Table 5A.
Cardiopulmonary changes during heartworm adulticide treatment in dogs, using moxidectin and doxycycline.
| References | Study protocol | Exercise restriction | Summary findings |
|---|---|---|---|
| Savadelis et al. (31), Savadelis et al. (53) | EI M/I + doxy (n = 8) | Moderate; housed in runs, in pairs | •Cough, quiet demeanor and crackles in 1/8 at ~1 month – treatment not needed •Suspected PTE in 1 infected dog (13%) at d 173 (6 m); resolved spontaneously within 24 h •Radiographic and echo evidence of disease similar to untreated controls •Arterial thrombi scores significantly higher in treated dogs, attributed to dead and dying worms |
| Paterson et al. (9) | NI M/I + doxy (n = 15) | Recommended, but many were free-roaming | •4/15 (27%) developed cough requiring treatment •3 required prednisone on only one occasion; 1 required prednisone intermittently for parasitic pneumonitis that was present at enrollment •Onset of new cough occurred 3 to 5 months after initiation of treatment |
| Genchi et al. (52) | NI M/I + doxy (n = 14) | Not stated | Interstitial lung scores on radiographs, worst possible score 3/3. Echo scores based on pulmonary hypertension, worst possible score 3/3 •No dog had radiographic or echo score > 1/3 at enrollment •Radiographic score progressed in 1/14 (7%) at 6 months (from 0/3 to 1/3) •All radiographic scores normal (0/3) from 12 months •Two dogs (14%) abnormal echo scores (1/3) at enrollment •All other echo scores normal at all time points |
| Ames et al. (48) | NI M/I + doxy (n = 22) | None | •5/22 (23%) – cough at enrollment; no treatment needed; worsened in 2/5 during treatment •8/22 (36%) – new or worse cough during treatment, onset 60–180 (mean 89 d); 4 required treatment •1/22 (5%) – dyspnea and cough at 12 w, pneumonitis, hospitalized and recovered •Subjective radiographic severity scores, with worst possible score 3/3 – baseline median 1; peak 1.25 •Peak score occurred at an average of 58 d after initiating treatment •Highest scores (3/3) in two dogs with cough requiring treatment, on days 60 and 84 •Nine (56%) had normal (0/3) to mild scores (1/3). |
| Alberigi et al. (55) | NI PH + doxy (n = 20) | Mild to moderate | •Statistically significant improvement in most measures (cough, dyspnea, expiratory sounds, pulmonary artery enlargement) by time of first NAD, several measures improved at second NAD •Bronchointerstitial pattern in all dogs at intake; no significant improvement •Micronodular pattern prevalence increased at time of first NAD, returned to baseline at second NAD (7/19 vs. 6/19 at intake) |
NI, natural infection; EI, experimental infection; M/I, moxidectin/imidacloprid as Advantage Multi® or Advocate® PH, moxidectin as ProHeart® 12; echo, echocardiogram/echocardiographic; PTE, pulmonary thromboembolism; NAD, No antigen detected.