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| Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 2 Dogs protected with Double Defense protocol had no adult heartworms 1,2 FightHeartwormNow.com Learn why Vectra® 3D and Double Defense make sense for your practice at Double Defense Uses: Vectra® 3D for Dogs which has a 99.1% anti-feeding efficacy against mosquitoes1 A heartworm preventive to kill heartworm larvae Groups Number of Dogs with Heartworms Average Number of Adult Heartworms Per Dog DOUBLE DEFENSE Vectra® 3D and Milbemycin Control Vectra® 3D Only Milbemycin Only + + + + + + + + + + + + + + + + + + + 0 Dogs 41 1.5 17.1 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 in- fected 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.

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| Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 4 TicksandfleasCAN turnmyworld D o w nUpside Credelio, Elanco and the diagonal bar logo are trademarks of Elanco or its affiliates.

© 2019 Elanco or its affiliates. PM-US-19-0027 ImportantSafetyInformation 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 XX. Talk to your Elanco sales representative for more information and to place your order today.

Calling All Dogs, BIG and Small! Credelio is available in five convenient SKUs for dogs 4.4 to 100 pounds. SKU Available for BIG Dogs 50.1-100 lbs! 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 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.

12925_01_Credelio_900_Trade_Ad_PennVet_8.625x11.indd 1 2/1/19 4:02 PM 44.

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1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 7 Please see prescribing Information on page 42.

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1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 11 For your FREE digital copy of this handout, contact your Penn Vet Rep today!

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| Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 18 LEPTOSPIROSIS IS A SMALL SIP AWAY Get full size protection in a half size vaccine 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

1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 19 VACCIPURE™ FILTRATION TECHNOLOGY1 Copyright © 2018 Intervet Inc., d/b/a Merck Animal Health, a subsidiary of Merck & Co., Inc.

All rights reserved. US/NCA/1118/0005 Reference: 1. Data on file, Merck Animal Health. Filtration membrane AFTER FILTRATION Filtration membrane BEFORE FILTRATION Purified solution Extraneous proteins Applied pressure “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 EDGETM vaccines.” – Dr.

Trathan, Oakdale Veterinary Group, Oakdale, CA NEW NOBIVAC 0.5 ml VACCINES • Full protection, half the injection volume (50% less volume than standard vaccines) • Proven protection for dogs of all sizes • VacciPure™ Technology supports vaccine safety CUTTING EDGE PROTECTION... NOBIVAC EDGE™ LEPTO4 • First 0.5 ml Leptospirosis vaccine shown to be effective against disease, mortality and shedding1 NOBIVAC EDGE™ DAPPv + L4 • First 0.5 ml combo vaccine to include parainfluenza protection1 • First 0.5 ml Leptospirosis combo vaccine shown to be effective against disease, mortality and shedding1 NOBIVAC EDGE™ DAPPv • First 0.5 ml combo vaccine to include parainfluenza protection1 TOTAL PROTEIN TESTING RESULTS FOR 0.5 ML VACCINES NOBIVAC EDGE™ DAPPv+L4 ULTRA™ DURAMUNE® DAP+4L 1 mg 3 5 2 4 6 5.0 mg/dose 5.8 mg/dose Average Total Protein (mg/dose) Product is registered trademark of respective owner.

99% Reaction Free Out of 1583 Doses Given in Clinical Impressions Study1

| Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 20 Introducing Elanco Portfolio Rewards Valid on cumulative purchases Jan 1 - Mar 31, 2019 Purchase one or a mix of these key Elanco products to receive the following rebates: Cumulative Spend Any combination of products from either group $5,000- $14,999 $15,000- $19,999 $20,000- $29,999 $30,000- $39,999 ≥$40,000 GROUP 1 PRODUCTS Rebate Earned 1% 2% 3% SPOTLIGHT BONUS Purchase $2,500 of Credelio to receive a 1% additional rebate on all group 1 products! Total Rebate Earned with Spotlight Bonus 2% 3% 4% GROUP 2 PRODUCTS Rebate Earned 10% 15% 20% 25% 30% SPOTLIGHT BONUS Purchase $2,500 of ULTRA Duramune, ULTRA Fel-O-Vax, ULTRA Hybrid FVRCP, ULTRA Duramune Lyme and/or Bronchi-Shield ORAL to receive a 5% additional rebate on all group 2 products! Total Rebate Earned with Spotlight Bonus 15% 20% 25% 30% 35% GROUP 2 PRODUCTS GROUP 1 PRODUCTS 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. 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

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| Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 24 VENDOR END DATE ITEMS PROMOTION 3M 12/31/2019 Avagard Purchase Avagard antiseptic hand prep and get a free wall bracket and foot pump or a wall bracket and hand pump.

Abaxis 3/31/2019 VetScan cPL Rapid Tests Purchase 20 tests, receive a free VUE, cPL Starter Kit, and Andriod Mobile Device 3/31/2019 VetScan UA Urine Analyzer Buy 25 VetScan UA14 strips and get 50% off your VetScan UA analyzer. Andover Healthcare 4/30/2019 PetFlex Buy any 2 boxes of PetFlex and get one 6‐pack sample box. Ceva 3/31/2019 Adaptil and Feliway Pheromone Products Buy 3, get 1 free. Mix and match. 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. Clorox Healthcare 3/31/2019 Fuzion, Hydrogen Peroxide, and Disinfecting Bio Stain & Odor Remover Buy 2, get 1 free. Kind for kind. 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. 3/31/2019 Carprofen Chew Tabs Buy 4, get 1 free plus 1 free bottle of Carprovet Flavored Tablets 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. 3/31/2019 DentAcetic, DenTees, and VetraDent Buy 2, get 1 free. Mix and match. 3/31/2019 Eicosa 3FF, EicosaCaps, and EicosaDerm Buy 5, get 1 free. Kind for kind. 3/31/2019 Vetropolycin & Vetropolycin HC Buy 4, get 1 free. Kind for kind. Merck 4/30/2019 Tri‐Heart Plus Buy 5 cartons, get 2 cartons free.

Mix and match. Norbrook 3/31/2019 Loxicom Oral Suspension Buy 4, get 1 free. Mix and match. Includes the new 2x100mL size!

Nutramax 3/31/2019 First Quarter Promotion For every $2,200 in purchases of Nutramax products made between January 1 , 2019 ‐ March 31, 2019, receive a Nutramax branded LiT Firefly TS‐300 cooler free. 3/31/2019 Denamarin Advanced Purchase $375 of Denamarin Advanced and get one 21ct. box of Crananidine Chewable Tablets and one 75ct. box of Crananidin Chewable Tablets free. SunTech 3/31/2019 Vet25 and Vet30 Blood Pressure Monitors Receive an extra set of blood pressure cuffs free with purchase. 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. 3/31/2019 MicroSpore Leave‐on Lotion, Micro BP Shampoo, Micro BP Gel Buy 4, get 1 free. Kind for kind. 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.

3/31/2019 Vetprofen Buy $1,750 cumulatively in Vetprofen before March 31, 2019 and get a pair of BLORX X‐ray gloves free. Buy $1,500 of Iverhart, get a 10% rebate; Buy $3,500 of Sentinel, PROMOTIONS FEATURED PROMOTIONS

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| Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 30 VetScan Rapid Tests are intended for veterinary use only. Abaxis and VetScan are registered trademarks of Abaxis, Inc. © Abaxis 2018. www.abaxis.com/flex4 Contact your Authorized Distributor to order today. 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 Easy-to-read results 8 minutes to result Proven lateral flow technology Staff friendly Heartworm Ehrlichia Lyme Anaplasma 3 simple, intuitive steps Room temperature storage 1-year shelf life 2 drops of sample 6 drops of 1 buffer PennVetAd_Flex4_2018-08_7.95x10.08_R1a-4.indd 1 7/24/18 4:59 PM

1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 31 Observelabeldirections.DonotuseLoxicomOralSuspensionincats.Acuterenalfailur eanddeathhavebeenassociatedwiththeuseofmeloxicamincats.Aswithanymedication, sideeffectsmayoccur.Theseareusuallymild,butmaybeserious.Themostcommonside effectsreportedinfieldstudieswerevomiting,softstool/diarrheaanddecreasedapp etite.Ifsideeffectsoccur,discontinuetreatmentimmediatelyandconsultaveterina rian.Dogsshouldbeevaluatedforpre-existingmedicalconditionspriortotreatmenta ndmonitored duringtherapy.Seeproductlabelingforfullproductinformation.

The Norbrook logos and Loxicom are registered trademarks of Norbrook Laboratories Limited. Metacam is a registered trademark of Boehringer IngelheimVetmedica, Inc. Meloxidyl is a registered trademark of Ceva Sante Animale S.A. 0818-497-I01A 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 From Norbrook... Loxicom ® Oral Suspension 2 x 100 mL Size For More Information Contact Your Distributor or Call Norbrook at (888) 705-0408 Save versus other meloxicam suspension brand econo sizes: Loxicom® 2 x 100 mL Metacam® 180 mL *Savings with Loxicom® Meloxidyl® 200 mL *Savings with Loxicom® $29.66 $95.15 $0.48 $2.81 Cost Per Carton Cost Per mL $92.34 $0.46 $109.80 $0.61 *Loxicomsavingscalculatedbasedon200mLsofMetacam Source:2018DVMlistprice www.norbrook.com 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 Key Benefits: ◊ ◊ ◊ ◊ ®

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| Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 36 ® Nutritional Management Guide – Canine Dermatologic: • Chronic Otitis Externa • Cutaneous Adverse Food Reactions (CAFR) • Chronic Non-Seasonal Pruritic Dermatitis Gastrointestinal: • Diet-Responsive Chronic Enteropathy • Chronic Gastroenteropathy • Intestinal Dysbiosis • Colitis Other Inflammatory Conditions: • Atopic Dermatitis • Pruritic Dermatitis • Acuteorchronicgastroenteritis • Inflammatory bowel disease • Motility/emptying disorders • Protein-losing enteropathy • Antibiotic-responsive diarrhea • Small and large bowel diarrhea • Exocrine pancreatic insufficiency • Colitis • Pancreatitis (non-hyperlipidemic) • Constipation DRY FOOD: 1.

Deboned Chicken 2. Chicken Meal 3. Oatmeal 4. Brown Rice 5. Peas WET FOOD: 1. Chicken 2. Chicken Broth 3. Chicken Liver 4. Potatoes 5. Whitefish DRY FOOD: 1. Salmon Hydrolysate 2. Pea Starch 3. Potatoes 4. Peas 5. Pea Protein WET FOOD: 1. Salmon Hydrolysate 2. Water 3. Potato Starch 4. Natural Flavor 5. Pea Fiber • Clinically shown to improve stool quality with 23% quicker resolution of diarrhea • Clinically shown to produce ideal fecal consistency scores • Prebiotic fibers and fermentation extracts to promote GI health • Complete and balanced nutrition • Features highly digestible salmon hydrolysate to help minimize the chances of adverse reactions to food • Enriched with omega-3 fatty acids which have been shown to reduce inflammation in skin cells • Complete and balanced nutrition V ETERIN A R Y E X C L U S I V E Category Products Indications Key Benefits Life Stage Top 5 Ingredients Puppy and Adult Note: Canned food not intended for large breed puppies Adult Weight Management Indications: • Weight management for obese or overweight dogs • Helps to support lean muscle mass maintenance Urinary Care Indications: • Dogs prone to lower urinary tract disease • Helps to limit the formation of struvite uroliths • Dissolutionof purestruviteuroliths • Helpstolimittheformationof calciumoxalateurolithiasis Contraindications: • Pregnancy or lactation • Growth • Use of concurrent urinary acidifiers • Weight management for obese or overweight dogs • Helps to maintain lean muscle mass • Degenerative joint disease • Helps to limit the formation of struvite uroliths • Dissolution of pure struvite uroliths Contraindications: • Growth • Calciumoxalateurolithiasis Dermatologic: • Chronic Otitis Externa • Cutaneous Adverse Food Reactions (CAFR) • Chronic Non-Seasonal Pruritic Dermatitis Gastroinestinal: • Diet-Responsive Chronic Enteropathy • Chronic Gastroenteropathy • Intestinal Dysbiosis • Colitis Other Inflammatory Conditions: • Atopic Dermatitis • Pruritic Dermatitis DRY FOOD: 1.

Deboned Chicken 2. Chicken Meal 3. Peas 4. Pea Protein 5. Powdered Cellulose WET FOOD: 1. Chicken 2. Chicken Broth 3. Water 4. Chicken Liver 5. Pea Protein DRY FOOD: 1. Deboned Salmon 2. Chicken Meal 3. Pea Protein 4. Powdered Cellulose 5. Peas DRY FOOD: 1. Deboned Alligator 2. Peas 3. Pea Starch 4. Alligator Meal 5. Pea Protein Weight management benefits: • Clinically proven to reduce body fat by 39.6% and body weight by 16.3% in dogs • Clinically shown to support lean muscle mass maintenance during weight loss Urinary care benefits: • Clinically proven to produce a urine pH of 6.0–6.4 in dogs • Clinically proven to produce a Struvite Relative Supersaturation of

1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 37 ® Nutritional Management Guide – Feline Category Dermatologic: • Chronic Otitis Externa • Cutaneous Adverse Food Reactions (CAFR) • Eosinophilic Granulomatous Disease • Chronic Non-Seasonal Pruritic Dermatitis Gastrointestinal: • Diet-Responsive Chronic Enteropathy • Chronic Gastroenteropathy • Intestinal Dysbiosis • Colitis Other Inflammatory Conditions: • Atopic Dermatitis • Pruritic Dermatitis • Acute or chronic gastroenteritis • Inflammatory bowel disease • Motility/emptying disorders • Protein-losing enteropathy • Antibiotic-responsive diarrhea • Small and large bowel diarrhea • Exocrine pancreatic insufficiency • Colitis • Pancreatitis • Constipation Dry: Adult Wet: Kitten and Adult Adult DRY FOOD: 1.

Deboned Chicken 2. Chicken Meal 3. Tapioca Starch 4. Peas 5. Turkey Meal WET FOOD: 1. Chicken 2. Chicken Broth 3. Chicken Liver 4. Whitefish 5. Potatoes DRY FOOD: 1. Salmon Hydrolysate 2. Peas 3. Potatoes 4. Pea Starch 5. Pea Protein WET FOOD: 1. Salmon Hydrolysate 2. Water 3. Potato Starch 4. Natural Flavor 5. Pea Fiber • Clinically shown to improve stool quality with 29% quicker resolution of diarrhea • Clinically shown to produce ideal fecal consistency scores • Prebiotic fibers and fermentation extracts to promote GI health • Complete and balanced nutrition • Features highly digestible salmon hydrolysate to help minimize the chances of adverse reactions to food • Enriched with omega-3 fatty acids which have been shown to reduce inflammation in skin cells • Complete and balanced nutrition • Kidney disease • Calcium oxalate urolithiasis • Joint disease Contraindications: • Struvite urolithiasis • Growth • Pregnancy or lactation Adult Note: Canned food intended for intermittent or supplemental feeding only DRY FOOD: 1.

Deboned Chicken 2. Peas 3. Pea Starch 4. Dried Egg 5. Potato Starch WET FOOD: 1. Chicken 2. Chicken Broth 3. Water 4. Potatoes 5. Potato Starch • Controlled protein and mineral levels to help manage kidney disease • Clinically proven to produce a Calcium Oxalate Supersaturation value of

| Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 38 NEW LOOK – The same product you’ve known to trust you can now order by name. To order or schedule a lunch and learn, call your Dechra representative or call (866) 683-0660. This product has new Dechra-branded packaging. The product itself is the same so you can continue to prescribe with confidence. OLD LABEL NEW LABEL Enroquin TM Flavored Tablets (enrofloxacin) Explore & Download Dechra’s FREE NEW IV Fluids Calculator App Dechra is a registered trademark of Dechra Pharmaceuticals PLC. Vetivex is a registered trademark of Dechra Limited.

01AD-DEC50130-0219 Ask your Dechra or Distributor Rep for current promotions and pricing or call (866) 683-0660.

24 Hour Technical Support: 866-933-2472 | support@dechra.com www.dechra-us.com

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| Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 42 INFORMATION FOR DOSING DOGS Theonce-a-monthtabletthatpreventsheartwormdisease,controlsadulthookworm,and removesandcontrols adultroundwormandwhipworminfectionsindogsandpuppies.

Caution: Federal(USA)lawrestrictsthisdrugtousebyorontheorderofalicensedveterinarian. Keepthisandall drugsoutofthereachofchildren. Description: MILBEGUARD(milbemycinoxime)FlavoredTabletsareavailableinfourtabletsizesinco lor-coded packagesfororaladministrationtodogsandpuppies.Eachtabletisformulatedtoprovi deaminimumof0.23mg/lb (0.5mg/kg)bodyweightofmilbemycinoxime.Milbemycinoximeconsistsoftheoximederi vativesof 5-didehydromilbemycinsintheratioofapproximately80%A4 (C32H45NO7,MW555.71)and20%A3 (C31H43NO7,MW541.68). Packagecolor Milbemycinoximetablet Yellow 2.3mg* Blue 5.75mg Purple 11.5mg Red 23.0mg *fordogsonly Indications: MILBEGUARDFlavoredTabletsareindicatedforuseinthepreventionofheartwormdiseas ecausedby Dirofilariaimmitis,thecontrolofadultAncylostomacaninum(hookworm),andtheremo valandcontrolofadult ToxocaracanisandToxascarisleonina(roundworms)andTrichurisvulpis(whipworm)in fectionsindogsandin puppiesfourweeksofageorgreaterandtwopoundsbodyweightorgreater.

Dosage: MILBEGUARDFlavoredTabletsaregivenorally,onceamonth,attherecommendedminimumd osagerate of0.23mgmilbemycinoximeperpoundofbodyweight(0.5mg/kg). RecommendedDosageScheduleforDogs BodyWeight MILEBEGUARDFlavoredTablets 2-10lbs. Onetablet(2.3mg) 11-25lbs. Onetablet(5.75mg) 26-50lbs. Onetablet(11.5mg) 51-100lbs. Onetablet(23.0mg) Dogsover100Ibs.areprovidedtheappropriatecombinationoftablets. Administration: MILBEGUARDFlavoredTabletsaredual-purposeandmaybeofferedinfoodoradministered as othertabletmedications.Watchthedogcloselyfollowingdosingtobesuretheentiredo sehasbeenconsumed.Ifitis notentirelyconsumed,redoseoncewiththefullrecommendeddoseassoonaspossible.

MILBEGUARDFlavoredTabletsmustbeadministeredmonthly,preferablyonthesamedatee achmonth.Thefirstdose shouldbeadministeredwithinonemonthofthedog’sfirstexposuretomosquitoesandmon thlythereafteruntilthe endofthemosquitoseason.Ifadoseismissedanda30-dayintervalbetweendosingisexce eded,administer MILBEGUARDFlavoredTabletsimmediatelyandresumethemonthlydosingschedule. IfMILBEGUARDFlavoredTabletsreplacesdiethylcarbamazine(DEC)forheartwormpreve ntion,thefirstdosemustbe givenwithin30daysafterthelastdoseofDEC.

Precautions: Donotuseinpuppieslessthanfourweeksofageorlessthantwopoundsofbodyweight.Prio rto initiationoftheMILBEGUARDFlavoredTabletstreatmentprogram,dogsshouldbetested forexistingheartworm infections.Infecteddogsshouldbetreatedtoremoveadultheartwormsandmicrofilari aepriortoinitiatingtreatment withMILBEGUARDFlavoredTablets.Mild,transienthypersensitivityreactionsmanife stedaslaboredrespiration, vomiting,salivationandlethargy,havebeennotedinsometreateddogscarryingahighn umberofcirculating microfilariae.Thesereactionsarepresumablycausedbyreleaseofproteinfromdeador dyingmicrofilariae. AdverseReactions: ThefollowingadversereactionshavebeenreportedfollowingtheuseofMILBEGUARD FlavoredTablets:Depression/lethargy,vomiting,ataxia,anorexia,diarrhea,convu lsions,weaknessandhypersalivation.

Efficacy: MILBEGUARDFlavoredTabletseliminatethetissuestageofheartwormlarvaeandtheadul tstageof hookworm(Ancylostomacaninum),roundworms(Toxocaracanis,Toxascarisleonina)and whipworm(Trichuris vulpis)infestationswhenadministeredorallyaccordingtotherecommendeddosagesch edule.Theanthelmintic activityofmilbemycinoximeisbelievedtobearesultofinterferencewithinvertebrat eneurotransmission. Safety: Milbemycinoximehasbeentestedsafelyinover75differentbreedsofdogs,includingco llies,pregnant females,breedingmalesandfemales,andpuppiesovertwoweeksofage.Inwell-controll edclinicalfieldstudies,786 dogscompletedtreatmentwithmilbemycinoxime.Milbemycinoximewasusedsafelyinani malsreceivingfrequently usedveterinaryproductssuchasvaccines,anthelmintics,antibiotics,steroids,fle acollars,shampoosanddips.

Twostudiesinheartworm-infecteddogswereconductedwhichdemonstratedmild,transi enthypersensitivity reactionsintreateddogswithhighmicrofilaremiacounts(seePrecautionsforreactio nsobserved).Safetystudiesin pregnantdogsdemonstratedthathighdoses(1.5mg/kg=3X)ofmilbemycinoximegivenina nexaggerateddosing regimen(dailyfrommatingthroughweaning),resultedinmeasurableconcentrationsof thedruginmilk.Puppies nursingthesefemaleswhichreceivedexaggerateddosingregimensdemonstratedmilbem ycin-relatedeffects.These effectsweredirectlyattributabletotheexaggeratedexperimentaldosingregimen.Th eproductisnormallyintended foronce-a-monthadministrationonly.Subsequentstudiesincludedusing3Xdailyfrom matingtooneweekbefore weaninganddemonstratednoeffectsonthepregnantfemalesortheirlitters.Asecondst udywherepregnant femalesweredosedonceat3Xthemonthlyuserateeitherbefore,onthedayoforshortlyaf terwhelpingresultedin noeffectsonthepuppies.

Somenursingpuppies,at2,4,and6weeksofage,givengreatlyexaggeratedoralmilbemyc inoximedoses(9.6 mg/kg = 19X) exhibited signs typified by tremors, vocalization and ataxia.These effects were all transient andpuppiesreturnedtonormalwithin24to48hours.Noeffectswereobservedinpuppiesg iventhe recommendeddoseofmilbemycinoxime(0.5mg/kg).Thisproducthasnotbeentestedindog slessthan1kg 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 oxime (5X monthly use rate) on day 0, followed by 5.0 mg/kg (10X monthly use rate) on day 14 and 10.0 mg/kg (20X monthly use rate) on day 32. No adverse reactions were observed in any of the collies treated with this regimen up through the 10.0 mg/kg (20X monthly use rate) dose.

How supplied: MILBEGUARD FlavoredTablets are available in four tablet sizes (see Dosage section), 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. Storage conditions: MILBEGUARD FlavoredTablets should be stored at room temperature, between 68° and 77°F (20-25°C). The once-a-month tablet that prevents heartworm disease and removes adult roundworms and hookworms in cats and kittens.

Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian.

Keep this and all drugs out of the reach of children. Description: MILBEGUARD FlavoredTablets for Cats are available in three tablet sizes in color-coded packages for oral administration to cats and kittens. Each tablet is formulated to provide a minimum of 0.9 mg/lb (2.0 mg/kg) body weight of milbemycin oxime. Milbemycin oxime consists of the oxime derivatives of 5-didehydromilbemycins in the ratio of approximately 80% A4 (C32 H45 NO7 , MW 555.71) and 20% A3 (C31 H43 NO7 , MW 541.68). Indications: MILBEGUARDFlavoredTabletsforCatsareindicatedforuseinthepreventionofheartwor m diseasecausedbyDirofilariaimmitis,andtheremovalofadultAncylostomatubaeforme (hookworm)and Toxocaracati(roundworm)incatsandkittenssixweeksofageorgreaterand1.5lbs.body weightorgreater.

Dosage: MILBEGUARD FlavoredTablets for Cats are given orally, once a month, at the recommended minimum dosage rate of 0.9 mg milbemycin oxime per pound of body weight (2.0mg/kg). Recommended Dosage Schedule for Cats Body Weight MILEBEGUARD Flavored Tablets 1.5-6 lbs. One tablet (5.75 mg) 6.1-12 lbs. One tablet (11.5 mg) 12.1-25 lbs. One tablet (23.0 mg) Cats over 25 Ibs. are provided the appropriate combination of tablets. Administration: MILBEGUARD FlavoredTablets for Cats may be offered in food or administered as other tablet medications.The tablets can be broken for ease of administration.Watch the cat 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.

MILBEGUARD FlavoredTablets for Cats must be administered monthly, preferably on the same date each month.The first dose should be administered within one month of the cat’s first exposure to mosquitoes and monthly thereafter until the end of the mosquito season. If a dose is missed and a 30-day interval between dosing is exceeded, administer MILBEGUARD FlavoredTablets for Cats immediately and resume the monthly dosing schedule. It is recommended that cats be tested for existing heartworm infection prior to starting treatment with MILBEGUARD FlavoredTablets for Cats (See Precautions). Precautions: Do not use in kittens less than six weeks of age or less than 1.5 lbs.

body weight. Safety in heartworm positive cats has not been established. Safety in breeding, pregnant, and lactating queens and breeding toms has not been established.

Efficacy: MILBEGUARD FlavoredTablets for Cats eliminate the tissue stage of heartworm larvae and hookworm (Ancylostoma tubaeforme) and roundworm (Toxocara cati) infections when administered orally according to the recommended dosage schedule.The anthelmintic 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 different breeds of cats. In well-controlled clinical field studies 141 cats completed treatment with milbemycin oxime. Milbemycin oxime was used safely in animals receiving frequently used veterinary products such as vaccines, anthelmintics, anesthetics, 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 recommended dose of 2.0 mg/kg demonstrated no drug- related effects.Tolerability studies at exaggerated doses of 10X also demonstrated no drug-related adverse effects in kittens and young adult cats. How supplied: MILBEGUARD FlavoredTablets for Cats are available in three tablet sizes (see Dosage section), formulated according to the weight of the cat. Each tablet size is available in color-coded packages of 6 tablets each, which are packaged 10 per display carton.

Storage conditions: MILBEGUARD FlavoredTablets for Cats should be stored at room temperature, between 68° and 77°F (20-25°C).

Manufactured for: Ceva Animal Health, LLC Lenexa, KS 66215 Made in Canada. ANADA #200-629, Approved by FDA INFORMATION FOR DOSING CATS ©2019 Ceva Animal Health, LLC. Lenexa, KS 66215 MilbeGuard™ trademark is the property of Ceva Santé Animale S.A.

1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 43 Flavored chews for dogs. Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Description: Each chew is formulated to provide a minimum dose of 11.4 mg/lb (25 mg/kg) body weight. The chemical name of fluralaner is (±)-4-[5-(3,5-dichlorophenyl)-5-(trifluoromethyl)-4,5- dihydroisoxazol-3- yl]-2-methyl-N-[2-oxo-2-(2,2,2-trifluoroethylamino) ethyl]benzamide. Indications: Bravecto kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides felis) and the treatment and control of tick infestations [Ixodes scapularis (black-legged tick), Dermacentor variabilis (American dog tick), and Rhipicephalus sanguineus (brown dog tick)] for 12 weeks in dogs and puppies 6 months of age and older, and weighing 4.4 pounds or greater.

Bravecto is also indicated for the treatment and control of Amblyomma americanum (lone star tick) infestations for 8 weeks in dogs and puppies 6 months of age and older, and weighing 4.4 pounds or greater. Dosage and Administration: Bravecto should be administered orally as a single dose every 12 weeks according to the Dosage Schedule below to provide a minimum dose of 11.4 mg/lb (25 mg/kg) body weight. Bravecto may be administered every 8 weeks in case of potential exposure to Amblyomma americanum ticks (see Effectiveness).

Bravecto should be administered with food. Dosage Schedule Body Weight Ranges (lb) Fluralaner Content (mg) Chews Administered 4.4 – 9.9 112.5 One >9.9 – 22.0 250 One >22.0 – 44.0 500 One >44.0 – 88.0 1000 One >88.0 – 123.0* 1400 One *Dogs over 123.0 lb should be administered the appropriate combination of chews TreatmentwithBravectomaybeginatanytimeoftheyearandcancontinueyearroundwitho utinterruption.

Contraindications: There are no known contraindications for the use of the product. Warnings: Not for human use. Keep this and all drugs out of the reach of children. Keep the product in the original packaging until use, in order to prevent children from getting direct access to the product. Do not eat, drink or smoke while handling the product. Wash hands thoroughly with soap and water immediately after use of the product.

Precautions: Bravecto has not been shown to be effective for 12-weeks duration in puppies less than 6 months of age. Bravecto is not effective against Amblyomma americanum ticks beyond 8 weeks after dosing (see Effectiveness). Adverse Reactions: In a well-controlled U.S. field study, which included 294 dogs (224 dogs were administered Bravecto every 12 weeks and 70 dogs were administered an oral active control every 4 weeks and were provided with a tick collar); there were no serious adverse reactions. All potential adverse reactions were recorded in dogs treated with Bravecto over a 182-day period and in dogs treated with the active control over an 84-day period.

The most frequently reported adverse reaction in dogs in the Bravecto and active control groups was vomiting. Percentage of Dogs with Adverse Reactions in the Field Study Adverse Reaction (AR) Bravecto Group: Percentage of Dogs with the AR During the 182-Day Study (n=224 dogs) Active Control Group: Percentage of Dogs with the AR During the 84-Day Study (n=70 dogs) Vomiting 7.1 14.3 Decreased Appetite 6.7 0.0 Diarrhea 4.9 2.9 Lethargy 5.4 7.1 Polydipsia 1.8 4.3 Flatulence 1.3 0.0 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. 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 state, fluralaner should be administered with food.

Mode of Action: Fluralaner is for systemic use and belongs to the class of isoxazoline-substituted benzamide derivatives. Fluralaner is an inhibitor of the arthropod nervous system. The mode of action of fluralaner is the antagonism of the ligand-gated chloride channels (gamma-aminobutyric acid (GABA)-receptor and glutamate-receptor). Effectiveness: Bravecto began to kill fleas within two hours after administration in a well-controlled laboratory study. In a European laboratory study, Bravecto killed fleas and Ixodes ricinus ticks and reduced the numbers of live fleas and Ixodes ricinus ticks on dogs by >98% within 12 hours for 12 weeks.

In a well-controlled laboratory study, Bravecto demonstrated 100% effectiveness against adult fleas 48 hours post-infestation for 12 weeks. In well- controlled laboratory studies, Bravecto demonstrated ≥93% effectiveness against Dermacentor variabilis, Ixodes scapularis and Rhipicephalus sanguineus ticks 48 hours post-infestation for 12 weeks. Bravecto demonstrated ≥90% effectiveness against Amblyomma americanum 72 hours post-infestation for 8 weeks, but failed to demonstrate ≥90% effectiveness beyond 8 weeks.

In a well-controlled U.S. field study, a single dose of Bravecto reduced fleas by ≥99.7% for 12 weeks. Dogs with signs of flea allergy dermatitis showed improvement in erythema, alopecia, papules, scales, crusts, and excoriation as a direct result of eliminating flea infestations. Palatability: In a well-controlled U.S. field study, which included 559 doses administered to 224 dogs, 80.7% of dogs voluntarily consumed Bravecto within 5 minutes, an additional 12.5% voluntarily consumed Bravecto within 5 minutes when offered with food, and 6.8% refused the dose or required forced administration.

Animal Safety: 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 control group (0X) were untreated.

There were no clinically-relevant, treatment-related effects on physical examinations, body weights, food consumption, clinical pathology (hematology, clinical chemistries, coagulation tests, and urinalysis), gross pathology, histopathology, or organ weights. Diarrhea, mucoid and bloody feces were the most common 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 the 3X treatment group was observed to be dull, inappetant, with evidence of bloody diarrhea, vomiting, and weight loss beginning five days after the first treatment.

One dog in the 1X treatment group vomited food 4 hours following the first treatment.

Reproductive Safety Study: Bravecto was administered orally to intact, reproductively-sound male and female Beagles at a dose of up to 168 mg/kg (equivalent to 3X the maximum label dose) on three to four occasions at 8-week intervals. The dogs in the control group (0X) were untreated. There were no clinically-relevant, treatment-related effects on the body weights, food consumption, reproductive performance, semen analysis, litter data, gross necropsy (adult dogs) or histopathology findings (adult dogs and puppies). One adult treated dog suffered a seizure during the course of the study (46 days after the second treatment).

Abnormal salivation was observed on 17 occasions: in six treated dogs (11 occasions) after dosing and four control dogs (6 occasions).

The following abnormalities were noted in 7 pups from 2 of the 10 dams in only the treated group during gross necropsy examination: limb deformity (4 pups), enlarged heart (2 pups), enlarged spleen (3 pups), and cleft palate (2 pups). During veterinary examination at Week 7, two pups from the control group had inguinal 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). In a well-controlled field study Bravecto was used concurrently with other medications, such as vaccines, anthelmintics, antibiotics, and steroids.

No adverse reactions were observed from the concurrent use of Bravecto with other medications.

Storage Information: Do not store above 86°F (30°C). How Supplied: Bravecto is available in five strengths (112.5, 250, 500, 1000, and 1400 mg fluralaner per chew). Each chew is packaged individually into aluminum foil blister packs sealed with a peelable paper backed foil lid stock. Product may be packaged in 1, 2, or 4 chews per package. NADA 141-426, Approved by FDA Distributed by: Intervet Inc (d/b/a Merck Animal Health) Madison, NJ 07940 Made in Austria Copyright © 2014 Intervet Inc, a subsidiary of Merck & Company Inc. All rights reserved 154545 R1

| Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 44 For oral use in dogs Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian.

Description: CREDELIO (lotilaner) is a beef-flavored, chewable tablet for oral administration to dogs and puppies according to their weight. Each chewable tablet is formulated to provide a minimum lotilaner dosage of 9 mg/lb (20 mg/kg). Lotilaner has the chemical composition of 5-[(5S)-4,5-dihydro-5-(3,4,5-trichlorophenyl)- 5-(trifluoromethyl)-3-isoxazolyl]-3-methyl-N-[2-oxo-2-[(2,2,2-trifluoroethy l)amino]ethyl]- 2-thiophenecarboxamide.

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 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. Dosage and Administration: CREDELIO is given orally once a month, at the minimum dosage of 9 mg/lb (20 mg/kg). Dosage Schedule: Body Weight Lotilaner Per Chewable Tablets Chewable Tablet (mg) Administered 4.4 to 6.0 lbs 56.25 One 6.1 to 12.0 lbs 112.5 One 12.1 to 25.0 lbs 225 One 25.1 to 50.0 lbs 450 One 50.1 to 100.0 lbs 900 One Over 100.0 lbs Administer the appropriate combination of chewable tablets CREDELIO must be administered with food (see Clinical Pharmacology).

Treatment with CREDELIO can begin at any time of the year and can continue year round without interruption.

Contraindications: There are no known contraindications for the use of CREDELIO. Warnings: Not for human use. Keep this and all drugs out of the reach of children. Precautions: 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 (see Adverse Reactions). Adverse Reactions: In a well-controlled U.S. field study, which included 284 dogs (198 dogs treated with CREDELIO and 86 dogs treated with an oral active control), there were no serious adverse reactions.

Over the 90-day study period, all observations of potential adverse reactions were recorded.

Reactions that occurred at an incidence of 1% or greater are presented in the following table. Dogs with Adverse Reactions in the Field Study Adverse Reaction CREDELIO Group: Active Control Group: (AR) Number (and Percent) of Number (and Percent) of Dogs with the AR (n=198) Dogs with the AR (n=86) Weight Loss 3 (1.5%) 2 (2.3%) Elevated Blood Urea Nitrogen (BUN) 2 (1.0%)* 0 (0.0%) Polyuria 2 (1.0%)* 0 (0.0%) Diarrhea 2 (1.0%) 2 (2.3%) *Two geriatric dogs developed mildly elevated BUN (34 to 54 mg/dL; reference range: 6 to 31 mg/dL) during the study. One of these dogs also developed polyuria and a mildly elevated potassium (6.5 mEq/L; reference range: 3.6 to 5.5 mEq/L) and phosphorous (6.4 mg/dL; reference range: 2.5 to 6.0 mg/dL).

The other dog also developed a mildly elevated creatinine (1.7 to 2.0 mg/dL; reference range: 0.5 to 1.6 mg/dL) and weight loss. 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 1-888-FDA-VETS or http://www.fda.gov/AnimalVeterinary/SafetyHealth. Clinical Pharmacology: Following oral administration of 43 mg/kg (approximately 1X the maximum labeled dose), peak lotilaner concentrations were achieved between 6 hours and 3 days in dogs 2 months of age and between 1 and 7 days in dogs 10 months of age. Dogs 2 months of age had a shorter elimination half-life (average of 9.6 days) than at 10 months of age (average of 28.4 days). Due to reduced drug bioavailability in the fasted state, CREDELIO must be administered with a meal or within 30 minutes after feeding.

Mode of Action: Lotilaner is an ectoparasiticide belonging to the isoxazoline group. Lotilaner inhibits insect and acarine gamma-aminobutyric acid (GABA)-gated chloride channels. This inhibition blocks the transfer of chloride ions across cell membranes, which results in uncontrolled neuromuscular activity leading to death of insects and acarines. The selective toxicity of lotilaner between insects and acarines and mammals may be inferred by the differential sensitivity of the insects and acarines’ GABA receptors versus mammalian GABA receptors. Effectiveness: In well-controlled European laboratory studies, CREDELIO began to kill fleas four hours after administration or infestation, with greater than 99% of fleas killed within eight hours after administration or infestation for 35 days.

In a well-controlled U.S. laboratory study, CREDELIO demonstrated 100% effectiveness against adult fleas 12 hours after administration or infestation for 35 days.

In a 90-day well-controlled U.S. field study conducted in households with existing flea 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 signs of flea allergy dermatitis showed improvement in erythema, papules, scaling, alopecia, dermatitis/pyodermatitis and pruritus as a direct result of eliminating fleas. In well-controlled laboratory studies, CREDELIO demonstrated > 97% effectiveness against Amblyomma americanum, Dermacentor variabilis, Ixodes scapularis and Rhipicephalus sanguineus ticks 48 hours after administration or infestation for 30 days.

In a well-controlled European laboratory study, CREDELIO started killing Ixodes ricinus ticks within four hours after administration.

Palatability: In the U.S. field study, which included 567 doses administered to 198 dogs, 80.4% of dogs voluntarily consumed CREDELIO when offered by hand or in an empty bowl, an additional 13.6% consumed CREDELIO when offered with food, and 6.0% required placement of the chewable tablet in the back of the dog’s mouth. Animal Safety: In a margin of safety study, CREDELIO was administered orally to 24 (8 dogs/group) 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 eight consecutive doses.

The 8 dogs in the control group (0X) were untreated. There were no clinically-relevant, treatment-related effects on clinical observations, physical and neurological examinations, body weights, food consumption, electrocardiograms, clinical pathology (hematology, clinical chemistries, coagulation profiles and urinalysis), gross pathology, histopathology, or organ weights. Blood concentrations of lotilaner confirmed systemic exposure of all treated dogs, although the exposure was less than dose proportional at 5X.

In a well-controlled field study, CREDELIO was used concurrently with other medications, such as vaccines, anthelmintics, antibiotics, steroids, NSAIDS, anesthetics, and antihistamines. No adverse reactions were observed from the concomitant use of CREDELIO with other medications. Storage Information: Store at 15-25°C (59 -77°F), excursions permitted between 5 to 40°C (41 to 104°F). How Supplied: 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 of 1 or 6 chewable tablets.

NADA #141-494, Approved by the FDA Manufactured for: Elanco US Inc Greenfield, IN 46140 USA Credelio.com Credelio, Elanco and the diagonal bar logo are trademarks of Eli Lilly and Company or its affiliates. Rev. date 11/2017 PA209456X 12266 CRE1 Chewable Tablets

1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 45

| Penn Veterinary Supply | March-April 2019 1-800-233-0210 | www.pennvet.com 46 © 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 For oral use in dogs only. Caution: Federal (U.S.A.) law restricts this drug to use by or on the order of a licensed veterinarian. Description: IVERHART MAX® Soft Chew is a combination of three anthelmintics (ivermectin/pyrantel pamoate/ praziquantel). The soft chews are available in four sizes in color-coded packages for oral administration to dogs according to their weight (see Dosage and Administration).

Indications: 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 roundworms (Toxocara canis, Toxascaris leonina), hookworms (Ancylostoma caninum, Uncinaria stenocephala, Ancylostoma braziliense), and tapeworms (Dipylidium caninum, Taenia pisiformis). Dosage and Administration: IVERHART MAX Soft Chew should be administered orally at monhly intervals and the recommended minimum dose level of 6 mcg of ivermectin per kilogram (2.72 mcg/lb), 5 mg of pyrantel (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: IVERHART MAX Soft Chew is recommended for dogs 8 weeks of age or older.

For dogs over 100 lbs, use the appropriate combination of these soft chews.

Remove only one dose at a time from the packaging. Return the remaining soft chew(s) to their box to protect from light. The soft chew can be offered to the dog by hand or added, intact, to a small amount of dog food. Care should be taken to ensure that the dog consumes the complete dose. The treated dog should be observed for a few minutes after administration to confirm that none of the dose has been lost or rejected. If it is suspected that any of the dose has been lost, redosing is recommended. IVERHART MAX Soft Chew should be given at monthly intervals during the period of the year when mosquitoes (vectors), potentially carrying infective heartworm larvae, are active.

The initial dose must be given within a month (30 days) after the dog’s first exposure to mosquitoes. The final dose must be given within a month (30 days) after the dog’s last exposure to mosquitoes.

When replacing another heartworm preventative product in a heartworm disease prevention program, the first dose of IVERHART MAX Soft Chew must be given within a month (30 days) of the last dose of the former medication. A heartworm test should be performed prior to switching heartworm preventative products. If the interval between doses exceeds a month (30 days), the effectiveness of ivermectin can be reduced. Therefore, for optimal performance, the soft chew must be given once a month on or about the same day of the month. If treatment is delayed, whether by a few days or many, immediate treatment with IVERHART MAX Soft Chew and the recommended dosing regimen will minimize the opportunity for the development of adult heartworms.

Warnings: For use in dogs only. Keep this and all drugs out of reach of children and pets. In safety studies with ivermectin/pyrantel pamoate/praziquantel tablets, testicular hypoplasia was observed in some dogs receiving 3 and 5 times the maximum recommended dose monthly for 6 months (see Animal Safety). In case of ingestion by humans, clients should be advised to contact a physician immediately. Physicians may contact a Poison Control Center for advice concerning cases of ingestion by humans. Precautions: Use with caution in sick, debilitated, or underweight animals and dogs weighing less than 10 lbs (see Animal Safety).

The safe use of this drug has not been evaluated in pregnant or lactating bitches. All dogs should be tested for existing heartworm infection before starting treatment with IVERHART MAX Soft Chew, which is not effective against adult Dirofilaria immitis. Infected dogs should be treated to remove adult heartworms and microfilariae before initiating a heartworm prevention program. 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, 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.

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 coughing were reported. Self-limiting adverse reactions, including lethargy, limpness, salivation, shaking, diarrhea, decreased appetite, licking lips, and belching were reported between 20 minutes and 72 hours following treatment in a field study with ivermectin/pyrantel pamoate/praziquantel tablets. In field studies with ivermectin/pyrantel pamoate tablets, vomiting or diarrhea within 24 hours of dosing was 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. 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 laboratory studies.

Palatability: In a field study of 132 dogs, IVERHART MAX Soft Chew was offered once monthly 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 by placing onto the back of the dog’s tongue (pilling), and 0.7% of the doses were unable to be administered. Animal Safety: Studies with ivermectin indicate that certain dogs of the Collie breed are more sensitive to the effects of ivermectin administered at elevated dose levels (more than 16 times the target dose level of 6 mcg/kg) than dogs of other breeds.

At elevated doses, sensitive dogs showed more adverse reactions, which included mydriasis, depression, ataxia, tremors, drooling, paresis, recumbency, excitability, 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 support the safety of ivermectin products in dogs, including Collies, when used at the label recommended dose.

Because ivermectin and praziquantel are approximately 30% more bioavailable in the IVERHART MAX Soft Chew than in the ivermectin/ pyrantel pamoate/praziquantel tablets used in the following target animal safety studies, the margin of safety is narrower than reported in these studies. The potential for adverse reactions may be greater in individual dogs administered IVERHART MAX Soft Chew than ivermectin/pyrantel pamoate/ praziquantel tablets. In a target animal safety study using ivermectin/pyrantel pamoate/praziquantel tablets, 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, and 10.47 mg/kg praziquantel.

The dogs were treated every 30 days for 6 months. 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, head movements, shallow, audible or difficult breathing, and salivation. One dog in the 5X group had tremors and decreased activity. All of these signs were transient. No treatment was required. Histopathology showed testicular hypoplasia in the 3X and 5X groups (see Warnings).

In a laboratory safety study using ivermectin/pyrantel pamoate/praziquantel tablets, 12-week-old Beagle puppies receiving 3 and 5 times the recommended dose once weekly for 13 weeks demonstrated a dose-related decrease in testicular maturation compared to controls. In this study, all treated puppies had significantly higher cholesterol levels compared to untreated controls. In a reproductive safety study, adult males were treated at 37.5 mcg/kg ivermectin, 31.4 mg/kg pyrantel, and 31.4 mg/kg praziquantel every 14 days during two full spermatogenic cycles (112 days). The quality of semen and reproductive health were not affected by treatment.

Treatment-related vomiting and soft feces were reported during this study.

In a study of the effectiveness of ivermectin/pyrantel pamoate/praziquantel tablets for the treatment of Toxocara canis, one 8.1 lb, 72-day-old puppy died 6 days after administration of the label dose. This puppy and many other puppies in the study had high worm burdens and were reported to have diarrhea, sometimes bloody, frequently before and after treatment. Dehydration and signs of anemia (pale mucous membranes) were the only abnormal gross necropsy finding observed. No definitive cause was determined. In a 90-day field study using ivermectin/pyrantel pamoate/praziquantel tablets, the most serious adverse reactions (lethargy, limpness, and salivation) were seen in dogs weighing less than 10 lbs (see Precautions).

Storage Information: Store at 20°C to 25°C (68°F to 77°F), excursions permitted between 15°C and 30°C (59°F to 86°F). How Supplied: IVERHART MAX Soft Chew is available in four dosage strengths (see Dosage and Administration) for dogs of different weights. Each strength comes in a package of 6 soft chews. NADA 141-441, Approved by FDA. Manufactured by: Virbac AH, Inc. Fort Worth, TX 76137 USA Phone: 1-800-338-3659 IVERHART MAX is a registered trademark of Virbac Corporation. 302143-03 9/17 Soft Chew Dog Weight Pounds Soft Chew per Month Soft Chew Size Ivermectin Content Pyrantel Pamoate Content Praziquantel Content 6.0 to 12 1 Toy 34 mcg 28.5 mg 28.5 mg 12.1 to 25 1 Small 68 mcg 57 mg 57 mg 25.1 to 50 1 Medium 136 mcg 114 mg 114 mg 50.1 to 100 1 Large 272 mcg 228 mg 228 mg

1-800-233-0210 | www.pennvet.com Penn Veterinary Supply | March-April 2019 | 47 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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