Lungworm prophylaxis

Re: Lungworm prophylaxis

ruths — Sat, 01 Nov 2014 14:15:11 GMT

Lol- obviously I didn't suggest pancakes for lungworm prophylaxis -))

Re: Lungworm prophylaxis

Hannah Wynne Richards — Sat, 01 Nov 2014 09:51:50 GMT

Ruths Baths may explain my lack of faith in Advocate. A lot of my clients (during the winter) regularly exercise their dogs on the beach, then immediatelybath them. That,together with seagulls explains the high incidence I see of Campylobacter

Wynne

Re: Lungworm prophylaxis

Hannah Wynne Richards — Sat, 01 Nov 2014 09:48:42 GMT

Virginia Yes - but I haven't yet turned up a case of Angio in a dog regularly treated with Advocate by that method, so it wouldn't be answering Malcolm's question. Having said that,it's not my treatment of choice.

Wynne

Re: Lungworm prophylaxis

ruths — Fri, 31 Oct 2014 08:16:31 GMT

My concern about advocate is that two baths seems to render it ineffective according to the data sheet. I always thought people used pancakes due to the fact that it was the first treatment available and it is hard to change a habit- it's frustrating that there is only anecdotal evidence. I suppose I've treated 10's not 100's of cases and found both treatments to be effective. In one puppy, there was lungworm a month later after an advocate treatment and this was resolved by using both advocate and panacur- I was worried! And I don't understand Bayer suggesting drontal plus and not droncit in that suggested treatment protocol. Interesting stuff

Re: Lungworm prophylaxis

james herriot lied — Thu, 30 Oct 2014 23:43:56 GMT

[quote user="Virginia Campbell"]

Do you use the AngioDetect snap?

[/quote]

We tend to do this routinely; previously, if we were doing xrays, a BAL was easy to do at the same time - and somehow supremely satisfying in the event of a positive diagnosis.

Re: Lungworm prophylaxis

Virginia Campbell — Thu, 30 Oct 2014 20:22:39 GMT

[quote user="Hannah Wynne Richards"]

Confirmation Sometimes ocular inspection, sometimes radiographu - pics of lungs look like cotton wool balls all over the place, sometimes the lab gives a pos on a pooled faeces sample. If I'm suspicious, I'll have started treatment with panacur well before the lab result comes back.

Wynne

[/quote]

Do you use the AngioDetect snap?

Re: Lungworm prophylaxis

Mark Holmes — Thu, 30 Oct 2014 15:39:25 GMT

They claim to prevent angiostrongylosis by a reduction in parasitic burden. That to me isn't the same. The only study I can find looking at Milbemycin suggests it doesn't work reliably and hence I imagine a tendency towards promoting resistance.

Re: Lungworm prophylaxis

Hannah Wynne Richards — Thu, 30 Oct 2014 15:22:40 GMT

Read the Milbemax leaflet They don't even attempt to claim that once monthly milbemax is adequate to control Angio

Wynne

Re: Lungworm prophylaxis

Martin Atkinson — Thu, 30 Oct 2014 14:53:47 GMT

[quote user="Bob Russell"]As we are in a high tick and relatively low lungworm risk area Seresto and Milbemax (even if only 3 monthly) is my choice. It is how my pets are treated. I make it clear to owners what the options are but considering client compliance is likely to fall well short of 100%. think this is as good a compromise as I am likely to get.[/quote]We've just had a client come in for some more Advocate and raised the issue that her dog gets the occasional tick. We do not see a lot of ticks round here but quite a bit of lungworm and I've never seen or even suspected a case of tick borne disease. So my stock reply is that the stuff Advocate does is more useful and to pull the odd tick off with a tick-hook. However she then went on to say that her dog is off colour for a day and has an unpleasant smell for several days after applying Advocate. We happened to have some Nexguard tablet samples the rep gave us so I suggested she used those and Milbemax monthly. We'll see how that goes and hope it doesn't get mites, or lice!!

Re: Lungworm prophylaxis

Hannah Wynne Richards — Thu, 30 Oct 2014 13:39:19 GMT

Suspicion - resp symptoms or pallor with no known exposure to rodenticides (and bearing in mind could have second hand poisoning ) or sudden onset neuro symptoms.

Wynne

Re: Lungworm prophylaxis

Bob Russell — Thu, 30 Oct 2014 13:21:47 GMT

Off the record chats with more than one medical specialist has suggested they prefer fenbendazole.

I know David Walker is doing some work related to Advocate and lungworm. If this matches Bayer's confidence in the product then I will be convinced.

Not sure if fear is related to a product being so easy to use or fear of facing Bayer!

As we are in a high tick and relatively low lungworm risk area Seresto and Milbemax (even if only 3 monthly) is my choice. It is how my pets are treated. I make it clear to owners what the options are but considering client compliance is likely to fall well short of 100%. think this is as good a compromise as I am likely to get.

If generic Milbemax equivalents become significantly cheaper I may be able to persuade owners to do better.

As I understand it Bayer advise Seresto, Advocate plus Drontal Plus. Very nice earner if you can get clients to fork out the readies!

Re: Lungworm prophylaxis

Malcolm Ness — Thu, 30 Oct 2014 13:01:26 GMT

[quote user="Hannah Wynne Richards"]

I've seen clinical cases of Angiostrongylus in dogs given Advocate

Wynne

[/quote]

What makes you suspect lungworm and how are you making/confirming the diagnosis?

Re: Lungworm prophylaxis

Hannah Wynne Richards — Thu, 30 Oct 2014 12:29:22 GMT

It took me a bit longer to develop self-confidence - but I'm now making up for lost time

Wynne

Re: Lungworm prophylaxis

Martin Atkinson — Thu, 30 Oct 2014 11:56:09 GMT

[quote user="Hannah Wynne Richards"]

Martin I'm often the only member of the "awkward squad" as well.

[/quote] Well tell me why I'm not surprised at that either!

'I'm surprisingly often the only one of my generation present'.

I'm not surprised and I invariably look around and think the same. Is it because the others have been able to afford/wanted to retire and live off their fortune or have they just become dinovets?

'When I was the age of the average member of the audience, I was a timid little mouse as well'.

Well that's where we do differ. I don't recall being timid since I emerged from behind my mother's apron strings at around 18 which roughly coincided with going to university of course!

Re: Lungworm prophylaxis

Hannah Wynne Richards — Thu, 30 Oct 2014 11:10:27 GMT

Martin I'm often the only member of the "awkward squad" as well. I'm surprisingly often the only one of my generation present - how the others manage their CPD is a mystery! When I was the age of the average member of the audience, I was a timid little mouse as well.

Wynne

Re: Lungworm prophylaxis

Martin Atkinson — Thu, 30 Oct 2014 10:50:33 GMT

I went to a CPD meeting last night about disorders of haemostasis by Eleanor Raffan from Cambridge Vet School. One point was the treatment of lungworm and she had fenbendazole and Advocate on the screen with a suggestion that they were equally efficacious. I put in my penno'worth (I'm the annoying one who always sits at the front and asks all the questions and challenges the speaker - as if you'd all never guess!) and said that I wouldn't trust Advocate and would always go for the fenbendazole, and asked the rest of the audience for a poll on what they thought. The silence was deafening. Now whether they were scared to say anything, really didn't have experience or an opinion or just wanted this loud-mouth up the front shut up so the meeting could end and they could go home I'm not sure, but I felt it was a wasted opportunity to get some feed-back. Incidentally Eleanor agreed with me.

Re: Lungworm prophylaxis

Hannah Wynne Richards — Thu, 30 Oct 2014 09:47:28 GMT

PS to above. I don't have psychiatric hang-ups about total cost of PROPER treatment

Wynne

Re: Lungworm prophylaxis

Hannah Wynne Richards — Thu, 30 Oct 2014 09:25:42 GMT

Martin. Bloke in pub who's wormed his dog with Bob Martins then ended up with a veterinary bill and a dead dog brings clients hot-footing it to my door asking for something to treat "lugworms". After that - well no-one has ever accused me of ambiguity. I tell them theclinical facts as they are.

Wynne

Re: Lungworm prophylaxis

Thomas Johnson — Thu, 30 Oct 2014 08:55:05 GMT

[quote user="Bob Russell"]

Once the specialists have the same level of confidence in Advocate as Bayers marketing, I will bow to their superior knowledge.

[/quote]

I was thinking about this overnight, sad I know, and I wonder if part of the reason people use Panacur to treat lungworm is psychological. Putting a couple of millilitres of liquid on the back of a dog's neck can't be enough treatment for such a serious disease, whereas something you have to give daily for a week must work better.

Re: Lungworm prophylaxis

Hannah Wynne Richards — Wed, 29 Oct 2014 18:42:34 GMT

Swansea = Lungworm capital of Great Britain - however a fairly recent Merial worm survey totally failed to find any in ny client's dogs

Wynne

Re: Lungworm prophylaxis

Martin Atkinson — Wed, 29 Oct 2014 18:34:21 GMT

[quote user="Hannah Wynne Richards"] I've seen clinical cases of Angiostrongylus in dogs given Advocate[/quote]We've had the discussion on treatment of clinical cases before and there was a consensus that Advocate is not effective enough but my first thought on it not working as a preventative is more lack of compliance rather than efficacy.

[quote user="Hannah Wynne Richards"]My favourite regime is alternate months 1/2 strength panacur daily for a week, and single dose milbemax. Add on Frontline combo monthly. [/quote] Seems a bit OTT for compliance unless you can really convince the client that angiostrogylus is a clear and present danger. As for Frontline, maybe it works for Welsh fleas but there are very clear signs that it is ineffective against our Home Counties fleas - I see an endless stream of Frontline users coming in with animals with very, very heavy flea burdens. I think a lot of this is because it is difficult to apply effectively so there is a lack of compliance (ditto Advocate) but there are so many I am now convinced there is a resistance issue.

Re: Lungworm prophylaxis

Thomas Johnson — Wed, 29 Oct 2014 17:27:26 GMT

[quote user="Bob Russell"]

If Bayer's claim of 100% efficacy for Advocate is correct why do none of the medical specialists seem to use it? Generally they prescribe long courses of fenbendazole.

[/quote]

Below is a link to the paper Bayer reference in their promotional material for Advocate, which showed no statistically significant difference between treatment with Advocate or Panacur for lungworm:

http://www.ncbi.nlm.nih.gov/pubmed/17544583

And another study here looking at just Advocate:

http://www.sciencedirect.com/science/article/pii/S0304401709005378

Re: Lungworm prophylaxis

Bob Russell — Wed, 29 Oct 2014 17:03:55 GMT

Not a specialist or an advanced lungworm practitioner but included as much more experienced than most!

Re: Lungworm prophylaxis

Hannah Wynne Richards — Wed, 29 Oct 2014 16:58:35 GMT

Am I included as a specialist, given the incidence in Swansea?

Wynne

Re: Lungworm prophylaxis

Bob Russell — Wed, 29 Oct 2014 16:52:04 GMT

If Bayer's claim of 100% efficacy for Advocate is correct why do none of the medical specialists seem to use it? Generally they prescribe long courses of fenbendazole.

Seresto Collars are really good and no we have not seen cases in three monthly milbemax dogs. Not a high risk area but none of the cases were wormed with milbemax.

Perhaps it could be argued that it may protect them for part of the year therefore reduces a low risk to lower! There are occasional cases locally.

Once the specialists have the same level of confidence in Advocate as Bayers marketing, I will bow to their superior knowledge.