Pyrantel Pamoate (Strongid)

Pyrantel Pamoate

Antiparasitic
(Strongid, Nemex)
By Dr. Karen Burgess

• Pyrantel pamoate (generic formula)
• Strongid, Nemex, Virbantel (brand name animal formula)
• Tablet, Liquid

What is pyrantel?
Pyrantel is an antiparasitic known for its efficacy against roundworms, hookworms, and stomach worm. The drug paralyzes the parasite thereby causing it to release from a pet’s intestine and be passed naturally with fecal matter.

How is pyrantel given?
Pyrantel is typically prescribed as a single dose medication.

How should pyrantel be stored?
Store at room temperature and protected from light.

What side effects are associated with pyrantel?
Vomiting may occur after treatment with pyrantel. Worms may be seen visually passing in stool or in vomitus.

What drugs should not be given with pyrantel?
There are no specific drug interactions of major concern.

What follow up is necessary with pyrantel use?
Pyrantel only treats adult worms leaving immature migrating worms behind. Follow up dosing is recommended at two week intervals for a total of two to three doses. Prevention of future re-exposure is recommended via monthly heartworm preventative administration. Follow up fecal examination is recommended a week after treatment is completed.

• Proviable-DC, FortiFlora
• Capsule, paste, powder

What are probiotics used for?
Probiotics are used in the treatment of acute diarrhea associated with stress, change in diet, travel, and antibiotic usage. There have been promising results seen also with the use of probiotics in the treatment of conditions causing chronic diarrhea.

What are probiotics?
Probiotics are good live bacteria or microorganisms that provide a health benefit to an animal. They are considered live bacteria similar to those found naturally in the intestinal tract. In cases of diarrhea, imbalance in the intestine occur often causing bad bacteria to outnumber good bacteria. When given orally to pets, probiotics can help restore intestinal and overall health. Prebiotics are also included in products such as Proviable and serve as food for the probiotics.

What is the difference between a product like Proviable and yogurt?
The bacteria found in yogurt is often not life or in the numbers necessary to help with diarrhea.

Is there a difference between probiotic products?
Yes. Because probiotics are a nuetraceutical and not a drug therefore they are not regulated by anyone including the FDA. This means that manufacturers can sell an inferior product with little to no live bacteria or benefit to a patient. Proviable and FortiFlora are both produced by reliable companies and contain appropriate strains and numbers of bacteria.

How are probiotics given and what if a dose is missed?
Probiotics are typically prescribed for once daily dosing. If a dose is missed and it is less than 12 hours late, go ahead and give missed dose. If it is within 12 hours of the next dose, skip a dose and resume regular schedule with next dose. Use is typically continued for several days beyond resolution of symptoms at a minimum. Probiotics are often nice for owners to have on hand to administer at the first sign of diarrhea or prior to a known stressful situation in hopes of prevention.

Are there any common adverse effects with the use of Probiotics?
No.

Who should not take probiotics?
Avoid use of probiotics in patients that are vomiting, severely dehydrated, or immunocompromised.

What drugs should not be given with probiotics?
Antibiotic efficacy can be affected by probiotics; separate administration times by two hours to avoid this as a concern.

• Generic, human medication
• Tablets

What is prednisone used for?
Prednisone decreases inflammation and at high doses acts as an immunosuppressive drug. Allergic and autoimmune diseases, swelling in the nervous system, shock and cancer therapies all commonly utilize prednisone in their treatment.

What is prednisone?
Prednisone is a classified as a glucocorticoid hormone or steroid and is known for its broad anti-inflammatory effects. Steroid hormone is naturally produced in the body by the adrenal gland and is necessary in very small quantities for survival. Anabolic steroids, commonly referenced in sports, are used to build up tissue (muscle) while catabolic steroids such as prednisone break down stored resources to create energy. Prednisone is changed into prednisolone in the liver making the two drugs interchangeable.

How is prednisone given and what if a dose is missed?
Prednisone is typically given in a tapering dose schedule to prevent potentially life threatening side effects. When a pet is given prednisone as a medication it suppresses the adrenal gland’s natural production. For this reason it can be very dangerous to suddenly stop prednisone treatment without giving the body ample time to restart its own steroid production. If a dose is missed and it is less than 12 hours late, go ahead and give missed dose. If it is within 12 hours of the next dose, skip a dose and resume regular schedule with next dose. Give prednisone with food to help prevent stomach upset.

What side effects can be expected and what pets should not receive prednisone therapy?
Steroids as a class stimulate the desire to drink and production of urine. It is not uncommon for pets on prednisone to have urinary accidents in particular at the beginning of therapy and plans should be made for extra trips to the bathroom or cleaning of the litterbox. Increase in appetite, panting, and behavior changes (including aggression) are also common side effects. Suppression of the immune system by steroids can put a pet at increased risk for infection. With long term prednisone therapy changes in skin, haircoat, and body musculature (potbellied appearance) are often noted. Pets with heart disease may get worse on steroids. Diabetes may develop with steroid treatment and diabetic pets in general should not receive steroids. Pregnant pets should not take steroids.

What drugs should not be given with prednisone?
NSAIDs as a class should never be given at the same time as steroids. This can be life threatening. There should be a “washout” period when changing from an NSAID to a steroid. Discuss how long to wait between NSAID and steroid use with your veterinarian.

Are there any other concerns with prednisone?
Steroids can alter several commonly run blood laboratory tests. Make sure your veterinarian is aware of steroid therapy when interpreting labwork.

Praziquantel (Drontal Plus)

Praziquantel

Antiparasitic
(Droncit, Drontal Plus, Sentinel Spectrum)
By Dr. Karen Burgess

• Praziquantel (generic formula)
• Droncit, Drontal Plus, Sentinel Spectrum (brand name animal formula)
• Tablet, Flavor Tablet, Injectable

What is praziquantel?
Praziquantel is an antiparasitic known for its efficacy against the tapeworm class of parasites. The drug damages the parasites skin leading to disintegration. Worms are not commonly seen in the feces in response to treatment.

How is praziquantel given and what if a dose is missed?
Praziquantel is typically prescribed as a single dose medication.

How should praziquantel be stored?
Store at room temperature and protected from light.

What side effects are associated with praziquantel?
Gastrointestinal signs including appetite loss, vomiting, and diarrhea occur in approximately 5% of patients taking praziquantel. The oral formulation may taste bitter to pets.

What drugs should not be given with praziquantel?
There are no specific drug interactions of major concern.

What follow up is necessary with praziquantel use?
Prevention of future re-exposure is recommended via flea and rodent control. Follow up fecal examination is recommended a week after treatment is completed.

• Remeron
• Tablet, dissolvable tablet

What is Mirtazapine used for?
Mirtazapine is used to stimulate the appetite and prevent vomiting.

What is Mirtazapine?
Mirtazapine is a human antidepressant that works in the brain to increase norepinephrine and serotonin activity stimulating appetite centers in the brain as a side effect.

How is Mirtazapine given and what if a dose is missed?
Mirtazapine is typically prescribed for once daily dosing in dogs and a twice weekly dosing in cats. If a dose is missed and it is less than 12 hours late, go ahead and give missed dose. If it is within 12 hours of the next dose, skip a dose and resume regular schedule with next dose. If using dissolvable tablet formulation, place it under the tongue and hold mouth shut for several seconds. Follow with a swallow of water.

Are there any common adverse effects with the use of Mirtazapine?
Reported side effects include increased vocalization and affection in cats, drowsiness, and elevated heart rate.

Who should not take Mirtazapine?
Use with caution in patients that have heart disease. Patients with liver or kidney disease may require a lower dose.

What drugs should not be given with Mirtazapine?
Mirtazapine should not be used in pets that have taken selegiline or amitraz in the last fourteen days. Use with care in patients taking tramadol or fluoxetine.

What follow up is necessary with Mirtazapine use?
Withdrawal signs with discontinuation of mirtazapine can occur in humans after longterm use.