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FECES :  A SOURCE OF DISEASES

Race Foster, DVM
Drs. Foster & Smith, Inc

 

Yellow lab outsideDogs smell it, roll in it, walk in it, even ingest it. And, oftentimes, pick up serious diseases from it. Animal feces are one of the most common sources of the following diseases:
Parvo Virusis one of the deadliest diseases in the dog population, particularly among puppies. Gaining entry through the mouth, the virus attacks the digestive tract and kills cells that are critical in the absorption of nutrients. Severe fluid loss through diarrhea and vomiting can lead to death. Parvo also temporarily affects a dog's immune system, and can lead to heart failure in some young dogs.
Whipwormsare blood suckers, tunneling into the wall of the intestine for their blood meals. Vomiting, diarrhea, and weight loss are common symptoms, and in large numbers, these parasites can cause anemia. Difficult to diagnose, they are even harder to eliminate because they are often present in very large numbers.
Hookworms are blood suckers, attaching to the intestinal wall where they suck plugs of the intestinal tissue into their mouth structures. Anemia and/or intense inflammation can result. Hookworm infections can be passed to humans.
Roundworms (ascarids)can affect the lungs and the digestive system, with typical signs being vomiting and diarrhea. Convulsions can occur with heavy infections and the disease can spread to humans.
Giardiaare one-celled parasites that can cause diarrhea in cats and dogs. Infection with Giardia is often difficult to diagnose and treat effectively.
Coccidia are also one-celled parasites that can cause diarrhea, especially in puppies and kittens.
The best way to prevent these, and the many bacterial infections dogs can acquire from stools, is to remove feces at least weekly (more often if possible) and keep current on your dog's vaccinations, fecal examinations, and deworming. Also pick up waste before a rain which breaks up or scatters the feces and allows the worms or germs to spread into the environment.
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"Coccidia"

Coccidia (Coccidiosis): A Cause of Diarrhea



What are coccidia?
Coccidia are small protozoans(one-celled organisms) that multiply in the intestinal tracts of dogs and cats, most commonly in puppies and kittens less than six months of age, in adult animals whose immune system is suppressed, or in animals who are stressed in other ways (e.g.; change in ownership, other disease present).
In dogs and cats, most coccidia are of the genus called Isospora. Isospora canis and I. ohioensisare the species most often encountered in dogs. Regardless of which species is present, we generally refer to the disease as coccidiosis. As a puppy ages, he tends to develop a natural immunity to the effects of coccidia. As an adult, he may carry coccidia in his intestines, and shed the cyst in the feces, but experience no ill effects.
How are coccidia transmitted?
A puppy is not born with the coccidia organisms in his intestine. However, once born, the puppy is frequently exposed to his mother's feces, and if the mother is shedding the infective cystsin her feces, then the young animals will likely ingest them and coccidia will develop within their intestines. Since young puppies, usually those less than six months of age, have no immunity to coccidia, the organisms reproduce in great numbers and parasitize the young animal's intestines. Oftentimes, this has severe effects.
From exposure to the coccidia in feces to the onset of the illness is about 13 days. Most puppies who are ill from coccidia are, therefore, two weeks of age and older. Although most infections are the result of spread from the mother, this is not always the case. Any infected puppy or kitten is contagious to other puppies or kittens. In breeding facilities, shelters, animal hospitals, etc., it is wise to isolate those infected from those that are not.
What are the symptoms of coccidiosis?
The primary sign of an animal suffering with coccidiosis is diarrhea. The diarrhea may be mild to severe depending on the level of infection. Blood and mucous may be present, especially in advanced cases. Severely affected animals may also vomit, lose their appetite, become dehydrated, and in some instances, die from the disease.
Most infected puppies encountered by the authors are in the four to twelve week age group. The possibility of coccidiosis should always be considered when a loose stool or diarrhea is encountered in this age group. A microscopic fecal exam by a veterinarian will detect the cysts confirming a diagnosis.
What are the risks?
Although many cases are mild, it is not uncommon to see severe, bloody diarrhea result in dehydration and even death. This is most common in animals who are ill or infected with other parasites, bacteria, or viruses. Coccidiosis is very contagious, especially among young puppies. Entire kennels may become contaminated, with puppies of many age groups simultaneously affected.
What is the treatment of coccidiosis?
It should be mentioned that stress plays a role in the development of coccidiosis. It is not uncommon for a seemingly healthy puppy to arrive at his new home and develop diarrhea several days later leading to a diagnosis of coccidia. If the puppy has been at the new home for less than thirteen days, then he had coccidia before he arrived. Remember, the incubation period (from exposure to illness) is about thirteen days. If the puppy has been with his new owner several weeks, then the exposure to coccidia most likely occurred after the animal arrived at the new home.
Fortunately, coccidiosis is treatable. Drugs such as sulfadimethoxine (Albon®) and trimethoprim-sulfadiazine (Tribrissen®)have been effective in the treatment and prevention of coccidia. Because these drugs do not kill the organisms, but rather inhibit their reproduction capabilities, elimination of coccidia from the intestine is not rapid. By stopping the ability of the protozoa to reproduce, time is allowed for the puppy's own immunity to develop and remove the organisms.
How is coccidiosis prevented or controlled?
Because coccidia is spread by the feces of carrieranimals, it is very important to practice strict sanitation. All fecal material should be removed. Housing needs to be such that food and water cannot become contaminated with feces. Clean water should be provided at all times. Most disinfectants do not work well against coccidia; incineration of the feces, and steam cleaning, immersion in boiling water, or a 10% ammonia solution are the best methods to kill coccidia. Coccidia can withstand freezing.
Cockroaches and flies can mechanically carry coccidia from one place to another. Mice and other animals can ingest the coccidia and when killed and eaten by a dog, for instance, can infect the dog. Therefore, insect and rodent control is very important in preventing coccidiosis.
The coccidia species of dogs and cats do not infect humans.

 

"Giardia"

Giardia (Giardia canis)


Giardia are protozoa (one-celled organisms) that live in the small intestine of dogs and cats. Giardia are found throughout the United States and in many other parts of the world. Infection with Giardia is called 'giardiasis.'
There are many things we do not know about this parasite. Experts do not agree on how many species of Giardia there are and which ones affect which animals. Veterinarians do not even agree on how common Giardia infections are and when they should be treated. Generally, it is believed that infection with Giardia is common but disease is rare. There is much about the life cycle we do not know either.
How do Giardia reproduce and how are they transmitted?
Giardia multiply by dividing.
A dog becomes infected by eating the cystform of the parasite. In the small intestine, the cyst opens and releases an active form called a trophozoite. These have flagella, hair-like structures that whip back and forth allowing them to move around. They attach to the intestinal wall and reproduce by dividing in two. After an unknown number of divisions, at some stage, in an unknown location, this form develops a wall around itself (encysts) and is passed in the feces. The Giardia in the feces can contaminate the environment and water and infect other animals and people.
What are the signs of a Giardia infection?
Most infections with Giardia are asymptomatic. In the rare cases in which disease occurs, younger animals are usually affected, and the usual sign is diarrhea. The diarrhea may be acute, intermittent, or chronic. Usually the infected animals will not lose their appetite, but they may lose weight. The feces are often abnormal, being pale, having a bad odor, and appearing greasy. In the intestine, Giardia prevents proper absorption of nutrients, damages the delicate intestinal lining, and interferes with digestion.
Can Giardia of dogs infect people?
This is another unknown. There are many species of Giardia, and experts do not know if these species infect only specific hosts. Sources of some human infections have possibly been linked to beavers, other wild animals, and domestic animals. Until we know otherwise, it would be wise to consider infected animals capable of transmitting Giardia to humans.
You may have heard about Giardia outbreaks occurring in humans due to drinking contaminated water. Contamination of urban water supplies with Giardiais usually attributed to (human) sewage effluents. In rural settings, beavers most often get the blame for contaminating lakes and streams. Giardia outbreaks have also occurred in day care centers fueled by the less than optimal hygienic practices of children.
How do we diagnose giardiasis?
Giardiasis is very difficult to diagnose because the protozoa are so small and are not passed with every stool. Tests on serial stool samples (one stool sample every day for three days) are often required to find the organism. Special diagnostic procedures, beyond a routine fecal examination, are necessary to identify Giardia. The procedures we use to identify roundworms and hookworms kill the active form of Giardia and concentrate the cyst form.
To see the active form, a small amount of stool may be mixed with water on a microscope slide and examined under high magnification. Because these forms have flagella, you can see them move around on the slide. The active forms are more commonly found in loose stools. If you ever have the opportunity to see the active form of Giardiaunder the microscope, take it! It is an interesting-looking creature. It is pear-shaped and its anatomy makes it look like a cartoon face, with eyes (which often look crossed), nose, and mouth. Once you see it, you will not forget it.
Cysts are more commonly found in firm stools. Special solutions are used to separate the cysts from the rest of the stool. The portion of the solution that would contain the cysts is then examined microscopically.
In spring, 2004, a diagnostic test using ELISA technology became available. This test uses a very small fecal sample, and can be performed in 8 minutes in a veterinarian's office. It is much more accurate than a fecal examination.
We have done the tests, now what?
Now we come to how to interpret the test results. It can be a dilemma for your veterinarian. What you see (or do not see) is not always a correct indication of what you have. A negative test may mean the animal is not infected. However, few, if any, laboratory tests are 100% accurate. Negative test results can also occur in some infected animals. If a negative test occurs, your veterinarian will often suggest repeating the test.
What about a positive test? That should not be hard to interpret, right? Wrong. Giardia can be found in many dogs with and without diarrhea. If we find Giardia, is itthe cause of the diarrhea or is it just coincidence we found it? The animal could actually have diarrhea caused by a bacterial infection, and we just happened to find the Giardia. Test results always need to be interpreted in light of the signs, symptoms, and medical history.
If we find Giardia, how do we treat it?
Here we go again; treatment is controversial too. There is a question about when to treat. If Giardia is found in a dog without symptoms should we treat the animal? Since we should not know if G. canis can infect man, we often err on the side of caution and treat an asymptomatic infected animal to prevent possible transmission to people.
If we highly suspect infection with Giardia, but can not find the organism, should we treat anyway? This is often done. Because it is often difficult to detect Giardiain the feces of dogs with diarrhea, if there are no other obvious causes of diarrhea (e.g.; the dog did not get into the garbage several nights ago) we often treat the animal for giardiasis.
There are several treatments for giardiasis, although some of them have not been FDA-approved for that use in dogs. Fenbendazole is an antiparasitic drug that kills some intestinal worms and can help control giardia. It may be used alone or with metronidazole. Metronidazole can kill some types of bacteria that could cause diarrhea. So if the diarrhea was caused by bacteria, and not Giardia, the bacteria can be killed and the symptoms eliminated. Unfortunately, metronidazole has some drawbacks. It has been found to be only 60-70% effective in eliminating Giardia from infected dogs, and probably is not 100% effective in cats, either. It can be toxic to the liverin some animals. It is suspected of being a teratogen (an agent that causes physical defects in the developing embryo), so it should not be used in pregnant animals. Finally, it has a very bitter taste and many animals resent taking it – especially cats.
Quinacrine hydrochloride has been used in the past, but is not very effective and can cause side effects such as lethargy, vomiting, anorexia, and fever.
But now we come to yet another unknown. It is possible these treatments only remove the cysts from the feces but do not kill all theGiardia in the intestine. This means even though the fecal exams after treatment may be negative, the organism is still present in the intestine. This is especially true of the older treatments. So treated animals could still be a source of infection for others.
How can I prevent my pet from becoming infected with Giardia?
The cysts can live several weeks to months outside the host in wet, cold environments. So lawns, parks, kennels, and other areas that may be contaminated with animal feces can be a source of infection for your pet. You should keep your pet away from areas contaminated by the feces of other animals. This is not always easy.
As with other parasites of the digestive system, prevention of the spread of Giardiacenters on testing and treating infected animals and using sanitary measures to reduce or kill the organisms in the environment. Solutions of Lysol, bleach, and quaternary ammonium compounds are effective against Giardia.
How do I control Giardia in my kennel?
Infection with Giardia can be a big problem in kennels, and a multi-faceted approach is needed.
Treat Animals: Treat all nonpregnant animals with fenbendazole for 5 days. On the last day of treatment, move them to a holding facility while a clean area is established. When the animals are moved back to the clean area, treat them once again with a 5-day course of fenbendazole or albendazole.
Decontaminate the Environment: Establish a clean area. If possible, this can be the whole facility. Otherwise, create a few clean runs or cages, separate from the others. Remove all fecal material from the areas since the organic matter in feces can greatly decrease the effectiveness of many disinfectants. Steam clean the area. Quaternary ammonium disinfectants used according to manufacturer's directions or a 1:5 or 1:10 solution of bleach can usually kill the cysts within one minute. Allow the area to dry for several days before reintroducing the animals. NOTE: Use extreme caution when using quaternary ammonium compounds and bleach solutions. Use proper ventilation, gloves, protective clothing and follow your veterinarian's recommendations.
Clean the Animals: Cysts can remain stuck to the haircoats of infected animals. So during treatment and before moving the treated animals to the clean area, they should be regularly shampooed and rinsed well. Especially concentrate on the perianal area.
Prevent Reintroduction of Giardia: Giardiacan be brought into the kennel either by introducing an infected animal or on your shoes or boots. Any new animal should be quarantined from the rest of the animals and be treated and cleaned as described above. You should either use disposable shoe covers or clean shoes/boots and use a footbath containing quaternary ammonium compounds to prevent people from reintroducing Giardia.
Remember, Giardia of dogs may infect people, so good, personal hygiene should be used by adults when cleaning kennels or picking up the yard, and by children who may play with pets or in potentially contaminated areas.

"Parvo"

Parvovirus
Canine parvovirus disease is currently the most common infectious disorder of dogs in the United States.
'Parvo' is a highly contagious disease characterized by diarrhea that is often bloody and is caused by a pathogen called canine parvovirus, Type 2 (CPV-2). In 1980, the original strain of CPV-2 was replaced by CPV-2A and in 1986, another variation called CPV-2B appeared. Today, CPV-2B has largely replaced the previous strains as the most common isolate. Since all of these strains are similar, we will lump them together and refer to them as CPV-2 (parvo). There is currently some discussion that there may be other strains that are beginning to emerge and have yet to be formally identified. Current vaccinations have helped to control the spread of this disease but despite being vaccinated, some dogs still contract and die from parvo. There is much that we do not know about the virus or the best way to control the disease, but we are learning new information daily. Misinformation about the disease, its spread, and vaccination is widespread in both breeding and veterinary circles. We hope that with a better understanding of the disease, pet owners will be able to make good husbandry decisions that will help prevent and reduce the spread of this disease.
How is parvo spread?
CPV-2 is known to survive on inanimate objects - such as clothing, food pans, and cage floors - for 5 months and longer in the right conditions. Insects and rodents may also serve as vectors playing an important role in the transmission of the disease. All parvoviruses are extremely stable and are resistant to adverse environmental influences such as low pH and high heat. Exposure to ultraviolet light and sodium hypochlorite (a 1:32 dilution of household bleach - ½ cup bleach to 1 gallon of water) can inactivate parvovirus. The bleach solution can be impaired by organic matter and needs to have adequate exposure time and proper concentrations to work effectively. The normal incubation period (time from exposure to the virus to the time when signs of disease appear) is from 7-14 days. Active excretion of the virus in the feces can begin the third day after exposure, often before clinical signs appear, and may last for one to two weeks after the onset of the disease.
Symptoms
PuppyThere is a broad range in the severity of symptoms shown by dogs that are infected with parvovirus. Many adult dogs exposed to the virus show very few if any symptoms. The majority of cases are seen in dogs less than 6 months of age, with the most severe cases seen in puppies younger than 12 weeks of age. There are also significant differences in response to CPV-2 infections and vaccines among different breeds of dogs, with Rottweilers, Doberman Pinschers, and Labrador Retrievers being more susceptible than other breeds.
The most common form of the disease is the intestinal form known as enteritis. CPV-2 enteritis is characterized by vomiting (often severe), diarrhea, dehydration, dark or bloody feces, and in severe cases, fever and lowered white blood cell counts. AcuteCPV-2 enteritis can be seen in dogs of any breed, sex, or age. The disease will progress very rapidly and death can occur as early as two days after the onset of the disease. The presence of gram negative bacteria, parasites, or other viruses can worsen the severity of the disease and slow recovery.
Diagnosis
Not all cases of bloody diarrhea with or without vomiting are caused by Parvovirus and many sick puppies are misdiagnosed as having 'Parvo.' The only way to know if a dog has Parvovirus is through a positive diagnostic test. In addition to the more time consuming and expensive traditional testing of the blood for titers, a newer and simpler test of the fecal matter with an enzyme-linked immunosorbent assay antigen test (ELISA) are also available through most veterinary clinics. Testing of all suspect cases of Parvo is the only way to correctly diagnose and treat this disease.
Treatment
The treatment of Parvovirus is fairly straightforward and directed at supportive therapy. Replacing fluids lost through vomiting and diarrhea is probably the single most important treatment. Intravenous administration of a balanced electrolyte solution is preferred, but in less severe cases, subcutaneousor oral fluids may be used. Antibiotic therapy is usually given to help control secondary bacterial infections. In cases of severe vomiting, drugs to slow the vomiting may also be used. After the intestinal symptoms begin to subside, a broad spectrum de-worming agent is often used. Restricting the food during periods of vomiting is also necessary. Undertaking the treatment of affected dogs and puppies without professional veterinary care is very difficult. Even with the best available care, the mortality of severely infected animals is high. Without the correct amount of properly balanced intravenous fluids, the chance of recovery in a severely stricken animal is very small.
Immunity and vaccination
If a puppy recovers from CPV-2 infection, it is immune to reinfection for probably at least twenty months and possibly for life. In addition, after recovery, the virus is not shed in the feces. There are many commercially prepared attenuated(modified) live CPV-2 vaccines available. Although some people have expressed concern about the possibility of attenuated live vaccines reverting to a virulent strain after being given and then causing disease, studies have repeatedly shown that this does not occur. Commercially prepared vaccines are safe and do not cause disease.
The primary cause of failure of canine parvovirus vaccines is an interfering level of maternal antibody against the parvovirus.
The primary cause of failure of canine parvovirus vaccines is an interfering level of maternal antibody against the canine parvovirus. Maternal antibodies are the antibodies present in the mother's milk during the first 24 hours after the puppy's birth. The age at which puppies can effectively be immunized is proportional to the titer of the mother and the effectiveness of colostral transfer of maternal antibody within those first 24 hours. High levels of maternal antibodies present in the puppies' bloodstream will block the effectiveness of a vaccine. When the maternal antibodies drop to a low enough level in the puppy, immunizationby a commercial vaccine will work. The complicating factor is that there is a period of time from several days to a couple weeks in which the maternal antibodies are too low to provide protection against the disease, but too high to allow the vaccine to work. This period is called the window of susceptibility. This is the time when despite being vaccinated, a puppy can still contract parvovirus. The length and timing of the window of susceptibility is different in every litter.
A study done in 1985 in a cross section of different puppies showed, that the age at which they were able to respond to a vaccine and develop protection covered a wide period of time. At six weeks of age, 25% of the puppies could be immunized. At 9 weeks of age, 40% of the puppies were able to respond to the vaccine. The number increased to 60% by 16 weeks, and by 18 weeks of age, 95% of the puppies could be immunized.
When we examine all of the information about maternal derived antibodies, windows of susceptibility, throw in breed susceptibilities, the possibility of unidentified strains, and the effectiveness of different vaccines, we begin to see why there are so many different vaccination protocols and why some vaccinated animals still develop the disease. Drs. Foster and Smith recommend a protocol that will help protect the widest range of dogs. We realize that with our protocol, we will be vaccinating some dogs that are not capable of responding and we will be revaccinating some dogs that have already responded and developed a high titer. But without doing an individual test on each puppy, it is impossible to determine where the puppy is in its immune status. We also realize due to the window of susceptibility, some litters will contract parvovirus despite being vaccinated. By using quality vaccines and an aggressive vaccination protocol, we can make this window of susceptibility as small as possible.
Conclusion
In summary, parvovirus is a very common problem that is a huge killer of puppies. Due to its ability to be transmitted through hands, clothes, and most likely rodents and insects, it is virtually impossible to have a kennel that will not eventually be exposed to the disease. Modified live vaccinesare safe and effective, but despite the best vaccination protocol, all puppies will have a window of susceptibility of at least several days where they will be at risk. Using the newer high titer vaccines may shorten the window of susceptibility on many puppies. Prompt treatment by a veterinarian will increase survivability in infected puppies and working with your veterinarian on a vaccination program that is best for your puppy is important. As new information on this disease and vaccines become available, we will continue to update this article in hopes of keeping you as informed on Parvo as possible.