>From:    sukie crandall <[log in to unmask]>
 
>>But when vets, and others, publish articles for consumption by the
>>general ferret owning public endorsing the routine introduction of
>>Frontline drops into the ear canal, in spite of its undenied potential
>>for ototoxic effects when used in that way, I believe that raises
>>issues of professional misconduct that need to be addressed by the
>>Royal College of Veterinary Surgeons.
 
>Provide medical references tot the FML, please, and, please, have those
>include veterinary ones, especially ferret ones.  I've heard a lot of
>assertions made here but have seen no proof, so would like to read
>something substantial.
 
Please remember that I have argued specifically against the use of
Frontline drops introduced into the ear canal; I have made no comment
about its conventional off-label use when applied topically as per the
manufacturer's instructions.
 
So far as references are concerned, are you aware of any authority who
has argued that the active ingredient in Frontline is not fipronil?  Are
you aware of any authority who has argued that fipronil does not act by
blocking the GABA receptors?  Are you aware of any authority who has
argued that the mammalian central nervous system does not contain GABA
receptors?  Are you aware of any authority who has argued that there is
no possibility of a neurotoxin introduced into the outer ear being able
to penetrate to the inner ear and hence the CNS?  If so, then I look
forward to seeing your references.
 
I have no direct evidence that putting a ferret into a microwave oven at
900W for 10 minutes will not make it explode, and I sincerely hope that
I never shall.  But I certainly wouldn't recommend that as a safe and
effective treatment for ear mites just because I had not yet received any
reports of exploding ferrets.  Surely common sense should prevail?
 
But for something more substantial than mere common sense, let me refer
you to a statement issued by the holder of the marketing authorisation
here in the UK, Merial Animal Health Ltd.  This statement was approved by
Merial's veterinary technical manager, Rachel Smithson BVetMed MRCVS on
the 18th August 2003.
 
'Do not apply Frontline directly into the ears of ferrets, or indeed any
other mammal.  Follow the manufacturer's instructions and only apply
Frontline topically.'
 
'In the event of a ruptured ear drum, products introduced into the outer
ear may enter the inner ear and cause damage.  Frontline is not licensed
in any species for use in the ear canal.'
 
I believe that Merial themselves have carried out clinical trials on the
intraural use of Frontline, and so you may care to contact them directly.
 
I have already, on several occasions, published the statement from the
author of the widely misunderstood material in the BSAVA Manual of Exotic
Pets, Nico Shoemaker of the University of Utrecht, in which he further
agrees that the intraural use of Frontline breaches the Royal College of
Veterinary Surgeons Prescribing Guidelines (the prescribing cascade).
 
Eric Corbett
[Posted in FML issue 4395]