Abnormal urine odour after Imidacloprid + Moxidectin (Advantage Multi) in dogs

88 reports to the FDA describe abnormal urine odour in dogs given Imidacloprid + Moxidectin. That is 0.7% of all reports for this medicine, compared with 0.0% across reports for all dog medicines, so it is reported unusually often with this medicine.

88Reports
63%Marked serious
65%Recovered
1.1%Died or euthanised
Same dayTypical onset
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How soon it started

Same day
29 52%
1–2 days
19 34%
3–7 days
3 5.4%
1–4 weeks
1 1.8%
Over a month
4 7.1%

How the animals did

Recovered
56 64%
Recovered with lasting effects
1 1.1%
Still unwell when reported
1 1.1%
Euthanised
1 1.1%
Not known
29 33%

Problems reported at the same time

20 23%
17 19%
10 11%
7 8.0%
Increased urine concentration
5 5.7%

Age of the animals

Under 1 year
17
1–3 years
31
4–7 years
25
8–11 years
10
12+ years
5

About this medicine

Imidacloprid kills fleas (spot-on or collar). Moxidectin prevents heartworm disease (monthly topical, or a 6- or 12-month injection for dogs).

Products with this combination include Advantage Multi. The FDA hides brand names in its public data, so these reports cover every product with the same active ingredients.

Questions owners ask

Can Imidacloprid + Moxidectin cause abnormal urine odour in dogs?
88 reports link the two, but a report alone does not prove the medicine was the cause: other illnesses, other medicines or coincidence can be involved. Your vet can judge it for your animal.
How soon after a dose was it reported?
In half of the reports with dates, it started within the same day of the first dose.
What should I do?
Don't give another dose until you've spoken to your vet, and keep the packaging so you can tell them the product and dose. Your vet can also report it to the FDA (or you can, through the manufacturer or FDA form 1932a).

All reported side effects of Imidacloprid + Moxidectin in dogs · Medicines most reported with abnormal urine odour