than 25 kg body weight With the dog in the standing position, part the coat between the shoulder blades until the skin is visible. Place the tip of the tube on the skin and squeeze firmly several times to empty the contents directly onto the skin. For dogs of 25 kg body weight and greater The dog should be standing for easy application. The entire contents of the tube should be applied evenly to 3 or 4 spots all located at different application sites along the dog’s backline from the shoulder to the base of the tail. At each spot, part the coat until the skin is visible. Place the tip of the tube on the skin and gently squeeze the tube to expel a portion of its contents directly onto the skin. Do not apply an excessive amount of solution at any one spot, as that could cause some of the product to run down the animal’s side. For all dogs Do not apply an excessive amount of solution at any one spot that could cause some of the solution to run down the side of the dog. The product is bitter tasting and salivation may occasionally occur if the dog licks the application site immediately after treatment. This is not a sign of intoxication and disappears within some minutes without treatment. Correct application will minimize the opportunity for the dog to lick the product. Apply only to undamaged skin. Do not allow recently treated animals to groom each other.

Use During Pregnancy and Lactation: No reproductive toxic effects have been observed in rats and no primary embryotoxic or teratogenic toxic effects have been observed during the studies on rats and rabbits. Studies on pregnant and lactating bitches, queens and does together with their offspring are limited. Evidence so far indicates that no adverse effects are to be expected in these animals.

Contra-indications, warnings, etc: Do not treat unweaned puppies or kittens of less than 8 weeks of age. Do not use on pet rabbits of less than 10 weeks of age. Do not use in animals that are known to be hypersensitive to the active substance or any of the excipients. Apply only to undamaged skin. This product is for topical use and should not be administered orally. Care should be taken to avoid the contents of the tube coming into contact with the eyes or mouth of the recipient animal. Do not allow recently treated animals to groom each other. For external use only. The product is bitter tasting and salivation may occasionally occur if the animal licks the application site immediately after treatment. This is not a sign of intoxication and disappears within a few minutes without treatment (see Dosage and administration). In very rare occasions skin reactions such as hair loss, redness, itching and skin lesions may occur. Agitation and disorientation has also been reported. Excessive salivation and nervous signs such as incoordination, tremors and depression have been reported exceptionally in dogs. No incompatibility has been observed between this product at twice the recommended dose and the following commonly used veterinary products: fenthion, lufenuron, milbemycin, febantel, pyrantel and praziquantel (dogs) and lufenuron, pyrantel and praziquantel (cats). The compatibility of the product was also demonstrated with a wide range of routine treatments under field conditions including vaccination. In cats, no adverse clinical signs were produced using doses of five times the therapeutic level for eight consecutive weeks. In dogs, no adverse clinical signs were produced by individual doses of up to 200 mg/kg body weight (five to eight times the therapeutic dose), daily treatments at 100 mg/kg body weight for five consecutive days or weekly treatments at five times the maximum dose rate for eight consecutive weeks.

In rabbits, no adverse clinical signs were seen using doses of up to 45 mg/kg body weight (4 times the therapeutic level) weekly for 4 consecutive weeks. Dogs: In rare cases of overdose or licking of treated fur, nervous system disorders (such as twitching, tremors, ataxia, mydriasis, miosis, lethargy) can occur. Poisoning following inadvertent oral uptake in either man or animals is unlikely. In this event, treatment should be symptomatic. There is no known specific antidote but administration of activated charcoal may be beneficial. The solvent in this product may stain certain materials including leather, fabrics, plastics and finished surfaces. Allow the application site to dry before permitting contact with such materials. Withdrawal period(s) Do not use on rabbits intended for human consumption.

User Safety: Wash hands thoroughly after use. Wash off any skin contamination with soap and water. After application do not stroke or groom animals until the application site is dry (typically within an hour or so). People with known skin sensitivity may be particularly sensitive to the product. This product contains benzyl alcohol and may cause skin sensitisation or transient skin reactions (for example allergy, irritation, tingling). Avoid contact between the product and the skin, eyes and mouth. If the product gets into eyes accidentally, the eyes should be thoroughly flushed with water. If skin or eye irritation persists, seek medical attention. If the product is accidentally swallowed, obtain medical attention immediately. Do not eat, drink or smoke during application. Store away from food, drink or animal feeding stuffs.

Environmental Safety: Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local / national requirements.

Pharmaceutical precautions: No special precautions for storage. Store away from food, drink and animal feeding stuffs. Shelf-life of the veterinary medicinal product as packaged for sale: 5 years Legal category: NFA-VPS

Advantix Incorporating the data sheets for the following products: Advantix spot-on Solution for dogs up to 4 kg, Advantix spot-on Solution for dogs of 4 kg up to 10 kg, Advantix spot-on Solution for dogs of 10 kg up to 25 kg, Advantix spot-on Solution for dogs of 25 kg and over.

Presentation: A clear yellowish to brownish, solution containing imidacloprid and permethrin as active substances and 1.0 mg/ml butylhydroxytoluene (E321) as an antioxidant. The product is presented in a single use plastic pipette for dermal ( spot-on) treatment in dogs. Each tube contains 100 mg/ml Imidacloprid and 500 mg/ml Permethrin.

Uses: For the treatment and prevention of flea (Ctenocephalides canis, Ctenocephalides felis) infestations in dogs only. Fleas on dogs are killed within one day following treatment. One treatment prevents further flea infestation for four weeks. The product can be used as part of a treatment strategy for flea allergy dermatitis (FAD). For the treatment of biting lice (Trichodectes canis). The product has a persistent acaricidal and repellent efficacy against tick infestations (Rhipicephalus sanguineus, Ixodes ricinus for four weeks, and Dermacentor reticulatus for three weeks).

Ticks already on the dog may not be killed within two days after treatment and may remain attached and visible.

Therefore the removal of ticks already on the dog at the time of treatment is recommended, in order to prevent them from attaching and having a blood meal. One treatment provides repellent (antifeeding) activity against sand flies (Phlebotomus papatasi for two weeks and Phlebotomus perniciosus for three weeks), against mosquitoes (Aedes aegypti for two weeks and Culex pipiens for four weeks) and against stable flies (Stomoxys calcitrans) for four weeks.

Dosage and administration: The recommended minimum dose is: 10 mg/kg body weight imidacloprid and 50 mg/kg body weight permethrin. For dermal use only. Apply only to undamaged skin. To reduce reinfestation from emergence of new fleas it is recommended that all dogs in a household be treated. Other pet animals living in the same household should also be treated with a suitable product. To further aid in reducing environmental challenge, the additional use of a suitable environmental treatment against adult fleas and their developmental stages is recommended. The product remains effective if the animal becomes wet. However, prolonged, intense exposure to water should be avoided. In cases of frequent water exposure the persistent efficacy may be reduced. In these cases do not retreat more frequently than once weekly. If a dog requires a shampoo, it should be administered before applying Advantix or at least 2 weeks after application, to optimise efficacy of the product. In case of biting louse infestation, a further veterinary examination 30 days after treatment is recommended as some animals may require a second treatment.

Method of Administration: Remove one pipette from the package. Hold pipette in an upright position, twist and pull cap off. Turn the cap around and place the other end of the cap back on the pipette. Twist cap to break seal, then remove cap from pipette. Administration to dogs weighing under 10 kg With the dog standing still, part the coat between the shoulder blades until the skin is visible. Place the tip of the pipette on the skin and squeeze firmly several times to empty the contents directly onto the skin. Administration to dogs weighing 10 kg and over With the dog standing still, the entire contents of the Advantix pipette(s) should be applied evenly to four spots on the top of the back from the shoulder to the base of the tail. At each spot, part the hair until the skin is visible. Place the tip of the pipette on the skin and gently squeeze to expel a portion of the solution on to the skin. Do not apply an excessive amount of solution at any one spot that could cause some of the solution to run off the side of the dog.

Use during pregnancy and lactation: The product may be used during pregnancy and lactation.

Contra-indications, warnings, etc: Do not use on cats. This product is extremely poisonous to cats and could be fatal due to the unique physiology of this species which is unable to metabolise certain compounds, including permethrin. To prevent cats from being accidentally exposed to the product, keep cats away from treated dogs until the application site is dry. It is important to ensure that cats do not groom the site of application on a dog which has been treated with this product. Seek veterinary advice immediately if this occurs. In the absence of

available data, the product should not be used on puppies of less than 7 weeks of age or 1.5 kg of weight. Do not use in cases of known hypersensitivity to the active substances or to any of the excipients. Care should be taken to avoid the contents of the pipette coming into contact with the eyes or mouth of the recipient dogs. Care should be taken to administer the product correctly as described above, under Method of Administration. In particular, oral uptake due to the licking of the application site by treated or in contact animals should be avoided. Consult your veterinary surgeon before using the product on sick and debilitated dogs. On very rare occasions reactions in dogs may include transient skin sensitivity (increased local itching, scratching and rubbing, hair loss and redness at the application site) or lethargy that are generally self-resolving. In very rare cases dogs may show behaviour changes (agitation, restlessness, whining or rolling), gastrointestinal symptoms (vomiting, diarrhoea, hypersalivation, diminished appetite) and neurological signs such as unsteady movement and twitching in dogs susceptible to the ingredient permethrin. These signs are generally transient and self-resolving. Poisoning following inadvertent oral uptake in dogs is unlikely but may occur in very rare cases. In this event, neurological signs such as tremor and lethargy can occur. Treatment should be symptomatic. There is no known specific antidote. There may be an attachment of single ticks, or bites by single sand flies or mosquitoes. For this reason, a transmission of infectious diseases by these parasites cannot be completely excluded if conditions are unfavourable. However, the product provides repellent (antifeeding) activity against ticks, sand flies and mosquitoes, thus preventing the repelled parasites from taking a blood meal and reducing the risk of Canine Vector Borne Disease (CVBD) transmission (e.g. borreliosis, rickettsiosis, ehrlichiosis, leishmaniosis). No adverse clinical signs were noted in healthy puppies or adult dogs exposed to 5x overdosage or for puppies whose mothers were treated with 3x overdosage of the product. The solvent in Advantix spot-on solution may stain certain materials including leather, fabrics, plastics and finished surfaces. Allow the application site to dry before permitting contact with such materials.

User Safety: Avoid contact between the product and skin, eyes or mouth. Do not eat, drink or smoke during application. Wash hands thoroughly after use. In case of accidental spillage on to skin, wash off immediately with soap and water. People with known skin sensitivity may be particularly sensitive to this product. The predominant clinical symptoms that in extremely rare cases may be shown are transient sensory irritations of the skin like tingling, burning sensation or numbness. If the product gets accidentally into the eyes, they should be thoroughly flushed with water. If skin or eye irritation persists, or if the product is accidentally swallowed, obtain medical attention immediately and show the package insert to the physician. Treated dogs should not be handled, especially by children, until the application site is dry. This may be ensured by treating dogs when children are not present, eg in the evening. Recently treated dogs should not be allowed to sleep together with their owner, especially children.

Environmental Safety: The product should not be allowed to enter water courses, as this may be dangerous for fish and aquatic organisms. Treated dogs must not under any circumstances be allowed to enter into any type of surface water for at least 48 hours after treatment. Permethrin containing products are toxic to honey bees. Any unused product or waste material should be disposed of in accordance with national requirements.

Pharmaceutical precautions: Do not freeze. After opening the foil pouch store in a dry place at a temperature not above 30°C. After use, replace cap on tube. Shelf-life of product in foil pouch: 5 years Shelf-life of product after opening foil pouch: 24 months (all pipettes should be used within 24 months after opening the foil pouch or before expiry date on the pipette, whichever is shorter). Shelf-life of the broached pipette: Once opened, the entire contents of the pipette has to be applied to the animal’s skin.

Legal category: POM-V

DO NOT USE ON CATS

An assessment of each individual pet’s lifestyle and associated risk should be made to determine choice of parasiticidal products, spectrum of activity and frequency of administration. Prescribing rules should always be followed.

Use Medicines Responsibly (www.noah.co.uk/responsible) Please refer to appropriate data sheet, further information is available on request. ® Registered Trade Mark of Bayer AG. Bayer plc, Animal Health Division, Bayer House, Strawberry Hill, Newbury RG14 1JA. Tel: 01635 563000. Bayer Ltd., Animal Health Division, The Atrium, Blackthorn Road, Dublin 18. Tel: (01) 299 9313. 1WRIGHT, I. (2009) Toxocarosis: Still in the public eye? UK Vet Companion Animal. 14.3, 36. 2Government Health Protection Agency. 3Quantifying sources of environmental contamination with Toxocara spp. eggs, E. R. Morgan, D. Azam, K. Pegler, Veterinary Parasitology, available online 22 December 2012. http://www.bristol.ac.uk/ news/2013/9107.html. 4Prevalence of zoonotic nematode species in dogs in Lancashire, I. P. Wright, A. Wolfe, 2007. 5Toxocara species egg contamination of soil from children’s play areas in southern England. R. Kirchheimer, D. E. Jacobs, 2008. 6NHS: http://www.nhs.uk/conditions/Toxocarosis/Pages/Introduction.aspx. 7Onepoll survey of 1,000 pet owners in the UK, June 2012. 8Lloyd, S. (1993) Toxocara canis: the dog. In Toxocara and Toxocarosis: Clinical, epidemiological and molecular perspectives. Eds. Lewis, J.W., and Maizels, R.M. IOB-BSP, London. pp 11-24. 5. 9www.esccap.org. 10B. Good et al, Ocular Toxocariasis in Schoolchildren, Clinical Infectious Diseases 2004; 39,173-8. 11Wolfe A., Wright, I.P. Vet Record (2004) 154,408. 12Intestinal nematodes. JUN.0213.LP.ZO.7

2537_3 Focus On Toxocara_A4 16pp_HH_ART.indd 16

19/04/2013 15:23