informed consent for prevention treatment of parasites

Electronic medical records (EMRs) hold great promise for improving the practice of evidence based medicine by facilitating communication between members of the health care team. The most profound influence of EMRs may lie in their ability to encourage clients' involvement in their own pets care.

informed consent for prevention treatment of parasites

Postby malernee » Sat Sep 18, 2004 7:51 pm

First let me say to avoid some confusion that the so called parasite preventions in veterinary medicine do not prevent parasites. They kill parasites (also called bugs and worms). "Therapy ain't prevention" So any pet owner needs to decide if they want a therapeutic intervention for parasite disease without evidence the disease is present. If we find parasites then the best treatment options are not as difficult to determine. For some dogs using so called injectable prevention any effort to kill parasites without evidence the pet or human has parasites may not be worth the risk and cost. ... 7c274fd5fb
For other pets and even humans topical or oral treatments can be life savers and very cost effective.

Without our so called parasite preventatives may people would get rid of their pets rather than live with worms and crawling pest that can infect the family or cause continual pet diseases

The CDC or USA center for disease control currently wants dogs and cats be periodically treated for human health protection. The CDC guidelines do not advise what treatment is best or how often it should be repeated. ... ?p=386#386

Scientific evidence based guidelines that tell us when pets should be treated for parasites when none are known to be present in or on the body are not currently available to follow for pets. Effective periodic human parasite treatment programs using similar products in South America Africa and India exist where sanitation control problems occur. People taking parasite prevention medication cannot afford quality medical care so similar macrolid drugs are given to those who must live in poor sanitary conditions. These human macrolid drugs are usually given away for human use. Human programs use treatment four times a year.

In the USA the pets get the parasite preventative medication rather than the humans. Why give them to humans when the pets can be treated before we get them from our pets?

A similar topical product is now available for dogs and cats called transdermal selamection. For those clients wishing treatment without knowledge of infestation we offer this topical macrolid treatment given to most patients on an average of four times a year at a cost of about five dollars a month. It’s topical and does not wash off so it can kill the external as well as internal parasites. ... 1b6557#384

The effect of topical selamectin is not gone in a one day treatment but unlike other oral marcolids has a long half life. A continuous and prolonged absorption occurs from extravascular sites. ... =1927#1927

About 1% of the dog and cats treated in selamectin clinical trials are experiencing side effects most often itching and hair loss in the area of application. We see fewer side effects but we usually use the product at the human dose interval or a third less frequently than studies measuring side effects in dogs and cats. I suspect that's why we see less side effects than the FDA does. Some patients may need this product less frequently or more frequently but house pets in our practice almost never need them as often as once or twice a month if no parasites are know to be in or on the pet. The benefit, risk and cost of continuing to use them should be reevaluated each time they are purchased. How often to use these products must be to some extent investigational since FDA allows them to be used per label directions as often as every two weeks. When used as directed in our practice when no known parasites are present in or on the pet we can find little scientific medical justification to give them more frequently than every three months, which turns out to be just how often similar products are often used in humans. We have tried to go every four months between treatments but find fleas are a problem the fourth month. FDA label directions to give once or twice a month might be ok for worse case pets roaming the neighborhood twenty-four hours a day but for the typical house dog and cats in south florida there is no science to justify the risk and cost of 1-2x month treatment if the pet is not known to have internal or external parasites. These parsite products have been granfathered in by the FDA to have a give once a month label with the FDA never making the drug companys show just how often they really are needed. To simplify your informed consent decision we will only provide information about one parasite prevention product. It’s called transdermal selemection. The product had its roots along with a macrolid antibiotic called erythromycin. Rather than kill bacteria the macrolid selamectin kills internal and exterior parasites. Since it’s in the same group of drugs as the antibiotic erythromycin the FDA controls selamectin rather than EPA who control pesticides. Selamectin is used for killing the pest below but is classified as a non pesticide. It replaces the heartworm drugs and pesticides below. No one heartworm preventative can easily be said to be better than the next. They all have slightly different characteristics such as mode of treatment and ability to control certain intestinal parasites. The same thing can be said about the new, topically-applied flea products. Selamectin brand name Revolution, besides being a FDA safe and efficacious product, has the positive characteristics that it controls multiple parasites and can be easily applied to cats, in which it will prevent heartworm and remove the intestinal helminths that could be the cause of zoonotic disease.

fleas ... 9c347#1922
lice ... =1923#1923 ... ?p=591#591
ear mites
mange sarcoptic

pinworms ... d65c0#1924
roundworms ... 858a5#1925
heartworms larvae, microfilaria and adults ... ?p=387#387
Nasal Mite ... =1926#1926
and replaces previous drugs or a combination of the following drugs
flea and tick dips
other heartworm medication pills and shots
Caparsolate has arsenic in it
Immiticide has arsenic in it ... =1931#1931

supplementary environmental control measures for flea allergy
treating the house for fleas
Hartz flea and tick

Pfizer has a patent on selemection in the USA and the drug is sold only by prescription only in the USA. If you want to buy it without a prescription you must buy it on the Internet from Australia where it is sold without a prescription. Let us know if you are not buying it from us. Watch out for counterfeit drugs. Due to their mode of action it's always been my impression that the avermectins (abamectin, oramectin, eprinomectin, ivermectin, selamectin) and milbemycins (milbemectin, milbemycin oxime, moxidectin) produce a host of neurologic signs in animals and humans (mydriasis, depression, coma, tremors, ataxia, stupor, emesis, drooling, death) with a mutation in the P-glycoprotein (the protein responsible for the so-called blood brain barrier) gene or dogs that receive a large overdose of one of these drugs. A blood test can be taken to see if a human or pet is hypersensitive to these macrolid drugs due to a gene mutation. ... ?p=134#134
I have seen only hair loss and itching at the application site using selamectin at the human frequency macrolid dose of four times a year. We have had no other symptoms with patients who had a mutation of the so-called blood brain barrier gene so we do not advise testing for the gene unless itching or hair loss occurs at the site of application.
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