Diabetes after Milbemycin Oxime + Spinosad (Trifexis) in dogs

107 reports to the FDA describe diabetes in dogs given Milbemycin Oxime + Spinosad. That is 0.1% of all reports for this medicine, compared with 0.1% across reports for all dog medicines.

107Reports
100%Marked serious
37%Recovered
26%Died or euthanised
14 daysTypical onset
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How soon it started

Same day
26 45%
1–2 days
2 3.4%
3–7 days
0 0.0%
1–4 weeks
6 10%
Over a month
24 41%

How the animals did

Recovered with lasting effects
40 37%
Still unwell when reported
28 26%
Died
13 12%
Euthanised
15 14%
Not known
11 10%

Problems reported at the same time

Age of the animals

Under 1 year
0
1–3 years
3
4–7 years
23
8–11 years
43
12+ years
24

About this medicine

Milbemycin Oxime prevents heartworm and controls some intestinal worms (monthly). Spinosad kills fleas; monthly chewable.

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

Some herding breeds (for example Collies) carry the MDR1 gene variant and can be more sensitive to this drug class at high doses.

Questions owners ask

Can Milbemycin Oxime + Spinosad cause diabetes in dogs?
107 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 14 days 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).

Diabetes with similar medicines

All reported side effects of Milbemycin Oxime + Spinosad in dogs · Medicines most reported with diabetes