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Deworming right

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Presentation from 2020 Weekly Worm Webinar Series. By Susan Schoenian, Sheep & Goat Specialist for University of Maryland Extension.

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Deworming right

  1. 1. Dewormingright SUSAN SCHOENIAN Sheep & Goat Specialist University of Maryland Extension sschoen@umd.edu | wormx.info | sheepandgoat.com
  2. 2. Deworming • Dewormers are a valuable,but limited resource. • Our goalshould be to minimize their use by relying on other strategies to control internal parasitism in our flocks/herds, such as pasture/grazing management and genetic selection. • However, when dewormingis required it should be done right.
  3. 3. Goalsofdeworming • Therapeutic, not prophylactic. • Treat clinically-parasitized animals to save their lives, improve their welfare, and reduce production losses. • Need to do so in a manner that minimizes thedevelopmentof resistantworms.
  4. 4. Dewormers 101
  5. 5. Whatisadewormer? • Drug that kills or expels parasitic worms by starving or paralyzing them. • Must be selectively toxic to the worm(s) without harming the host. • Today’s dewormers are muchsafer and more powerful than older drugs or old-time remedies. • Also called anthelmintics.
  6. 6. ThreedewormerclassesforsmallruminantsinUSA Thereiscross-resistanceamongdrugsinthesamegroupduetosimilarmodeofaction. 1 Benzimidazoles (white) 2 Macrocylic lactones 3 Thiabendazole – TBZ® Fenbendazole - Safe-Guard®, Panacur® Albendazole - Valbazen® Oxyfendazole - Synanthic® Avermectins Ivermectin - Ivomec® Doramectin - Dectomax® Eprinomectin - Eprinex® Milbimycins Moxidectin - Cydectin®, Quest® Imidazothiaoles (clear) Levamisole Prohibit®, Leva-Med® Tetrahydropyrimidines Morantel tartrate - Rumatel® Goat Dewormer, GoatCare, Positive Pellet 1960’s 1980-1990’s 1960’s
  7. 7. DewormersFDA-approvedforsheep 1 Benzimidazoles Valbazen® 2 Macrocyliclactones 3 IMID/TETR Prohibit®,Leva- Med® Avermectins Ivomec® Milbimycins Cydectin® Adult worms     Immatureworms (L4)    Variable Hypobiotic larvae    Lung worms     Tapeworms segments Liver flukes adult Coccidia External parasites   Persistent activity  Perlabel Valbazen® Ivomec® Cydectin® Prohibit®,Leva- Med® Dosage 3 ml/100 lbs. 3 ml/26 lbs. 1 ml/11 lbs. Depends on dilution
  8. 8. 1 Benzimidazoles 3 IMID/TETR Safe-Guard® Valbazen® Moranteltartrate Adult worms    Immatureworms (L4)   Hypobiotic larvae   Lungworms   Tapeworms not labeled  Liver flukes adult Coccidia External parasites Per label Safe-Guard® Valbazen® Morantel tartrate Dosage per 50lbs. 1.2 ml 2 ml Depends on product Meat withdrawal 6 days 7 days 30days Milk withdrawal NA NA 0 days DewormersFDA-approvedforgoats
  9. 9. 1 Benzimidazoles 2 Macrocyliclactones 3 IMID/TETR Safe-Guard® Valbazen® Ivomec® Cydectin® Prohibit®,Leva-Med® Adult worms      Immatureworms (L4)     Variable Hypobiotic larvae     Lung worms      Tape worms segments segments Adult liver flukes adults Coccidia External parasites   Persistent activity  PerACSRPC(wormx.info) Safe-Guard® Valbazen® Ivomec® Cydectin® Prohibit®,Leva-Med® Dosage per 50lbs. 2.3 ml 4 ml 12ml 9 ml Depends on dilution Meat withdrawal 16days 9 days 14days 17days 4 days Milk withdrawal 4days 7days 9days 8days 3days Extra-labeldewormersforgoats
  10. 10. 1 Benzimidazoles 2 Macrocyliclactones 3 IMID/TETR Safe-Guard® Valbazen® Ivomec® Cydectin® Prohibit®,Leva-Med® Adult worms      Immatureworms (L4)     Variable Hypobiotic larvae     Lung worms      Tape worms segments segments Adult liver flukes adults Coccidia External parasites   Persistent activity  PerACSRPC(wormx.info) Safe-Guard® Valbazen® Ivomec® Cydectin® Prohibit®,Leva-Med® Dosage per 50lbs. 4.5 4.0 11.4 9.0 Depends on dilution Extra-labeldewormersforcamelids
  11. 11. Safety of dewormers Dew o rmer Label Restric tio ns A ppro x. safety m argins Sheep G o a t Fenbendazole Safe-Guard®suspension 500 NA Albendazole Valbazen®oralsuspension Pregnancy First 30days 20 NA Ivermectin Ivomec® oraldrench Otheranimals 30 NA Moxidectin Cydectin®oraldrench >4 monthsofage Otheranimals 5 NA Levamisole Prohibit®drench powder 3 4 Moranteltartrate 20 NA Human safety: avoid skin contact, wash hands after use Various sources, including parasitipedia.net
  12. 12. Environmentalconsiderations Properdisposal • Preferablybyuse. • In a sealedcontainer. • At approvedlandfillor byincineration. • Outofand away from waterways. • Whenused correctly,mostofthe dewormers havea low potentialfor environmental pollution. • Macrocycliclactones (endectocides)may adverselyaffectfishand certainaquatic species,bedetrimentalto dungbeetles,and reduceinsectdiversity. • However,MLs havereducedthe useof much moretoxicchemicals.
  13. 13. How to reduce efficacy of dewormers • Use past expiration dates. • Store in open containers. • Too much exposure to light. • Store in extreme heat or in freezing temperatures. • Store where there is extreme temperature variation. • Allow contamination of drench solution. • Mix with other product(s) before administration.
  14. 14. Dewormer resistance
  15. 15. Whatis dewormer resistance? • Heritable ability of a worm to survive a dose of dewormer that should have killed it. • Exists in a population of worms if more than 5% of worms survive treatment. • Resistant genes are passed onto the next generation of worms.
  16. 16. Dewormerresistance • May not be noticed untilmore than50% of worms survive treatment, and treatmentfails to alleviateclinical disease. • Resistanceis generally thought to be permanent. • Resistanceis different in levamisole (autosomal recessive).
  17. 17. StateofdewormerresistanceinUSA • Worms have developed varying degrees of resistance to all dewormers and dewormer classes. • Resistance varies by geographic region and individual farm. • Many farms have resistance to multiple drugs. • The only way to know which drugs work on your farm is to test. 0 10 20 30 40 50 60 70 80 90 100 Benzimidazoles Ivermectin Moxidectin Levamisole All drugs Percent farms with anthelmintic resistance (< 95% FECR) 2008-2009 - Mid-Atlantic farms 2016-2017 - MD, VA & GA farms
  18. 18. Twowaystotestfordewormerresistance Fecal egg count reduction test • Compare before and after fecal egg counts (before treatment and 10-14 days later). • Use individual or pooled samples from at least 10 animals for each dewormer you want to test. • Need a lot of animals to test all drugs. • Minimum FEC of 250 EPG. • Determines percent fecal egg count reduction • Cost varies. Can learn to do yourself. DrenchRite® larval development assay • Lab test that determines resistance to all dewormer groups simultaneously from a single pooled fecal sample from at least 8 animals. • Minimum FEC of 500 EPG. • Reports resistance, suspected resistance, and susceptibility (detects resistance sooner). • Identifies species of parasites from hatched larvae. • University of Georgia is only place that does test in North America (~$500 per sample) Note: New protocols arebeing developed forthe fecal egg count reduction test, which has beenthe “gold standard” for determining dewormer resistance.
  19. 19. Practiceswhichacceleratedewormerresistance • Frequent deworming • Whole flock/herd treatments • Calendar-based treatments • Treat and move (to clean pasture) • Underdosing • Depositing drug in mouth instead of body cavity. • Persistent-activitydewormers • Pouring on dewormers • Injecting dewormers • Use of expired dewormers • Improper storage of dewormers
  20. 20. Proper use of dewormers
  21. 21. Targeted Selective Treatment (TST)
  22. 22. Targetedselectivetreatment(TST) • Only dewormingthoseanimalswhich requiretreatmentor wouldbenefitmost from treatment. • Slows dewormerresistanceby reducing numberoftreatments andincreasing refugia. • Refugia are worms thathavenotbeen exposedtodewormer(s). • TST alsohelpsto identifyanimalswhich are more resistantandresilientto worms (and viceversa). Refugiais nowthe primarystrategy formaintainingdewormereffectiveness.
  23. 23. Toolsfortargetedselectivetreatment(TST) For chute-sidedecision-making 1. FAMACHA©eye anemia system 2. Bodyconditionscore 3. FivePointCheck© 4. Performancefactors 5. Other combinedTST
  24. 24. FAMACHA©eyeanemiasystem • Color eye chart that is used to determine level of anemia in animal;thus, need for deworming. • Anemia is primary symptom of barber pole worm (Haemonchuscontortus) infection. • Trainingis required to purchase a FAMACHA© card. Due to Covid 19, some universitiesare now offering online FAMACHA© certification (www.wormx.info/ workshops). Online certification has been available via University of Rhode Island for several years.FAMACHA© estimates PCV.
  25. 25. FAMACHA©EyeAnemiaSystem Clinical Category Eye Lid Color Packed Cell Volume/PCV Treatment recommendation 1 Red > 28 No 2 Red-Pink 23-27 No 3 Pink 18-22 ? 4 Pink-White 13-17 Yes 5 White < 12 Yes COVER PUSH PULL POP
  26. 26. Bodyconditionscore(BCS) • Bodyconditionscore(BCS) is a measureof therelativefatnessof ananimal. • Low bodyconditionscore(<2)is indicative ofa nutritionissueandsuchanimalsare moreproneto parasiticinfection. • Variousstudieshaveshownbodycondition scoreto bea reliableindicatorofinternal parasitismin adult animals. • LeavingfemaleswithhigherBCS (>3) untreatedcanhelpto maintainrefugia. Body condition scoresrangefrom 1 to 5.
  27. 27. FivePointCheck© 5.© • ExtensionofFAMACHA©system,whichisonlyusefulfor blood-feedingparasites. • Usesfivecheck pointsonthe animal’sbodyto make dewormingdecisionsfor all parasites thatcommonlyaffectsmallruminants.Alsousefulfor determiningneed to deworm FAMACHA©3’s. 1. Eye(FAMACHA©score 2. Back (bodyconditionscore) 3. Tail(dagscore,fecalsoiling,scours) 4. Jaw (bottlejaw) 5. Nose(clear nasaldischarge) Coat condition(goats)
  28. 28. Performanceasadewormingcriteria • Growthperformance Deworm anyanimalwhichfailsto reachperformancetarget (ADG) Example:theHappyFactor™ • Milk production Deworm higherproducing dairyfemales • Numberof offspring Deworm femaleswith 3 or moreoffspring.
  29. 29. Periparturient females Any one • FAMACHA© > 4 • BCS < 2 • > 3 offspring • Yearlings,firsttime fresheners Growing lambs/kids FAMACHA© > 3 + ADG (performance target varies) Ewes/does FAMACHA > 4 + BCS < 2.5 + FEC (threshold varies)
  30. 30. Whataboutfecaleggcounts(FEC)? • Fecal exams are NOT a reliable way to diagnose parasitic disease in individual animals; it is not their intended purpose. • There are no widely-accepted FEC thresholds for treatment. • While generally predictive, FEC is not always a good measure of the worm burden an animal is carrying. Correlations between FEC and FAMACHA© are not always high. • Instead, use FEC to 1) determine efficacy of dewormers, 2) monitor pasture contamination, and 3) identify more resistant (or susceptible) animals.
  31. 31. Combination treatments
  32. 32. Combination treatments • It is now recommended that clinically- parasitized animalsbe given combination treatments. • A combination treatment is when you give more thanone dewormer (drug active) to kill the same worms. • The purpose of combination treatments is to killas many worms as possible. • Worms not killed by the first drug can be killed by the second (and third).
  33. 33. Recommendations for combination treatments • Give most potent drug from each dewormer class. albendazole+ moxidectin+ levamisole (Valbazen® + Cydectin® + Prohibit®) • Give full dose of each dewormer. • Do not mix dewormers; they are not chemically compatible. • Use separate syringe/drench gun for each drug (ideally).Combination dewormers are not available in USA.
  34. 34. Recommendations for combination treatments • Give dewormers sequentially, one after theother to get additive effect. • Observe withdrawal period of dewormer with longestwithdrawal. • ONLY give combinationtreatments to clinically-parasitizedanimals, as determinedby TST criteria. Do not give combination treatments to all animals!
  35. 35. Non-drug options for “deworming”
  36. 36. Copperoxidewireparticles(COWP) • Tiny metal rods of copper oxide. • Slow release, poorly absorbed form of copper. • Proven to be effective againstbarber pole worms (Haemonchuscontortus). • May increaseefficacy of treatment when given in combination with a dewormer, e.g. COWP + Valbazen® (USDA, 2020). • May be approved by some organic certifiers.
  37. 37. DewormingwithCOWP • Availableas coppersupplements (boluses) for cattle(12.5and 25 g) andgoats (2 and 4 g). • Repackage larger bolusesintosmallerdoses for dewormingsheepandgoats. • Give smallesteffectivedose,usually0.5-1g for lambs/kidsand 1-2 g for matureanimals. • Selectivelytreat accordingto TSTguidelines. Usesafely. Monitor copperstatus (especially with sheep).
  38. 38. Othernon-drugoptionsfordeworming • Hundreds of “natural” things are said to have deworming properties. • With the exception of COWP, none have been proven to kill worms safely, effectively,and consistently. • However,if a naturalremedyimproves host immunity or disrupts the free-livingstage of the worm,it could reduce the number of animals that need treatedwith drugs (Examples: sericealespedeza, BioWorma®). • If you choose to use naturalremedies, be sure to keep monitoring animals for signs of parasitismand give them drugs (when necessary) to save their lives. Thereisnoscientific evidence that DEis effective asadewormer.
  39. 39. Treatment of other parasites
  40. 40. Treatingmeningealworm(deer,brainworm) • Thereare noFDA-approvedtreatment protocolsfor meningealworm insmall ruminants. • Alltreatmentprotocolsare extra label andrequireveterinaryapproval. • Treatmentusuallyinvolveshigh-dose,multiday dosingwitha dewormer (fenbendazole) and anti-inflammatorydrug(s). • CornellUniversityhas evaluatedtreatmentprotocolsfor sheepand goats. http://blogs.cornell.edu/smallruminantparasites/chemical-treatment-protocols/ Parelaphostrongylustenuis_
  41. 41. Treatmentfortapeworms • Tapewormsare usually non-pathogenic;most studiesshownobenefitto treating(lambs). • Albendazole(Valbazen®)is the onlydewormer labeledfor theremovaloftapeworms(segments) insmallruminants(and insheeponly). • Fenbendazole(Safe-Guard®)is notlabeledfor tapewormremoval,butis effectiveat higherdoses. • Praziquantel isthe drugof choicefor tapewormremoval. It’susein small ruminantsis extra-label.It is availableinseveralhorsepastewormers (e.g.Quest®Plus). Monieziaexpansa_
  42. 42. Treatmentofliverflukes • Liver flukesare onlyproblematicincertain areas of theUSA (Northwest,GulfStates). • Albendazole(Valbazen®)is theonly dewormerlabeledfor theremovalofliver flukes(adultflukesonly)insheep/goats. • Ivomec®Plus(ivermectin+ clorsulon)is an extra labeloptionfor tapewormremovalin smallruminants. • Timingoftreatmentis important:consultyour veterinarian. Fasciolahepatica_
  43. 43. Extra label drug use
  44. 44. ExtralabeldruguseintheUSA • Only a licensed veterinarian has the legal right to use or prescribe a drug extra label. • Extralabel is when you use a drug in any manner that is not listed on its label. This includes different species, dosage, frequency, or route of administration. • Not all drugs can be used extra label; there are specific requirements governing the extra label use of drugs. “Off-label”is notalegal termin USA.
  45. 45. ExtralabeldruguseintheUSA • Extralabeldrug use is usually required to dewormgoats,as the moreeffective dewormersare not FDA-approvedfor goats. • Extralabeldrug use is required to deworm camelids,as no dewormersare FDA- approved for camelids. • To use drugs extralabel, you need to have a valid veterinarian-client-patientrelationship (VCPR).Ivomec® drenchis onlyapprovedforsheep.
  46. 46. SUSAN SCHOENIAN Sheep & Goat Specialist University of Maryland Extension sschoen@umd.edu | wormx.info | sheepandgoat.com Thank you. Questions?

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