# Efficacy of a Topical Esafoxolaner, Eprinomectin and Praziquantel Combination Against Most Commonly Found Metazoan Parasites of Client-Owned Cats in Greece

## TL;DR

This study shows that a combination medication is highly effective and safe for treating common parasites in cats in Greece.

## Contribution

Demonstrates the efficacy of a topical triple-action antiparasitic treatment in a real-world feline population in Greece.

## Key findings

- 22.9% of cats in Greece were found to be infected with parasites, with Toxocara cati being the most common.
- NexGard® Combo achieved 100% efficacy against gastrointestinal helminths and mites after one dose.
- The treatment showed notable efficacy against fleas and lungworms, with 100% efficacy against lungworms after two doses.

## Abstract

Pet cats can be infected with many internal and external parasites. These parasites may cause health problems in cats and some of them may also infect humans. In this study 472 household cats from Greece were examined for the presence of parasites. Furthermore, in positive animals an antiparasitic medication, namely NexGard® Combo, was administered topically. This product combines three antiparasitic substances that kill internal and external parasites at the same time. Results confirmed that owned cats in Greece are often infected by parasites and that multiparasitism is common. This study also proved that NexGard® Combo is efficient against the major parasites of cats in Greece and also safe and easy to use.

Feline parasitism affects animals’ health and welfare. Faeces from 472 client-owned cats from Greece were examined to provide updated data on the epizootiology of metazoan endo- and ectoparasites (namely, Toxocara cati, Ancylostomatidae, Dipylidium caninum, lungworms, Toxascaris leonina, Otodectes cynotis, fleas, ticks and Notoedres cati). All positive animals received a topical formulation containing esafoxolaner, eprinomectin and praziquantel (NexGard® Combo, Boehringer Ingelheim), and its efficacy was evaluated. The overall prevalence of parasitism was 22.9%, while that of multiparasitism was 16.3%. Toxocara cati (18.4%) was the most prevalent endoparasite, followed by Ancylostomatidae (10.8%), D. caninum (4.7%), lungworms (2.5%) and T. leonina (0.4%). Regarding ectoparasites, O. cynotis (3.2%), fleas (2.3%), ticks (0.6%) and N. cati (0.4%) were found. To estimate the efficacy of treatment, the geometric means of the number of parasitic elements before the first treatment and post-treatment, (i) 14 days for intestinal helminths, (ii) 28 and 56 days for lungworms and (iii) 28 days for O. cynotis and fleas, were estimated and compared. Following statistical analyses (paired t-test and McNemar’s test), an efficacy of 100% was recorded against the most commonly detected parasites (gastrointestinal helminths and mites) and a notable statistically significant effect against fleas and lungworms after one dose, while 100% efficacy against lungworms was achieved after two doses of the product. No adverse effects were reported. The prevalence of parasitism in owned cats in Greece remains high, highlighting the demand for targeted preventive antiparasitic schemes. This study demonstrated high-level efficacy and tolerance of NexGard® Combo against common endoparasites and ectoparasites of household cats in Greece.