Malarone® induced pancreatitis and alopecia in a dog: a case report

Abstract

Background Malarone ® is a drug used for the treatment of malaria in humans. This drug is also particularly effective in the treatment of canine Babesia gibsoni infections. Malarone ® is rarely used in dogs, and its adverse effects have not been widely reported. Its mechanism of action is related to the inhibition of cytochrome b and electron transport in the cell. This is the first known report of the development of acute pancreatitis and alopecia in a dog following the administration of Malarone ® . Case presentation A 3-year-old, intact, female Maltese was referred to our clinic with intermittent vomiting and sudden, generalized alopecia. Two months previously, the dog had been prescribed Malarone ® for the treatment of a suspected B. gibsoni infection. The dog was evaluated using hematology, radiography, ultrasonography, a PCR for Babesia detection, and a canine pancreatic lipase immunoreactivity (cPLI) assay. The result of the PCR test was negative, whereas the cPLI assay yielded a positive result. Dermatologic examination revealed bacterial infection with hair cycle arrest. Conclusions Based on these findings, drug-induced acute pancreatitis and alopecia with superficial pyoderma were diagnosed. Malarone ® may induce severe adverse reactions in dogs. Therefore, careful monitoring for adverse effects is required when using Malarone ® in dogs.

New insights into the etiology, risk factors, and pathogenesis of pancreatitis in dogs: Potential impacts on clinical practice

“…High fat diet [2][3][4] Ingestion of unusual food items 5,6 Ingestion of table scraps 5 Ingestion of trash 5 Drugs/toxins L-asparaginase 7,8 Phenobarbital and potassium bromide 9-11a Azathioprine [12][13][14] Potentiated sulfonamides 15 Organophosphates 12,16 Corticosteroids, 12,17b Furosemide 12 Atovaquone/proguanil (Malarone) 18 N-methyl-glucamine (Meglumine), 19b…”

“…Potentiated sulfonamides, furosemide, clomipramine, atovaquone/ proguanil (Malarone), and n-methyl-glucamine (Meglumine) are associated with the development of AP in isolated dogs. 12,15,[18][19][20] Another prospective study reported that none of 20 dogs treated with meglumine and allopurinol developed increased cPLI concentrations or clinical signs consistent with pancreatitis. 78 Isolated reports of toxins such as zinc causing AP have been reported.…”