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When traditional dewormers fail against resistant hookworms, veterinarians may turn to emodepside as a last resort. But are all formulations created equal? Not according to recently published research.

Join us as Theresa Quintana and Drs. Jeba Jesudoss Chelladurai and Stephanie Martinez reveal critical findings about bioequivalence between different emodepside formulations. Their research demonstrates that the feline topical formulation, when given orally to dogs at 3 mg/kg, produces approximately three times higher peak concentrations and 2.4-2.8 times greater systemic exposure compared to the EU canine modified-release tablet at the same dose.

These findings carry significant clinical implications, particularly for dogs with MDR1 mutations lacking P-glycoprotein transport mechanisms. Without this protective system, emodepside can accumulate in the brain and cause neurotoxicity. The research team guides us through proper diagnostic confirmation of resistant hookworms, recommended treatment approaches, and crucial safety considerations before turning to this last-line therapy.

The conversation expands into formulation differences, bioavailability challenges, and practical clinical protocols. Teresa, Jeba, and Stephanie emphasize that clients must follow strict fasting guidelines before and after administration, as food dramatically enhances emodepside absorption and could potentially lead to toxicity with the already higher-concentration feline product.

Whether you're dealing with suspected resistant hookworms in your practice or simply want to understand the science behind bioequivalence and drug safety, this episode provides essential knowledge for evidence-based clinical decision-making. This episode centers around the intersection of parasitology, pharmacology, and clinical medicine and highlights why the details matter when it comes to drug formulations and routes of administration.

AJVR article: https://doi.org/10.2460/ajvr.25.01.0027

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