EVALUATION OF ALTERNATIVE DOSE OF IVERMECTIN IN THE SLOWKILL PROTOCOL FOR THE TREATMENT OF DOGS NATURALLY INFECTED BY Dirofilaria immitis.
heartworm, canines, helminths, slow-kill.
Dirofilaria immitis (Leidy & J., 1856) is a nematode whose main habitat is the pulmonary arteries and right heart chambers of canids, being the etiological agent of clinical signs such as cough and dyspnea, generally associated with lung parenchymal disease. All individuals of the species D. immitis depend on bacteria of the genus Wolbachia for the maintenance of their vital functions. The recommended alternative adulticide treatment is based on the combination of doxycycline at high doses (10 mg/kg/BID for 28 days) with macrocyclic lactones from the milbemycin group, characterizing the slow kill protocol. With the aim of evaluating the efficacy and safety of a viable and lower-cost adulticide protocol, the association of doxycycline at the recommended dose (10 mg/kg/BID for 28 days) with a macrocyclic lactone from the avermectin group (ivermectin) at a high dose (100 µg/kg/month) was proposed. Thirty-nine dogs naturally infected with D. immitis, from the municipalities of Seropédica, Praia Seca, and Maricá, were included; 21 were male and 18 were female. Four animals were excluded from the study for various reasons, including one case of a gastrointestinal reaction attributed to doxycycline. The remaining 35 dogs were followed for up to 24 months (540 days) or until two negative antigen tests were obtained with a six-month interval. At the end of the follow-up period, all monitored animals became amicrofilaremic, and 16/35 showed negative antigenemia by 540 days of treatment. During follow-up, hematological and liver biochemistry tests were performed, with eosinophilia being the most frequent laboratory finding. Alanine aminotransferase (ALT) levels did not show significant changes during the therapeutic protocol. The results indicate that the adopted therapeutic regimen showed good tolerability, without the occurrence of serious adverse clinical effects, and demonstrated efficacy in the progressive elimination of adult parasites in a significant portion of the dogs evaluated, in a safe manner. Thus, the proposed protocol is a viable alternative for the treatment of canine dirofilariasis, especially in situations where conventional adulticidal protocols are not indicated or are not available. However, it is important to emphasize the need for a longer follow-up period for animals remaining in treatment, in order to assess complete parasitological negativity and more precisely characterize the total time required for cure.