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Internal Parasites: Canine Coccidiosis ....
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Canine Coccidiosis:
Diagnosis, Treatment and Prevention
What is Coccidiosis?

Coccidiosis can be your worst nightmare. If not treated correctly it can become a circle of infection and reinfection - a never ending story. Coccidiosis in young puppies is often fatal. Great care should be taken with the treatment and prevention of this parasite.

Coccidiosis is an intestinal disease that affects several different animal species including canines and humans. Coccidia is one of the most prevalent protozoal infections in North American animals, second only to giardia. Eimeria and Isospora are the two genera that are often referred to as "coccidia." These two genera contain a large number of species that infect a variety of animals throughout the world.

The diseases caused by these microscopic protozoal parasites are referred to collectively as coccidiosis, and they vary tremendously in virulence.

Some species cause diseases that result in mild symptoms that might go unnoticed (i.e., mild diarrhea) and eventually disappear, while other species cause highly virulent infections that are rapidly fatal. The causative agent is a protozoan that has the ability to multiply rapidly. The major damage is due to the rapid multiplication of the parasite in the intestinal wall, and the subsequent rupture of the cells of the intestinal lining. Several stages of multiplication occur before the final stage, the oocyst, is passed in the feces. Oocysts are extremely resistant to environmental stress and are difficult to completely remove from the environment. Oocysts are frequent contaminants of feed and water and when the sporulated oocysts are ingested by other animals they start the life cycle over in the new host.

Life Cycle of Coccidia

The life cycles of both genera of coccidia are similar. A host is infected when it ingests oocysts that have been passed in the feces of another host. The oocyst encysts in the host's small intestine, and the sporozoites contained within the oocyst are liberated. The sporozoites penetrate the cells of the host's small intestine and reproduce asexually. Each generation of asexual reproduction produces multiple merozoites; the merozoites are liberated from the cell and infect new cells. It is this stage of the infection that can result in destruction of massive numbers of cells in the host's small intestine and, ultimately, lead to the host's death. Some of the merozoites that enter the host's cells transform into gametocytes. The gametocytes transform into gametes, the gametes fuse, and the resulting zygote begins to develop into an oocyst. The developing oocyst escapes from the host's cell, and it is passed in the host's feces. Typically, when the oocyst is passed in the feces, it is not infective because it does not contain sporozoites; this is an unsporulated oocyst. After several days (or weeks, depending on the species) outside of the host's body, the oocyst completes development and sporozoites are found within; this is a sporulated oocyst, and it is infective to the next host.

Clinical Signs

Clinical signs of coccidiosis usually are present or shortly following stress such as weather changes; weaning; overcrowding; long automobile or plane rides; relocation to a new home and new owners; and/or unsanitary conditions. Symptoms or signs of coccidiosis will depend on the state of the disease at the time of observation. In general, coccidiosis affects the intestinal tract and symptoms are associated with it. In mild cases, only a watery diarrhea may be present, and if blood is present in the feces, it is only in small amounts. Severely affected animals may have a thin, watery feces with considerable amounts of intestinal mucosa and blood. Straining usually is evident, rapid dehydration, weight loss and anorexia (off feed) also may be clinically visible. One of the most prevalent canine coccidia is S. tenella and during autopsies of dead animals appears as microscopic muscle cysts in the host animal. Oocysts in the feces of dogs are also microscopic in size and can only be positively identified through lab tests or direct observation under a microscope.

"Nervous coccidiosis" is a nervous system condition associated with coccidial infection. Signs are consistent with central nervous system involvement, and include muscle tremors, convulsions and other central nervous system symptoms. A consistent sign in "nervous cocci" dogs is that stimulation of any type seems to trigger the symptoms.

Death may follow the acute disease either directly or from secondary diseases such as pneumonia. Animals that survive for 10 to 14 days may recover, however, permanent damage may occur. Research has indicated that canines may experience reduced food consumption for up to 13 weeks following clinical infection. Diagnosis usually is obvious but confusion does exist – apparently normal animals can also have oocysts present in their feces. Diarrhea may be present in the animal before the oocysts can be found, therefore, a confirmed laboratory diagnosis may not always be possible. Laboratory findings should be correlated with clinical signs for a diagnosis.

The susceptibility of animals to this disease varies. The ingestion of oocysts may not produce the disease; some animals constantly carry them without being affected. Recovered animals develop immunity and seem to be partially resistant to reinfection.

Coccidiosis is frequently referred to as an opportunist – a disease that will develop when other stress factors are present. For example, the highest incidence of coccidiosis is in the first 21 days after a dog has changed owners and moved to a new residence. If a normal animal carries oocysts, it is relatively easy for rapid development when the conditions are right – adverse weather, shipping, dog food changes, new owners, new residence, and other stresses are important.

In case of a confirmed outbreak of coccidiosis in a kennel or multiple dog setting,
the following steps should be started immediately:
  1. Separate the sick animals from the healthy ones.
  2. Treat sick animals with effective medications.
  3. Medicate all the dogs in the kennel or home, as the other animals are likely infected.

General Information General information on coccidiosis in canines:
  1. Coccidiosis is an opportunistic disease – it generally affects stressed animals.
  2. Kennel conditions provide ideal circumstances for an outbreak.
  3. In most confinement situations, prevention with sulfadimethoxine drug such as Albon® is recommended.
  4. Mass treatment of all dogs in an entire kennel is usually the only effective method.
  5. Sick animals should be treated as soon as possible and isolated from the healthy animals.
  6. Have your veterinarian confirm positive diagnosis of the coccidia protozoa in your dog's feces through the use of lab tests or positive identification through direct observation under a microscope.

How can I be sure my dog has Coccidia?

Diagnosing coccidia is not easy. Diagnosis can be done in one of two ways: via fecal sample by a Vet or via educated evaluation of clinical findings by the breeder/owner or the Vet. Via fecal sample is not straightforward. Even when a flare is at it's worst, the oocysts may not be shedding in every single stool. Therefore, a negative report does not rule out coccidia. The most thorough way to assess is to collect a sample from every single stool produced for 48 to 72 hours and have a Vet examine it.

How can infection be treated?

Treatment of infected animals is required. Individual treatment should be used when possible, however, medications are available for entire kennel applications. The actual coccidiosis problem is critical and in addition, dehydration and loss of appetite must be treated. Drug selection should be handled with regards to the number of animals infected and the type of application. Sulfas and antibiotics for secondary bacterial infections are available for use. Treatment and prevention are most effective when started early.

Infection may be treated using a sulfadimethoxine drug such as Albon®, Bactrovet®, or Tribrissen®. Data regarding acute and chronic toxicities of sulfadimethoxine indicate the drug is very safe whether administered intraperitoneally or orally. Diarrhea was the only adverse effect observed. For Dosage information SEE Commercial Treatment. Treatment may be initiated by a Vet with an Albon Injection 40% to obtain effective blood levels almost immediately or to facilitate treatment of the fractious animal. With the Albon Injection 40%, each mL contains 400 mg sulfadimethoxine. Albon is also available in liquid form: Albon Oral Suspension 5%: Albon Liquid 12.5% . Length of treatment with any sulfadimethoxine drug depends on the clinical response. In most cases treatment for 10 days is adequate. Treatment should be continued until the animal is asymptomatic for at least 48 hours. For additional Treatment Options See Commercial Treatment

It is difficult to eliminate 100% of the coccidiosis infection in all dogs. Adaptations that may be made to try to improve the success rate of a treatment regime include extending the duration and dose of the treatment. Care must obviously be taken with this approach to make sure that an adequate safety margin is always maintained. Another approach is to retreat after an interval of one week of completion of the initial treatment. Alternatively, repeat fecal samples may be collected one week after the treatment and a dog which is still passing oocysts can be identified and treated. It should be recognized that, when treating multiple dogs, there may still be one or two dogs that remain as carriers of infection that will act as a potential source for reintroducing the infection into your home or kennel.

No matter which treatment method is used, the simple fact is that it may not kill all of the coccidia oocysts. A certain number of them can burrow into the lining of the intestines and go dormant. They can stay dormant for years. Due to the hard shell protecting the oocysts, it is almost impossible to kill them when they are encysted in the lining of the intestines. Therefore, during times of stress, the oocysts may re-activate and start to reproduce, causing another outbreak of coccidiosis in your home or kennel. The amount of stress needed to cause a flare seems to be highly variable with different dogs and dog breeds. Alaskan Malamutes are one of the hardiest breeds since they were developed as a working class dog.

Important Note: A healthy adult dog may have been infected years before and never have shown any symptoms
(asymptomatic carrier). Coccidiosis and giardiasis are both very common protozoal infestations that have the exact
same clinical symptoms. See Giardiasis.

** To a young puppy coccidia can be life threatening - symptoms include diarrhea in the beginning, vomiting and weakness will follow.

How to eliminate coccidia from your kennel or home?
Once infection is present in a home or kennel, control may be approached in two ways:-
  1. identification, isolation and treatment of infected dogs.
  2. mass treatment of all dogs.

Option 1 is only practical where a few dogs in a isolated area that has been identified as being infected and where complete isolation is feasible, either within their own area or in a specific isolation area. Such isolation includes complete isolation of exercise areas and other shared areas. These animals should be fed and maintained completely separate of other animals on the premises using separate cleaning and feeding equipment. Treatment of all dogs should commence on the same day when option 2 is adopted.

Thorough cleaning of all kennel areas where infected dogs have access is essential. Once organic debris has been removed, thorough disinfection will help to further reduce the level of environmental contamination and reduce the risk of dogs becoming re-infected after the completion of treatment. Disinfectants containing quaternary ammonium compounds have been found to kill Coccidia oocysts at the manufacturers' recommended dilutions. We disinfect all kennels bimonthly with a mixture consisting of 3 cups of bleach per gallon of water. Make sure you let it set at least 20 minutes, rinse thoroughly, and then let it get completely dry before letting your dogs use the kennels again.

Important Note: The efficacy of killing is increased by prolonged contact time, therefore disinfectant solution should be left for 20 minutes to half an hour before being rinsed off kennel or run surfaces. Since disinfection of grass runs is impossible, such areas should be regarded as contaminated for at least a month after infected dogs last had access. Introduction of new dogs into the infected area should be avoided until the period of treatment and fecal sample checking has been completed. It should not be overlooked that some of the infected dogs may continue to excrete low numbers of oocysts even after all treatments and examinations have been completed. It is therefore important that rigorous disinfection is maintained and a careful check is kept on the condition of all treated and introduced animals.

The following are recommendations for eliminating coccidia from kennels and homes:
  • treat all dogs with sulfadimethoxine (Albon) for 10 days
  • disinfect kennel areas, etc, with a suitable disinfectant which is effective in inactivating coccidia oocysts
  • bath dogs with shampoo to remove all fecal matter, rinse with water
  • one week after original treatment retreat with sulfadimethoxine for 7 days
  • treat any new dogs with sulfadimethoxine (e.g. Albon) for 10 days even if they test negative for coccidia because it is so hard to detect in fecal tests

How can infection be prevented?

It is very difficult to prevent the entry of an infection that is known to be carried by a percentage of normal dogs into a kennel. However, an initial period of isolation for all new entrants into kennels, for perhaps ten days, would reduce the risk of an infected dog spreading a large number of oocysts around the main kennel area. All dogs could be observed and any infection present, which in the case of coccidia might be exacerbated by the stress of entry in kennels, could be identified and treated before entry into the main kennels.

Small numbers of oocysts may occasionally be present in the potable water supply but the risk of this being a major source of infection is small. It is best to use chlorinated water for your dogs drinking water as much as possible. If you are using non-chlorinated water from a well, lake, or stream, you need to chlorinate the water yourself. To chlorinate drinking water: Use only liquid bleach that contains 5.25% sodium hypochlorite as its only active ingredient - no soap. Use 2 teaspoons of bleach per 10 gallons of water. Remember, Cool moist conditions favor the survival of the organism; therefore, simply by keeping everything clean, disinfected, and dry will help.

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