# Panacur PowerPak



## Ryle (Jul 13, 2007)

Why are you using a powerpac? If you want to treat encysted strongyles and there are no health issues in this horse, moxidectin is actually easier on the GI tract. Fenbendazole has been shown to cause the same sort of damage you treat encysted strongyles to prevent. Fenbendazole treatment mimics the kind of severe inflammatory event in the lining of the GI tract when encysted strongyles are present.


Vet Parasitol. 2006 Jun 30;139(1-3):115-31. Epub 2006 May 3.
*Small strongyle infection: consequences of larvicidal treatment of horses with fenbendazole and moxidectin.*

Steinbach T, Bauer C, Sasse H, Baumgärtner W, Rey-Moreno C, Hermosilla C, Damriyasa IM, Zahner H.
Institute of Parasitology, Justus Liebig University Giessen, Rudolf-Buchheim-Strasse 2, D-35392 Giessen, Germany.
The study was undertaken to evaluate adverse effects of larvicidal treatment in horses naturally infected with cyathostomins. Out of 24 ponies kept on pasture, four animals were housed in September and anthelmintically cured to serve as worm-free controls (group C-0). The others were housed in December. Eight animals each were treated 8 weeks later with 5 x 7.5mg/kg fenbendazole (FBZ) or 1 x 0.4 mg/kg moxidectin (MOX). Four animals remained untreated (group C-i). Two, 4, 6 and 14 days after the end of treatment two animals of each of the treated groups were necropsied together with group C-0 and C-i animals. Infected animals before treatment showed weight loss, eosinophilia, increased plasma protein and globulin contents. Treatment was followed by weight gain and temporal plasma protein and globulin increase. Proportions of CD4+ and CD8+ T lymphocytes in the peripheral blood did not differ between the groups before treatment but dropped significantly temporally after FBZ treatment. Group C-0 was worm-free at necropsy. Group C-i animals contained variable numbers of luminal and tissue cyathostomins. Histological sections showed larval stages in the lamina propria und submucosa surrounded by macrophages. Either treatment was effective against luminal parasites and reduced the number of larvae in the bowel wall beginning 4-6 days after FBZ and 6-14 days after MOX treatment. Histologically, as a first reaction after FBZ application T lymphocytes accumulated around morphologically intact L4 in the submucosa. Subsequently T lymphocytes associated with eosinophils infiltrated the submucosa. Parasites became enclosed by granulomas with eosinophils adhering to and invading the larvae which started to disintegrate on day 4. Later on, particularly on day 14 inflammation extended into the mucosa and was frequently associated with ulcerations. Third stage larvae in general and L4 in the lamina propria, however, seemed not to be affected until day 14 and even then, parasites did usually not generate extensive inflammation. After MOX treatment severe morphologically detectable alterations of tissue larvae could not be observed earlier than day 14. Different from FBZ treatment, larvae disintegrated and were obviously resorbed without causing severe inflammation in the gut wall. In conclusion treatment with either drug was efficacious against tissue larvae of cyathostomins but there may be different clinical consequences: in contrast to MOX effects, killing of larvae due to FBZ was associated with severe tissue damage, which clinically may correspond to reactions caused by synchronous mass emergence of fourth stage larvae, i.e., may mimic larval cyathostominosis.


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## sillybunny11486 (Oct 2, 2009)

My vets suggested something other than a powerpack to treat my infected horse. He got a regular dose of pyrantel, then a some sort of pills for 5-7 days. I have the leftovers at my barn, I forget what they actually are. My vet suggested that pack safeguard has, to give once a year to once every two years to get ride of the baby worms (also forget what they are called.)

My vet has never had a problem with any wormer, except quest gel (caused mouth uclers in some horses) and regular suggests equimax instead of regular ivermectin, because that kills tapeworms as well.


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## My Beau (Jan 2, 2009)

Ryle said:


> Why are you using a powerpac? If you want to treat encysted strongyles and there are no health issues in this horse, moxidectin is actually easier on the GI tract.


Because I'm using it on a lactating mare.


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## My Beau (Jan 2, 2009)

I was running out to get a load of hay earlier when I posted.

In addition to it being used on a lactating mare, here are other reasons why I want to use it:
The PPP gets the 3rd stage encysted larvae that moxidectin does not get. I know that the PPP causes a mucus inflammation around day 14 (after the first dose) that mimics the emergence (they're really just dying) of the encysted larvae... it causes some horse to act colicky. I've never had a horse act colicky, so until I have a horse that shows s/he can't handle it, then I'm going to use it. I've read about problems with Quest crossing the blood-brain barrier, and know of someone whose *healthy* horse died from it... and it was not because of an OD.

I've dosed horses with unknown deworming history with PPP and have never had an issue with it. I don't know this mare's history and am looking to PP her in January or February. It would be great if she could get one sooner, but we can't fit it into our rotation at the next deworming.

If something in the environment triggers the emergence of the little ******s I don't want my mare to bleed to death internally, I want them out ASAP and it not going to be by the way of Quest because of the above reasons and the fact that she is still occasionally nursing her last foal.


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## AlmagroN (Jul 19, 2009)

i love the panacur powerpacs. that sounds cheap to me. the last time i bought it, it was 70 bucks!


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## Ryle (Jul 13, 2007)

Mouth ulcerations can be seen with moxidectin or ivermectin due to the killing of bot fly larva that are encysted in the gums/tongue. However this is more common with one specific ivermectin product-Zimectrin Gold.

Quest Plus doesn't cross the blood brain barrier unless there is a problem such as over-dosing or some damage the the central nervous system or organ dysfunction. Head/neck trauma, inflammation of the central nervous system, EPM, etc can all affect the functioning of the blood-brain-barrier and lead to neurotoxicity from allowing substances that should not pass into the CNS to do get there. 

I've been party to hundreds of doses of moxidectin being given---even in senior horses, pregnant mares, etc and have seen no adverse reactions. However, you are right, I wouldn't dose it in lactating mares. 

I simply cannot understand the logic behind giving a drug to kill encysted larva that are doing no damage and with which the major issue is the severe GI inflammation that they can cause if they all emerge at once when you know that the drug you are giving causes the very severe inflammation that is the main reason for getting rid of encysted strongyles.


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## Alwaysbehind (Jul 10, 2009)

I thought My Beau just asked where she could find a PP for a good price, not a long drawn out speech about what a bad horse owner she was being for using it.

I personally have never heard of a PP being a bad thing. Ryle you are the first person I have ever heard say they are a bad thing, actually. I have heard people say they are not as affective as some would like them to be but never they are evil.


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## Ryle (Jul 13, 2007)

Lots of people missed the study done on them in 2006. Until then there hadn't been a study that looked at the adverse affects in that way. And any colic that occured 2 weeks after dosing with a Powerpac was just assumed to be coincidental rather than possibly caused by the dewormer because no one knew that it caused that sort of damage to the GI tract. 

(I posted a summary of the study above.)


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## Alwaysbehind (Jul 10, 2009)

I read what you posted.

Thanks......... 

Again, you are the one and only person I have ever heard insist that Quest is more safe on a horse with an unknown de-worming history.



OP, though I am not fond of Horse.com they seem to have the best prices on those things. I say go for it.


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## Ryle (Jul 13, 2007)

My boss at the equine hospital regularly dosed otherwise healthy adult horses with no known deworming history with Quest with no ill effects. Since adult horses are much less likely to carry heavy parasite loads even with limited deworming, the risk of impaction colic due to killing parasites in adult horses is lower than in foals. Around 50% of adult horses control parasite burdends due to their own developed immunity with minimal deworming, meaning twice a year to treat parasites that they don't develop a resistance to--bots and tapeworms.


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## sillybunny11486 (Oct 2, 2009)

It may just be my vets experience, but she specifically said dont use quest. The gel is absorbed very quickly, so she said inacurate doses can cause problems (under or over.) She saw three horses this year who all got ulcers from it. It could be from worms in the mouth, but my point is simmilar products dont have those effects she saw. 

I used PP on my horse about 6 years ago, he had an infestation and that why the vet recomended. That study wasnt out then. This time around when my new horse got an infestation we used pills. with the PP the vet told me not to ride the horse till it all out of his system, and I was advised to call the vet if I saw anything unusual. This time around the vet didnt say anything about adverse effects. Ive only been told to use PP when absolutely necessary, when you know their is an infestation. 

How sever is the GI inflamation? Does it go away quickly?


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## Alwaysbehind (Jul 10, 2009)

Before you toss out there that my vets are out of date I will say that they just totally re-vamped their de-worming protocol after much study. It still includes a PP when necessary. You do what your vets tell you to do and the rest of us will follow what our vets tell us to do.  I trust my vets.


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## My Beau (Jan 2, 2009)

Ryle said:


> Mouth ulcerations can be seen with moxidectin or ivermectin due to the killing of bot fly larva that are encysted in the gums/tongue. However this is more common with one specific ivermectin product-Zimectrin Gold.
> 
> Quest Plus doesn't cross the blood brain barrier unless there is a problem such as over-dosing or some damage the the central nervous system or organ dysfunction. Head/neck trauma, inflammation of the central nervous system, EPM, etc can all affect the functioning of the blood-brain-barrier and lead to neurotoxicity from allowing substances that should not pass into the CNS to do get there.


The horse I know of that died from Quest was because it crossed the blood-brain barrier. Because of an oral ulcer... most likely from a plant of some kind. I cannot guarantee that my horses' mouths are in perfect condition, other than from a dentistry stand point. 



Ryle said:


> I simply cannot understand the logic behind giving a drug to kill encysted larva that are doing no damage and with which the major issue is the severe GI inflammation that they can cause if they all emerge at once when you know that the drug you are giving causes the very severe inflammation that is the main reason for getting rid of encysted strongyles.


My logic goes like this. If she does have a load of encysted larvae and I treat them with a PP - they die. Not all horses have a reaction to it - I've never had any show discomfort in any way. If the PP were to cause inflammation it's because it's killing the encysteds, rather than them emerging, and I'm ready if she gets a bit colicky. 

But if left untreated, and the larvae emerge, then there are some major issues. One of which being internally bleeding to death. No thanks.


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## Ryle (Jul 13, 2007)

sillybunny11486 said:


> How sever is the GI inflamation? Does it go away quickly?


The results from the study showed severe inflammation and even ulceration of the GI tract---severe enough to mimic the larval cyathostomiasis that treating encysted strongyles is supposed to prevent because it can lead to severe colic and death of tissues in the GI tract.

How do you know if you have an infestation of encysted strongyles? There is no test that can determine this except for actually looking at the lining of the GI tract. As for having a high number of strongyle eggs shed in the feces, that doesn't necessarily mean that you need to PP your horses. Treating with ivermectin or moxidectin will clear the adult parasites and moxidectin will clear a large number of the encysted larva without the inflammation.


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## Ryle (Jul 13, 2007)

My Beau said:


> The horse I know of that died from Quest was because it crossed the blood-brain barrier. Because of an oral ulcer... most likely from a plant of some kind. I cannot guarantee that my horses' mouths are in perfect condition, other than from a dentistry stand point.


I would question this. Mouth ulcers should not cause moxidectin to cross the blood brain barrier. However if the issue was that the horse had eaten silverleaf nightshade (bull nettle), then it could definitely lead to toxicity issues with moxidectin even at normally safe doses. This occurs with ivermectin too if a horse has eaten bull nettle---A&M did a study on it a few years ago. But it's because of the damage done by the toxic plant not that the dewormer is bad.





My Beau said:


> My logic goes like this. If she does have a load of encysted larvae and I treat them with a PP - they die. Not all horses have a reaction to it - I've never had any show discomfort in any way. If the PP were to cause inflammation it's because it's killing the encysteds, rather than them emerging, and I'm ready if she gets a bit colicky.
> 
> But if left untreated, and the larvae emerge, then there are some major issues. One of which being internally bleeding to death. No thanks.


Your logic is rather skewed.

Most likely your horse didn't show symptoms of the inflammation in the past that you noticed for the same reason that many many horses can have GI ulcers without owners noticing symptoms. It is extremely common for horses to have severe GI ulcers without owners being aware.

If your horse has significant enough encysted strongyles to lead to internally bleeding to death (btw, not likely) then by giving a PP you are simply triggering the process of severe inflammation that you are trying to stop by killing the encysted parasites. In this case, it's not likely that there would have been a mass emergence of the larva all at one time but rather that a small portion would have emerged and not caused nearly as much damage. You are better off to treat with moxidectin and kill a portion of the encysted strongyles without causing GI inflammation than to kill all of them and trigger a serious GI disturbance.


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## My Beau (Jan 2, 2009)

Ryle said:


> I would question this. Mouth ulcers should not cause moxidectin to cross the blood brain barrier. However if the issue was that the horse had eaten silverleaf nightshade (bull nettle), then it could definitely lead to toxicity issues with moxidectin even at normally safe doses. This occurs with ivermectin too if a horse has eaten bull nettle---A&M did a study on it a few years ago. But it's because of the damage done by the toxic plant not that the dewormer is bad.


Ok, maybe. It's not my horse. That is what the vet who necropsied it said.







Ryle said:


> Your logic is rather skewed.
> 
> Most likely your horse didn't show symptoms of the inflammation in the past that you noticed for the same reason that many many horses can have GI ulcers without owners noticing symptoms. It is extremely common for horses to have severe GI ulcers without owners being aware.
> 
> If your horse has significant enough encysted strongyles to lead to internally bleeding to death (btw, not likely) then by giving a PP you are simply triggering the process of severe inflammation that you are trying to stop by killing the encysted parasites. In this case, it's not likely that there would have been a mass emergence of the larva all at one time but rather that a small portion would have emerged and not caused nearly as much damage. You are better off to treat with moxidectin and kill a portion of the encysted strongyles without causing GI inflammation than to kill all of them and trigger a serious GI disturbance.


So your saying, like horses with ulcers, it's extremely common for horses to have severe inflammation without the owner's being aware?... Yea, exactly my point.

Look, I have my reasons to use a PP and reasons why I'm not going to use Quest. I've never had problem with a PP - every horse I've worked with who has ever been given it has looked WAY better afterwards. I'm not going to sit here and beat this to death - all I asked was if anyone knew of a cheaper place to pick up a PP, that's it. My horses are in excellent condition, I know what I'm doing - although you might beg to differ.

And for the last time, Moxidectin does not clear everything.


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## Alwaysbehind (Jul 10, 2009)

I think a PP is one of those situations where different is not wrong even though some people insist it is their way or the highway!


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## 5cuetrain (Dec 11, 2009)

Wow. Lots of info for sure. Brands galore and several opinions on wormers for sure. Been using PP for quite a while--all new horses to my facility get em period.

Havn't had one die on me yet!!


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## Ryle (Jul 13, 2007)

You may not have one die, but you may be causing gastric ulcers which can lead to all sorts of problems including colic.


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## 5cuetrain (Dec 11, 2009)

Sounds like you truly believe in what you say and I respect your opinion but there are other opinions out there for sure.

How about a little respect in return??


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## Ryle (Jul 13, 2007)

I haven't shown you any disrespect, simply pointed out flaws in logic or areas things that might not be considered.


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## qtrhrsecrazy (Aug 2, 2009)

Just a side note regarding Quest. I will not use it again. I have used it in the past with no problem thankfully.. however -

A friend of mine's vet dosed my friends horses with Quest. The problem one gelding had, and was proven to be from the Quest was everywhere he had white hair/pink skin, (he's a bay) the hair fell out and his skin sluffed off.

Extensive testing proved moxidectin was the culprit, and Ft Dodge settled with my friend out of court admitting it was the fault of their product


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## sillybunny11486 (Oct 2, 2009)

^^ good to know. Ive never used it, not because of anything Ive herd but based on my vets recomendation.


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## Alwaysbehind (Jul 10, 2009)

Ryle said:


> I haven't shown you any disrespect, simply pointed out flaws in logic or areas things that might not be considered.


:roll: :-?

I believe the point is, you have said it over and over again and anyone who does not agree with you gets reminded by you that they are nothing short of stupid.

You have your opinion. Other vet practices have other opinions.


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## mls (Nov 28, 2006)

qtrhrsecrazy said:


> Extensive testing proved moxidectin was the culprit, and Ft Dodge settled with my friend out of court admitting it was the fault of their product


However - no one can predict what a horse (or human) may have a reaction to.

Vaccines, wormer, feed, fly spray, shampoo . . . .


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## Alwaysbehind (Jul 10, 2009)

mls said:


> However - no one can predict what a horse (or human) may have a reaction to.
> 
> Vaccines, wormer, feed, fly spray, shampoo . . . .


Very good point.

What one horse might react to might not be a problem for someone else, etc.


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## qtrhrsecrazy (Aug 2, 2009)

mls said:


> However - no one can predict what a horse (or human) may have a reaction to.
> 
> Vaccines, wormer, feed, fly spray, shampoo . . . .


That's right, and her other horses were fine... it was just the one. It's enough of a red flag with the reaction being so traumatic, that why push it.

There's plenty of other wormers that are effective, and much safer than Quest. I'm sticking with those.

I have a mare that one year had a reaction to the flu/rhino vaccine. Never an issue up to that point. She no longer can have it. My other horses never had a problem with flu/rhino. 3 veterinarians said it's that particular type of rhino vaccine (don't remember the details it's been to long ago) but you can't get a flu shot without it


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## Ryle (Jul 13, 2007)

qtrhrsecrazy said:


> There's plenty of other wormers that are effective, and much safer than Quest. I'm sticking with those.


Unfortunatly that is simply not the case anymore. There is widespread resistance among strongyles to the benzimendazole class of dewormers with fenbendazole having resistance issues in 95+% of areas tested in the US. And there is resistance among strongyles to pyrantel (Strongid) in around 50% of areas tested. This past year a study with the first farm showing resistance of strongyles to ivermectin was published. Strongyles are the biggest problem to focus on in adult horses. 

Then you look at ascarids which are a huge concern in foals and you see resistance to ivermectin and resistance to pyrantel. 

So truthfully the number of deworming chemicals that are currently effective in a given situation is around 2. And moxidectin is in the same chemical family as ivermectin so it won't take as long to start seeing resistance to it because the parasites have had such long and frequent exposure to a similar chemical.


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## qtrhrsecrazy (Aug 2, 2009)

Ryle said:


> *Unfortunatly that is simply not the case anymore*. There is widespread resistance among strongyles to the benzimendazole class of dewormers with fenbendazole having resistance issues in 95+% of areas tested in the US. And there is resistance among strongyles to pyrantel (Strongid) in around 50% of areas tested. This past year a study with the first farm showing resistance of strongyles to ivermectin was published. Strongyles are the biggest problem to focus on in adult horses.
> 
> Then you look at ascarids which are a huge concern in foals and you see resistance to ivermectin and resistance to pyrantel.
> 
> So truthfully the number of deworming chemicals that are currently effective in a given situation is around 2. And moxidectin is in the same chemical family as ivermectin so it won't take as long to start seeing resistance to it because the parasites have had such long and frequent exposure to a similar chemical.


I'm not having any problems thankfully _not _using moxidectin. I have fecal's done a couple of times a year, and they're clean


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