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PRODUCT RANGE Table of contents page 1 ® page 2 ® page page page 3-4 5 6 page 7 – 13 ® page 15 – 18 Leaflet Artuvetrin Therapy ® page 19 – 22 Contact details ArtuVet Animal Health b.v. page 23 Introduction Artuvetrin Product range Artuvetrin Serum Test - North-West European panel - South European panel ® ® Artuvetrin Skin Test and Artuvetrin Therapy – available allergens Leaflet Artuvetrin Skin Test Artuv-Eng 04-2016 Introduction This brochure contains information about the veterinary products ArtuVet Animal Health BV can supply, the different allergens for the diagnosis and treatment of atopic dermatitis and the package insert leaflets of these products. Diagnosis and treatment 1 Allergies are common in dogs (between 3% and 15% of dogs suffer from an atopic condition) . Other conditions that appear similar to atopy must first be excluded, based upon previous history and an extensive examination. To determine the allergens a dog is allergic to a veterinarian can make use of a skin test and/or a serum test. Based on the allergens that cause a positive reaction in the patient a special vaccine (immunotherapy) can be prepared. Allergen-specific immunotherapy (Artuvetrin® Therapy) is effective (75% of dogs show a clinical improvement)2,3 and safe4. This causal treatment avoids a long-term symptomatic treatment (e.g. corticosteroids) with possible side effects. Artuvetrin® is the only licensed allergen specific treatment available in Europe*. Therefore under the European veterinary medicines regulations (directives 2004/28/EC), ® Artuvetrin is the product of choice. ® Ordering Artuvetrin products ® To order the Artuvetrin products you can contact ArtuVet by email ([email protected]). Delivery, under normal circumstances, will be within 8 working days after ordering. ArtuVet ArtuVet has many years of experience, with veterinary allergies. ArtuVet is therefore ideally placed to provide optimum advice and support to the veterinarian, with allergy summaries, customer leaflets and expert advice. ArtuVet is situated in Lelystad, The Netherlands. ArtuVet is particularly active in the field of immunotherapy for allergies. Its core activity is the development, manufacturing and marketing of immunotherapy products for veterinary use. All products of ArtuVet are produced following the latest pharmaceutical requirements, and our modern laboratory is GMP (= Good Manufacturing Practice) approved. This way we can be sure to serve you and your patients with quality products with the highest reliability. References: 1. Hillier, et al. Vet. Immunol. Path 81 (2001) 147-151 2. Willemse. Tijdschr. Diergeneesk. Deel 129 (2004) 402-408 3. Tarpataki et al, Hun. Vet. J. 126 (2004) 545-552 4. Griffin, et al. Vet. Immunol. Path 81 (2001) 363-383 * Licensed in the Netherlands 1 Artuvetrin® product range Artuvetrin® Diagnosis Artuvetrin® Serum Test Artuvetrin® Skin Test Treatment Artuvetrin® Therapy ® Artuvetrin Skin Test (intradermal test) The specially developed Artuvetrin® Skin Test determines which substances the dog is allergic to, with over 80 allergens available for testing. The Skin Test Set can be configured to suit your needs includes 2 control solutions. An overview of all the allergens available, which can be ordered as individual tests, is listed in this brochure (page 7 – 13). Artuvetrin® Serum Test A serological allergy test, to determine the allergens causing the allergic reaction, is a good alternative ® for the intradermal skin test. The Artuvetrin Serum Test is such a good and reliable alternative. This serological test has been specially developed in cooperation with Greer Laboratories (internationally recognised allergen specialists) and is characterised by high specificity and sensitivity. The test utilizes the Fc region on the allergen-specific IgE antibodies. On the basis of this test the allergens that may be responsible for the pet’s atopic dermatitis can be determined. In the Artuvetrin® Serum Test, an extensive panel of relevant indoor and outdoor allergens is examined. The specially constructed European panels (North-West and South European panel) contain the allergens that are clinically relevant for and characteristic of these regions. The composition of both panels is listed in this brochure (page 5-6). ® The Artuvetrin Serum Test outcome will be communicated as a clear and easy to interpret result together with a treatment advice. Artuvetrin® Therapy Once it has been established with the aid of the skin test or serum test which substances are causing the allergy, it is possible to make the dog less sensitive to these substances, or even insensitive. To this end, an allergen-specific immunotherapy is produced - Artuvetrin® Therapy – on the basis of the patient-specific substances that are causing the allergic symptoms. A dog can be treated simultaneously for a number of different allergens with Artuvetrin Therapy (up to 8 allergens can be combined in 1 therapy). More information about Artuvetrin Test and Artuvetrin Therapy, the safe and effective treatment of atopic dermatitis, can also be found on www.artuvetrin.com. 2 Artuvetrin® Serum Test 3 Artuvetrin® Serum Test ® With the Artuvetrin Serum Test, an extensive panel of relevant indoor and outdoor allergens is examined. The specially constructed European panels (North-West and South) contain the allergens that are clinically relevant for and characteristic of these regions. Allergen adsorbed to the surface of polystyrene microtiter wells Serum is added to the test well. If present in the serum sample, specific IgE binds to the allergen A biotinylated monoclonal cocktail of antibodies with specific anti-Fc epsilon reactivity is added to the well. This monoclonal cocktail binds to different epitopes on the Fc epsilon portion of the IgE molecule. Avidin-Alkaline Phosphatase conjugate is added to each well. Each enzyme molecule will bind to a biotin molecule on the IgE-monoclonal complex, enhancing specificity and sensitivity. To detect the binding of the enzyme, p-nitrophenyl phosphate (pNPP) substrate is added to each well. When the enzyme is bound to the well, the pNPP substrate converts from a colourless solution to a yellow coloured end product. The intensity of the signal is proportional to the amount of allergen specific IgE present in the test serum 4 North-West European panel Indoor Outdoor Mites and insects Grass pollen Latin Acarus siro English Grain mite Latin Dactylis glomerata English Orchard grass Ctenophalides spp. Flea Festuca pratensis Fescue, meadow Dermatophagoïdes farinae Farinae mite Lolium perenne Rye grass, perennial Dermatophagoïdes House dust mite Phleum pratense Timothy Poa pratensis Blue grass, Kentucky pteronyssinus Lepidoglyphus destructor Hay mite Tyrophagus putrescentiae Copra mite Fungi Pollen from weeds and flowers Latin Alternaria alternata Latin Artemisia vulgaris English Mugwort, common Aspergillus fumigatus Chenopodium album Lambs quarter Cladosporium herbarum Parietaria officinalis Pellitory, wall or erect Plantago laceolata Plantain, English Urtica dioica Nettle, stinging Epithelia Latin Felis domesticus Yeast Tree pollen English Cat Latin Betula spp. English Birch Corylus spp. Hazel Salix viminalis Willow Latin Malassezia 5 South European panel Indoor Outdoor Mites and insects Grass pollen Latin Acarus siro English Grain mite Latin Dactylis glomerata English Orchard grass Ctenophalides spp. Flea Festuca pratensis Fescue, meadow Dermatophagoïdes farinae Farinae mite Lolium perenne Rye grass, perennial Dermatophagoïdes House dust mite Phleum pratense Timothy Poa pratensis Blue grass, Kentucky pteronyssinus Lepidoglyphus destructor Hay mite Tyrophagus putrescentiae Copra mite Fungi Pollen from weeds and flowers Latin Alternaria alternata Latin Artemisia vulgaris English Mugwort, common Aspergillus fumigatus Chenopodium album Lambs quarter Cladosporium herbarum Parietaria officinalis Pellitory, wall or erect Plantago laceolata Plantain, English Epithelia Latin Felis domesticus Yeast Latin Malassezia Tree pollen English Cat Latin Corylus spp. English Hazel Cupressus sempervirens Cypress, Italian Olea europaea Olive Platanus occidentalis Sycamore, eastern 6 Artuvetrin® Skin Test and Artuvetrin® Therapy available allergens 7 Grass pollen Latin English Agropyron repens Cough grass Agrostis gigantea Redtop Anthoxanthum odoratum Vernal grass, sweet Bromus inermis Brome smooth Cynodon dactylon Bermuda grass Dactylis glomerata Orchard grass Festuca pratensis Fescue, meadow Holcus lanatus Velvet grass Lolium multiflorum Rye grass, Italian Lolium perenne Rye grass, perennial Phleum pratense Timothy Poa pratensis Blue grass, Kentucky Grass pollen mixture: Bermuda grass, Orchard grass, Sweet vernal grass, Timothy and Velvet grass 8 Pollen from trees and hedges Latin English Tree pollen mixture I: Acer negundo* Maple, ash leaved* Birch, Alder and Hazel Aesculus hippocastanum Buckeye, horse chestnut Alnus glutinosa* Alder, black* Betula pendula* Birch* Corylus avellana Hazel Cupressus sempervirens Cypress, Italian Fagus sylvatica Beech, European White poplar, Willow, Ash and Ash-leaved Fraxinus excelsior* Ash* maple Liguster vulgare European Privet Olea europaea Olive Pinus sylvestris Pine, scotch Platanus occidentalis Sycamore, eastern Populus alba Poplar, white* Salix viminalis* Willow* Tilia cordata Linden Ulmus Americana* Elm, American* Tree pollen mixture II: English oak, European beech and American elm Tree pollen mixture III*: * Only available in an Artuvetrin® Therapy, not available in the Artuvetrin® Skin Test 9 Pollen from weeds and flowers Latin English Ambrosia elatior Ragweed, common Artemisia vulgaris Mugwort, common Chenopodium album Lambs quarter Leucanthemum vulgare Daisy Weed pollen mixture I: Parietaria officinalis Pellitory, wall or erect Common mugwort and Stinging nettle Plantago laceolata Plantain, English Rumex acetosella Sorrel, red or sheep Rumex crispus Dock, yellow Solidago virgaurea Goldenrod Taraxacum officinale* Dandelion, common* Urtica dioica* Nettle, stinging* Weed pollen mixture: Common mugwort, Stinging nettle, Common dandelion and English plantain Weed pollen mixture II: Goldenrod, Lambs quarter, Common dandelion, Red or sheep sorrel and English plantain * Only available in an Artuvetrin® Therapy, not available in the Artuvetrin® Skin Test Pollen of crops Latin English Avena sativa Oat, cultivated Brassica napus Rape Secale cereale Rye, common Triticum aestivum Wheat Zea mays Corn 10 Mites Latin English Acarus siro Grain mite Dermatophagoïdes farinae Farinae mite Dermatophagoïdes pteronyssinus House dust mite Euroglyphus maynei Euroglyphus maynei Lepidoglyphus destructor Hay mite Tyrophagus putrescentiae Copra mite Insects Latin English Aedes communis Mosquito Culex Culicoides Ctenophalides spp Flea Musca domestica House fly Periplanata Americana Cockroach Tabanus 11 Epithelia Latin English Anas platyrhynca* Duck* Anser anser Goose Canis familiaris Dog Epithelia mixture II: Cavia porcellus* Guinea pig* Duck, Goose and Chicken Columba palumpus Pigeon Cricetus cricetus Hamster Equus caballus Horse Felis domesticus Cat Melopsittacus undulatus Parakeet Mus musculus Mouse Oryctolagus cuniculus Rabbit Ovis aries Sheep Pullus gallinaceus Chicken Epithelia mixture I: Guinea pig, Dog, Cat, Hamster and Rabbit * Only available in an Artuvetrin® Therapy, not available in the Artuvetrin® Skin Test 12 Fungi Latin Alternaria alternata Aspergillus fumigatus Fungi mixture I: Alternaria alternata, Aspergillus fumigatus, Cladosporium herbarum Botrytis cinerea Candida albicans Aspergillus mix: Cladosporium herbarum Aspergillus flavus, Aspergillus fumigatus, Mucor mucedo Phoma betae Aspergillus nidulans and Aspergillus niger Yeast Rhizopus nigricans Latin Malassezia 13 Leaflets 14 Artuvetrin® Skin Test 1. NAME AND ADDRESS OF THE MANUFACTURING AUTHORISATION HOLDER RESPONSIBLE FOR BATCH RELEASE Artu Biologicals Europe b.v. Vijzelweg 11 8243 PM Lelystad (NL) 2. NAME OF THE VETERINARY MEDICINAL PRODUCT Artuvetrin Test 3. STATEMENT OF THE ACTIVE SUBSTANCES AND OTHER INGREDIENTS Active substance(s): Allergen extracts from pollen, mites and insects, epithelia, yeast and moulds: See vial label. Per ml: Concentration per pollen extract/allergen(mixture) Concentration per epithelium extract/allergen(mixture) Except for sheep epithelium Concentration per yeast-/mould extract/allergen Concentration per mite-/insect extract/allergeen Except for aedis, flea, culex, tabanus, culicoides Except for housefly 1000 NU*/ml 100 µg/ml 10 µg/ml 100 µg/ml 100 NU/ml 1000 NU/ml 10 NU/ml *NU=Noon Unit, defined as follows: the amount of allergen extract obtained from 1 gram raw material is by definitioin equivalent to 106 Noon Units. Vial with negative control solution: Physiological saline solution Vial with positive control solution: Histamine phosphate : 0.1 mg/ml 4. INDICATION(S) Diagnosis of atopy. The veterinary medicinal product is indicated for the diagnosis of atopic hypersensitivity reactions in dogs. For the correct diagnostic assessment, a proper anamnesis must be done along with an IgE-specific test like the skin test. 15 5. CONTRAINDICATIONS - Skin changes in and around the test area. - Conditions reducing the dog’s general state of health. 6. ADVERSE REACTIONS Slight itching after injection. In sporadic cases anaphylactic shock can occur after injections with allergens with symptoms like lethargy, oedema of the head, pruritus, dyspnea, vomiting, diarrhea or fainting. In such cases intravenous treatment with 1 to 5 milliliter (until effective, inject slowly) of an adrenaline solution (1:1000) is indicated. If you notice any serious effects or other effects not mentioned in this package leaflet, please inform your veterinary surgeon. 7. TARGET SPECIES Dog 8. DOSAGE FOR EACH SPECIES, ROUTE(S) AND METHOD OF ADMINISTRATION One 0.05 ml per allergen extract administered intracutaneously in the lateral thorax wall. 9. ADVICE ON CORRECT ADMINISTRATION Instructions for correct administration and conduct of the test • Carefully shave the dog’s lateral thorax wall, the test must be administered on intact skin. • Number the injection sites on the dog’s skin with a marker or pen at intervals of 2.5 cm. • Fill the syringes with the different allergen and control solutions. • Administer 0.05 ml of each allergen and control solution intracutaneously (a bubble will appear after injection) with the number on the holder corresponding to the number written on the skin. • Read the skin reaction after 15-20 minutes by labelling the increase in the wheal with a marker or pen. Interpretation of the skin test The response to the negative control is usually zero. The response to the allergen solution with a wheal diameter greater than half the wheal produced by the positive control solution (or larger than half of the difference in diameter of the positive and negative controls) is considered positive. False-positive reactions can be caused by: • Solutions being injected too close together. • Damaged skin caused by the shaving or injection in irritated skin. • The dog scratching the injection site(s) in the period between the intracutaneous injection and the reading of the test. • Sedation with morphine. This substance leads to a release of histamine which produces the wheal. 16 False-negative reactions can be caused by: • Subcutaneous injection instead of intracutaneous injection. • Testing outside the relevant season (if applicable). • Interaction with certain medicines, see under 4.8 Interactions • The dog lies on the tested side on a cold surface, which reduces the evident increase in a wheal. • The dog is greatly stressed. 10. WITHDRAWAL PERIOD Not applicable. 11. SPECIAL STORAGE PRECAUTIONS Keep out of the sight and reach of children. Store in a refrigerator (2 °C - 8 °C). Do not freeze. Store in the original package. Do not use after the expiry date which is stated on the label after EXP: 12. SPECIAL WARNING(S) Special precautions to be taken by the person administering the veterinary medicinal product to animals. In case of accidental self-injection, consult a doctor immediately and show him/her the leaflet or the label. People with a known hypersensitivity to mite/insect allergens or one of the excipients must avoid contact with the veterinary medicinal product. Use during pregnancy, lactation or lay The safety of the veterinary medicinal product has not been proven during pregnancy or lactation. Interaction(s) with other medicinal products and other forms of interaction The immunological veterinary medicinal product must be administered at different sites. Corticosteroids, tranquillizers, immunosuppressants and antihistamines can interfere with the allergy test. Therefore, these veterinary medicinal products must be stopped at least two weeks (depot preparations 6 weeks) prior to the allergy test. Available safety and efficacy data show that this immunological veterinary medicinal product can be administered on the same day but not mixed with other Artuvetrin Test preparations. There is no information available about the safety and effectiveness of this immunological veterinary medicinal product with any other veterinary medicinal product, except the abovementioned veterinary medicinal products. Regarding the use of this immunological veterinary medicinal product before or after any other veterinary medicinal product, a decision should be made in each individual case. 17 Overdose (symptoms, emergency procedures, antidotes) No other adverse effects are known with overdose than those listed under section 6. Incompatibilities As no research has been done into compatibility, the veterinary medicinal product must not be mixed with other veterinary medicinal products. 13. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR WASTE MATERIALS, IF ANY Unused veterinary medicinal product or waste materials should be disposed of in accordance with the national regulations. Ask your veterinary doctor about how to dispose of medicines no longer required. These measures should help to protect the environment. 14. DATE ON WHICH THE PACKAGE LEAFLET WAS LAST APPROVED 1 March 2014 15. OTHER INFORMATION Glass 3-ml vial with a rubber stopper and aluminium cap. POM-V For any information about this veterinary medicinal product, please contact: Artu Biologicals Europe b.v. Vijzelweg 11 NL-8243 PM, Lelystad 18 Artuvetrin® Therapy 1. NAME AND ADDRESS OF THE MANUFACTURING AUTHORISATION HOLDER RESPONSIBLE FOR BATCH RELEASE Artu Biologicals Europe b.v. Vijzelweg 11 8243 PM Lelystad (NL) 2. NAME OF THE VETERINARY MEDICINAL PRODUCT Artuvetrin Therapy 3. STATEMENT OF THE ACTIVE SUBSTANCE(S) AND OTHER INGREDIENT(S) Active substances: Allergen extracts from pollen, mites and insects, epithelia, yeast and moulds: See vial label. The veterinary medicinal product prescribed by a veterinary doctor is individually prepared for a dog and contains at most eight (8) allergens or mixtures of allergens. 1 ml contains: Artuvetrin Therapy Number of extracts (allergens) Concentration per pollen extract/ allergen(mixture) Concentration per epithelium extract/ allergen(mixture) Except for sheep epithelium Concentration per yeast/mould extract/ allergen Concentration per mite/insect extract/ allergen Except for flea, culex, tabanus, culicoides 1 Artuvetrin Therapy Forte 2 3 4 5 6 7 8 500 NU/ml 333 NU/ml 250 NU/ml 400 NU/ml 333 NU/ml 286 NU/ml 250 NU/ml 100 µg/ml 50 µg/ml 33 µg/ml 25 µg/ml 40 µg/ml 33 µg/ml 29 µg/ml 25 µg/ml 10 µg/ml 5 µg/ml 4 µg/ml 3 µg/ml 4 µg/ml 3 µg/ml 3 µg/ml 3 µg/ml 100 µg/ml 50 µg/ml 33 µg/ml 25 µg/ml 40 µg/ml 33 µg/ml 29 µg/ml 25 µg/ml 100 NU/ml 50 NU/ml 33 NU/ml 25 NU/ml 40 NU/ml 33 NU/ml 29 NU/ml 25 NU/ml 10 NU/ml 5 NU/ml 3 NU/ml 3 NU/ml 4 NU/ml 3 NU/ml 3 NU/ml 3 NU/ml 1000 NU/ml * NU=Noon Unit, defined as follows: the amount of allergen extract obtained from 1 gram raw material is by definitioin equivalent to 106 Noon Units. 19 Adjuvant: Aluminium hydroxide Artuvetrin Therapy : Artuvetrin Therapy forte : 4. 0.3 mg 0.5 mg INDICATION(S) Treatment of allergen-specific atopy in dogs. For the correct diagnostic assessment, a proper anamnesis must be done along with an IgEspecific test. 5. CONTRAINDICATIONS Do not use with: -Disorders affecting the working of the immune system (e.g. immunodeficiencies, malignities and auto-immune diseases). -Renal function disorders -Hypersensitivity to the adjuvant or one of the excipients. 6. ADVERSE REACTIONS A slight worsening of pruritus can be noted after the allergen injection. In sporadic cases anaphylactic shock can occur after injections with allergens with symptoms like lethargy, oedema of the head, pruritus, dyspnea, vomiting, diarrhoea or fainting. In such cases intravenous treatment with 1 to 5 milliliter (until effective, inject slowly) of an adrenaline solution (1:1000) is indicated. If you notice any serious effects or other effects not mentioned in this package leaflet, please inform your veterinary surgeon. 7. TARGET SPECIES Dog 8. DOSAGE FOR EACH SPECIES, ROUTE(S) AND METHOD OF ADMINISTRATION The veterinary medicinal product is administered subcutaneously according to the following dosage schedule. Adjustment period: Week number 1 3 5 7 10 13 Day 1 15 29 43 64 85 Dosage (in ml) 0.2 0.4 0.6 0.8 1.0 1.0 Maintenance period: Week number 17 21 Etc. Day 113 141 Dosage (in ml) 1.0 1.0 20 The maintenance treatment (1.0 ml) is continued after an interval of at least 4 weeks and lasts for life in principle. The effect of the treatment can be judged by the improvement in the clinical picture. If no improvement is evident by 8 months after the start of the treatment, it can be concluded that further treatment with the allergens in question will not have any effect. In periods of high concentrations of an allergen in the air (for example during the flowering season of grasses) to which the dog is allergic, there may occasionally be brief relapses in the symptoms. It is recommended to reduce the dose during these periods. In consultation with the treating veterinary doctor, deviations may be made in the dosing schedule. 9. ADVICE ON CORRECT ADMINISTRATION The veterinary medicinal product prescribed by a veterinary doctor is individually prepared for a patient. Check that the vial contains the therapy prepared for the patient before drawing it up into the syringe. The allergens are listed on the vial’s label. Check the quantity of suspension to be administered, following the dosage schedule. Shake the vial before use. Then insert the needle of the syringe through the rubber cap and withdraw the required quantity of suspension. Hold the syringe vertical with the needle upwards and remove any bubbles by tapping the syringe. Press carefully on the plunger until the first drop appears. Pull up a fold of skin and form a depression with your index finger. Place the needle in the depression and push it slowly through the skin. Let go of the skin. Press down on the plunger slowly and smoothly until the syringe is empty. 10. WITHDRAWAL PERIOD Not applicable. 11. SPECIAL STORAGE PRECAUTIONS Keep out of the sight and reach of children. Store in a refrigerator (2 °C - 8 °C). Do not freeze. Store in the original package. Do not use after the expiry date which is stated on the label after EXP: 12. SPECIAL WARNING(S) Special precautions for use in animals It is recommended to reduce as much as possible or even stop the dose of any current treatment with corticosteroids or immunosuppressants two weeks before starting the adjustment period for the veterinary medicinal product. Special precautions to be taken by the person administering the veterinary medicinal product to animals. In case of accidental self-injection, consult a doctor immediately and show him/her the leaflet or the label. 21 People with a known hypersensitivity to allergens or one of the excipients must avoid contact with the veterinary medicinal product. Use during pregnancy, lactation or lay The safety of the veterinary medicinal product has not been proven during pregnancy or lactation. Interaction(s) with other medicinal products and other forms of interaction The immunological veterinary medicinal product must be administered at different sites. Available safety and efficacy data show that this immunological veterinary medicinal product can be administered on the same day but not mixed with other Artuvetrin Therapy preparations. There is no information available about the safety and effectiveness of this immunological veterinary medicinal product with any other veterinary medicinal product, except the abovementioned veterinary medicinal products. Regarding the use of this immunological veterinary medicinal product before or after any other veterinary medicinal product, a decision should be made in each individual case. Overdose (symptoms, emergency procedures, antidotes) No other adverse effects are known with overdose than those listed under section 6. Incompatibilities As no research has been done into compatibility, the veterinary medicinal product must not be mixed with other veterinary medicinal products. 13. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR WASTE MATERIALS, IF ANY Unused veterinary medicinal product or waste materials should be disposed of in accordance with the national regulations. Ask your veterinary doctor how to dispose of medicines no longer required. These measures should help to protect the environment. 14. DATE ON WHICH THE PACKAGE LEAFLET WAS LAST APPROVED 1 March 2014 15. OTHER INFORMATION POM-V For any information about this veterinary medicinal product, please contact: Artu Biologicals Europe b.v. Vijzelweg 11 NL-8243 PM, Lelystad 22 Artuvet Animal Health Mail address P.O. Box 612 8200 AP Lelystad The Netherlands Visiting-address Vijzelweg 11 8243 PM Lelystad The Netherlands Phone +31 36 539 7840 (general) +31 36 539 7847 (sales dep.) Fax E-mail [email protected] [email protected] (sales dep.) Website +31 36 539 7841 (general) +31 36 536 6321 (sales dep.) www.artuvetrin.com 23
