Monday, March 25, 2019

#3 Parasites - Mange! Yuck!

In my parasite series this week, I will tell you everything you never wanted to know about those lovely skin parasites...mange mites! 

Mange, what an ugly word.  Nobody likes to deal with it.  Mange can be a difficult and messy thing to treat.

Mange is caused by a parasitic mite that burrows into the animals skin or nestles into the hair follicles, which is what causes the itching.  There are two primary forms of mange, sarcoptic mange and demodectic mange.  These two forms are very different. They are caused by different mites, present with different symptoms and deal the animal varying amounts of misery. 

Sarcoptic mange usually centers around the face and ears, but can also appear on the legs, especially at the joints, and even on the feet.  Sarcoptic mange is contagious, even to people, though in people, usually the only symptom is a slight itching that goes away without treatment.  Itching and hair loss are the primary symptoms of this parasitic infection in dogs.  It is sarcoptic mange that causes the intense itching.  Infected animals will scratch themselves raw, allowing secondary skin infections to take hold.  It is those infections that will make an animal with sarcoptic mange ill.  The good news is, sarcoptic mange usually responds well to treatment.  The primary form of treatment for this parasite is weekly injections of Ivermectin.  Some breeds of dog do not do well on this treatment though, and they will be treated with a weekly Lyme Sulfur dip.  BEWARE: Small dog owers take note...this dip is VERY toxic and has been known to do small breeds more harm than good. 

Demodectic mange is a little different.  The mites burrow into the hair follicles, which causes the hair loss.  Dogs with demodectic mange rarely have a great deal of itching, which helps to keep the secondary skin infections from setting in.  The primary symptom of this parasitic infection is hair loss.  However, the hair loss can vary from one very small patch, to complete hair loss over the entire body. 

There are two types of demodectic mange, and they get get their names from the amount of hair loss associated with the infection.  Localized demodex is confined usually to one or a few small patches of hair loss, and is generally seen on the torso, but may also appear around the ears or hauches.  Generalized demodex is the term for the wide spread hair loss.  There is a higher risk of secondary infections in the generalized form. 

Demodex is usually considered the "puppy mange" because it is not often seen in healthy adult dogs. Unlike sarcoptic mange, all dogs carry the mange mites for demodectic mange.  They contract them from their mother shortly after birth.  In most dogs, the immune system keeps these mites in check, but in animals with underdeveloped (in puppies) or weakened (in animals who have been ill) immune systems, the mites are able to flourish. Treatment of demodectic mange is usually the same as in sarcoptic mange, but demodex does not usually respond quite as easily to it.  This form often requires a longer treatment cycle.  However, the good news is, a great many cases of demodex will clear up without treatment.  As the immune system gets stronger, the dog's body will once again be able to bring those mites under control. 

So, if you see patches of hair loss on your dog, or if your dog begins to constantly and sometimes violently scratch himself, you should suspect mange and take him to the vet for a skin scrape test.  These tests are not the most pleasant, and will leave a little sore for a few days, but they are the only means for detecting mange.  Sarcoptic mange must always be treated, but if you have a small breed dog with localized demodectic mange, my recommendation is to do nothing unless it becomes generalized or fur doesn't grow back on its own after a couple of months.  For small breeds, the cure really can be much worse than the disease! 

Monday, March 18, 2019

#2 Parasites - Protozoal Parasites of the Digestive System.

This week, I continue the series on parasites with some information about intestinal protozoa parasites, coccidia and giardia. 

The two most common intestinal parasites in canines, besides intestinal worms, are coccidia and giardia.  Both of these organisms are protozoal and both can wreak havoc on the digestive system, especially of young puppies. 
Coccidia and giardia usually present with almost identical symptoms.  The beginning symptom is diarrhea, which usually will progress to a very watery stool and often will be bloody or blood streaked. Then you may begin to see some depression and fatigue, which are often the results of hypoglycemia and dehydration, brought about by the diarrhea.  Some pups with coccidia or giardia will refuse food and water and some won't....usually though, it's those affected with giardia that refuse food and water because giardia often causes severe abdominal cramping.

Giardia infection usually takes place as a result of a contaminated water source, however, both coccidia and giardia cysts can live in the soil for quite some time, so it is possible for puppies to pick up the cysts in the soil and ingest them that way. Both protozoa can be passed from other infected dogs in feces as well. 

Coccidia and giardia infect the host in similar ways.  Cysts are picked up from soil or passed in fecal matter from infected animals and any animal that comes into contact with the cysts can become infected by picking up the cysts on it's paws and ingesting them when it cleans itself. 
Once inside the host, giardia and coccidia begin to differentiate in how they act upon their hosts.  For an indepth look at how these two protozoal parasites behave inside the host, click on the links below.

https://www.whole-dog-journal.com/issues/20_4/features/Giardiasis-and-Coccidiosis-in-Puppies_21624-1.html

https://vcahospitals.com/know-your-pet/giardia-in-dogs

https://vcahospitals.com/know-your-pet/coccidiosis-in-dogs

Another area where these two protozoal organisms differ is how they are diagnosed.  There is a snap test available for giardia, which tests for the protien that the organisms use to encyst themselves.  Because of this, the snap test is not always reliable, as there will not be those protiens present in every stool.  The protozoa will encyst when changes in the digestive tract indicate that they are about to be expelled.  Once encysted, the protiens will dwindle and eventually there will be none left to create a positive test.  Fecal float testing can, at times, be used to diagnose giardia, but it has a very low success rate as the organism is very very difficult to see, even under a microscope.
Coccidia, on the other hand, is usually diagnosed with a fecal float test.  Still difficult to see, it is usually possible to find coccidia oocytes in the stool.  Alternatively, a blood test may help to diagnose coccidia. 

And these two parasites are also different in how they are treated.  Coccidia is treated with Albon or Ponazuril, and often an antibiotic to ensure that no secondary infections set in.  Giardia is treated with Panacur or Safeguard (a common wormer) and metronidazole, an antibiotic that not only helps to prevent secondary infections, but also appears to have some effect on the giardia organisms themselves. 

There was a controversial vaccine for giardia on the market at one time.  It was called Giardia Vax and was made by Fort Dodge.  The controversy surrounded the debate over whether or not this vaccine actually benefits the animal.  It did not prevent infection, and did not claim to.  The vaccine claimed to reduce clinical symptoms and the amount of time the animal will shed the cysts.  If the vaccine actually did this, it would be very beneficial to the animal because reduction of diarrhea would eliminate a whole host of problems associated with it, such as hypoglycemia and dehydration.  Also, reducing the amount of time the cysts are shed may also help to reduce the risks of other animals becoming infected.  However, research suggests that the vaccine has no effect on the presence of giardia in the stools of infected but asymptomatic dogs.  Further, the vaccine is now very difficult to find, so it appears as though it may have been taken off the market.   

In the end, there is no absolute cure for either of those parasites, unfortunately, except for the animal's body's own defenses.  Dogs naturally carry coccidia in their digestive systems, but what makes the animal sick is the overwhelming rapidity with which these protozoas reproduce. This happens in puppies becaue of immature immune systems.  Adult dogs rarely become ill from giardia or coccidia, but they may be carriers of the protozoa.  If given time and a little help with the medicines mentioned above though, most animals will be able to rid themselves of these organisms.

Monday, March 11, 2019

Parasites...The Worst Enemy of Man's Best Friend. Intestinal Worms

This week, I will begin a short series focusing on common parasites seen in our canine companions.  The first topic, which I will cover this week, is intestinal worms.  All dogs, no matter how well cared for, are susceptible to these parasites.  Intestinal worms can make our furry friends very ill if left untreated, but the good news is, they are easy to treat.  Here, I describe the most common types of worms and the best treatments for each.

We all hate them, and practically every dog gets them at least once in its life.  Parasitic worms of the digestive tract are no fun to deal with, that's for sure.  There are several types of parasitic worms, but the most common are, by far, roundworms, followed by tapeworms, hook worms and whip worms.  Most types, if treated properly, pose little real threat to your dog.  However, if left untreated, some dogs, especially puppies, can die from worm infestation blocking their intestinal flow.

Roundworms look a bit like spaghetti.  They are long and brownish or pinkish white in color.  Live roundworms can present in the stool before worming treatment is given.  And dogs will expel dead roundworms after treatment.  In some cases, puppies may be born with roundworm larva already in their digestive tracts, but they can also get them through nursing, which is why we worm at 2 weeks of age (the approximate time it takes for roundworm larva to mature.)  The most common symptom of roundworm infestation is the presentation of live roundworms in the stool.  But in some cases, roundworms can cause irritation in the bowel, which may lead to diarrhea.  Especially in puppies, a severe roundworm infestation can cause a distended abdomen (which looks like a constantly full belly) accompanied by weight loss (you may even be able to see the puppy's ribs!). 
Roundworms are usually treated with pyrantel pamoate, which is sold as Strongid T, Evict or variety of other names, including names that you can buy at our favorite place...Wal-Mart!!  However, fenbendazole (sold as Safeguard or Panacur) will also rid your dog of roundworms and can be used to treat other types of worms as well (more info on this product below, in the discussion of whipworms)  

Tapeworms can be a bit trickier.  They can present before worming treatment is given as tiny segments that resemble bits of rice.  Or, they can present as a long whitish worm that comes out as your dog potties and then sucks back up when he's finished.  Or, they may not present at all.  The symptoms are so few, and so few dogs get any of them, that you may not ever even know your dog is infected.  The symptoms can include "growling tummies" and diarrhea. 
Tape worms do attach to the intestinal wall, which is why they suck back up into the intestines after your dog potties.  Because of this, they can cause some irritation in the intestines, which may lead to a bit of blood in the feces.  Tapeworms are difficult to diagnose because they don't lay eggs inside their host, which is how most worms are detected in a fecal exam done by a vet.  But, tapeworms are transmitted by fleas, so if your dog has fleas, there's a good chance he also has tapeworms. 
Over the counter wormers will not have any affect on tapeworms.  Praziquantel or Droncit are the prefered wormers for tapeworms.  Dogs will not pass dead tapeworms after worming treatment because the wormers disolve the worm's outer covering so that the worm is digested by the dog's digestive tract. 

Hookworms are interesting creatures. The most common way for your dogs to get hookworms is by walking in an area where an infected animal has left feces.  Hookworm larva deposited into soil mature into free living organisms which can actually penetrate your dog's skin and infect the dog without the need for ingestion, which is required for most other worm infestation. 
Symptoms of hookworm infestation are diarrhea (especially black, tarry diarrhea), vomiting, loss of appetite, weakness and in puppies, poor growth. 
Dogs will not pass live hookworms prior to treatment, as the worms attach to the intestinal wall.  These worms are very tiny and cannot be seen without the use of a microscope, which is why you will also never see them even after treatment. Your vet can test for the presence of hookworm eggs in a fecal exam though.    
Hookworms are treated with pyrantel pamoate or fenbendazole (discussed below)

Whipworms are quite infectious, but the only way for your dog to get whipworms is to actually eat the egg.  Whip worms bury their entire heads into the large intestine of the dog and they are not contagious to cats.  Whipworms are also too tiny to see without a microscope, so you'll never see your dog pass them, even after treatment.  Like most other worms besides the tapeworm, diagnosis is made with a fecal flotation exam which detects whipworm eggs. 
Whipworms can be difficult to diagnose because they may not lay their eggs every day, so if you happen to take your dog to the vet for a fecal exam on a day that the worms aren't laying eggs, whipworm infestation can be easily overlooked.  However, there are usually some signs of whipworm infestation, including diarrhea, especially diarrhea that comes and goes (colitis), and weight loss.   
Whip worms are easy to treat using fenbendazole, marketed as Panacur. This really is the only wormer that will rid your dog of whipworms.

Now that you have a pretty good idea of the types of worms you may face with your dog and how to treat for them, you should be well equipped to keep your dog healthy and safe from these nasty parasites. The next topic in this series will cover other types of intestinal parasites.