Key points:
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Reptiles commonly carry parasites
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Faecal testing is advised before any treatment is administered
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Adverse effects are rare but should be taken in to account
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Drugs are prescribed following EU and UK regulations
The main authorised veterinary medicines are:
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Prescription-only Medicine – Veterinarian; abbreviated to POM-V;
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Prescription-only Medicine – Veterinarian, Pharmacist, Suitably Qualified Person (SQP); abbreviated to POM-VPS;
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Non-Food Animal – Veterinarian, Pharmacist, Suitably Qualified Person; abbreviated to NFA-VPS; and,
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Authorised Veterinary Medicine – General Sales List; abbreviated to AVM-GSL.
Something to keep in mind:
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Prescription medications (POM, POM-V) have to go through extensive validated methods and tests to reach market.
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Other products sold as "over the counter" do not go through extended testing and validations.
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POMs and POM-Vs will always require a prescription where the veterinary surgeon has the animal under his care.
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Drugs in other medication categories prescribed by a vet for species different to the label, also require a prescription.
Reptiles are frequent carriers of parasites in captivity and thankfully most of those parasites detected are not zoonotic (they mostly are not passed on to people), unlike those found in cats and dogs. Hence why preventative "deworming" of reptiles is becoming a thing of the past, quite the contrary as in cats and dogs.
Before treatment, a risk assessment should be undertaken by understanding the reptile parasites detected and potential adverse drug effects to then enable us to decide whether the parasite detected should be treated at all and, if so, which drugs should be used.
Commonly used anti-parasitic drugs used in reptiles in the United Kingdom:
Fenbendazole (Panacur, Lapizole) - NFA-VPS
Fenbendazole is a medication that is used to treat a variety of parasites, including some protozoa, tapeworms and roundworms. It is arguably the most commonly used reptile anti-parasitic.
The previous licensed product in the United Kingdom called Lapizole, was discontinued and therefore other commercial names are used for treating some of these parasites. Commercial names include Panacur, which comes in different formats, including granules, paste and oral solution.
There are different treatment protocols, with different doses and durations depending on the species and parasites detected.
Adverse effects of this drug may include immune-suppression where white blood cells may decrease as seen in a variety of animal groups, including rabbits, birds and reptiles. It is very important to take this in to account when deciding a treatment regime as this could have serious consequences in a species of reptile that hibernates, aestivates or brumates.
Sulfamethoxazole trimethoprim (Sulfatrim®)
The sulfonamide group of antibiotics (and anti-coccidians) most commonly used in reptiles is Sulfamethoxazole trimethoprim (often referred to as TMPS) and the licensed product in the UK for Bearded Dragons, pigeons and rabbits is Sulfatrim. This commercially available prescription only veterinary medication (POM-V) is licensed for the treatment of coccidiosis in Bearded Dragons, which means that legally this has to be used a a first choice of treatment for this condition. There are other products available that can be used "off label" as they may be licensed for different animals (for example Baycox which is licensed for birds and farm animals and must be diluted as it is a very alkaline product).
This medication is generally used for the treatment of coccidia.
Sulftatrim can be used for 7-14 days, once daily or alternate days form the second dosage as per the datasheet.
Adverse effects are rarely seen and, where the adverse effect that can be attributed to the medication, this would be reported as with any medication. Common complaints we hear from owners are Bearded Dragons that show a black beard or rub their face after dosing, also anorexia (as seen in other species). This is thought to be a stress behavioural physiological response and the manufacturer (Virbac) nor the Veterinary Medicines Directorate (VMD) have information on these reports as they are considered mild.
Other anti-patasitics used:
Emodepside (Profender®)
The spot on product Profender is frequently used in the UK in cats.
In reptiles this may be an alternative option for the treatment of roundworms or tapeworms due to the ease of application. There have been studies, albeit limited, in treating roundworms with this product in reptiles.
Levamisole (Beaphar reptile wormer®)
Levamisole is available in the United Kingdom under the Small Animal Exemption Scheme (which means that requirements to reach market are not as strict as with other medications i.e. prescription medications). It is marketed as a “routine wormer to keep reptiles free from whipworm, hookworm and other roundworms”. The only available doses in the literature are anecdotal .
Potential side effects range from salivation, tremors and even death when given parenterally. No doses have been published as safe or effective for tortoises and treatment has been suggested to be unsatifactory against pinworms and ascarids (Wilkinson, 2004), although work has been performed on sliders where they looked at levels in the blood (Corum et al, 2019).