Coccidiosis & Giardia
Diagnosis,
Treatment, and Prevention
What is Coccidiosis?
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 (view diagram of the life
cycle).
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
full of Poms, 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. Most kennels need to segregate and medicate
new dogs at the time of arrival. Kennel owners can also
reduce exposure by reducing stress, such as overcrowding
and poor sanitation.
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. The LD50 in mice is greater than 2 g/kg of
body weight when administered intraperitoneally and
greater than 16 g/kg when administered orally. In dogs
receiving massive single oral doses of 3.2 g/kg of body
weight, diarrhea was the only adverse effect observed. Dogs
given 160 mg/kg of body weight orally daily for 13 weeks
showed no signs of toxicity. Treatment may be initiated by a
Vet with an Albon Injection 40% (100-mL multiple-dose
vials) 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 compounded with 20% propylene glycol,
1% benzyl alcohol, 0.1 mg disodium edetate, 1 mg sodium
formaldehyde sulfoxylate, and pH adjusted with sodium
hydroxide. Albon is also available in liquid form: Albon Oral
Suspension 5%: 2- and 16-oz bottles; each tsp (5 mL)
contains 250 mg sulfadimethoxine in a custard-flavored
carrier. Length of treatment with any sulfadimethoxine drug
depends on the clinical response. In most cases treatment for
5 days is adequate. Treatment should be continued until the
animal is asymptomatic for at least 48 hours.
The cost to effectively keep coccidiosis infestations out of
your Poms may be entirely too much if you take your dog(s)
to a Veterinarian. As already stated, a Vet will charge you
for an office visit plus the cost of canine dosage
sulfadimethoxine pills (Tablets-125 mg, 250 mg, and 500
mg), Albon Injection 40%, and/or Albon Oral Suspension 5%.
The cost for the Veterinarian treatments along with the cost
of the office visits will add up to a lot of money per year,
especially if you have more than one Beagle. Once again, I
want to remind everyone that I am not a Veterinarian, but
rather a long time Beagle kennel owner. I'll tell you what I
use and do, you can use your own judgment whether you
want to follow in my footsteps. This article is presented only
as a documentation of how I treat coccidiosis infestations in
the Poms that I own at a fraction of the cost that a
Veterinarian will charge you.
Sulfadimethoxine 12 1/2% solution
What I do is buy the Sulfadimethoxine 12 1/2% solution
(generic Albon) from Lambert Vet Supply without a
prescription and for a lot less money. Active ingredients:
Each fluid ounce contains 3.75 grams Sulfadimethoxine
solubilized with sodium hydroxide. I buy the one-gallon size
jug of the generic brand of Albon which is the
Sulfadimethoxine 12 1/2% solution for $40.75 (accurate price
as of 04/20/2008) per gallon. Simply click on either picture
to the left of this paragraph and order a gallon jug of either
the Sulfadimethoxine (generic Albon) or the name brand
Albon today. They do have the absolute lowest prices
available to help all of us keep our Poms in great health
while we save hundreds of dollars each and every year.
Dyne High Calorie Supplement
This gallon jug of liquid Sulfadimethoxine is enough
antibiotic to medicate a huge kennel full of Poms for several
months or even years. If you have more than one Pom to
treat with the Sulfadimethoxine drug for a coccidiosis
outbreak, I highly recommend you follow in my footsteps and
buy and use the gallon size jug of this medication as well as
another product described below and then you can make
your own 5% Albon solution just like you get from the Vet.
I also purchase a gallon jug of Dyne High Calorie
Supplement, which is a liquid nutritional supplement, from
Lambert Vet Supply. I buy the one-gallon size jug for $33.50
each (accurate price as of 04/20/2008). Simply click on the
picture of Dyne High Calorie Supplement to the right of this
paragraph and order a gallon jug today. This product is
formulated to provide a nutrient dense liquid diet with
essential vitamins and has a high caloric value. This product
expedites the rate of recovery of weak or sick animals. It
also may be fed as is or diluted with milk for animals unable
to eat solid foods.
Then what I do next is I mix 5 ounces of Dyne High
Calorie Supplement with 4 ounces of the Sulfadimethoxine
12 1/2% solution discussed above. This gives me a fairly
palatable mixture of the 5% Albon (Rx) at a 85% or higher
savings without the required prescription or the expense of a
Vet office visit. I know many breeders that are paying $75 or
more per pint for the 5% Albon (Rx) solution that they get
from their Vet. This will give you approximately 2-gallons of
the 5% Albon (RX) for only $75 rather than only 1-pint that
a Vet will sell you for $75 -- you figure up the savings! Once
you have this 5% Albon solution mix, each teaspoonful (5
mL) will contain 250 mg of Sulfadimethoxine. Beagles
should receive 1 teaspoonful of this 5% Albon Oral
Suspension mixture per 10 lb of body weight (25 mg/lb or 55
mg/kg) as an initial dose, followed by ½ teaspoonful per 10
lb of body weight (12.5 mg/lb or 27.5 mg/kg) every 24 hours
thereafter. I recommend you give this treatment for a total
of 10 days. The medication may be administered in food or
water, given as a drench orally. I give each dog its own food
and medicine in its own feed dish to make sure each dog is
getting the proper amount of food and medicine or at least
use it as a drench to be given orally to each dog/puppy. This
Sulfadimethoxine 12 1/2% solution mixed with the Dyne
High Calorie Supplement will save you hundreds of dollars a
year. I urge all kennels to keep a gallon of each handy. This
Sulfadimethoxine 5% solution mix has a wide margin for
safety, is very easy to administer, and absolutely works
miracles on getting rid of coccidiosis in your hounds. Since
coccidiosis is so easily spread from one Pom to the next, I
highly recommend all hounds get a full treatment even if
only one hound shows symptoms -- better to be safe than
sorry.
This is the treatment that I use in my kennel and you
can also check out the article Giardiasis: Diagnosis,
Treatment, and Prevention to learn more about the other
common protozoal infection called giardiasis. It is very
unlikely 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 dogs which are
still passing oocysts can be identified and treated. It should
be recognized that, when treating a large number of 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 entire kennel.
No matter which treatment you choose to utilize (Vet Rx
or over-the-counter cattle drugs), 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 Pom or Pom kennel. The amount of stress
needed to cause a flare seems to be highly variable with
different dogs and dog breeds. Beagles are one of the
hardiest breeds since they were developed as hunting hounds.
Important Note: A healthy dog may have been infected
years before and never have shown any symptoms
(asymptomatic carrier). They may occasionally shed very low
numbers of oocysts in stools--evaluating every stool (the
WHOLE stool) for something like six months is supposed to
be the conclusive way to rule out an asymptomatic carrier
(someone did this with a couple dogs for a study). This would
cost literally thousands of dollars! Not exactly a practical
way to test. Coccidiosis and giardiasis are both very common
protozoal infestations that have the exact same clinical
symptoms; therefore, I recommend that both diseases get
treated one right after the other: coccidiosis for 10 days and
giardiasis for 5 days if using Metronidazole or 3 days if
using Fenbendazole. Once again, I treat coccidiosis with
Sulfadimethoxine (Albon), and giardiasis with
Metronidazole (Flagyl) or Fenbendazole (Safe-Guard).
How to eliminate coccidia from your kennel or home?
Once infection is present in a 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 discrete
area have been identified as being infected and where
complete isolation is feasible, either within their own block
or in a specific isolation block. Such isolation includes
segregation of exercise areas and these animals should be
fed and cleaned after all others on the premises, preferably
using separate cleaning and feeding equipment and separate
staff if possible. 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 (dilutions of one
disinfectant up to 1:704 were found to be effective at both
low and high environmental temperatures). I disinfect all
my kennels twice per month by washing everything down
with a mixture consisting of 8 ounces of Clorox 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 Poms 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
area 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 for 10 days
- disinfect kennel areas, etc, with quaternary ammonium
disinfectants which are effective in inactivating coccidia
oocysts
- bathe dogs with shampoo to remove all fecal matter,
rinse with water
- rinse dogs with quaternary ammonium disinfectants,
then water
- allow kennels to dry thoroughly for several days
- 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 case of
coccidia might be exacerbated by the stress of entry in
kennels, could be identified and treated before entry into the
main kennels.
Dogs should be prevented from access to foul water that
may contain large numbers of oocysts (e.g.: river-flooded
paddocks). 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 a scant 4 drops of Clorox bleach
per quart of water or 2 teaspoons per 10 gallons. As an
alternate method of purification, you can also boil all of your
dog's drinking water. To make sure the water is completely
bacteria free, you need to bring the water to a rapid boil for
a minimum of five (5) minutes. Remember, Cool moist
conditions favor the survival of the organism; therefore,
simply by keeping everything clean, disinfected, and dry you
will be getting a lot further toward exterminating this nasty
little one-celled parasite.
Remember, coccidiosis and giardiasis are both very
common protozoal infestations that have the exact same
clinical symptoms; therefore, I recommend that both
protozoans get treated one right after the other: coccidia for
10 days and then giardia for 5 days if using Metronidazole
or 3 days if using Fenbendazole. Once again, I treat
coccidiosis with Sulfadimethoxine (Albon) and giardiasis
with Metronidazole (Flagyl), which is my 1st choice, or
Fenbendazole (Safe-Guard), which is my second choice.