Use of Slow-Release Injectable Moxidectin for Treatment of Dirofilaria immitis Infection During Pregnancy

Canine heartworm disease is a life-threatening disease caused by Dirofilaria immitis and is prevalent in Brazil. The standard drug for its treatment, melarsomine dihydrochloride, is a fast-killing organic arsenical chemotherapeutic agent not approved in Brazil. Therefore, an alternative strategy, su...

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Main Authors: Bruno Alberigi, Celeste da Silva Freitas de Souza, Julio Israel Fernandes, Alexandre Merlo, Norma Labarthe
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-01-01
Series:Frontiers in Veterinary Science
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fvets.2019.00440/full
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author Bruno Alberigi
Celeste da Silva Freitas de Souza
Julio Israel Fernandes
Alexandre Merlo
Norma Labarthe
author_facet Bruno Alberigi
Celeste da Silva Freitas de Souza
Julio Israel Fernandes
Alexandre Merlo
Norma Labarthe
author_sort Bruno Alberigi
collection DOAJ
description Canine heartworm disease is a life-threatening disease caused by Dirofilaria immitis and is prevalent in Brazil. The standard drug for its treatment, melarsomine dihydrochloride, is a fast-killing organic arsenical chemotherapeutic agent not approved in Brazil. Therefore, an alternative strategy, such as macrocyclic lactone in combination with a tetracycline antibiotic, has to be used. The alternative method is a long-term therapy that could lead to compliance issues during treatment. The aim of this case report is to present a preliminary assessment on the efficacy and safety of an off-label biannual administration of slow-release moxidectin (0.5 mg/kg every 6 months), which is formulated for annual administration (0.5 mg/kg annually). This overdose was chosen to test if moxidectin serum levels could be maintained high enough to harm the worms. It was administered to a 4-year-old female dog in combination with a 30-day doxycycline course. The second dose of moxidectin was administered approximately a week before she gave birth to three healthy puppies. Microfilariae were not detected on day 180 of treatment. Serological tests showed that the worms were eliminated, as two negative antigen tests were obtained 6 months apart (at day 180 and day 360 of treatment). Therefore, the off-label biannual use of moxidectin in combination with doxycycline was effective in eliminating D. immitis in 360 days and was harmless for the pregnant dog and her offspring, suggesting that this strategy is promising. Although these results are encouraging, further studies are needed to confirm safety and efficacy issues.
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spelling doaj.art-bc1d9b6359d4458ab589a8109cbe76162022-12-22T02:44:45ZengFrontiers Media S.A.Frontiers in Veterinary Science2297-17692020-01-01610.3389/fvets.2019.00440492485Use of Slow-Release Injectable Moxidectin for Treatment of Dirofilaria immitis Infection During PregnancyBruno Alberigi0Celeste da Silva Freitas de Souza1Julio Israel Fernandes2Alexandre Merlo3Norma Labarthe4Programa de Pós-Graduação em Medicina Veterinária, Universidade Federal Rural do Rio de Janeiro, Rio de Janeiro, BrazilLaboratório de Imunomodulação e Protozoologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, BrazilDepartamento de Medicina e Cirurgia Veterinária, Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro, Rio de Janeiro, BrazilTechnical Services for Companion Animals, Zoetis, São Paulo, BrazilPrograma de Pós-Graduação em Bioética, Ética Aplicada e Saúde Coletiva. Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, BrazilCanine heartworm disease is a life-threatening disease caused by Dirofilaria immitis and is prevalent in Brazil. The standard drug for its treatment, melarsomine dihydrochloride, is a fast-killing organic arsenical chemotherapeutic agent not approved in Brazil. Therefore, an alternative strategy, such as macrocyclic lactone in combination with a tetracycline antibiotic, has to be used. The alternative method is a long-term therapy that could lead to compliance issues during treatment. The aim of this case report is to present a preliminary assessment on the efficacy and safety of an off-label biannual administration of slow-release moxidectin (0.5 mg/kg every 6 months), which is formulated for annual administration (0.5 mg/kg annually). This overdose was chosen to test if moxidectin serum levels could be maintained high enough to harm the worms. It was administered to a 4-year-old female dog in combination with a 30-day doxycycline course. The second dose of moxidectin was administered approximately a week before she gave birth to three healthy puppies. Microfilariae were not detected on day 180 of treatment. Serological tests showed that the worms were eliminated, as two negative antigen tests were obtained 6 months apart (at day 180 and day 360 of treatment). Therefore, the off-label biannual use of moxidectin in combination with doxycycline was effective in eliminating D. immitis in 360 days and was harmless for the pregnant dog and her offspring, suggesting that this strategy is promising. Although these results are encouraging, further studies are needed to confirm safety and efficacy issues.https://www.frontiersin.org/article/10.3389/fvets.2019.00440/fullheartwormmicrofilariaemacrocyclic lactonedoxycyclinevector-borne disease
spellingShingle Bruno Alberigi
Celeste da Silva Freitas de Souza
Julio Israel Fernandes
Alexandre Merlo
Norma Labarthe
Use of Slow-Release Injectable Moxidectin for Treatment of Dirofilaria immitis Infection During Pregnancy
Frontiers in Veterinary Science
heartworm
microfilariae
macrocyclic lactone
doxycycline
vector-borne disease
title Use of Slow-Release Injectable Moxidectin for Treatment of Dirofilaria immitis Infection During Pregnancy
title_full Use of Slow-Release Injectable Moxidectin for Treatment of Dirofilaria immitis Infection During Pregnancy
title_fullStr Use of Slow-Release Injectable Moxidectin for Treatment of Dirofilaria immitis Infection During Pregnancy
title_full_unstemmed Use of Slow-Release Injectable Moxidectin for Treatment of Dirofilaria immitis Infection During Pregnancy
title_short Use of Slow-Release Injectable Moxidectin for Treatment of Dirofilaria immitis Infection During Pregnancy
title_sort use of slow release injectable moxidectin for treatment of dirofilaria immitis infection during pregnancy
topic heartworm
microfilariae
macrocyclic lactone
doxycycline
vector-borne disease
url https://www.frontiersin.org/article/10.3389/fvets.2019.00440/full
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