Route of administration affects the efficacy of moxidectin against Ostertagiinae nematodes in farmed red deer (Cervus elaphus).

The influence of route of administration on the pharmacokinetics and efficacy of macrocyclic lactone anthelmintics has been a subject of interest due to its potential to influence the development of anthelmintic resistance. For most parasite species studied so far, oral administration results in the highest concentrations of drug in the parasites and the highest efficacy against resistant genotypes. However, a recent study in cattle measured the highest levels of ivermectin in the abomasal Ostertagia ostertagi following subcutaneous injection, but it was not possible to correlate these elevated levels with efficacy. Therefore, the current study was initiated to determine whether injectable delivery might be optimal for attaining high efficacy against this important group of parasites. Three on-farm trials were conducted to measure the efficacy of moxidectin administered by the oral, injectable, and pour-on routes against Ostertagiinae parasites in farmed red deer. Groups of rising 1-year old stags (red or red-wapiti crossbreds) in the 84-104 kg weight range were randomised on liveweight into treatment groups of 6 (1 farm) or 8 (2 farms). Animals were treated to individual liveweight with moxidectin oral (0.2 mg/kg), injectable (0.2 mg/kg), pour-on (0.5 mg/kg) or remained untreated. Twelve days later all animals were euthanised and abomasa recovered for worm count. Adult worms were counted in a 2% aliquot of abomasal washings, and adult and fourth stage larvae in a 10 % aliquot following mucosal incubation in physiological saline. In addition, blood was collected from the same 5 animals in each of the treatment groups on days 0, 1, 2, 3, 5, 7 and 12 after treatment and moxidectin levels in plasma were determined using a mass spectrometer. The number of Ostertagiinae surviving treatment was significantly different for each of the treatment groups with injectable administration being most effective, oral administration being the next most effective and pour-on administration the least effective. This applied to both adult worms and fourth stage larvae. A similar pattern was seen in the levels of moxidectin in plasma with both the peak value and area under the concentration curve being highest following injectable administration and lowest following pour-on treatment. Although undertaken in a different host species, the results support the proposition that injectable administration of macrocyclic lactone anthelmintics is likely to be optimal for efficacy against Ostertagiinae parasites and potentially useful in slowing the emergence of resistance in these parasites.

The effect on liveweight gain of using anthelmintics with incomplete efficacy against resistant Cooperia oncophora in cattle.

A replicated field trial was conducted to measure the effect on liveweight gain of failing to adequately control anthelmintic resistant populations of Cooperia oncophora and to determine whether populations, and hence production losses, increased with time. Eight mobs of 10 Friesian-Hereford calves were run on independent farmlets from January to December, over each of two years. All mobs were routinely treated with a pour-on formulation of eprinomectin every six weeks, which controlled parasites other than Cooperia. Four mobs also received six weekly treatments with an oral levamisole plus albendazole combination anthelmintic to control Cooperia. Liveweights, condition scores, faecal egg counts and larval numbers on pasture were measured throughout. In the first year animals treated with eprinomectin alone were 12.9 kg lighter in November than those treated with eprinomectin plus albendazole and levamisole, however, in the second year there was no difference between the treatment groups. The data, therefore, support the view that while C. oncophora is less pathogenic than other cattle parasite species it can still cause production losses when present in sufficient numbers. In the first year of the study, parasite load, as measured by faecal nematode egg count and larval numbers on herbage, tended to be higher and calf growth rates lower than in the second year. In both years, counts of infective larvae on herbage declined over winter-spring to be at low levels before mid-summer. This suggests that the carry-over of infection from one crop of calves to the next was relatively small and hence that the level of challenge to the young calves at the start of each year was largely due to the effectiveness of the quarantine treatments administered when the animals arrived on the trial site. Low survival of larvae on pasture between grazing seasons, resulting in small larval populations on pasture when drenching programmes start each summer, might help to explain the widespread development of anthelmintic resistance in this parasite under New Zealand grazing systems.

Confirmation of ivermectin resistance in Ostertagia ostertagi in cattle in New Zealand.

Six suspected cases of ivermectin resistance in Ostertagia spp. in cattle were investigated after routine anthelmintic efficacy testing on commercial farms. On four farms a comprehensive faecal egg count reduction test (FECRT) was undertaken using oral formulations of ivermectin (0.2mg/kg), albendazole (10mg/kg) and levamisole (7.5mg/kg) while on two farms only ivermectin was tested. The proportions of Ostertagia spp. in the untreated control and post-treatment larval cultures were used to apportion egg counts to genera and determine efficacy against this genus. Isolates of Ostertagia spp. recovered from three of the farms were each used to infect 18 six month old calves. The efficacy of oral formulations of ivermectin and moxidectin, both at 0.2mg/kg, was determined against each isolate by slaughter and worm count. The efficacy of ivermectin against Ostertagia spp., based on differentiated FECRT for each of the farms varied from 0% to 88%. The efficacy of ivermectin based on worm counts in the slaughter trial varied from 13% to 75% but moxidectin was >99% effective against all isolates. In addition, in the FECRT albendazole, at a dose rate of 10mg/kg, failed to achieve 95% efficacy against Ostertagia spp. on two farms (82% and 85%). Levamisole consistently failed to achieve 95% efficacy against Ostertagia spp. which is consistent with its known lesser efficacy against this parasite. These results confirm the presence of macrocyclic lactone resistant O. ostertagi in cattle in New Zealand and the likely presence of dual resistance, to macrocyclic lactones and albendazole, in some isolates. Resistant populations of this highly pathogenic parasite are probably not uncommon in New Zealand and pose a significant threat to animal production and welfare in the future.

Reoperation after limb preservation surgery for sarcomas of the knee in children.

Limb preservation surgery compares favorably with amputation in oncologic and functional outcomes. However, an increased incidence of complications and reoperations is associated with limb preservation. This study compared the outcome of a group of young patients who required at least one reoperation after limb preservation surgery because of a complication or need for prosthetic lengthening with the outcome of a similar group who did not require additional surgery. The functional scores before and after reoperation are compared to determine the impact on reported function and patient satisfaction. Forty-four consecutive patients younger than 19 years were treated for a malignancy of the distal femur or proximal tibia. Six of these patients required an amputation because of extensive disease or inadequate response to chemotherapy. The Musculoskeletal Tumor Society functional evaluation scores of 26 patients who required at least one reoperation (Group A) were compared with the scores of 10 patients who have not required additional surgery (Group B). Average before and after reoperation functional scores were compared to discern a decline in function with time. The minimum followup was 2 years. Patients in Group A required 54 reoperations. No difference in mean functional scores between Group A and Group B was detected. Likewise, after isolating Group A scores, no significant difference was detected between the average functional scores before (67%) and after (68%) reoperation or lengthening. Despite relatively small numbers, the current study suggests that adequate function is maintained despite reoperation or revision in young patients with malignancies of the knee who have limb preservation surgery.