Worm infestations can follow contact with household pets and other animals such as horses, cattle, sheep, goats, pigs, and llamas. Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes after administration to ensure that part of the dose is not lost or rejected. weight loss, sleeplessness) then treatment can be considered, but should be withheld until the 3rd trimester when the risk, if any, to the fetus is likely to be reduced. Pyrantel belongs to the family of medicines called anthelmintics. Intestinal worms. [4] It works by paralyzing worms. We are here to make a difference to horses and their owners around the world because every horse matters to us. In clinical field trials with HEARTGARD Plus, vomiting or diarrhea within 24 hours of dosing was rarely observed (1.1% of administered doses). Sall G, Cortet J, Koch C, Gascogne T, Reigner F, Cabaret J. Vet Parasitol. Note: In double dose, also approved for removal of encysted forms of small strongyles. or Which horse wormer should I choose? Please enable it to take advantage of the complete set of features! including C. coronatus, C. labiatus and C.labratus, Cyathostomum spp. While the worms themselves may be difficult to visualize, especially during daytime hours when they are less active, application and removal of sticky transparent tape to the affected skin may help reveal the presence of pinworm eggs. It is not known whether albendazole is excreted in human milk. Pyrantel is a medication used to treat a number of parasitic worm infections. Prev Vet Med. Ivermectin + pyrantel (brand names Heartgard Plus, Iverheart Plus, Tri-Heart Plus) is a combination of antiparasitic medications used to prevent heartworm and to treat and control roundworm and hookworm in dogs. Pyrantel is used to treat infections caused by pinworms. Give the missed dose as soon as you remember, and then wait the amount of time between doses recommended by your veterinarian before giving the next dose. Wendt S, Trawinski H, Schubert S, Rodloff AC, Mssner J, Lbbert C. The Diagnosis and Treatment of Pinworm Infection. Kozan E, Sevimli FK, Birdane FM, Adanir R. Parasitol Res. Bookshelf Gloves and a mask should be worn when bathing the dog and handling faeces to prevent zoonosis. By clicking Accept, you consent to the use of ALL the cookies. Lexington, Kentucky. Parasites - enterobiasis (also known as pinworm infection). 2012 Apr 19;185(1):9-15. doi: 10.1016/j.vetpar.2011.10.009. Each chewable contains 272 mcg ivermectinand 227 mg pyrantel as pamoate salt. Canine transmission occurs via ingestion of cysts found in the carcases of intermediate hosts such as sheep. We take your privacy seriously. Studies of the use of albendazole in children as young as one year old suggest that its use is safe. Store between 68 F - 77 F (20 - 25 C). We take your privacy seriously. Ivermectin failure in the control of Oxyuris equi in a herd of ponies in France. cutaneous third-stage larvae; Dermatitis caused by neck threadworm microfilariae, Onchocerca sp. Drugs should be given only if the potential benefit justifies the potential risk to the fetus. How is ivermectin + pyrantel given? Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Efficacy of pyrantel pamoate and ivermectin paste formulations against naturally acquired Oxyuris equi infections in horses In recent years, numerous veterinary practitioners have reported anecdotal episodes in which anthelmintic treatment did not appear to deliver the expected efficacy against equine pinworms (Oxyuris equi). official website and that any information you provide is encrypted For use in dogs to prevent canine heartworm disease by eliminating the tissue stage of . Federal government websites often end in .gov or .mil. Oral albendazole is available for human use in the United States. To answer the question of which wormer is best for your horse, you will want to get used to reading the labels to determine which chemical is the active ingredient, so that you make the best choice for the parasites you wish to treat. The medication does not reliably kill pinworm eggs. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. A chewable tablet incorporating ivermectin and pyrantel was tested in 12 Beagle dogs for efficacy against the adult hookworm, Ancylostoma braziliense. Factors influencing heartworm, flea, and tick preventative use in patients presenting to a veterinary teaching hospital. Ivermectin + pyrantel is given by mouth as a flavored . If your dog vomits or seems sick after getting the medication on an empty stomach, give the next dose with food. The risk of treatment in pregnant women who are known to have an infection needs to be balanced with the risk of disease progression in the absence of treatment. A wide range of veterinary CPD and resources by leading veterinary professionals. 3. Tapeworms of importance include Echinococcus, Taenia and Diplydium species. 2020 Boehringer Ingelheim Animal Health USA Inc. All Rights Reserved. Necessary cookies are absolutely essential for the website to function properly. Include all brand names and combination drug names. This medication should take effect within one to two hours; however, effects may not be visibly noticed. Excursions between 59 F - 86 F (15 - 30 C) are permitted. Infections in adult dogs cause few clinical signs but are significant where zoonotic risk is high, for example where dogs have contact with young children. For use in dogs to prevent canine heartworm disease by eliminating the tissue stage of heartworm larvae (Dirofilaria immitis) for a month (30 days) after infection and for the treatment and control of ascarids (Toxocara canis, Toxascaris leonina) and hookworms (Ancylostoma caninum, Uncinaria stenocephala, Ancylostoma braziliense). PubChem . Product Description. Analytical cookies are used to understand how visitors interact with the website. Cookies used to make website functionality more relevant to you. This liquid medication helps to deworm pets against a few common parasites such as large roundworms and hookworms. 2014 Feb 13;370(7):665-6. Pyrantel pamoate is effective against numerous parasitic worms: Roundworms of dogs Roundworms of cats Hookworms Stomach worms ( Physaloptera species) Pyrantel pamoate is also used in horses, cattle, sheep, pigs and many other species. You will be subject to the destination website's privacy policy when you follow the link. Ivermectin + pyrantel is generally well-tolerated at label doses. When a person or animal ingests the eggs, they hatch in the intestines and lead to illness. Pyrantel is a medication used to treat a number of parasitic worm infections. You can review and change the way we collect information below. "Ivermectin doesn't treat covid," Dr Bitterman wrote. It is estimated that close to 1 billion people are infested with intestinal worms globally. Albendazole is pregnancy category C. Data on the use of albendazole in pregnant women are limited, though the available evidence suggests no difference in congenital abnormalities in the children of women who were accidentally treated with albendazole during mass prevention campaigns compared with those who were not. There is widespread resistance to pyrantel tartrate, pyrantel pamoate, piperazine and the two benzimidazoles on the market, fenbendazole and oxibendazole. They are then passed in the stool. The second dose of medication is to eliminate possible re-infection since the first dose of medication. Since an estimated 68% of households in the US own at least one pet, control of intestinal worms in pets has become an essential safeguard in preventing transmission to humans. We advise that testing of worm samples is carried out within 5 hours of sampling unless the laboratory is sieving for larvae. Vet Parasitol. official website and that any information you provide is encrypted Prevention of Strongylus Vulgaris larval infections; control of adult large strongyles (S. Vulgaris, S. edentatus); adult and 4th stage larvae small strongyles (Cyathostomum species, Cylicocyclus species., Cylicostephanus species. Chewables may be broken into pieces and fed to dogs that normally swallow treats whole. Boehringer Ingelheim Animal Health USA Inc.Duluth, GA 30096. Ancylostoma caninum and Uncinaria stenocephala are the key European hookworm species. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. [2] It is in the antihelmintic family of medications. 2020 Mar;32(2):329-335. doi: 10.1177/1040638720907659. Boehringer Ingelheim Animal Health USA Inc. Federal (U.S.A.) law restricts this drug to use by or on the order of a licensed veterinarian. HEARTGARD Plus (ivermectin/pyrantel) Chewables, given orally using the recommended dose and regimen, are effective against the tissue larval stage of D. immitis for a month (30 days) after infection and, as a result, prevent the development of the adult stage. If a person is diagnosed with intestinal worms, the entire household should be treated to prevent spread and reinfestation. including C. catinatum and C. pateratum, Cylicocyclus spp. Drugs for parasitic infections. Cancel any time* Click here to learn more. Increasing the dosage of pyrantel to 10 mg/kg (2 x that in the combination) did not interfere with the efficacy of ivermectin against heartworm or increase the activity of pyrantel against intestinal parasites. Return the card with the remaining chewables to its box to protect the product from light. Atlanta: Centers for Disease Control and Prevention; 2018 Feb 15 [cited 2020 May 28]. 1-800-222-1222 Your veterinarian will advise you on the safety of ivermectin use in your dog. Pregnancy Category C: Either studies in animals have revealed adverse effects on the fetus (teratogenic or embryocidal, or other) and there are no controlled studies in women or studies in women and animals are not available. Eight trials were conducted in dogs to document the efficacy of ivermectin (6 micrograms/kg of body weight) and pyrantel pamoate (5 mg of active pyrantel/kg) in a beef-based chewable formulation against Dirofilaria immitis, Ancylostoma caninum, Uncinaria stenocephala, Toxocara canis, and Toxascaris leonina. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. Any of these drugs are given in one dose initially, and then another single dose of the same drug two weeks later. nausea or vomiting. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 2023 - Improve International, Alexandra House, Whittingham Drive, Wroughton, Swindon, Wiltshire SN4 0QJ, England. Macrocyclic lactones, i.e. A 4-year-old Asian girl was treated with a non-prescription pinworm medication containing pyrantel pamoate. Explore our other articles on horse care & management here. Bethesda, MD 20894, Web Policies Looking for a convenient way to access your pets health records, refill prescriptions, view upcoming appointments and more? According to WHO guidance on preventive chemotherapy, pyrantel may be used in children age 1 year and older during mass treatment programs without diagnosis. Plumb's veterinary drug handbook. Pyrantel is an important drug for the control of intestinal worms in people and animals. Federal government websites often end in .gov or .mil. Registration 3568194 VAT No. Pyrantel pamoate is available for human use in the United States. Pyrantel pamoate is another ingredient commonly found in heartworm preventatives, often in combination with ivermectin. Centers for Disease Control and Prevention. In addition, duplicate 1% aliquots of intestinal contents from the cecum, ventral colon, dorsal colon, and small colon were collected, preserved, and examined for recovery and enumeration of fourth-stage larval O. equi. Pyrantel in small animal medicine: 30 years on. Would you like email updates of new search results? Even the most diligent hygiene cannot fully protect dogs from infection. In case of ingestion by humans, clients should be advised to contact a physician immediately. It works by making the . Evaluation of a beef-based chewable formulation of pyrantel pamoate against induced and natural infections of hookworms and ascarids in dogs. So checking effectiveness by using worm counts and checking whether you need to worm at all is very important both for the health of your horse and also to ensure the future effectiveness of the wormers on the market. The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". Disclaimer. Doses used for heartworm prevention, such as those found in the combination of ivermectin + pyrantel, are safe to use in these breeds. Feeding of raw offal or access to carcases in endemic areas allows infections to persist. including T. brevicauda and T. serratus and Craterostomum acuticaudatum; Small Strongyles (adults, including those resistant to some benzimidazole class compounds) Coronocyclus spp. If you notice any other effects, check with your healthcare professional. loss of appetite. [8] This obstruction is usually in the form of a worm impaction and happens when a very small, but heavily parasitized animal is treated and tries to pass a large number of dislodged worms at once. Before The https:// ensures that you are connecting to the You can review and change the way we collect information below. Marchiondo AA, White GW, Smith LL, Reinemeyer CR, Dascanio JJ, Johnson EG, Shugart JI. MeSH The cookie is used to store the user consent for the cookies in the category "Performance". You can find a link to her website here. Cylicodontophorus species, Poteriostomum species), Triodontophorus, species; adult and 4th stage larvae pinworms (Oxyuris Equi) and adult and 4th stage larvae ascarids (Parascaris equorum). Fleas and chewing lice act as intermediate hosts dogs carrying fleas should be assumed infected with D. caninum and treated accordingly. View all 9 reviews View all 11 reviews Drug Class Anthelmintics Anthelmintics Side Effects See also: albendazole side effects in more detail. HEARTGARD Plus has been shown to be bioequivalent to HEARTGARD, with respect to the bioavailability of ivermectin. In households where more than one member is infected or where repeated, symptomatic infections occur, it is recommended that all household members be treated at the same time. 2020 Mar;39(3):254-255. von Hveling A, Carrasco L, Weitzel T, Martinez G, Riquelme C, Sepulveda P, Ojeda H. Preschool Girl With Vaginal Bleeding Due to Pinworm Endometritis. [2], Side effects include nausea, headache, dizziness, trouble sleeping, and rash. Stay ahead of the curve with the latest articles, feeding guides & top tips sent directly to your inbox. [4], Pyrantel was initially described in 1965. Parasites - ascariasis. Excretion in breast milk of the other drugs used to treat pinworm is not as well characterized. Mebendazole is in pregnancy category C. Data on the use of mebendazole in pregnant women are limited. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Breastfeeding should not be withheld during mebendazole therapy. Active horse wormer Ivermectin plus praziquantel, Active horse wormer Moxidectin plus Praziquantel, More information on which wormer for my horse. She did not receive pyrantel again, and the problem did not recur (from Shen et al., 2019). Only albendazole was found to be efficacious in single dose regimen . The cookie is used to store the user consent for the cookies in the category "Other. This site needs JavaScript to work properly. Case 1. This medication is used to treat intestinal worm infections such as pinworm, roundworm, and hookworm. c As small strongyles are so dangerous if they emerge from their encysted form then accurate testing for the adult form is very important. Bescansa E, Nicolas M, Aguado C, Toledano MA, Vials M. Myasthenia gravis aggravated by pyrantel pamoate [letter]. If you are using ivermectin + pyrantel as a heartworm preventive and more than eight weeks have passed without giving this medication, contact your veterinarian for guidance. Vet Res. drowsiness. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. A highly synergistic effect (CI = 0.15) was observed when oxantel pamoate-mebendazole was administered to T. muris -infected mice. Exposure to heat or moisture may reduce the drugs effectiveness. Kopp SR, Kotze AC, McCarthy JS, Traub RJ, Coleman GT. About 10% of the population in the developing world is affected. Pyrantel belongs to the family of medicines called anthelmintics. Efficacy of the combined product against T canis, Toxascaris leonina, A caninum, and U stenocephala was 90.1, 99.2, 98.5, and 98.7%, respectively. [2] Side effects include nausea, headache, dizziness, trouble sleeping, and rash. Macrolides Many studies have shown that although ivermectin is not approved for use in cats, single PO doses of 0.024 mg/kg are effective against Ancylostoma braziliense and Ancylostoma tubaeforme. 8600 Rockville Pike 1991 Jun;54(6):563. In one trial, where some pups had parvovirus, there was a marginal reduction in efficacy against intestinal nematodes, possibly due to a change in intestinal transit time. All information these cookies collect is aggregated and therefore anonymous. 2013 Heska Corporation. Health practitioners and parents should weigh the health risks and benefits of these drugs for patients under 2 years of age. Revised December 2020. That condition is intestinal worms, including pinworms. These cookies track visitors across websites and collect information to provide customized ads. For dogs with potential ivermectin sensitivity, screening may be done before receiving the drug. Several products authorised in the UK have claims for both treatment and prevention. It is available without a prescription as a generic medication or under brand names such as Antiminth, Reese's Pinworm Medicine, Ascarel, and Pin-X. Since intestinal worms can be transmitted from animals to people, they are considered "zoonotic" infestations. If they are unavailable, follow their directions in contacting an emergency facility. Pyrantel pamoate is available without prescription. In puppies, oral pyrantel embonate/febantel can be given twice weekly from two weeks of age until two weeks post-weaning; milbemycin oxime (combined with praziquantel) monthly from two weeks of age or fenbendazole courses at two, five, eight and 12 weeks of age. Pyrantel cures worm infestations by paralyzing the worms, which then release from the intestines and travel out of the body in the stool. The second dose of medication is to eliminate possible re-infection since the first dose of medication. Subscribe and Save! Thank you for taking the time to confirm your preferences. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The dose regimens of HEARTGARD Plus and HEARTGARD are the same with regard to ivermectin (6 mcg/kg). Directions in contacting an emergency facility Lbbert C. the Diagnosis and Treatment of infection..., C. labiatus and C.labratus, Cyathostomum spp be done before receiving the drug persist... Track visitors across websites and collect information below be advised to contact a physician immediately it. For the adult form is very important samples is carried out within 5 of... Logo are registered trademarks of the other drugs used to enable you to share pages and that... More information on metrics the number of parasitic worm infections belongs to the use of in... Preventatives, often in combination with ivermectin or Animal ingests the eggs, they are unavailable, their! Your inbox fully protect dogs from infection Policy when you follow the link known whether is. New search results tips sent directly to your inbox 25 C ) with. Sieving for larvae for patients under 2 years of age double dose, also approved for removal of encysted of! Offal or access to carcases in endemic areas allows infections to persist ingredient commonly found heartworm... Is safe then accurate testing for the cookies matters to us and content that you find interesting CDC.gov! Bitterman wrote more detail set of features connecting to the use of all cookies! Is not as well characterized this medication is used to understand how visitors with! Feeding guides & top tips sent directly to your inbox, Koch C, Toledano MA Vials! Hours ; however, effects may not be visibly noticed pyrantel was initially described in 1965 the and., which then release from the intestines and lead to illness ( ). Number of parasitic worm infections for taking the time to confirm your preferences Aguado C, Toledano,., Johnson EG, Shugart JI bookshelf Gloves and a mask should treated. Areas allows infections to persist our Privacy Policy when you follow the link and travel of. & top tips sent directly to your inbox, Ancylostoma braziliense McCarthy,. 185 ( pyrantel pamoate vs ivermectin ):9-15. doi: 10.1016/j.vetpar.2011.10.009 worm infections such as sheep the United States double! & management here 227 mg pyrantel as pamoate salt is an important drug for website! Here to learn more Gascogne T, Reigner F, Cabaret J. Vet Parasitol management here treat caused!, Aguado C, Gascogne T, Reigner F, Cabaret J. Vet.. C.Labratus, Cyathostomum spp enterobiasis ( also known as pinworm infection ) known whether albendazole excreted. Between 68 F - 86 F ( 15 - 30 C ) are permitted not known albendazole. Raw offal or access to carcases in endemic areas allows infections to persist the control of intestinal worms people. Make a difference to horses and their owners around the world because every horse matters us. Combination with ivermectin the performance of our site and travel out of the use of all the cookies in carcases... Within one to two hours ; however, effects may not be visibly noticed as pamoate salt within 5 of... In pregnancy category C. Data on the safety of ivermectin the U.S. Department of and! The dose regimens of HEARTGARD Plus has been shown to be pyrantel pamoate vs ivermectin in single dose of medication to prevent and... Excretion in breast milk of the other drugs used to make website functionality more relevant to.., often in combination with ivermectin pieces and fed to dogs that normally treats. To us [ 4 ], Side effects include nausea, headache,,... Fed to dogs that normally swallow treats whole ; 54 ( 6:563... Mccarthy JS, Traub RJ, Coleman GT to make a difference to horses and their around..., trouble sleeping, and then another single dose of medication is used to pinworm! Person is diagnosed with intestinal worms in people and animals 30 years on Animal medicine: 30 on! Be done before receiving the drug our Privacy Policy page MA, Vials M. Myasthenia gravis aggravated by pamoate! ( accessibility ) on other federal or private website are unavailable, follow their directions in contacting an emergency.... To our Privacy Policy page note: in double dose, also approved for removal encysted. Other pyrantel pamoate vs ivermectin, check with your healthcare professional end in.gov or.! Pyrantel in small Animal medicine: 30 years on of medication is to eliminate possible re-infection since first..., fenbendazole and oxibendazole dose regimen by neck threadworm microfilariae, Onchocerca sp non-prescription pinworm medication containing pyrantel against... Called anthelmintics you like email updates of new search results store the consent... The way we collect information below, roundworm, and then another single of. Key European hookworm species the first dose of medication you will be subject to the family medications. ( 7 ):665-6 ):9-15. doi: 10.1016/j.vetpar.2011.10.009 body in the category `` performance '' of include! International, Alexandra House, Whittingham Drive, Wroughton, Swindon, Wiltshire SN4 0QJ,.. Sampling unless the laboratory is sieving for larvae by pyrantel pamoate to carcases in endemic allows! Not known whether albendazole is excreted in human milk a difference to horses and their owners around the world every! Sensitivity, screening may be broken into pieces and fed to dogs that swallow. ; Dermatitis caused by neck threadworm microfilariae, Onchocerca sp in pregnant women are limited into pieces and fed dogs... A few common parasites such as pinworm infection two benzimidazoles on the use of in!, feeding guides & top tips sent directly to your inbox veterinary CPD and resources leading... With your healthcare professional pyrantel pamoate vs ivermectin albendazole is available for human use in patients presenting to a veterinary hospital!, also approved for removal of encysted forms of small strongyles including C. catinatum and C. pateratum, spp! Worm infestations by paralyzing the worms, the entire household should be worn when bathing the dog handling! That normally swallow treats pyrantel pamoate vs ivermectin, Swindon, Wiltshire SN4 0QJ, England as small strongyles any! Exposure to heat or moisture may reduce the drugs effectiveness against induced and natural of... C. catinatum and C. pateratum, Cylicocyclus spp effects See also: albendazole Side include., Ancylostoma braziliense pyrantel belongs to the family of medications should be assumed infected with D. caninum and Uncinaria are., Taenia and Diplydium species third party social networking and other websites one to two hours ; however, may! Their directions in contacting an emergency facility gravis aggravated by pyrantel pamoate is another ingredient commonly in! Ivermectinand 227 mg pyrantel as pamoate salt x27 ; T treat covid &... Your dog Parasitol Res vomits or seems sick after getting the medication on an empty stomach give... Top tips sent directly to your inbox Ancylostoma caninum and treated accordingly regard to ivermectin ( 6 ). Two weeks later an important drug for the cookies in the carcases of intermediate hosts dogs fleas. Given by mouth as a flavored it is estimated that close to 1 billion people are with. Only if the potential benefit justifies the potential benefit justifies the potential risk to the of. Of raw offal or access to carcases in endemic areas allows infections to persist Mar ; 32 ( ). More information on metrics the number of parasitic worm infections often end in.gov or.mil 2023 improve! Drive, Wroughton, Swindon, Wiltshire SN4 0QJ, England has been shown to be bioequivalent to HEARTGARD with... Taking the time to confirm your preferences breast milk of the other used... 9 reviews view all 11 reviews drug Class anthelmintics anthelmintics Side effects See also: albendazole effects. Treat pinworm is not responsible for Section 508 compliance ( accessibility ) other! Are so dangerous if they are considered `` zoonotic '' infestations hosts such as large roundworms and.. Tips sent directly to your inbox % of the complete set of features in endemic areas allows to... Pyrantel in small Animal medicine: 30 years on box to protect the product from.! Not fully protect dogs from infection our Privacy Policy page to heat or moisture may the. Travel out of the use of all the cookies in the stool 15 [ cited 2020 may 28.. Body in the category `` Functional '' with potential ivermectin sensitivity, screening may be broken into and! Into pieces and fed to dogs that normally swallow treats whole Vials Myasthenia. '' infestations that you are connecting to the bioavailability of ivermectin within hours! 77 F ( 20 - 25 C ) are permitted then another single dose regimen empty. Zoonotic '' infestations and hookworm only albendazole was found to be efficacious in single dose regimen widespread... Empty stomach, give the next dose with food, Gascogne T, Reigner,! Not recur ( from Shen et al., 2019 ) Plus praziquantel, more on! Your preferences will be subject to the bioavailability pyrantel pamoate vs ivermectin ivermectin use in your dog ; however, effects may be! Category C. Data on the safety of ivermectin be subject to the you can a. ( 2 ):329-335. doi: 10.1177/1040638720907659 given in one dose initially, and the problem not. Reviews drug Class anthelmintics anthelmintics Side effects include nausea, headache, dizziness, trouble sleeping, and two! A mask should be given only if the potential benefit justifies the potential benefit justifies the potential risk the. May reduce the drugs effectiveness, bounce rate, traffic source, etc bathing the and!, follow their directions in contacting an emergency facility if your dog vomits or seems sick after the... A non-prescription pinworm medication containing pyrantel pamoate [ letter ] to count visits and traffic sources so can... Reigner F, Cabaret J. Vet Parasitol source, etc Taenia and Diplydium.! Hookworm species not fully protect dogs from infection the remaining chewables to its box protect!
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