COVER DESIGN Double Defense Uses

COVER DESIGN Double Defense Uses:

Vectra® 3D for Dogs which has a 99.1% anti-feeding efficacy against mosquitoes 1 A heartworm preventive to kill heartworm larvae

Dogs protected with Double Defense protocol had no adult heartworms1,2

Average Number Groups Number of Dogs with Heartworms of Adult Heartworms Per Dog

Control + + + + + + + + 41

Vectra® 3D Only + + + 1.5 Milbemycin Only + + + + + + + + 17.1

DOUBLE DEFENSE Vectra® 3D and Milbemycin 0 Dogs 0

Learn why Vectra® 3D and Double Defense make sense for your practice at FightHeartwormNow.com

DO NOT USE VECTRA® 3D ON CATS ©2018 Ceva Animal Health, LLC Vectra® and Vectra® 3D logo are registered trademarks of Ceva Animal Health, LLC Double Defense logo trademark is the property of Ceva Animal Health, LLC

1. McCall, J.W., Hodgkins, E., Varloud, M., Mansour, A., DiCosty, U., McCall, S., Carmichael, J., Carson, B., & Carter, J. (2016, August). Blocking of the transmission of Dirofilaria immitis L3 (JYD-34 ML resistant strain) from infected mosquitoes to dogs and prevention of infection in dogs treated topically with dinotefuran-permethrin-pyriproxyfen and orally with milbemycin oxime alone or in combination. In 61st Annual Meeting Proceedings: American Association of Veterinary Parasitologists- 61st Annual Meeting. San Antonio, TX. Abstract No. 21, 61.

2. McCall, J.W., Hodgkins, E., Varloud, M., Mansour, A., & DiCosty, U. (2015, July). Inhibition of the transmission of Dirofilaria immitis to mosquitoes by weekly exposure to microfilaremic dogs treated topically with dinotefuran-permethrin-pyriproxyfen to uninfected Aedes aegypti. In Annual Meeting Proceedings: American Association of Veterinary Parasitologists- 60th Annual Meeting. Boston, MA. Abstract No. 7, 59.

Ticks and fleas CAN

turn my world UpsideDown

Calling All Dogs, BIG and Small! Credelio is available in five convenient SKUs for dogs 4.4 to 100 pounds. Talk to your Elanco sales representative for more information and to place your order today. SKU Available for Indications Credelio kills adult fleas and is indicated for the treatment of flea infestations (Ctenocephalides felis) and the treatment and control of tick infestations [Amblyomma americanum (lone star tick), Dermacentor variabilis (American BIG Dogs dog tick), Ixodes scapularis (black-legged tick) and Rhipicephalus sanguineus (brown dog tick)] for one month in dogs and puppies 8 weeks of age and older, and weighing 4.4 pounds or greater. 50.1-100 lbs! Important Safety Information The safe use of Credelio in breeding, pregnant or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures. The most frequently reported adverse reactions are weight loss, elevated blood urea nitrogen, excessive urination, and diarrhea. For product information, including complete safety information, see page 44.XX.

10 | Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com For your FREE digital copy of this handout, contact your Penn Vet Rep today!

™ Nobivac EDGE Lepto4 is the FIRST and ONLY 0.5 ml Leptospirosis vaccine to help prevent mortality and urinary shedding for dogs of all sizes.1

18 | Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 99% Reaction Free Out of 1583 Doses Given in CUTTING EDGE PROTECTION... Clinical Impressions Study1

Applied pressure NEW NOBIVAC 0.5 ml VACCINES Puriﬁed • Full protection, half the injection volume solution

(50% less volume than standard vaccines) Filtration membrane Filtration membrane • Proven protection for dogs of all sizes Extraneous AFTER BEFORE proteins FILTRATION FILTRATION • VacciPure™ Technology supports vaccine safety VACCIPURE™ FILTRATION TECHNOLOGY1

NOBIVAC EDGE™ NOBIVAC EDGE™ NOBIVAC EDGE™

LEPTO4 DAPPv + L4 DAPPv • First 0.5 ml Leptospirosis • First 0.5 ml combo vaccine • First 0.5 ml combo vaccine vaccine shown to be effective to include parainfluenza to include parainfluenza against disease, mortality and protection1 protection1 1 shedding • First 0.5 ml Leptospirosis combo vaccine shown to be effective against disease, mortality and shedding1

TOTAL PROTEIN TESTING RESULTS FOR 0.5 ML VACCINES Average Total Protein (mg/dose)

™ NOBIVAC EDGE DAPPv+L4 5.0 mg/dose

ULTRA™ DURAMUNE® DAP+4L 5.8 mg/dose

Product is registered trademark of respective owner. mg 1 2 3 4 5 6

“While the decrease from 1 ml to 0.5 ml doesn’t sound like a lot, the ease of administration is notable. Not all vaccines are equal. The difference between injecting 0.5 ml and 1 ml when you have a puppy and 2-3 vaccines to give, you barely notice you’ve injected the volume. With the 0.5 ml vaccine, there was much less vocalization, and much less spilled vaccine. Thumbs-up from us for using NOBIVAC EDGE TM vaccines.” – Dr. Trathan, Oakdale Veterinary Group, Oakdale, CA

1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 19 Introducing Elanco Portfolio Rewards Valid on cumulative purchases Jan 1 - Mar 31, 2019

A Portfolio That Pays You Back Choosing the right products to meet your patients’ needs has never been more rewarding. Increasing your use of our best-selling products qualifies you for bigger savings.

Purchase one or a mix of these key Elanco products to receive the following rebates:

GROUP 1 PRODUCTS

GROUP 2 PRODUCTS

Cumulative Spend $5,000- $15,000- $20,000- $30,000- Any combination of products ≥$40,000 from either group $14,999 $19,999 $29,999 $39,999

Rebate Earned 1% 2% 3%

SPOTLIGHT BONUS Purchase $2,500 of Credelio to receive a 1% additional rebate on all group 1 products!

GROUP 1 PRODUCTS Total Rebate Earned with Spotlight Bonus 2% 3% 4%

Rebate Earned 10% 15% 20% 25% 30%

SPOTLIGHT Purchase $2,500 of ULTRA Duramune, ULTRA Fel-O-Vax, ULTRA Hybrid FVRCP, ULTRA Duramune BONUS Lyme and/or Bronchi-Shield ORAL to receive a 5% additional rebate on all group 2 products!

GROUP 2 PRODUCTS Total Rebate Earned with Spotlight Bonus 15% 20% 25% 30% 35%

Here’s how it works: • Purchase one product or mix and match multiple Elanco products in group 1 and group 2 • Rebates will be issued quarterly • Purchase specific products to unlock Spotlight Bonuses

VENDOR END DATE ITEMS PROMOTION Purchase Avagard antiseptic hand prep and get a free wall 3M 12/31/2019 Avagard bracket and foot pump or a wall bracket and hand pump. Purchase 20 tests, receive a free VUE, cPL Starter Kit, and Abaxis 3/31/2019 VetScan cPL Rapid Tests Andriod Mobile Device Buy 25 VetScan UA14 strips and get 50% off your VetScan UA 3/31/2019 VetScan UA Urine Analyzer analyzer. Andover Healthcare 4/30/2019 PetFlex Buy any 2 boxes of PetFlex and get one 6‐pack sample box. Adaptil and Feliway Pheromone Ceva 3/31/2019 Buy 3, get 1 free. Mix and match. Products 3/31/2019 Catego Buy 3 cartons, get 1 carton free. Mix and match.

3/31/2019 Clenz‐a‐dent & Breakables Products Buy 1, get 1 free. Mix and match.

3/31/2019 MilbeGuard Buy 1 carton of each size, get 1 carton of each size free.

3/31/2019 Vectra & Vectra 3D Buy 3 cartons, get 1 carton free. Mix and match. Fuzion, Hydrogen Peroxide, and Clorox Healthcare 3/31/2019 Buy 2, get 1 free. Kind for kind. Disinfecting Bio Stain & Odor Remover Datamars 4/30/2019 PetLink Slim Microchips Buy 50 microchips, get 10 microchips free.

Dechra 3/31/2019 Carprofen Injection Buy 3, get 1 free.

3/31/2019 Carprofen Caplets Buy 4, get 1 free. Mix and match. Buy 4, get 1 free plus 1 free bottle of Carprovet Flavored Tablets 3/31/2019 Carprofen Chew Tabs 100mg. 3/31/2019 Carprovet Flavored Tabs Buy 3, get 1 free. Mix and match.

3/31/2019 Cefpodoxime Proxetil Tabs Buy 3, get 1 free. Mix and match.

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3/31/2019 Eicosa 3FF, EicosaCaps, and EicosaDerm Buy 5, get 1 free. Kind for kind.

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Merck 4/30/2019 Tri‐Heart Plus Buy 5 cartons, get 2 cartons free. Mix and match. Buy 4, get 1 free. Mix and match. Includes the new 2x100mL Norbrook 3/31/2019 Loxicom Oral Suspension size! For every $2,200 in purchases of Nutramax products made Nutramax 3/31/2019 First Quarter Promotion between January 1 , 2019 ‐ March 31, 2019, receive a Nutramax branded LiT Firefly TS‐300 cooler free. Purchase $375 of Denamarin Advanced and get one 21ct. box of 3/31/2019 Denamarin Advanced Crananidine Chewable Tablets and one 75ct. box of Crananidin Chewable Tablets free. Vet25 and Vet30 Blood Pressure SunTech 3/31/2019 Receive an extra set of blood pressure cuffs free with purchase. Monitors Vedco 6/30/2019 CeftiFlex Injection Buy 11, get 1 free. Kind for kind.

3/31/2019 ClotIt Buy 4, get 2 free. Kind for kind. MicroSpore Leave‐on Lotion, Micro BP 3/31/2019 Buy 4, get 1 free. Kind for kind. Shampoo, Micro BP Gel 3/31/2019 Novox Caplets Buy 4, get 1 free. Mix and match.

3/31/2019 Novox Chewable Tablets Buy one 180ct. bottle, get one 60ct. bottle free.

Vetoquinol 3/31/2019 pH‐Notix Buy 9, get 3 free. Buy $1,750 cumulatively in Vetprofen before March 31, 2019 and 3/31/2019 Vetprofen 24 | Penn Veterinary Supply | March-April 2019 get a pair of BLORX X ‐ ray 1-800-233-0210 gloves free. | www.pennvet.com Buy $1,500 of Iverhart, get a 10% rebate; Buy $3,500 of Sentinel, Virbac 4/22/2019 Portfolio Offer get a 7% rebate plus earn additional rebates on shampoos, dental products, insecticides, and much more. Zoetis 3/31/2019 AlphaTRAK 2 Buy 2 AlphaTRAK 2 test strips, get 1 AlphaTRAK 2 starter kit free. 1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 25 26 | Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 27 28 | Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 29 Introducing the FLEX4 Rapid Test Now you have a choice. The VetScan Canine FLEX4 Rapid Test delivers all the benefits of the single Rapid Tests in one simple package. With four tests on one cassette, performing a comprehensive heartworm and tick panel has never been easier or more cost-effective. Check out some of the features below:

8 reasons thousands of veterinary hospitals have switched to the FLEX4

3 simple, intuitive steps Easy-to-read results Lyme Anaplasma

Room temperature storage 8 minutes to result

1-year shelf life Proven lateral flow technology Heartworm Ehrlichia 2 drops of sample 6 drops of 1 buffer Staff friendly

Contact your Authorized Distributor to order today.

www.abaxis.com/flex4

VetScan Rapid Tests are intended for veterinary use only. Abaxis and VetScan are registered trademarks of Abaxis, Inc. © Abaxis 2018.

30 PennVetAd_Flex4_2018-08_7.95x10.08_R1a-4.indd| Penn Veterinary Supply | March-April 1 2019 1-800-233-0210 | www.pennvet.com7/24/18 4:59 PM From Norbrook...® Loxicom® Oral Suspension 2 x 100 mL Size Each Carton Contains: • 2 Bottles of Loxicom Oral Suspension 100 mL • 1 Calibrated Syringe for Dogs 30 lbs and Under; 1 Calibrated Syringe for Dogs 30 lbs and Over • 1 Package Insert

For More Information Contact Your Distributor or Call Norbrook at (888) 705-0408

Key Benef its:

◊ Contains the same active ingredient and is bioequivalent to Metacam® (meloxicam) Oral Suspension ◊ Available in convenient 10 mL, 32 mL, 100 mL and new 2 x 100 mL sizes in 1.5mg strength ◊ Choosing to carry Loxicom® Oral Suspension over Metacam® Oral Suspension allows you to eliminate inventory (i.e. 0.5mg sizes) from your pharmacy ◊ Reduces your dispensing costs across all weight ranges of dogs Save versus other meloxicam suspension brand econo sizes:

Loxicom® Metacam® *Savings Meloxidyl® *Savings 2 x 100 mL 180 mL with Loxicom® 200 mL with Loxicom® Cost Per Carton $92.34 $109.80 $29.66 $95.15 $2.81 Cost Per mL $0.46 $0.61 $0.48

*Loxicom savings calculated based on 200 mLs of Metacam www.norbrook.com Source: 2018 DVM list price

Observe label directions. Do not use Loxicom Oral Suspension in cats. Acute renal failure and death have been associated with the use of meloxicam in cats. As with any medication, side effects may occur. These are usually mild, but may be serious. The most common side effects reported in field studies were vomiting, soft stool/diarrhea and decreased appetite. If side effects occur, discontinue treatment immediately and consult a veterinarian. Dogs should be evaluated for pre-existing medical conditions prior to treatment and monitored during therapy. See product labeling for full product information. The Norbrook logos and Loxicom are registered trademarks of Norbrook Laboratories Limited. Metacam is a registered trademark of Boehringer Ingelheim Vetmedica, Inc. Meloxidyl is a registered trademark of Ceva Sante Animale S.A. 0818-497-I01A

Contact your Penn Vet Rep R Y

E for a FREE Lunch & Learn X C L and Samples. U S I V E ®

Nutritional Management Guide – Canine

Category Products Indications Key Benefits Life Stage Top 5 Ingredients

• Acute or chronic gastroenteritis • Clinically shown to improve stool quality Puppy and DRY FOOD: • Inflammatory bowel disease with 23% quicker resolution of diarrhea Adult 1. Deboned Chicken • Motility/emptying disorders • Clinically shown to produce ideal fecal 2. Chicken Meal • Protein-losing enteropathy consistency scores 3. Oatmeal • Antibiotic-responsive diarrhea 4. Brown Rice • Small and large bowel diarrhea • Prebiotic fibers and fermentation extracts to Note: Canned 5. Peas • Exocrine pancreatic promote GI health food not GI insufficiency • Complete and balanced nutrition intended for WET FOOD: • Colitis large breed 1. Chicken GASTROINTESTINAL • Pancreatitis puppies 2. Chicken Broth (non-hyperlipidemic) 3. Chicken Liver SUPPORT • Constipation 4. Potatoes 5. Whitefish

Dermatologic: • Features highly digestible salmon hydrolysate Adult DRY FOOD: • Chronic Otitis Externa to help minimize the chances of adverse 1. Salmon Hydrolysate • Cutaneous Adverse Food reactions to food 2. Pea Starch Reactions (CAFR) • Enriched with omega-3 fatty acids which have 3. Potatoes • Chronic Non-Seasonal Pruritic been shown to reduce inflammation in skin cells 4. Peas Dermatitis 5. Pea Protein • Complete and balanced nutrition Gastrointestinal: WET FOOD: • Diet-Responsive Chronic 1. Salmon Hydrolysate Enteropathy HF 2. Water • Chronic Gastroenteropathy 3. Potato Starch • Intestinal Dysbiosis FOOD INTOLERANCE 4. Natural Flavor • Colitis 5. Pea Fiber Other Inflammatory Conditions: • Atopic Dermatitis • Pruritic Dermatitis

• Kidney disease • Controlled protein and mineral levels to help Adult DRY FOOD: • Calcium oxalate urolithiasis manage kidney disease 1. Deboned Chicken 2. Pea Starch Contraindications: • Clinically proven to produce a Calcium Oxalate Supersatu- 3. Potato Starch • Struvite urolithiasis ration value of <3, and to produce an 4. Peas • Growth average urine pH between 6.8 and 7.3 5. Dried Egg KS • Pregnancy or lactation • Clinically shown to produce ideal fecal consistency scores Note: WET FOOD: Canned food 1. Chicken KIDNEY SUPPORT • Complete and balanced nutrition intended for 2. Chicken Broth intermittent or 3. Water supplemental 4. Potato Starch feeding only 5. Potatoes

Weight Management Indications: Weight management benefits: Adult DRY FOOD: • Weight management for obese or • Clinically proven to reduce body fat by 39.6% 1. Deboned Chicken overweight dogs and body weight by 16.3% in dogs 2. Chicken Meal • Helps to support lean • Clinically shown to support lean muscle mass 3. Peas muscle mass maintenance maintenance during weight loss 4. Pea Protein Urinary Care Indications: Urinary care benefits: 5. Powdered Cellulose • Dogs prone to lower urinary tract • Clinically proven to produce a urine pH of disease 6.0–6.4 in dogs WET FOOD: + • Helps to limit the formation • Clinically proven to produce a Struvite Relative 1. Chicken W U of struvite uroliths 2. Chicken Broth Supersaturation of <1 and a Calcium Oxalate WEIGHT MANAGEMENT • Dissolution of pure struvite uroliths Relative Supersaturation of <5 3. Water • Helps to limit the formation of • Complete and balanced nutrition 4. Chicken Liver + URINARY CARE calcium oxalate urolithiasis 5. Pea Protein Contraindications: • Pregnancy or lactation • Growth • Use of concurrent urinary acidifiers

Dermatologic: • Studies have shown that 95% of dogs with confirmed dietary Puppy and DRY FOOD: • Chronic Otitis Externa sensitivity were successfully managed with selected protein Adult 1. Deboned Alligator • Cutaneous Adverse Food diets 2. Peas 3. Pea Starch Reactions (CAFR) • High levels of omega-3 fatty acids • Chronic Non-Seasonal Pruritic 4. Alligator Meal Dermatitis • Rich in fermentable fiber 5. Pea Protein Gastroinestinal: • Antioxidant-rich formulas Note: NP • Diet-Responsive Chronic Canned food Novel Protein Enteropathy intended for • Chronic Gastroenteropathy intermittent or Alligator • Intestinal Dysbiosis supplemental • Colitis feeding only Other Inflammatory Conditions: • Atopic Dermatitis • Pruritic Dermatitis

• Weight management for obese or • Clinically proven to improve arthritic scores over time Adult DRY FOOD: 1. Deboned Salmon overweight dogs • Ingredients rich in omega fatty acids such as deboned salmon, 2. Chicken Meal • Helps to maintain lean muscle fish oil, canola oil and flaxseed mass 3. Pea Protein • Degenerative joint disease • Shrimp meal as a source of natural glucosamine, plus added 4. Powdered Cellulose + • Helps to limit the formation of chondroitin sulfate 5. Peas W M struvite uroliths • Antioxidant-rich formula with ingredients such as turmeric and • Dissolution of pure struvite uroliths WEIGHT MANAGEMENT vitamin E Contraindications: + MOBILITY SUPPORT • Growth • Calcium oxalate urolithiasis

36 | Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com ER ET IN V A

R Y

X C L U S I V E ®

Nutritional Management Guide – Feline

Category Products Indications Key Benefits Life Stage Top 5 Ingredients

• Acute or chronic gastroenteritis • Clinically shown to improve stool quality with Dry: Adult DRY FOOD: • Inflammatory bowel disease 29% quicker resolution of diarrhea 1. Deboned Chicken • Motility/emptying disorders to produce ideal fecal 2. Chicken Meal • Protein-losing enteropathy • Clinically shown Wet: Kitten consistency scores 3. Tapioca Starch • Antibiotic-responsive diarrhea and Adult 4. Peas • Small and large bowel diarrhea • Prebiotic fibers and fermentation extracts to promote GI 5. Turkey Meal • Exocrine pancreatic health GI insufficiency • Complete and balanced nutrition WET FOOD: • Colitis 1. Chicken GASTROINTESTINAL • Pancreatitis 2. Chicken Broth • Constipation 3. Chicken Liver SUPPORT 4. Whitefish 5. Potatoes

Dermatologic: • Features highly digestible salmon hydrolysate Adult DRY FOOD: • Chronic Otitis Externa to help minimize the chances of adverse reactions 1. Salmon Hydrolysate • Cutaneous Adverse Food to food 2. Peas Reactions (CAFR) • Enriched with omega-3 fatty acids which have 3. Potatoes • Eosinophilic Granulomatous been shown to reduce inflammation in skin cells 4. Pea Starch Disease 5. Pea Protein • Chronic Non-Seasonal Pruritic • Complete and balanced nutrition Dermatitis WET FOOD: Gastrointestinal: 1. Salmon Hydrolysate HF • Diet-Responsive Chronic 2. Water FOOD INTOLERANCE Enteropathy 3. Potato Starch • Chronic Gastroenteropathy 4. Natural Flavor • Intestinal Dysbiosis 5. Pea Fiber • Colitis Other Inflammatory Conditions: • Atopic Dermatitis • Pruritic Dermatitis

• Kidney disease • Controlled protein and mineral levels to help Adult DRY FOOD: • Calcium oxalate urolithiasis manage kidney disease 1. Deboned Chicken • Joint disease to produce a Calcium Oxalate 2. Peas • Clinically proven 3. Pea Starch Contraindications: Supersaturation value of <3, and to produce • Struvite urolithiasis an average urine pH between 6.8 and 7.3 4. Dried Egg 5. Potato Starch • Growth to produce ideal fecal Note: • Pregnancy or lactation • Clinically shown KM consistency scores Canned food WET FOOD: KIDNEY + MOBILITY • EPA, DHA, plus added glucosamine and chondroitin intended for 1. Chicken sulfate which have been clinically shown to improve intermittent or 2. Chicken Broth SUPPORT mobility in cats 3. Water supplemental 4. Potatoes • Complete and balanced nutrition feeding only 5. Potato Starch

Weight Management Indications: Weight management benefits: Adult DRY FOOD: • Weight management for obese • Clinically proven to reduce body fat by 36.8% 1. Deboned Chicken or overweight cats and body weight by 12.5% in cats 2. Chicken Meal • Helps to support lean • Clinically shown to support lean muscle mass 3. Pea Protein muscle mass maintenance maintenance during weight loss 4. Tapioca Starch Urinary Care Indications: Urinary care benefits: 5. Powdered Cellulose • Cats prone to lower urinary tract • Clinically proven to produce a urine pH of disease 6.0 –6.4 in cats WET FOOD: + • Helps to limit the formation of • Clinically proven to produce a Struvite Relative W U struvite uroliths Supersaturation of <1 and a Calcium Oxalate 1. Chicken • Dissolution of pure struvite Relative Supersaturation of <5 2. Chicken Broth WEIGHT MANAGEMENT uroliths • Complete and balanced nutrition 3. Chicken Liver + URINARY CARE • Helps to limit the formation of 4. Water calcium oxalate urolithiasis 5. Pea Protein Contraindications: • Pregnancy or lactation • Growth • Use of concurrent urinary acidifiers

Dermatologic: • In a retrospective study, 100% of cats responded to dietary Kitten and DRY FOOD: • Chronic Otitis Externa change using a different intact protein Adult 1. Deboned Alligator • Cutaneous Adverse Food • High levels of omega-3 fatty acids 2. Alligator Meal Reactions (CAFR) 3. Pea Protein • Eosinophilic Granulomatous • Rich in fermentable fiber 4. Pea Starch Disease • Antioxidant-rich formulas 5. Peas • Chronic Non-Seasonal Pruritic Dermatitis NP Gastroinestinal: • Diet-Responsive Chronic Novel Protein Enteropathy • Chronic Gastroenteropathy Alligator • Intestinal Dysbiosis • Colitis Other Inflammatory Conditions: • Atopic Dermatitis • Pruritic Dermatitis

The Natural Alternative in Nutritional Therapy® Learn more about BLUE Natural Veterinary Diets Call 888-323-BLUE or visit TrueBLUEVets.com

1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 37 NEW LOOK – The same product you’ve known to trust you can now order by name.

EnroquinTM Flavored Tablets (enro oxacin) OLD LABEL

NEW LABEL

This product has new Dechra-branded packaging. The product itself is the same so you can continue to prescribe with con dence.

To order or schedule a lunch and learn, call your Dechra representative or call (866) 683-0660.

Explore & Download Dechra’s FREE NEW

IV Fluids Calculator App

Ask your Dechra or Distributor Rep for current promotions and pricing or call (866) 683-0660.

24 Hour Technical Support: 866-933-2472 | [email protected] www.dechra-us.com

Dechra is a registered trademark of Dechra Pharmaceuticals PLC. Vetivex is a registered trademark of Dechra Limited. 01AD-DEC50130-0219

38 | Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 39 40 | Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 41 recommended dose of milbemycin oxime (0.5 mg/kg). This product has not been tested in dogs less than 1 kg weight. A rising-dose safety study conducted in rough-coated collies, manifested a clinical reaction consisting of ataxia, pyrexia and periodic recumbency, in one of fourteen dogs treated with milbemycin oxime at 12.5 mg/kg (25X monthly use rate). Prior to receiving the 12.5 mg/kg dose (25X monthly use rate) on day 56 of the study, all animals had undergone an exaggerated dosing regimen consisting of 2.5 mg/kg milbemycin INFORMATION FOR DOSING DOGS oxime (5X monthly use rate) on day 0, followed by 5.0 mg/kg (10X monthly use rate) on day 14 and 10.0 The once-a-month tablet that prevents heartworm disease, controls adult hookworm, and removes and controls mg/kg (20X monthly use rate) on day 32. No adverse reactions were observed in any of the collies treated adult roundworm and whipworm infections in dogs and puppies. with this regimen up through the 10.0 mg/kg (20X monthly use rate) dose. Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Keep this and all How supplied: MILBEGUARD Flavored Tablets are available in four tablet sizes (see Dosage section), drugs out of the reach of children. formulated according to the weight of the dog. Each tablet size is available in color-coded packages of 6 tablets each, which are packaged 10 per display carton. Description: MILBEGUARD (milbemycin oxime) Flavored Tablets are available in four tablet sizes in color-coded packages for oral administration to dogs and puppies. Each tablet is formulated to provide a minimum of 0.23 mg/lb Storage conditions: MILBEGUARD Flavored Tablets should be stored at room temperature, between (0.5 mg/kg) body weight of milbemycin oxime. Milbemycin oxime consists of the oxime derivatives of 68° and 77°F (20-25°C). 5-didehydromilbemycins in the ratio of approximately 80% A4 (C32H45NO7, MW 555.71) and 20% A3 (C31H43NO7, MW 541.68). INFORMATION FOR DOSING CATS Package color Milbemycin oxime tablet Yellow 2.3 mg* The once-a-month tablet that prevents heartworm disease and removes adult roundworms and Blue 5.75 mg hookworms in cats and kittens. Purple 11.5 mg Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Keep Red 23.0 mg this and all drugs out of the reach of children. *for dogs only Description: MILBEGUARD Flavored Tablets for Cats are available in three tablet sizes in color-coded Indications: MILBEGUARD Flavored Tablets are indicated for use in the prevention of heartworm disease caused by packages for oral administration to cats and kittens. Each tablet is formulated to provide a minimum of 0.9 Diroﬁlaria immitis, the control of adult Ancylostoma caninum (hookworm), and the removal and control of adult mg/lb (2.0 mg/kg) body weight of milbemycin oxime. Milbemycin oxime consists of the oxime derivatives

Toxocara canis and Toxascaris leonina (roundworms) and Trichuris vulpis (whipworm) infections in dogs and in of 5-didehydromilbemycins in the ratio of approximately 80% A4 (C32H45NO7, MW 555.71) and 20% A3

puppies four weeks of age or greater and two pounds body weight or greater. (C31H43NO7, MW 541.68). Dosage: MILBEGUARD Flavored Tablets are given orally, once a month, at the recommended minimum dosage rate Indications: MILBEGUARD Flavored Tablets for Cats are indicated for use in the prevention of heartworm of 0.23 mg milbemycin oxime per pound of body weight (0.5 mg/kg). disease caused by Dirofilaria immitis, and the removal of adult Ancylostoma tubaeforme (hookworm) and Recommended Dosage Schedule for Dogs Toxocara cati (roundworm) in cats and kittens six weeks of age or greater and 1.5 lbs. body weight or greater. Body Weight MILEBEGUARD Flavored Tablets Dosage: MILBEGUARD Flavored Tablets for Cats are given orally, once a month, at the recommended 2-10 lbs. One tablet (2.3 mg) minimum dosage rate of 0.9 mg milbemycin oxime per pound of body weight (2.0mg/kg). 11-25 lbs. One tablet (5.75 mg) Recommended Dosage Schedule for Cats 26-50 lbs. One tablet (11.5 mg) Body Weight MILEBEGUARD Flavored Tablets 51-100 lbs. One tablet (23.0 mg) 1.5-6 lbs. One tablet (5.75 mg) Dogs over 100 Ibs. are provided the appropriate combination of tablets. 6.1-12 lbs. One tablet (11.5 mg) Administration: MILBEGUARD Flavored Tablets are dual-purpose and may be oered in food or administered as 12.1-25 lbs. One tablet (23.0 mg) other tablet medications. Watch the dog closely following dosing to be sure the entire dose has been consumed. If it is not entirely consumed, redose once with the full recommended dose as soon as possible. Cats over 25 Ibs. are provided the appropriate combination of tablets. MILBEGUARD Flavored Tablets must be administered monthly, preferably on the same date each month. The first dose Administration: MILBEGUARD Flavored Tablets for Cats may be oered in food or administered as other should be administered within one month of the dog’s first exposure to mosquitoes and monthly thereafter until the tablet medications. The tablets can be broken for ease of administration. Watch the cat closely following end of the mosquito season. If a dose is missed and a 30-day interval between dosing is exceeded, administer dosing to be sure the entire dose has been consumed. If it is not entirely consumed, redose once with the MILBEGUARD Flavored Tablets immediately and resume the monthly dosing schedule. full recommended dose as soon as possible. If MILBEGUARD Flavored Tablets replaces diethylcarbamazine (DEC) for heartworm prevention, the first dose must be MILBEGUARD Flavored Tablets for Cats must be administered monthly, preferably on the same date each given within 30 days after the last dose of DEC. month. The rst dose should be administered within one month of the cat’s rst exposure to mosquitoes Precautions: Do not use in puppies less than four weeks of age or less than two pounds of body weight. Prior to and monthly thereafter until the end of the mosquito season. If a dose is missed and a 30-day interval initiation of the MILBEGUARD Flavored Tablets treatment program, dogs should be tested for existing heartworm between dosing is exceeded, administer MILBEGUARD Flavored Tablets for Cats immediately and resume infections. Infected dogs should be treated to remove adult heartworms and microfilariae prior to initiating treatment the monthly dosing schedule. It is recommended that cats be tested for existing heartworm infection prior with MILBEGUARD Flavored Tablets. Mild, transient hypersensitivity reactions manifested as labored respiration, to starting treatment with MILBEGUARD Flavored Tablets for Cats (See Precautions). vomiting, salivation and lethargy, have been noted in some treated dogs carrying a high number of circulating Precautions: Do not use in kittens less than six weeks of age or less than 1.5 lbs. body weight. Safety in microfilariae. These reactions are presumably caused by release of protein from dead or dying microfilariae. heartworm positive cats has not been established. Safety in breeding, pregnant, and lactating queens and Adverse Reactions: The following adverse reactions have been reported following the use of MILBEGUARD breeding toms has not been established. Flavored Tablets: Depression/lethargy, vomiting, ataxia, anorexia, diarrhea, convulsions, weakness and hypersalivation. Efficacy: MILBEGUARD Flavored Tablets for Cats eliminate the tissue stage of heartworm larvae and Efficacy: MILBEGUARD Flavored Tablets eliminate the tissue stage of heartworm larvae and the adult stage of hookworm (Ancylostoma tubaeforme) and roundworm (Toxocara cati) infections when administered orally hookworm (Ancylostoma caninum), roundworms (Toxocara canis, Toxascaris leonina) and whipworm (Trichuris according to the recommended dosage schedule. The anthelmintic activity of milbemycin oxime is believed vulpis) infestations when administered orally according to the recommended dosage schedule.The anthelmintic to be a result of interference with invertebrate neurotransmission. activity of milbemycin oxime is believed to be a result of interference with invertebrate neurotransmission. Safety: Milbemycin oxime has been tested safely in over 8 dierent breeds of cats. In well-controlled Safety: Milbemycin oxime has been tested safely in over 75 dierent breeds of dogs, including collies, pregnant clinical field studies 141 cats completed treatment with milbemycin oxime. Milbemycin oxime was used females, breeding males and females, and puppies over two weeks of age. In well-controlled clinical field studies, 786 safely in animals receiving frequently used veterinary products such as vaccines, anthelmintics, anesthetics, dogs completed treatment with milbemycin oxime. Milbemycin oxime was used safely in animals receiving frequently antibiotics, steroids, flea collars, shampoos and dips. used veterinary products such as vaccines, anthelmintics, antibiotics, steroids, flea collars, shampoos and dips. Safety studies were conducted in young cats and kittens and doses of 1X, 3X and 5X the minimum Two studies in heartworm-infected dogs were conducted which demonstrated mild, transient hypersensitivity recommended dose of 2.0 mg/kg demonstrated no drug- related eects. Tolerability studies at exaggerated reactions in treated dogs with high microfilaremia counts (see Precautions for reactions observed). Safety studies in doses of 10X also demonstrated no drug-related adverse eects in kittens and young adult cats. pregnant dogs demonstrated that high doses (1.5 mg/kg =3X) of milbemycin oxime given in an exaggerated dosing How supplied: MILBEGUARD Flavored Tablets for Cats are available in three tablet sizes (see Dosage regimen (daily from mating through weaning), resulted in measurable concentrations of the drug in milk. Puppies section), formulated according to the weight of the cat. Each tablet size is available in color-coded packages nursing these females which received exaggerated dosing regimens demonstrated milbemycin-related eects. These of 6 tablets each, which are packaged 10 per display carton. eects were directly attributable to the exaggerated experimental dosing regimen. The product is normally intended Storage conditions: MILBEGUARD Flavored Tablets for Cats should be stored at room temperature, for once-a-month administration only. Subsequent studies included using 3X daily from mating to one week before between 68° and 77°F (20-25°C). weaning and demonstrated no eects on the pregnant females or their litters. A second study where pregnant Manufactured for: females were dosed once at 3X the monthly use rate either before, on the day of or shortly after whelping resulted in Ceva Animal Health, LLC no eects on the puppies. Lenexa, KS 66215 Some nursing puppies, at 2, 4, and 6 weeks of age, given greatly exaggerated oral milbemycin oxime doses (9.6 Made in Canada. mg/kg = 19X) exhibited signs typified by tremors, vocalization and ataxia. These eects were all transient ©2019 Ceva Animal Health, LLC. Lenexa, KS 66215 and puppies returned to normal within 24 to 48 hours. No eects were observed in puppies given the ANADA #200-629, Approved by FDA MilbeGuard™ trademark is the property of Ceva Santé Animale S.A.

42 | Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com Clinical Pharmacology: Peak fluralaner concentrations are achieved between 2 hours and 3 days following oral administration, and the elimination half-life ranges between 9.3 to 16.2 days. Quantifiable drug concentrations can be measured (lower than necessary for effectiveness) through 112 days. Due to reduced drug bioavailability in the fasted Flavored chews for dogs. state, fluralaner should be administered with food. Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Mode of Action: Fluralaner is for systemic use and belongs to the class of isoxazoline-substituted benzamide derivatives. Description: Fluralaner is an inhibitor of the arthropod nervous system. The mode of action of fluralaner is the antagonism Each chew is formulated to provide a minimum dose of 11.4 mg/lb (25 mg/kg) body weight. of the ligand-gated chloride channels (gamma-aminobutyric acid (GABA)-receptor and glutamate-receptor). The chemical name of fluralaner is (±)-4-[5-(3,5-dichlorophenyl)-5-(trifluoromethyl)-4,5- dihydroisoxazol-3- Effectiveness: yl]-2-methyl-N-[2-oxo-2-(2,2,2-trifluoroethylamino) ethyl]benzamide. Bravecto began to kill fleas within two hours after administration in a well-controlled laboratory study. In a Indications: European laboratory study, Bravecto killed fleas andIxodes ricinus ticks and reduced the numbers of live fleas Bravecto kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides and Ixodes ricinus ticks on dogs by >98% within 12 hours for 12 weeks. In a well-controlled laboratory study, felis) and the treatment and control of tick infestations [Ixodes scapularis (black-legged tick), Dermacentor Bravecto demonstrated 100% effectiveness against adult fleas 48 hours post-infestation for 12 weeks. In well- variabilis (American dog tick), and Rhipicephalus sanguineus (brown dog tick)] for 12 weeks in dogs and controlled laboratory studies, Bravecto demonstrated ≥93% effectiveness against Dermacentor variabilis, Ixodes puppies 6 months of age and older, and weighing 4.4 pounds or greater. scapularis and Rhipicephalus sanguineus ticks 48 hours post-infestation for 12 weeks. Bravecto demonstrated ≥90% effectiveness againstAmblyomma americanum 72 hours post-infestation for 8 weeks, but failed to Bravecto is also indicated for the treatment and control of Amblyomma americanum (lone star tick) infestations demonstrate ≥90% effectiveness beyond 8 weeks. for 8 weeks in dogs and puppies 6 months of age and older, and weighing 4.4 pounds or greater. In a well-controlled U.S. field study, a single dose of Bravecto reduced fleas by ≥99.7% for 12 weeks. Dogs Dosage and Administration: with signs of flea allergy dermatitis showed improvement in erythema, alopecia, papules, scales, crusts, and Bravecto should be administered orally as a single dose every 12 weeks according to the Dosage Schedule excoriation as a direct result of eliminating flea infestations. below to provide a minimum dose of 11.4 mg/lb (25 mg/kg) body weight. Palatability: In a well-controlled U.S. field study, which included 559 doses administered to 224 dogs, 80.7% Bravecto may be administered every 8 weeks in case of potential exposure to Amblyomma americanum ticks of dogs voluntarily consumed Bravecto within 5 minutes, an additional 12.5% voluntarily consumed Bravecto (see Effectiveness). within 5 minutes when offered with food, and 6.8% refused the dose or required forced administration. Bravecto should be administered with food. Animal Safety: Dosage Schedule Margin of Safety Study: In a margin of safety study, Bravecto was administered orally to 8- to 9-week-old puppies at 1, 3, and 5X the maximum label dose of 56 mg/kg at three, 8-week intervals. The dogs in the Body Weight Ranges (lb) Fluralaner Content (mg) Chews Administered control group (0X) were untreated. 4.4 – 9.9 112.5 One There were no clinically-relevant, treatment-related effects on physical examinations, body weights, food >9.9 – 22.0 250 One consumption, clinical pathology (hematology, clinical chemistries, coagulation tests, and urinalysis), gross >22.0 – 44.0 500 One pathology, histopathology, or organ weights. Diarrhea, mucoid and bloody feces were the most common >44.0 – 88.0 1000 One observations in this study, occurring at a similar incidence in the treated and control groups. Five of the twelve treated dogs that experienced one or more of these signs did so within 6 hours of the first dosing. One dog in >88.0 – 123.0* 1400 One the 3X treatment group was observed to be dull, inappetant, with evidence of bloody diarrhea, vomiting, and *Dogs over 123.0 lb should be administered the appropriate combination of chews weight loss beginning five days after the first treatment. One dog in the 1X treatment group vomited food 4 hours following the first treatment. Treatment with Bravecto may begin at any time of the year and can continue year round without interruption. Reproductive Safety Study: Bravecto was administered orally to intact, reproductively-sound male and female Contraindications: Beagles at a dose of up to 168 mg/kg (equivalent to 3X the maximum label dose) on three to four occasions at There are no known contraindications for the use of the product. 8-week intervals. The dogs in the control group (0X) were untreated. Warnings: There were no clinically-relevant, treatment-related effects on the body weights, food consumption, Not for human use. Keep this and all drugs out of the reach of children. Keep the product in the original reproductive performance, semen analysis, litter data, gross necropsy (adult dogs) or histopathology findings packaging until use, in order to prevent children from getting direct access to the product. (adult dogs and puppies). One adult treated dog suffered a seizure during the course of the study (46 days Do not eat, drink or smoke while handling the product. Wash hands thoroughly with soap and water after the second treatment). Abnormal salivation was observed on 17 occasions: in six treated dogs (11 immediately after use of the product. occasions) after dosing and four control dogs (6 occasions). Precautions: The following abnormalities were noted in 7 pups from 2 of the 10 dams in only the treated group during Bravecto has not been shown to be effective for 12-weeks duration in puppies less than 6 months of gross necropsy examination: limb deformity (4 pups), enlarged heart (2 pups), enlarged spleen (3 pups), and age. Bravecto is not effective againstAmblyomma americanum ticks beyond 8 weeks after dosing (see cleft palate (2 pups). During veterinary examination at Week 7, two pups from the control group had inguinal Effectiveness). testicles, and two and four pups from the treated group had inguinal and cryptorchid testicles, respectively. No undescended testicles were observed at the time of necropsy (days 50 to 71). Adverse Reactions: In a well-controlled U.S. field study, which included 294 dogs (224 dogs were administered Bravecto every In a well-controlled field study Bravecto was used concurrently with other medications, such as vaccines, 12 weeks and 70 dogs were administered an oral active control every 4 weeks and were provided with a tick anthelmintics, antibiotics, and steroids. No adverse reactions were observed from the concurrent use of collar); there were no serious adverse reactions. All potential adverse reactions were recorded in dogs treated Bravecto with other medications. with Bravecto over a 182-day period and in dogs treated with the active control over an 84-day period. The Storage Information: most frequently reported adverse reaction in dogs in the Bravecto and active control groups was vomiting. Do not store above 86°F (30°C). Percentage of Dogs with Adverse Reactions in the Field Study How Supplied: Bravecto Group: Percentage Active Control Group: Bravecto is available in five strengths (112.5, 250, 500, 1000, and 1400 mg fluralaner per chew). Each chew of Dogs with the AR During Percentage of Dogs with is packaged individually into aluminum foil blister packs sealed with a peelable paper backed foil lid stock. Adverse Reaction (AR) the 182-Day Study the AR During the 84-Day Product may be packaged in 1, 2, or 4 chews per package. (n=224 dogs) Study (n=70 dogs) NADA 141-426, Approved by FDA Vomiting 7.1 14.3 Distributed by: Decreased Appetite 6.7 0.0 Intervet Inc (d/b/a Merck Animal Health) Diarrhea 4.9 2.9 Madison, NJ 07940 Lethargy 5.4 7.1 Made in Austria Polydipsia 1.8 4.3 Copyright © 2014 Intervet Inc, a subsidiary of Merck & Company Inc. Flatulence 1.3 0.0 All rights reserved 154545 R1 In a well-controlled laboratory dose confirmation study, one dog developed edema and hyperemia of the upper lips within one hour of receiving Bravecto. The edema improved progressively through the day and had resolved without medical intervention by the next morning. For technical assistance or to report a suspected adverse drug reaction, contact Merck Animal Health at 1-800-224-5318. Additional information can be found at www.bravecto.com. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or online at http://www. fda.gov/AnimalVeterinary/SafetyHealth.

1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 43 In addition, one dog experienced intermittent head tremors within 1.5 hours of administration of vaccines, an ear cleaning performed by the owner, and its first dose of CREDELIO. The head tremors resolved within 24 hours without treatment. The owner elected to withdraw the dog from the study. In an Australian field study, one dog with a history of seizures experienced seizure activity (tremors and glazed eyes) six days after receiving CREDELIO. The dog recovered without treatment and completed the study. In the U.S. field study, two dogs with a history of seizures received CREDELIO and experienced no seizures throughout the study. In three well-controlled European field studies and one U.S. laboratory study, seven dogs experienced episodes of vomiting and four dogs experienced episodes of diarrhea between 6 hours and 3 days after receiving CREDELIO. To report suspected adverse events, for technical assistance or to obtain a copy of the Safety Data Sheet (SDS), contact Elanco US, Inc. at 1-888-545-5973. For additional information about adverse drug experience reporting for animal drugs, contact FDA at Chewable Tablets 1-888-FDA-VETS or http://www.fda.gov/AnimalVeterinary/SafetyHealth. For oral use in dogs Clinical Pharmacology: Following oral administration of 43 mg/kg (approximately 1X the maximum labeled dose), Caution: peak lotilaner concentrations were achieved between 6 hours and 3 days in dogs Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. 2 months of age and between 1 and 7 days in dogs 10 months of age. Dogs 2 months Description: of age had a shorter elimination half-life (average of 9.6 days) than at 10 months of age CREDELIO (lotilaner) is a beef-flavored, chewable tablet for oral administration to dogs (average of 28.4 days). Due to reduced drug bioavailability in the fasted state, CREDELIO and puppies according to their weight. Each chewable tablet is formulated to provide a must be administered with a meal or within 30 minutes after feeding. minimum lotilaner dosage of 9 mg/lb (20 mg/kg). Mode of Action: Lotilaner has the chemical composition of 5-[(5S)-4,5-dihydro-5-(3,4,5-trichlorophenyl)- Lotilaner is an ectoparasiticide belonging to the isoxazoline group. Lotilaner inhibits insect 5-(trifluoromethyl)-3-isoxazolyl]-3-methyl-N-[2-oxo-2-[(2,2,2-trifluoroethyl)amino]ethyl]- and acarine gamma-aminobutyric acid (GABA)-gated chloride channels. This inhibition 2-thiophenecarboxamide. blocks the transfer of chloride ions across cell membranes, which results in uncontrolled Indications: neuromuscular activity leading to death of insects and acarines. The selective toxicity of CREDELIO kills adult fleas and is indicated for the treatment of flea infestations lotilaner between insects and acarines and mammals may be inferred by the differential (Ctenocephalides felis) and the treatment and control of tick infestations [Amblyomma sensitivity of the insects and acarines’ GABA receptors versus mammalian GABA receptors. americanum (lone star tick), Dermacentor variabilis (American dog tick), Ixodes scapularis Effectiveness: (black-legged tick) and Rhipicephalus sanguineus (brown dog tick)] for one month in dogs In well-controlled European laboratory studies, CREDELIO began to kill fleas four hours and puppies 8 weeks of age and older, and weighing 4.4 pounds or greater. after administration or infestation, with greater than 99% of fleas killed within eight hours Dosage and Administration: after administration or infestation for 35 days. In a well-controlled U.S. laboratory study, CREDELIO is given orally once a month, at the minimum dosage of 9 mg/lb (20 mg/kg). CREDELIO demonstrated 100% effectiveness against adult fleas 12 hours after Dosage Schedule: administration or infestation for 35 days. In a 90-day well-controlled U.S. field study conducted in households with existing flea Body Weight Lotilaner Per Chewable Tablets Chewable Tablet (mg) Administered infestations of varying severity, the effectiveness of CREDELIO against fleas on Days 30, 60 and 90 compared to baseline was 99.5%,100% and 100%, respectively. Dogs with 4.4 to 6.0 lbs 56.25 One signs of flea allergy dermatitis showed improvement in erythema, papules, scaling, 6.1 to 12.0 lbs 112.5 One alopecia, dermatitis/pyodermatitis and pruritus as a direct result of eliminating fleas. 12.1 to 25.0 lbs 225 One In well-controlled laboratory studies, CREDELIO demonstrated > 97% effectiveness 25.1 to 50.0 lbs 450 One against Amblyomma americanum, Dermacentor variabilis, Ixodes scapularis and 50.1 to 100.0 lbs 900 One Rhipicephalus sanguineus ticks 48 hours after administration or infestation for 30 days. Over 100.0 lbs Administer the appropriate combination of chewable tablets In a well-controlled European laboratory study, CREDELIO started killing Ixodes ricinus ticks within four hours after administration. CREDELIO must be administered with food (see Clinical Pharmacology). Palatability: In the U.S. field study, which included 567 doses administered to 198 dogs, Treatment with CREDELIO can begin at any time of the year and can continue year round 80.4% of dogs voluntarily consumed CREDELIO when offered by hand or in an empty without interruption. bowl, an additional 13.6% consumed CREDELIO when offered with food, and 6.0% Contraindications: required placement of the chewable tablet in the back of the dog’s mouth. There are no known contraindications for the use of CREDELIO. Animal Safety: Warnings: In a margin of safety study, CREDELIO was administered orally to 24 (8 dogs/group) Not for human use. Keep this and all drugs out of the reach of children. 8-week-old Beagle puppies at doses of 43 mg/kg, 129 mg/kg, and 215 mg/kg (approximately 1, 3, and 5X the maximum labeled dose, respectively) every 28 days for Precautions: eight consecutive doses. The 8 dogs in the control group (0X) were untreated. There were The safe use of CREDELIO in breeding, pregnant or lactating dogs has not been no clinically-relevant, treatment-related effects on clinical observations, physical and evaluated. Use with caution in dogs with a history of seizures (see ). Adverse Reactions neurological examinations, body weights, food consumption, electrocardiograms, clinical Adverse Reactions: pathology (hematology, clinical chemistries, coagulation profiles and urinalysis), gross In a well-controlled U.S. field study, which included 284 dogs (198 dogs treated with pathology, histopathology, or organ weights. Blood concentrations of lotilaner confirmed CREDELIO and 86 dogs treated with an oral active control), there were no serious adverse systemic exposure of all treated dogs, although the exposure was less than dose reactions. proportional at 5X. Over the 90-day study period, all observations of potential adverse reactions were In a well-controlled field study, CREDELIO was used concurrently with other medications, recorded. Reactions that occurred at an incidence of 1% or greater are presented in the such as vaccines, anthelmintics, antibiotics, steroids, NSAIDS, anesthetics, and following table. antihistamines. No adverse reactions were observed from the concomitant use of Dogs with Adverse Reactions in the Field Study CREDELIO with other medications. Adverse Reaction CREDELIO Group: Active Control Group: Storage Information: (AR) Number (and Percent) of Number (and Percent) of Store at 15-25°C (59 -77°F), excursions permitted between 5 to 40°C (41 to 104°F). Dogs with the AR (n=198) Dogs with the AR (n=86) How Supplied: Weight Loss 3 (1.5%) 2 (2.3%) CREDELIO is available in five chewable tablet sizes for use in dogs: 56.25, 112.5, 225, 450, and 900 mg lotilaner. Each chewable tablet size is available in color-coded packages Elevated Blood Urea 2 (1.0%)* 0 (0.0%) of 1 or 6 chewable tablets. Nitrogen (BUN) NADA #141-494, Approved by the FDA Polyuria 2 (1.0%)* 0 (0.0%) Manufactured for: Elanco US Inc Diarrhea 2 (1.0%) 2 (2.3%) Greenfield, IN 46140 USA *Two geriatric dogs developed mildly elevated BUN (34 to 54 mg/dL; reference range: Credelio.com 6 to 31 mg/dL) during the study. One of these dogs also developed polyuria and a mildly Credelio, Elanco and the diagonal bar logo are elevated potassium (6.5 mEq/L; reference range: 3.6 to 5.5 mEq/L) and phosphorous trademarks of Eli Lilly and Company or its affiliates. (6.4 mg/dL; reference range: 2.5 to 6.0 mg/dL). The other dog also developed a mildly Rev. date 11/2017 elevated creatinine (1.7 to 2.0 mg/dL; reference range: 0.5 to 1.6 mg/dL) and weight loss. PA209456X 12266 CRE1

44 | Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 45 Effectiveness: Prevention of the tissue larval stage of heartworm (Dirofilaria immitis) and the elimination of the adult stage of hookworm (Ancylostoma caninum, Uncinaria stenocephala, Anyclostoma braziliense), roundworm (Toxocara canis, Toxascaris leonina), and tapeworm (Dipylidium caninum, Taenia pisiformis) infections in dogs was demonstrated in well-controlled So Chew laboratory studies. Palatability: In a field study of 132 dogs, IVERHART MAX Soft Chew was offered once monthly For oral use in dogs only. for 3 months. The dogs voluntarily consumed 86.3% of the doses from the owner’s hand or from a bowl within 5 minutes, 13.0% accepted the dose when it was offered in food or administered Caution: Federal (U.S.A.) law restricts this drug to use by or on the order of a licensed veterinarian. by placing onto the back of the dog’s tongue (pilling), and 0.7% of the doses were unable to Description: IVERHART MAX® Soft Chew is a combination of three anthelmintics (ivermectin/pyrantel pamoate/ be administered. praziquantel). The soft chews are available in four sizes in color-coded packages for oral administration to dogs Animal Safety: Studies with ivermectin indicate that certain dogs of the Collie breed according to their weight (see Dosage and Administration). are more sensitive to the effects of ivermectin administered at elevated dose levels Indications: For use in dogs to prevent canine heartworm disease by eliminating the tissue stage of heartworm (more than 16 times the target dose level of 6 mcg/ kg) than dogs of other breeds. larvae (Dirofilaria immitis) for a month (30 days) after infection and for the treatment and control of roundworms At elevated doses, sensitive dogs showed more adverse reactions, which included (Toxocara canis, Toxascaris leonina), hookworms (Ancylostoma caninum, Uncinaria stenocephala, Ancylostoma mydriasis, depression, ataxia, tremors, drooling, paresis, recumbency, excitability, braziliense), and tapeworms (Dipylidium caninum, Taenia pisiformis). stupor, coma, and death. No signs of toxicity were seen at 10 times the recommended dose (27.2 mcg/lb) in sensitive Collies. Data from these studies Dosage and Administration: IVERHART MAX Soft Chew should be administered orally at monhly intervals support the safety of ivermectin products in dogs, including Collies, when and the recommended minimum dose level of 6 mcg of ivermectin per kilogram (2.72 mcg/ lb), 5 mg of pyrantel used at the label recommended dose. (as pamoate salt) per kg (2.27 mg/lb), and 5 mg of praziquantel per kg (2.27 mg/lb) of body weight, as follows: Because ivermectin and praziquantel are approximately 30% more Dog Weight Soft Chew Soft Chew Ivermectin Pyrantel Pamoate Praziquantel bioavailable in the IVERHART MAX Soft Chew than in the ivermectin/ Pounds per Month Size Content Content Content pyrantel pamoate/praziquantel tablets used in the following target animal safety studies, the margin of safety is narrower than reported in 6.0 to 12 1 Toy 34 mcg 28.5 mg 28.5 mg these studies. The potential for adverse reactions may be greater in individual 12.1 to 25 1 Small 68 mcg 57 mg 57 mg dogs administered IVERHART MAX Soft Chew than ivermectin/ pyrantel pamoate/ praziquantel tablets. 25.1 to 50 1 Medium 136 mcg 114 mg 114 mg In a target animal safety study using ivermectin/pyrantel pamoate/praziquantel tablets, 50.1 to 100 1 Large 272 mcg 228 mg 228 mg doses were administered to 8-week-old Beagle puppies at one, three, and five times the maximum recommended dose of 12.5 mcg/kg ivermectin, 10.47 mg/ kg pyrantel, IVERHART MAX Soft Chew is recommended for dogs 8 weeks of age or older. For dogs over 100 lbs, use the and 10.47 mg/kg praziquantel. The dogs were treated every 30 days for 6 months. appropriate combination of these soft chews. Vomiting within 6 hours of dosing and soft or watery feces within 24 hours of dosing were observed. Other observations during the study were: ano-genital swelling, lethargy, Remove only one dose at a time from the packaging. Return the remaining soft chew(s) to their box to protect head movements, shallow, audible or difficult breathing, and salivation. One dog in from light. The soft chew can be offered to the dog by hand or added, intact, to a small amount of dog food. Care the 5X group had tremors and decreased activity. All of these signs were transient. should be taken to ensure that the dog consumes the complete dose. The treated dog should be observed for No treatment was required. Histopathology showed testicular hypoplasia in the 3X a few minutes after administration to confirm that none of the dose has been lost or rejected. If it is suspected and 5X groups (see Warnings). that any of the dose has been lost, redosing is recommended. In a laboratory safety study using ivermectin/pyrantel pamoate/praziquantel tablets, IVERHART MAX Soft Chew should be given at monthly intervals during the period of the year when mosquitoes 12-week-old Beagle puppies receiving 3 and 5 times the recommended dose once (vectors), potentially carrying infective heartworm larvae, are active. The initial dose must be given within weekly for 13 weeks demonstrated a dose-related decrease in testicular maturation a month (30 days) after the dog’s first exposure to mosquitoes. The final dose must be given within a month compared to controls. In this study, all treated puppies had significantly higher (30 days) after the dog’s last exposure to mosquitoes. cholesterol levels compared to untreated controls. When replacing another heartworm preventative product in a heartworm disease prevention program, the In a reproductive safety study, adult males were treated at 37.5 mcg/ kg ivermectin, first dose of IVERHART MAX Soft Chew must be given within a month (30 days) of the last dose of the former 31.4 mg/ kg pyrantel, and 31.4 mg/kg praziquantel every 14 days during two full medication. A heartworm test should be performed prior to switching heartworm preventative products. spermatogenic cycles (112 days). The quality of semen and reproductive health were If the interval between doses exceeds a month (30 days), the effectiveness of ivermectin can be reduced. not affected by treatment. Treatment-related vomiting and soft feces were reported Therefore, for optimal performance, the soft chew must be given once a month on or about the same during this study. day of the month. If treatment is delayed, whether by a few days or many, immediate treatment with In a study of the effectiveness of ivermectin/pyrantel pamoate/praziquantel tablets IVERHART MAX Soft Chew and the recommended dosing regimen will minimize the opportunity for the for the treatment of Toxocara canis, one 8.1 lb, 72-day-old puppy died 6 days development of adult heartworms. after administration of the label dose. This puppy and many other puppies Warnings: in the study had high worm burdens and were reported to have diarrhea, For use in dogs only. Keep this and all drugs out of reach of children and pets. In safety studies with sometimes bloody, frequently before and after treatment. Dehydration and ivermectin/pyrantel pamoate/praziquantel tablets, testicular hypoplasia was observed in some dogs signs of anemia (pale mucous membranes) were the only abnormal gross necropsy receiving 3 and 5 times the maximum recommended dose monthly for 6 months (see Animal Safety). finding observed. No definitive cause was determined. In a 90-day field study using ivermectin/pyrantel pamoate/praziquantel tablets, the most serious adverse In case of ingestion by humans, clients should be advised to contact a physician immediately. Physicians may reactions (lethargy, limpness, and salivation) were seen in dogs weighing less than contact a Poison Control Center for advice concerning cases of ingestion by humans. 10 lbs (see Precautions). Precautions: Use with caution in sick, debilitated, or underweight animals and dogs weighing less than 10 lbs Storage Information: Store at 20°C to 25°C (68°F to 77°F), excursions permitted (see Animal Safety). The safe use of this drug has not been evaluated in pregnant or lactating bitches. between 15°C and 30°C (59°F to 86°F). All dogs should be tested for existing heartworm infection before starting treatment with IVERHART MAX Soft How Supplied: IVERHART MAX Soft Chew is available in four dosage strengths Chew, which is not effective against adult Dirofilaria immitis. Infected dogs should be treated to remove adult (see Dosage and Administration) for dogs of different weights. Each strength heartworms and microfilariae before initiating a heartworm prevention program. comes in a package of 6 soft chews. While some microfilariae may be killed by the ivermectin in IVERHART MAX Soft Chew at the recommended dose level, IVERHART MAX Soft Chew is not effective for microfilariae clearance. A mild hypersensitivity-type reaction, NADA 141-441, Approved by FDA. presumably due to dead or dying microfilariae and particularly involving a transient diarrhea, has been observed in clinical trials with ivermectin alone after treatment of some dogs that have circulating microfilariae. Manufactured by: Adverse Reactions: In a field study with IVERHART MAX Soft Chew, self-limiting adverse reactions, including vomiting, diarrhea, lethargy, difficulty swallowing, excessive salivation, increased water consumption, and Virbac AH, Inc. coughing were reported. Self-limiting adverse reactions, including lethargy, limpness, salivation, shaking, Fort Worth, TX 76137 USA diarrhea, decreased appetite, licking lips, and belching were reported between 20 minutes and 72 hours Phone: 1-800-338-3659 following treatment in a field study with ivermectin/pyrantel pamoate/praziquantel tablets. IVERHART MAX is a registered trademark of Virbac Corporation. 302143-03 In field studies with ivermectin/pyrantel pamoate tablets, vomiting or diarrhea within 24 hours of dosing was 9/17 rarely observed (1.1% of administered doses). The following adverse reactions have been reported in dogs following the use of ivermectin products: depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions, and hypersalivation. To report suspected adverse events, for technical assistance, or to obtain a copy of the Safety Data Sheet (SDS), contact Virbac AH, Inc. at 1-800-338-3659 or us.virbac.com. For additional information about adverse drug experience reporting for animal drugs, contact the FDA at 1-888-FDA-VETS or online at http:// www.fda.gov/ AnimalVeterinary/SafetyHealth.

© 2018 Virbac Corporation. All Rights Reserved. IVERHART MAX is a registered trademark of Virbac Corporation. HEARTGARD and the Dog and Hand logo are registered trademarks of Merial, Inc. 3/18 17690 VPD286-18

46 | Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com A Message to You: As people in the animal health industry, we all know how vast the topic of preventive health is to our clients. From parasite prevention, to disease prevention, this edition of the Penn Connection explores products, equipment, and actions that convey the topics of prevention. We sincerely, want to thank you, the reader, for taking the time to enjoy this edition of “The Penn Connection”. Let’s stay aware and stay connected!

~The Penn Veterinary Supply Marketing Team

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