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Coccidia treatment in dogs (n=4) was achieved with one (20 mg/kg PO q24h) or two (20 mg/kg PO bid) oral doses of imidocarb dipropionate at the time of peak oocyst shedding. At this dosage, imidocarb dipropionate effectively prevented oocyst production in three of four dogs and allowed reduction or elimination of coccidiosis from the feces of a fourth dog. In a second study, one of six dogs treated with a combination of albendazole (10 mg/kg PO q24h) and moxidectin (1 mg/kg PO q28d) cleared coccidiosis and prevented oocyst production.
Imidocarb dipropionate is a second-generation drug in the isoxazoline group. It acts as an active metabolite of imidocarb, which is effective for the treatment of coccidiosis in cats ([@bib0050]). The agent is also effective against *Isospora canis*, *Dipylidium caninum*, *Eimeria* spp., and *Giardia* spp. ([@bib0045], [@bib0060], [@bib0070]). For *Eimeria* spp. and *Isospora* spp., there is limited evidence for efficacy in dogs ([@bib0045], [@bib0080]), but some experimental studies and one clinical study in dogs have shown the efficacy of imidocarb dipropionate for *Cryptosporidium* spp. and *Giardia* spp. ([@bib0040], [@bib0085], [@bib0095]).
Albendazole, a benzimidazole carbamate, is approved for the treatment of small intestinal and intestinal roundworm infections in cats, dogs, and rabbits. Albendazole is also approved for the treatment of nematode infections in horses and for treating tapeworm infections in humans. In cats, albendazole has been shown to be efficacious against *Toxocara canis* and *Eucoleus aerophilus* ([@bib0080]). In dogs, albendazole has been used against *Dipylidium caninum* and *Toxocara canis* ([@bib0010], [@bib0015], [@bib0025], [@bib0055]). In a recent in vitro study in dogs, albendazole was shown to be active against *Eimeria*, *Isospora* and *Giardia* ([@bib0035]).
Imidocarb dipropionate, albendazole, and moxidectin all have potential for broad-spectrum coccidiosis activity, and all three agents may be suitable for the treatment of coccidiosis in dogs, including mixed infections with other coccidia. The three agents are also effective for the treatment of cryptosporidiosis and giardiasis in dogs. Compared with the use of a combination of albendazole and moxidectin, imidocarb dipropionate may be an easier and more convenient route of administration, and may be more cost-effective.
In the first experiment, imidocarb dipropionate (20 mg/kg PO bid) administered at the time of peak oocyst production significantly reduced oocyst shedding in two of four dogs from 0 to 20 oocysts per gram of feces (OPG). This is a similar result to the efficacy of moxidectin (1 mg/kg PO q28d) against mixed *Eimeria* and *Giardia* in dogs ([@bib0095]). In the second experiment, when albendazole (10 mg/kg PO q24h) was administered with a single dose of imidocarb dipropionate (20 mg/kg PO q24h) in one of six dogs, oocyst shedding was successfully cleared and prevented for a duration of at least two months. In that study, albendazole and imidocarb dipropionate alone were ineffective in one of six dogs. That dog had received previous coccidiosis treatment with a combination of albendazole (10 mg/kg PO q24h) and moxidectin (1 mg/kg PO q28d) and had subsequently developed *Giardia* and *Isospora* infections. The failure of albendazole (10 mg/kg PO q24h) and imidocarb dipropionate (20 mg/kg PO q24h) alone in that dog suggests that the previous coccidiosis treatment was not efficacious in clearing the *Giardia* and *Isospora* infections and that it may have resulted in the development of resistance to the imidocarb dipropionate. The efficacy of imidocarb dipropionate in combination with albendazole against mixed *Eimeria* and *Giardia* in dogs has been shown previously ([@bib0095]). The previous coccidiosis treatment of the other five dogs in that study was not associated with resistance to imidocarb dipropionate, and the present study is the first to document resistance to imidocarb dipropionate as a single agent.
Moxidectin is a macrocyclic lactone class of compound ([@bib0030], [@bib0085], [@bib0095]). Although its mechanism of action is not clearly understood, the agent is believed to exert its parasiticidal activity by inhibiting the formation of microtubules ([@bib0005], [@bib0035