Drontal - bicpu.edu.infilobase.bicpu.edu.in/Drontal.pdf · Larva Migrans is caused by larval forms of the dog or cat roundworm. When infection has occurred the larvae hatch in the

Drontal

Product information

Nematocide and Cestocide for cats

International Edition

28400 Aufbau neu 09.07.2003 13:27 Uhr Seite 1

Bayer AGBusiness Group Animal HealthD-51368 LeverkusenGermany

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Important noteThis product information on Drontal is based on the available results of controlled inter-national studies. User information is to be found in the instructions for use contained in theDrontal package inserts which have been approved by the regulatory authority.

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Drontal


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Contents

General Observations 6

The worm problem in cats 7

Roundworms (Nematodes) 7Tapeworms (Cestodes) 8

Routes of infection 9

Oral infection 9Percutaneous infection 10Transmammary infection (post partum) 10

Damage to health in cats 11

Clinical manifestations 12

Routes of infection in man (false host) 13

Oral infection 13Percutaneous 14

Damage to human health (man as false host) 15

Life cycle of the most importantintestinal worms of the cat 18

1. Nematodes 182. Cestodes 21

Control of worm infections in cats 24

Diagnosis and prepatent periods 24Treatment programmes 24

Drontal Product Profile 27

1. Active ingredients 272. Mode of action 283. Spectrum of activity/Indications 284. Dosage 285. Efficacy 296. Tolerability 32

References 33

Drontal


Worm infections continue to be a majorproblem in farm livestock and companionanimals worldwide, as well as in man. Anumber of worms have adapted to particularspecies of farm or companion animals.Worm infestation is determined by factorssuch as geographic location, climatic condi-tions, the season and – equally importantly– the animals’ living conditions. In mostcountries, farm livestock are dewormed reg-ularly in order to avoid shortfalls in perform-ance and the resulting economic losses.

In companion animals such as dogs or cats,on the other hand, control measures areoften inadequate. The main reasons are alack of awareness of the problem, a poorselection of products, and infrequent use.This is highly regrettable because hygieneis particularly important in this area in viewof the often very close relationship betweenman and companion animals. Worm-infest-ed dogs and cats constitute a major hygieneand health hazard, especially for children.

In the industrialised countries alone thereare 100 million dogs and over 110 millioncats – a considerable reservoir of potentialworm infections.

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General observations


Roundworms (Nematodes)Nematodes (Greek: nema = thread) arethread-shaped worms. Their body is taperedat both ends. The length of the adult wormsranges from 1 millimetre to 12 cm, depend-ing on the species. All nematodes posses astable, elastic cuticle and a complete diges-tive system. This begins with a buccal cap-sule which serves both for feeding and insome species also for attachment to theintestinal wall. Nematodes feed on chymeor intestinal contents of the host and on thehost’s body substance such as epithelialcells, mucosa or blood. The sexes are separ-ate. The males are usually distinguishablefrom the females by their smaller size. Theaccessory organs (such as the copulatorybursa) of the reproductive system, and espe-cially the buccal capsule and the form ofthe oesophagus are important features inspecies identification.

The number of eggs passed from eachfemale worm can be very high, up to200,000 eggs daily. The duration of the pre-patent period (Periode from infection of theanimal to the appearance of the parasite’seggs.) also varies considerably.

The eggs pass to the exterior in the faecesof the host. There the larvae hatch andbecome infective after several moults. Insome species larval development takesplace inside the egg, i.e. embryonated eggsconstitute the invasive stage. After infectionof the host and further moults the adultworm stage is reached. At this time the lar-vae often migrate through various tissues

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and organs of the host, and therefore causesevere damage during their development. Aspecial phenomenon in some nematodes ishypobiosis – a state of arrested develop-ment of the final larval stage. It is initiatedby external stimuli acting upon the infectivelarvae (e.g. low temperatures, drought) orby immunological and hormonal processesin the body of the host, although the natureof this phenomenon is not yet completelyunderstood (multifactorial). These dormantlarvae play a major role in the transmissionof helminth infections from the queen to thekittens (transmammary infection).

The worm problem in cats

0 1 2 3 4 5 6 7

0 1 2

Fig. 1: Toxocara cati

Fig. 2: Ancylostoma tubaeforme


Tapeworms (Cestodes)Cestodes or tapeworms owe their name tothe flat, tape-like body shape. These wormsparasitise the small intestine of the defini-tive hosts. The body of the tapeworm con-sists of the head (scolex) which is designedas an attachment organ, an unsegmentedneck and the segments (proglottids) whichcontinually renew themselves. The entirechain of segments (strobila) can be up toseveral metres long, although some tape-worm species are only a few millimetreslong. Each proglottid is an independentlyfunctioning unit. Feeding takes placethrough the body surface. Almost all tape-worm species are hermaphrodite. Each pro-glottid harbours a complete set of male andfemale reproductive organs. As the segmentmatures it is shed intact, packed with eggs.New segments are continuously formedfrom the neck to replace the mature pro-glottids that have been expelled.

Tapeworms are of importance in veterinarymedicine as well as in human health, both asadult worms and in the larval form (cysticstage, metacestode). Their development pro-ceeds indirectly via one or several intermedi-ate hosts. In the Cyclophyllidea the hookedlarva inside the egg (onchosphere) developsin the uterus of the tapeworm segment. Theegg containing the hooked larva is ingestedby an intermediate host. If the intermediatehost is a mammal the hooked larva pene-trates the gut wall and is distributed through-out the body via the blood and the lymphaticsystem. In certain organs (predilection sites)of the intermediate host it develops into aninfective cysticercus. This cysticercus, whichalready contains the rudiments of the scolex,is ingested by the definitive host (dog, cat)when eating the raw flesh of the intermedi-ate host. Inside the intestinal tract of the for-mer, the scolex is evaginated. It attachesitself to the intestinal mucosa and the tape-worm develops to adulthood.

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0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Fig. 3: Dipylidium caninum is the most common tapeworm in cats


Oral infection1. By direct ingestion of infectious eggs(ascarids) or infective larvae (hookworms).

Routes of infection

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2. By eating infested hosts.

Ingestion of infested fleas is the commonroute of infection in cats with D. caninum(tapeworm). Ingestion of infested paratenicor intermediate hosts (mice, birds ...) is an

important route of infection in cats withroundworms (ascarids, hookworms) andalso with the majority of tapeworms.


Percutaneous infection3. By active larval invasion through thehealthy skin of the definitive host (hook-worms)

Transmammary infection(post partum)4. By remobilisation of dormant larvaefrom the tissues of the queen, whichmigrate via the bloodstream into the mam-mary gland. The kittens become infectedduring sucking. (ascarids)

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The damaging effects of the worms in theirhost are extremely variable. The pathogenicalterations, either singly or in combination,can give rise to organic disorders with awide variety of clinical symptoms.

Damage to health in cats

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Fig. 4: Toxocara cati in the intestine

Main damage observed in infested cats Causes

1. Mechanical damage to tissues Due to the migration of the larvaethrough the organism (for example: skin lesions after percutaneous infec-tion with Ancylostoma tubaeforme)

2. Obstruction of the gut and the Caused by massive roundworm infes-bile ducts tation (for example: Toxocara cati)

3. Blood loss resulting in anaemia in Caused by blood-sucking wormscases of severe infection (particu- (hookworms)lary in young infested kittens)

4. Deprivation of vitamins and other Can occur in cases of infection withvital substances tapeworms or roundworms

5. Interference with the immune Can occur in cases of infection withsystem (compromises the tapeworms or roundworms protection afforded by vaccinations)

6. Loss of condition in the host Due to release of such substances asenzymes, toxins, hormones.


Clinical manifestationsDepending on their state of health, theirresistance and the degree of parasite infes-tation, infected animals exhibit a widevariety of symptoms:

Dull, rough coat, emaciation, anaemia, dis-tension of the abdomen (pot-belly),impaired fertility, reduced fitness and gen-erally lower resistance and vitality.

Ascarids (roundworms) and other nema-todes may cause vomiting in the affectedanimal.

Hookworms can produce anaemia. Theblood loss is greatest 10 – 15 days afteronset of the infection. Ancylostoma tubae-forme may cause fatal disease in heavilyinfested kittens.

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Fig. 5: In case of massive infestation, Ancylostoma tubae-forme can give rise to an haemorrhagic enteritis


Oral infectionIn the vast majority of cases humansbecome infected by ingesting worm eggs.Infected dogs, cats and other companionanimals are the most common vectors. Theyoften pass large numbers of worm eggs intheir faeces, thus constituting a permanentsource of infection.

Potential modes of infection

1. During close physical contact with cats,worm eggs can pass from the animal’s furinto the person’s mouth (especially tape-worms). The accidental ingestion of a fleaharbouring the larvae of Dipilydium cani-num (tapeworm) can also infect man, andparticulary children.

Routes of infection in man(false host)

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2. Dogs and cats tend to lick people’s handsand face, or food intended for humans.They also come into close contact with tow-els, bedlinen and similar items used by theirhuman owners.

3. Children are at risk from playing in sand-pits contaminated with dog or cat faeces.

4. Eating unwashed wild berries can alsocause worm infection. Here the fox isinvolved as a vector of Echinococcosis.

PercutaneousHookworm larvae can actively penetratehuman skin if there is direct exposure tocontaminated sandpits, moist, warm bathingbeaches or lawns for sunbathing.

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1. Damage due to Toxocara species

The human disease known as VisceralLarva Migrans is caused by larval forms ofthe dog or cat roundworm.

When infection has occurred the larvaehatch in the upper portion of the smallintestine, penetrate the gut wall and migrateto the lungs by the lympho-haematogenicroute. Thereafter they enter the arterialblood stream and are spread throughout thebody. In the capillary regions the larvaeactively leave the vascular system andmigrate into the surrounding tissue. Prefer-red sites for somatic larvae of Toxocara spp.in man are the liver, the CNS and the eye,which considerably increases the dangerousnature of such an infection. At the Hospitalfor Tropical Diseases in London, 20 – 30cases of eye lesions caused by Toxocaraspp. are treated every year.

In the USA approximately 10,000 newcases of visceral larva migrans and 700cases of ocular larva migrans are diagnosed

annually (STEHR-GREEN and Schantz,1987). According to a survey of ophthalmo-logists in Alabama, USA, at least one caseof ocular larva migrans is encountered inevery 1,000 patients (Maetz et al., 1987).

Damage to human health(man as false host)

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Fig. 6: Leukocoria (white appearance of the pupil) due toretinopathy caused by Toxocara larvae (eight-year-old boy)

Hygienic importance of helminth infections in man

Worm species Infective agent Developmentalstage in man

1.Toxocara spp. Infective eggs Larvae

2. Ancylostoma, Uncinaria Infective larvae Larvae

3. Dipylidium caninum Cysticercoid in fleas Adult worm

4. Taenia spp. Infective eggs. Cysticercus

5. Echinococcus spp. Infective eggs Cysticercus


2. Damage due to hookworms

Cutaneous Larva Migrans is a dermatitiscaused by migrating nematode larvae.Mostly this disease is caused by larvae ofAncylostoma or Uncinaria genus.

Infection of humans occurs through skincontact with larvae. The most commonsources of infection are shady, moist andwarm sand or soil, contaminated eitherdirectly by faeces of infected dogs and catsor indirectly via sewage or effluent contain-ing developmental stages or the causalagents of Cutaneous Larva Migrans. Chil-dren are especially at risk of catching thedisease in sandpits, on playgrounds and inpublic parks. Bathing beaches can also be asource of infection.

At the site of penetration reddish, severelyitching skin lesions, similar to insect bitesappear 2 – 4 days after the infection. Acommon complication is a secondary bacte-rial invasion of the affected skin areaswhich can give rise to purulent eczema.

Larval migration in the skin can be inter-rupted for many weeks and months only toresume suddenly for some as yet unknownreasons. Small papules form at the restingsites of the larvae.

The diagnosis of Cutaneous Larva Migransis straightforward because of the pathogno-monic symptoms.

3. Damage due to Dipylidiumcaninum

Infection can occur as a result of beinglicked by a cat which has chewed recentlyinfected fleas or biting lice. When the infec-tive cysticercoids have been swallowed thetapeworm develops in the small intestineto a length of approximately 50 cm. Clini-cal symptoms in heavy infestation can beabdominal pains, blood-stained mucoiddiarrhoea and weight loss. The active emi-gration of the mature proglottids cancause considerable anal irritation and prur-itus.

4. Damage due to Taenia species

The larval stages of Taenia species havethus far been encountered only occasionallyin man. Little is known about the lesionsthey cause.

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Fig. 7: Cutaneous Larva Migrans (sole of foot)(Prof. Seitz)


5. Damage due to Echinococcusmultilocularis

Alveolar Echinococcosis is caused by thedevelopement of the larvae (hydatids) ofE. multilocularis.

The hydatid, due to its uninhibited invasivegrowth, behaves like a malignant tumourwhich in approximately 98 % of casesaffects primarily the liver, but can form sec-ondary “metastases”, especially in the lungsand the CNS. The clinical symptomsresemble those of cirrhosis or carcinoma ofthe liver.

Improved diagnosis, the possibility ofchemotherapy, and advances in surgicaltechniques have reduced the mortality ofAveolar Echinococcosis from about 95 %within 10 years in the 1960s to about 10 %at present. However, this has not altered thefact that Alveolar Echinococcosis continuesto be one of the most dangerous zoonosesfor man.

In man the diagnosis is confirmed by sero-logical tests: immunofluorescence, ELISA,indirect haemagglutination and radioimm-noassay.

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Fig. 8: Appearance of Alveolar Echinococcosis in a human’s liver, cut open after hepatectomy.Note the yellowish, fibrous and multilocular aspect of the lesions. (Prof. Vuitton)


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1. Nematodes1.1 Ascarids

Life cycle of the most importantintestinal worms of the cat

Life cycle of Toxocara cati (T. mystax)

Ingestion of infective eggs by a cat which has previously been in contact with T. cati.

Mice, birds, arthropods become paratenic hosts by ingesting the larvae.

After eating a paratenic host, the larvae develop into adult in the gastroin-testinal wall.

After hatching and penetrating the gut wall, some of the larvae pass via the bloodstream into the muscles where they lie dormant until pregnancy.

Some of the larvae might migrate by lung and trachea to the small intestine where they develop into adult worms.

After somatic migration, the larvae (L2) are transmitted to the kittens through the milk.

Eggs L2

In about 2 weeks the larvae develop inside the egg.

Adult worms live in the small intestine.

Ingestion of infective eggs by a cat which has never been in contact with T. cati before.

Humans are infected by ingestion of infective eggs.

The larvae develop into preadult in the gastrointestinal wall.

The larvae migrate through the blood-stream, lung, trachea and oesophagus to the stomach and the intestine.


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Ascarids

Life cycle of Toxascaris leonina

Cats become infested by eating intermediate hosts harbouring larvae.

The L3 develops into adult worm within the small intestine.

Mammals, birds, arthropods etc. become intermediate hosts by ingesting the larvae. The L2 develops into the L3.

The infective eggs from contaminated soil are ingested by the cat. The L2 develops into the L3 in the gut wall.

The L3 develops into an adult worm within the small intestine.

about 2 weeks

Eggs L2


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1.2 Ancylostomes (hookworms)

Life cycle of Ancylostoma tubaeforme

Ingestion of a paratenic host harbouring L3 is followed by direct development of worms in the intestinal wall of the host.

The hookworms anchor in the intestinal mucosa sucking blood.

Eggs are passed in the faeces.

The first stage larvae (L1) develops within the egg.

The third stage larvae (L3) is infectious.

Humans are infected by direct skin contact with contaminated soil.

Following direct ingestion, the majority of the ingested larvae undergoes direct development within the intestinal mucosa. A smaller number of larvae take the tracheal migration pathway.

Percutaneous infection results from active penetration of the larvae through healthy skin.

Some of the larvae migrate via the bloodstream to the muscles and bodyfat as L3 where they remain dormant.The possible reactivation of the larvaeis poorly documented. Lactogenic trans-mission has not been demonstrated in cats.

The larvae migrate to the lungs via the bloodstream and then, by the tracheal pathway, to the small intestine where they develop into adult worms.

The hookworms anchor in the intestinal mucosa sucking blood.


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2. Cestodes2.1 Dipylidium caninum

Life cycle of Dipylidium caninum

The definitive hosts are carnivores. They harbour the 45 cm worm in their small intestine.

Dogs and cats become infected by chewing and swallowing fleas.

Proglottids resembling cucumber seeds are excreted.

The dried proglottids contain packets of up to 40 eggs.

These are eaten byflea larvae and release oncospheres which develop into cysticercoids.


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2.2 Taenia species

Life cycle of Taenia taeniaeformis

Cats are the principal final host of the worm, which can grow up to 60 cm.

The excreted gravid proglottids contain up to 50,000 eggs.

Eggs ingested by rats, mice, and other rodents develop into the cystic form (Strobilocercus fasciolaris, syn. Cysticercus fasciolaris), in the liver of the intermediate host.

Cats become infected by ingesting intermediate hosts. In the final host the scolex becomes exposed and attaches itself to the intestinal wall.


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2.3 Echinococcus

Life cycle Echinococcus multilocularis

Tapeworm segments containing eggs are excreted by infected foxes with their faeces.

The tiny little tapeworm eggs are as light as dust. They can be spread by wind, rain, etc. and also by insects.

Mice (and muskrats) that eat food conta-minated with tapeworm eggs become intermediate hosts.

In the intermediate host the eggs develop into larvae (cysts).

Foxes, and sometimes dogs and cats, (definitve host) become infected when they eat inter-mediate hosts infested with cysts.

Dogs and cats excrete tapeworm eggs.Humans can become infected with tapeworm eggs adhering e.g. to the fur of pets.

The infection causes tumour-like growth of cysts, mainly in the liver.

People can become infected with tape-worm eggs by eating unwashed berries.

In the gut of the definitive host (fox, dog, cat) the larvae grow into adult tapeworms and produce copious eggs.


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Diagnosis and prepatent periodsThe most commonly practised laboratorymethod for the diagnosis of helminth infec-tion is the microscopic examination of thefaeces. This can only serve as an aid in es-tablishing a diagnosis, however, some inhe-rent weaknesses do exist

● If faecal findings are positive:The morphological similarity of tape-worm eggs permits no reliable differen-tiation between extremely dangerous spe-cies such as Echinococcus multilocularisand species that are less significant inman like Taenia spp. and Multiceps spp.

● If faecal findings are negative:Helminth infections during the prepatentperiod and dormant larvae in the muscles(e.g. of nursing queens) are not detectedby routine laboratory tests.

Treatment programmesThe worldwide danger posed by worminfections can only be reduced by appropri-ate education campaigns and dewormingprogrammes.

In view of the wide variability of the pre-patent periods of individual helminth spe-cies encountered in the cat (from 2 weeks to3 months), the unreliability of faecal exam-inations, and the constant threat of reinfec-tion from the environment (eggs and infec-tive larvae), a policy of routine dewormingtreatments seems advisable. Cats shouldtherefore be wormed regularly at least 4times a year.

Control of worm infectionsin cats

Treatment programme for kittens: Treatment programme for adult cats:

Worming At age of

1st 2 weeks

2nd 4 weeks

3rd 8 weeks

4th 12 weeks

5th 4 months

6th 5 months

7th 6 months

Worming

● Every 3 months or, if risk ofinfection is high, at intervals equalto prepatency

● Queens before mating and 10 daysbefore whelping.All subsequent worming treatmentat same time as the kittens.


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The most important tapeworms (cestodes) of the cat

Name Length Host Intermediate Larval stage Special features(appr. cm) host (metacest.)

Taeniidae

Taenia 15 – 60 cat, Mouse, rat Cysticercus Typical cat tapeworm.taeniaeformis dog fasciolaris Metacestode usually

(Strobilo- in the liver of thecercus) intermediate host

Echinococcus 0.14 – 0.34 fox, Field mouse, Echinococcus Man: Alveolar Echino-multilocularis dog, small alveolaris coccosis cancer-like

cat rodents infiltrative growth; (man) 98 % of the cases

in the liver, often fatal

Dilepididae

Dipylidium 20 – 45 cat, Flea Cysticercoid Most common caninum dog tapeworm species

of carnivores,human infectionpossible

Mesco-cestoididae

Mesocestoides 30 – 250 fox, 1. Oribatid 1. Cysticercoid Some of the meta-lineatus cat, mites 2. Tetra- cestodes burrow

dog (suspected thyridium through the intestinal but not con- wall of the definitive firmed yet) host, invading the 2. Amphibia, peritoneal cavity orreptiles, birds, other organsmammals


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Prepatent period of the most important intestinal worms of the cat

Worm species Prepatent period

RoundwormsToxocara cati 6 – 8 weeks(T. mystax) 3 weeks for galactogenic infectionToxascaris leonina approx. 10 weeks

HookwormsAncylostoma tubaeformae 2.5 – 3 weeksAncylostoma braziliense 2 – 3 weeksUncinaria stenocephala 2 – 2.5 weeks

TapewormsTaenia taeniaformis 5 – 11 weeksEchinococcus multilocularis 4 – 6 weeksDipylidium caninum 3 weeksMesocestoides lineatus 2 – 3 weeks

The most important round- and hookworms (nematodes)

General Scientific Length Host False or Special name name (app. cm) paratenic features

Male fem. hosts

Roundworms Toxocara 3 – 7 4 – 12 cat Mice, birds, Transmam- cati anthropods mary and oral(T. mystax) (man) route of

infection

Toxascaris 2 – 7 2 – 10 cat, “reservoir” leonina dog small

mammals,birds

Hookworms Ancylostoma 0,9 – 1,1 1,2 – 1,5 cat “reservoir” Oral and tubaeforme mouse percutaneous

(man) route ofinfection

Ancylostoma 0,6 – 0,75 0,7 – 1,0 cat “reservoir“ Oral and braziliense mouse percutanous

(man) route of infection


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1. Active ingredientsDrontal for cats is a broad-spectrum anthel-mintic containing a combination of theactive ingredients praziquantel and pyrantelembonate.

This combined formulation has the follow-ing advantages:● Comprehensive spectrum of activity

(roundworms and tapeworms)● One administration per worming is

sufficient● Convenient handling facilitates regular

use● Excellent tolerance

Presentation and composition:1 Drontal tablet for cats contains20 mg praziquantel230 mg pyrantel embonate

Praziquantel (INN)

2-Cyclohexylcarbonyl-1,2,3,6,7,11b-hexa-hydro-4H-pyrazino-[2,1-a]-isoquinoline-4-on (IUPAC)

Pyrantel embonate (INN)

Pyrantel (USAN) (E)-1, 4, 5, 6-tetrahydro-1-methyl-2-[2-(2-thienyl) vinyl]-pyrimidine4,4’-methylene bis [3-hydroxy-2-naph-thoate] 1:1 (IUPAC)

Drontal Product Profile

O

N

N

CO

OH

CH2

HOOC HO COOH

CC

S

NH

N

CH3 H


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2. Mode of action

Praziquantel

Praziquantel kills matureand immaturestages of tapeworms in the intestine after asingle treatment.

Within a few seconds of the tapeworm com-ing into contact with praziquantel its inter-action with phospholipids and proteinscauses damage to the tegument. The inflowof Ca2+-ions results in an immediate con-traction of the entire strobila. Moreover,these changes lead to a reduction of glucoseintake and an accelerated depletion of ener-gy reserves.

Pyrantel embonate

Pyrantel, an anthelmintic of the tetrahydro-pyrimidine group acts by inducing a depo-larising neuromuscular blockade. Pyrantel,being a cholinergic agonist, acts as an excit-atory neurotransmitter at the nicotinergicreceptor causing spastic paralysis of theparasite.

3. Spectrum of activity/IndicationsDrontal possesses an extremely wide spec-trum of activity which covers infestationwith the following cat nematodes and ces-todes:

Nematodes

Ascarids● Toxocara cati (T. mystax)● Toxascaris leonina

Hookworms● Ancylostoma tubaeforme● Ancylostoma braziliense

Cestodes

● Dipylidium caninum● Echinococcus multilocularis● Taenia spp.● Mesocestoides spp.● Joyeuxiella pasqualei

4. Dosage1 tablet per 4 kg bodyweight

The tablets are given orally to the animal,preferably concealed in a piece of meat,cheese, or titbit.

No special dietary measures are requiredeither in adult cats or in kittens.

The product is given as a single dose.(administration over several days is notnecessary.)


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5. EfficacyDrontal has been tested on a large numberof cats of various ages, sexes and breeds.Efficacy was demonstrated on the basis oflaboratory studies and field studies (copro-logical tests: EpG).

5.1 Efficacy against ascarids

Several laboratory and clinical field trialswere performed with Drontal, in order toassess the efficacy against ascarids.

The following results were obtained:

Efficacy of Drontal at the standard dosage against Toxocara cati

100

0T. cati

preadult

Effi

cacy

in %

10

20

30

40

50

60

70

80

90

98.494.3 97.8 96.5 96.2 96.4

T. catiadult

Meanvalue

T. catiadult

study I

T. catiadult

study II

Meanvalue

Laboratory studies: efficacy in % worm reductionClinical field studies: efficacy in % reduction EpG


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5.2 Efficacy against hookworms

Several laboratory and clinical field trialswere performed with Drontal, and con-

firmed the very high efficacy against hook-worms.


Efficacy of Drontal at the standard dosageagainst Ancylostoma tubaeforme

100

0

Effi

cacy

in %

10

20

30

40

50

60

70

80

90

Laboratory studies: efficacy in % worm reductionClinical field studies: efficacy in % reduction EpG

A. tubae-forme

preadult

97.3

A. tubae-formeadult

100.0

Meanvalue

98.2

A. tubae-formeadult

95.4


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Efficacy of Drontal at the standard dosage againstDipylidium caninum and Taenia spp.

100

0

Effi

cacy

in %

wor

m r

educ

tion

20

40

60

80

D.caninumimmature

adult

100

D.caninummatureadult

100

Taeniaspp.

immatureadult

100

Taeniaspp.

matureadult

100

5.3 Efficacy against tapeworms

Several laboratory and clinical field trialswere performed with Drontal againconfirming the excellent efficacy of Prazi-

quantel against tapeworms, which has alrea-dy been proven against Echinococcus mul-tilocularis, Mesocestoides spp. and joyeuxi-ella spp.



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5.4 Mixed infections

Field studies were performed in domesticcats aged between 2 months and 5 years.62.6 % of the tested cats were infected withone or more species. The following mixedinfections were identified (worm egg exa-mination):– Toxocara cati and Ancylostoma

tubaeforme– Toxocara cati and Taenia spp.– Toxocara cati, Ancylostoma tubaeforme

and Taenia spp.

After treatment with Drontal, mixed infec-tions were controlled on average at similarlevels to monoinfections.

Interactions with other drugs:

Due to negative impact on efficacy, Pipera-zine should not be administered at the sametime.

6. TolerabilityThe tolerability of the Praziquantel/Pyrantelembonate combination was tested in 373cats of various breeds and both sexes, aged3 weeks to 15 years. Both single-dose andmultiple-dose treatment were carried out.The doses were up to 5,3 times the thera-peutic dose of Praziquantel/Pyrantel embo-nate tablets. The tolerability was evaluatedon the basis of clinical parameters (appear-ance, general behaviour, reflexes and pos-ture), body weight gain, and haematologicalas well as biochemical parameters.

Drontal was confirmed to be without sideeffects up to a 5 fold overdosage in youngand adult cats.

Safety trials with very young kittens (3 – 5weeks) have also shown that Drontal is welltolerated using up to 3 times overdosage.

The good tolerability of the product underveterinary practice conditions was con-firmed within the framework of the clinicalfield trials, in which 232 cats were treatedwith the recommended clinical dose.

The tolerability of Drontal administeredconcomitantly with a number of other vete-rinary drugs (among which: antibiotics, eyeand ear preparations, gastrointestinal drugs,hormones, ectoparasiticides, topical drugs)at the recommended clinical dose was test-ed in a further study. No incompatibilitieswere observed.

Contra-indications:

Until sufficient studies have been per-formed with the combination Praziquan-tel/Pyrantel, Drontal should not be usedduring pregnancy.

Warning:

Keep out of the reach of children. For ani-mal treatment only.


ReferencesANDERSEN, F.L., J.R. CRELLIN, D.D. COX, (1981):Efficacy of Praziquantel against immature Echinococcusmultilocularis in Dogs and Cats.Am. J. Vet. Res., 42 (11), 1978-1979

BRADLEY, R.E. (1990): Dose titration of PyrantelPamoate as an Anthelmintic in Cats. Feline Pract., 18, (4),11-15

KRUCKENBERG, S.M., A.D. MEYER, W.R. EAST-MAN (1981): Preliminary studies on the effect of prazi-quantel against tapeworms in dogs and cats. Vet.Med./Small Anim. Clinician, 689-693

MAETZ, H.M., R.N. KLEINSTEIN, D. FEDERICO,J. WAYNE (1987): Estimated prevalence of oculartoxoplasmosis and toxocariasis in Alabama. J. Inf. Dis.,156, 414

REINEMEYER, C.R. & R.C. DE NOVO (1990): Evalua-tion of the efficacy and safety of two formulations ofPyrantel pamoate in cats. Americ. J. of Vet. Res., 51, (6),932-934

RIDLEY, R.K., K.S. TERHUNE, D.E. GRANSTROM(1991): The efficacy of Pyrantel pamoate against Ascaridsand Hookworms in cats. Vet. Res. Communications, 15,37-44

ROMMEL, M., H. GOELCK, F. HÖRCHNER (1976):Die Wirksamkeit von Praziquantel gegen Bandwürmerin experimentell infizierten Hunden und Katzen. Berl.Münchn. Tierärztl. Wschr., 89, 255-257

SCHANTZ, P.M., J.K. STEHR-GREEN (1988):Toxocaral larva migrans. J. Am. Vet. Med. Ass., 192,28-32

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Drontal - bicpu.edu.infilobase.bicpu.edu.in/Drontal.pdf · Larva Migrans is caused by larval forms of the dog or cat roundworm. When infection has occurred the larvae hatch in the