{"id":1233,"date":"2013-09-01T01:26:55","date_gmt":"2013-09-01T01:26:55","guid":{"rendered":"http:\/\/phosdev.com\/todaysveterinarypractice\/?p=1233"},"modified":"2022-02-17T18:56:11","modified_gmt":"2022-02-17T18:56:11","slug":"parasite-protocols-canine-protozoa","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-protozoa\/","title":{"rendered":"Parasite Protocols: Canine Protozoa"},"content":{"rendered":"<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2016\/09\/T1309C04.pdf\"><img decoding=\"async\" class=\"alignnone size-full wp-image-9886\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2011\/07\/pdf_button.png\" alt=\"pdf_button\" width=\"110\" height=\"27\" \/><\/a><\/p>\n<hr \/>\n<p><strong>Recommendations from the Companion Animal Parasite Council<\/strong><\/p>\n<p><i>Susan E. Little, DVM, PhD, Diplomate ACVM, and Emilio DeBess, DVM, MPVM<\/i><\/p>\n<p>This new column explores the diagnosis, treatment, prevention, and control of parasitic infections based on CAPC&#8217;s detailed recommendations. First up for discussion are canine protozoan parasites.<\/p>\n<hr \/>\n<p>The mission of the Companion Animal Parasite Council (CAPC) is to foster animal and human health, while preserving the human\u2013animal bond, through recommendations for the diagnosis, treatment, prevention, and control of parasitic infections. For more information, including detailed parasite control recommendations, please visit capcvet.org.<\/p>\n<div class=\"orange-box\">\n<h2><strong><span class=\"greenheader\">About This Series<\/span><\/strong><\/h2>\n<p>One of CAPC&#8217;s principal achievements has been creating recommendations that support practitioners in their efforts to protect pets and people from parasites. These recommendations are based on peer-reviewed, published research findings and the collective parasitologic and clinical expertise of the CAPC board.In this series, CAPC board members will:<\/p>\n<ul>\n<li>Review the diagnosis, treatment, and control of common parasites of dogs and cats<\/li>\n<li>Suggest strategies for implementing specific CAPC recommendations in practice.<\/li>\n<\/ul>\n<p>The full recommendations are available at capcvet.org.<\/p>\n<\/div>\n<p>Protozoan parasites, including vector-borne infections and intestinal protozoa, are responsible for a number of different diseases in dogs (<strong>Table<\/strong>). Although many infections are acquired by direct ingestion of infective stages, others may be transmitted by arthropods. These parasites are distributed worldwide or regionally. Accurate, prompt diagnosis and appropriate, specific treatment are critical to managing and preventing protozoan parasitic diseases in dogs.<\/p>\n<table border=\"1\" width=\"100%\" cellspacing=\"0\" cellpadding=\"3\">\n<tbody>\n<tr>\n<td class=\"greenheader\" colspan=\"4\" align=\"center\">Table. U.S. Canine Protozoa: Routes of Acquisition, Diagnostic Strategies, &amp; Preferred Treatments<\/td>\n<\/tr>\n<tr>\n<td><\/td>\n<td><strong>Transmission<\/strong><\/td>\n<td><strong>Diagnosis<\/strong><\/td>\n<td><strong>Preferred Treatment<\/strong><\/td>\n<\/tr>\n<tr>\n<td colspan=\"4\" bgcolor=\"#b1d78c\">CANINE VECTOR-BORNE PROTOZOA<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" bgcolor=\"#daecc8\"><em>Babesia<\/em><br \/>\nspecies<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Tick bite<br \/>\nBlood transfusion<br \/>\nDog fighting (<em>B gibsoni<\/em>)<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Blood smear<br \/>\nPCR of whole blood<br \/>\nSerology<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Large <em>Babesia<\/em> species: Imidocarb diproprionate<br \/>\nSmall <em>Babesia<\/em> species: Atovaquone\/azithromycin combination therapy<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" bgcolor=\"#daecc8\"><em>Hepatozoon<\/em><br \/>\nspecies<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Ingestion of ticks (<em>H canis<\/em>, <em>H americanum<\/em>)<br \/>\nIngestion of vertebrate paratenic host (<em>H americanum<\/em>)<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Blood smear<br \/>\nPCR of whole blood<br \/>\nHistologic examination of muscle biopsy (<em>H americanum<\/em>)<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\"><em>H canis<\/em>: Imidocarb diproprionate<br \/>\n<em>H americanum<\/em>: Ponazuril or trimethoprim sulfa combined with clindamycin and azithromycin, followed by long-term decoquinate<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" bgcolor=\"#daecc8\"><em>Leishmania<\/em><br \/>\nspecies<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Sandfly bite<br \/>\nDirect dog-to-dog transmission<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Impression smear of lesion<br \/>\nPCR<br \/>\nSerology<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Pentavalent antimonials<br \/>\nAllopurinol<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" bgcolor=\"#daecc8\"><em>Trypanosoma cruzi<\/em><\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Stercorarian from kissing bug<br \/>\nIngestion of infected bugs<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Blood smear<br \/>\nPCR<br \/>\nSerology<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Benzinidazole (not available in the U.S.)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"4\" bgcolor=\"#b1d78c\">CANINE VECTOR-BORNE PROTOZOA<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" bgcolor=\"#daecc8\"><em>Cystoisospora<\/em><br \/>\nspecies<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Ingestion of oocysts<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Fecal flotation<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Sulfadimethoxine<br \/>\nPonazuril<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" bgcolor=\"#daecc8\"><em>Cryptosporidium<\/em>species<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Ingestion of oocysts<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Fecal flotation<br \/>\nFecal IFA<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Paromomycin<br \/>\nAzithromycin<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" bgcolor=\"#daecc8\"><em>Giardia<\/em> species<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Ingestion of cysts<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Fecal flotation<br \/>\nFecal IFA<br \/>\nFecal ELISA<\/td>\n<td valign=\"top\" bgcolor=\"#daecc8\">Fenbendazole<br \/>\nFebantel<\/td>\n<\/tr>\n<tr>\n<td colspan=\"4\"><em>Additional treatment options and dosages for the medications listed in this table are available at capcvet.org (select CAPC Recommendations).<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<h2><span class=\"greenheader\">VECTOR-BORNE INFECTIONS<\/span><\/h2>\n<h3><em>Babesia<\/em> Species<\/h3>\n<p><strong>Distribution<\/strong>. Worldwide, dogs may become infected with <em>Babesia canis<\/em>, <em>B vogeli<\/em>, <em>B rossi<\/em>, <em>B gibsoni<\/em>, <em>B conradae<\/em>, and other small and large <em>Babesia<\/em> species, some that have yet to be named.<sup>1,2<\/sup><\/p>\n<p><strong>Vectors &amp; Transmission<\/strong>. Many different tick species transmit <em>Babesia<\/em> species when feeding on dogs; the most common U.S. species include:<\/p>\n<ul>\n<li><em>B vogeli<\/em> (formerly, <em>B canis vogeli<\/em>), transmitted by <em>Rhipicephalus sanguineus<\/em> ticks<\/li>\n<li><em>B gibsoni<\/em>; transmission with this species has been associated with dog fighting.<\/li>\n<\/ul>\n<p>Transmission of any <em>Babesia<\/em> species can occur following blood transfusion.<sup>1<\/sup><strong><br \/>\nDiagnosis<\/strong>. Dogs with babesiosis present with fever, anorexia, depression, and often, hemolytic anemia.<sup>1<\/sup> Diagnosis is achieved by examining stained blood smears for characteristic piroplasms in erythrocytes (<strong>Figure 1<\/strong>).<\/p>\n<div id=\"attachment_2752\" style=\"width: 310px\" class=\"wp-caption alignnone\"><img fetchpriority=\"high\" decoding=\"async\" aria-describedby=\"caption-attachment-2752\" class=\"wp-image-2752 size-medium\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-1.-Babesia-sp.-300x226.jpg\" alt=\"OLYMPUS DIGITAL CAMERA\" width=\"300\" height=\"226\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-1.-Babesia-sp.-300x226.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-1.-Babesia-sp..jpg 398w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><p id=\"caption-attachment-2752\" class=\"wp-caption-text\">Figure 1. Piroplasms of a large Babesia species in canine erythrocytes.<\/p><\/div>\n<p><strong>Treatment<\/strong>. Preferred treatment options include:<sup>3<\/sup><\/p>\n<ul>\n<li>Imidocarb diproprionate for large <em>Babesia<\/em> species (<em>B canis, B vogeli, B rossi<\/em>)<\/li>\n<li>Atovaquone\/azithromycin for small <em>Babesia<\/em> species (<em>B gibsoni, B conradae<\/em>).<\/li>\n<\/ul>\n<p><strong>Prevention<\/strong>. Infection prevention requires careful attention to tick control and avoidance of fighting among dogs.<\/p>\n<h3><span class=\"Gold\"><em>Hepatozoon<\/em> Species<\/span><\/h3>\n<p><strong>Distribution<\/strong>. <em>Hepatozoon americanum<\/em> has only been described in the U.S., while H canis is found worldwide.<sup>4<\/sup><\/p>\n<p><strong>Vectors &amp; Transmission<\/strong>. <em>H canis<\/em> and <em>H americanum<\/em> are transmitted to dogs by ingestion of the vector\u2014ticks\u2014rather than their bite. <em>H americanum<\/em> can also be transmitted by ingestion of paratenic vertebrate hosts.<\/p>\n<p><strong>Diagnosis<\/strong>. <em>H americanum<\/em> infection presents as severe, febrile disease, with lethargy, myalgia, and muscle wasting commonly reported. It also infects skeletal and cardiac muscle, and induces pyogranulomatous myositis. Chronically infected dogs often develop periosteal proliferative lesions on their long bones and bloodwork reveals profound neutrophilia. Clinical disease with <em>H canis<\/em> is relatively mild by comparison.<sup>5<\/sup><br \/>\nDiagnosis of both <em>Hepatozoon<\/em> species can be made by:<sup>5<\/sup><\/p>\n<ul>\n<li>Identifying gamonts in leukocytes on stained blood smears; gamonts are rare in <em>H americanum<\/em> infection but much more common in <em>H canis<\/em> infection (Figure 2).<\/li>\n<li>Polymerase chain reaction (PCR) of whole blood<\/li>\n<li>Histologic examination of muscle biopsy (more sensitive in detecting <em>H americanum<\/em> infection than PCR).<\/li>\n<\/ul>\n<div id=\"attachment_2753\" style=\"width: 310px\" class=\"wp-caption alignnone\"><img decoding=\"async\" aria-describedby=\"caption-attachment-2753\" class=\"wp-image-2753 size-medium\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-2.-Hepatozoon-americanum-300x224.jpg\" alt=\"Figure 2. Hepatozoon americanum\" width=\"300\" height=\"224\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-2.-Hepatozoon-americanum-300x224.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-2.-Hepatozoon-americanum.jpg 402w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><p id=\"caption-attachment-2753\" class=\"wp-caption-text\">Figure 2. Gamont of Hepatozoon americanum in canine leukocyte<\/p><\/div>\n<p><strong>Treatment<\/strong>. <em>H canis<\/em> infection is treated with imidocarb diproprionate. <em>H americanum<\/em> requires more aggressive and long-term therapy consisting of ponazuril or trimethoprim\/sulfamethoxazole combined with clindamycin and azithromycin, followed by long-term decoquinate therapy and pain management with nonsteroidal anti-inflammatory drugs.<sup>5<\/sup><\/p>\n<p><strong>Prevention<\/strong>. Tick control helps prevent infection by limiting the number of ticks ingested. Prevention of <em>H americanum<\/em> also requires limiting consumption of paratenic hosts, especially rabbits and rodents.<sup>6<\/sup><\/p>\n<h3><span class=\"Gold\"><em>Leishmania<\/em> Species<\/span><\/h3>\n<p><strong>Distribution<\/strong>. Althought fairly uncommon in North America, dogs are infected with <em>Leishmania<\/em> species throughout much of the world. Infection has been diagnosed in dogs imported from endemic areas, such as the Mediterranean basin and Central and South America.<\/p>\n<p><strong>Vectors &amp; Transmission<\/strong>. In many areas of the world, phlebotomine sandflies that have fed on an infected vertebrate transmit <em>Leishmania<\/em> species to dogs. In the U.S., transmission by sandflies has not been epidemiologically demonstrated, but canine infections are recognized, particularly in foxhound kennels, and are presumably acquired by direct transmission between dogs.<sup>7<\/sup><\/p>\n<p><strong>Diagnosis<\/strong>. Infected dogs may remain asymptomatic or can develop severe, chronic disease, involving muscle wasting, ocular signs, renal disease, and alopecia and other skin lesions.<sup>8<\/sup> Diagnosis is made by serology or identification of amastigotes in impression smears from affected tissues (Figure 3); PCR assays are also available.<\/p>\n<div id=\"attachment_2754\" style=\"width: 310px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2754\" class=\"wp-image-2754 size-medium\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-3.-Leishmania-300x199.jpg\" alt=\"Figure 3. Leishmania\" width=\"300\" height=\"199\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-3.-Leishmania-300x199.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-3.-Leishmania.jpg 453w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><p id=\"caption-attachment-2754\" class=\"wp-caption-text\">Figure 3. Amastigotes of Leishmania species from ruptured macrophages on impression smear.<\/p><\/div>\n<p><strong>Treatment<\/strong>. Canine leishmaniasis is difficult to treat, although pentavalent antimonials and allopurinol can be used.<\/p>\n<p><strong>Prevention<\/strong>. In endemic areas, protecting dogs from sandflies by routine application of repellent insecticides decreases transmission of <em>Leishmania<\/em> species<sup>9<\/sup>; isolation of infected dogs is recommended to prevent direct transmission.<\/p>\n<p><strong>Zoonosis<\/strong>. Dogs are a major reservoir host for leishmaniosis\u2014a zoonotic disease. Euthanasia of infected dogs has been recommended to limit transmission to humans and other dogs, particularly in regions where vector-borne <em>Leishmania<\/em> transmission is not yet endemic.<\/p>\n<h3><em><span class=\"Gold\">Trypanosoma cruzi<\/span><\/em><\/h3>\n<p><strong>Distribution<\/strong>. <em>Trypanosoma cruzi<\/em> is the agent of American trypanosomiasis or <a href=\"https:\/\/todaysveterinarypractice.com\/chagas-disease-dogs\/\">Chagas disease<\/a>. Autochthonous cases are occasionally reported from dogs in the southern U.S., where natural maintenance cycles exist, and are common in parts of South and Central America and Mexico.<sup>10,11<\/sup><\/p>\n<p><strong>Vectors &amp; Transmission<\/strong>. Infection is transmitted from kissing bugs (triatominae) to dogs and humans. Canine infections occur when infected kissing bugs are ingested or the bugs&#8217; feces, which contain the organism, are deposited on or around the skin wound created by their feeding activity; infection is also transmitted transplacentally.<sup>12<\/sup><\/p>\n<p><strong>Diagnosis<\/strong>. Dogs with acute disease develop generalized lymphadenopathy, lethargy, enlarged liver and spleen, and myocarditis. Chronic infection often results in dilative myocarditis.<sup>12<\/sup><\/p>\n<p>Trypomastigotes may be identified on stained blood smears from acutely infected dogs (Figure 4); serology and PCR are also available.<\/p>\n<div id=\"attachment_2755\" style=\"width: 310px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2755\" class=\"wp-image-2755 size-medium\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-4.-T.-cruzi-300x174.jpg\" alt=\"Figure 4. T. cruzi\" width=\"300\" height=\"174\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-4.-T.-cruzi-300x174.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-4.-T.-cruzi.jpg 516w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><p id=\"caption-attachment-2755\" class=\"wp-caption-text\">Figure 4. Trypomastigotes of Trypanosoma cruzi on blood smear of dog<\/p><\/div>\n<p><strong>Treatment<\/strong>. Benznidazole, the drug of choice for treating T cruzi in dogs, is not available in the U.S., and infected dogs are often euthanized.<\/p>\n<p><strong>Prevention<\/strong>. Preventing infection requires limiting access to kissing bugs by sealing kennels and keeping dogs inside. Limiting predation is also recommended because, although unproven, ingestion of infected reservoir hosts is a suspected route of transmission.<sup>12<\/sup><\/p>\n<p><strong><span class=\"bold\">Zoonosis<\/span><\/strong>. <em>T cruzi<\/em> is zoonotic and, in endemic areas, people are readily infected from a feeding bug vector&#8217;s feces. In the U.S., most human infections are associated with blood transfusion or travel to endemic areas.<sup>11<\/sup><\/p>\n<h2><span class=\"greenheader\">INTESTINAL PROTOZOA<\/span><\/h2>\n<h3><span class=\"Gold\"><em>Cystoisospora<\/em> Species<\/span><\/h3>\n<p><strong>Distribution<\/strong>. Coccidia is a common finding in dogs, with some studies suggesting approximately 1% to 5% of dogs may be infected worldwide.<\/p>\n<p><strong>Vectors &amp; Transmission<\/strong>. Canine infection with <em>Cystoisospora<\/em> species (<em>Isospora<\/em> species) commonly occurs upon ingestion of:<sup>13,14<\/sup><\/p>\n<ul>\n<li>Sporulated oocysts from an environment contaminated with feces<\/li>\n<li>Transport hosts.<\/li>\n<\/ul>\n<p><strong>Diagnosis<\/strong>. Many infected dogs remain asymptomatic, developing immunity to limit infection and protect them from future infections; however, diarrhea, weight loss, dehydration, and even death can occur in severe infections, particularly those in young animals.<sup>15<\/sup> Infections are diagnosed by fecal flotation, which reveals the characteristic oocysts (Figure 5).<\/p>\n<div id=\"attachment_2756\" style=\"width: 310px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-5.-Cystoisospora.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2756\" class=\"wp-image-2756 size-medium\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-5.-Cystoisospora-300x194.jpg\" alt=\"Figure 5. Cystoisospora\" width=\"300\" height=\"194\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-5.-Cystoisospora-300x194.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Figure-5.-Cystoisospora.jpg 464w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-2756\" class=\"wp-caption-text\">Figure 5. Oocytes of Cystoisospora canis on fecal float<\/p><\/div>\n<p><strong>Treatment<\/strong>. Treatment with sulfadimethoxine, which is labeled as effective against the enteritis associated with coccidiosis, or ponazuril is recommended.<\/p>\n<p><strong>Prevention<\/strong>. Oocysts are resistant to environmental degradation; careful attention to sanitation, particularly in kennels and shelters where large numbers of young dogs are cohoused, is necessary to prevent infection.<sup>15<\/sup><\/p>\n<h3><span class=\"Gold\"><em>Cryptosporidium<\/em> Species<\/span><\/h3>\n<p><strong>Distribution<\/strong>. <em>Cryptosporidium<\/em> species infect a variety of vertebrate hosts, including dogs and humans. Active infections are present in a very small percentage of dogs; most of these are due to <em>C canis<\/em>, which rarely infects people.<sup>16<\/sup> The more common zoonotic agent, <em>C parvum<\/em>, is not known to occur in dogs.<\/p>\n<p><strong>Vectors &amp; Transmission<\/strong>. Oocysts of <em>Cryptosporidium<\/em> species are immediately infective when shed in the feces, which usually occurs 3 to 6 days after infection.<sup>13<\/sup><\/p>\n<p><strong>Diagnosis<\/strong>. Infections can cause secretory diarrhea, which can be particularly severe in immunocompromised individuals. Diagnosis is by sucrose flotation of feces, but recognizing minute oocysts can be difficult and use of a referral parasitology laboratory is recommended.<\/p>\n<p><strong>Treatment<\/strong>. Treatment is difficult\u2014few drugs are consistently effective against <em>Cryptosporidium<\/em> species in dogs.<\/p>\n<p><strong>Prevention<\/strong>. Canine infections are considered a low-risk zoonosis; <em>C canis<\/em> has only been reported in immunocompromised humans in the U.S.<sup>16<\/sup><\/p>\n<h3><span class=\"Gold\"><em>Giardia<\/em> Species<\/span><\/h3>\n<p><strong>Distribution<\/strong>. Infection with <em>Giardia duodenalis<\/em> is common in U.S. dogs.<sup>17<\/sup><br \/>\nVectors &amp; Transmission. Infection occurs following ingestion of cysts from fecal-contaminated water, food, or fomites, or through self-grooming. The different assemblages of <em>G duodenalis<\/em> are considered to be fairly host specific.<\/p>\n<div id=\"attachment_4509\" style=\"width: 180px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4509\" class=\"wp-image-4509 size-full\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Screen-Shot-2015-06-16-at-4.25.08-PM.png\" alt=\"Screen Shot 2015-06-16 at 4.25.08 PM\" width=\"170\" height=\"119\" \/><p id=\"caption-attachment-4509\" class=\"wp-caption-text\">Figure 6. Cysts of Giardia duodenalis on canine fecal float<\/p><\/div>\n<p><strong>Diagnosis<\/strong>. Following infection, trophozoites attach to intestinal villi, resulting in maldigestion, malabsorption, and diarrhea. Diagnosis is achieved by detection of:<\/p>\n<ul>\n<li>Trophozoites in direct smear of feces<\/li>\n<li>Cysts on fecal flotation with zinc sulfate (Figure 6)<\/li>\n<li>Antigen in feces of symptomatic dogs.<\/li>\n<\/ul>\n<p>Intermittent shedding of cysts and trophozoites can make direct microscopic identification of infection challenging.<\/p>\n<p><strong>Treatment &amp; Prevention<\/strong>. No drugs are approved for treatment of canine giardiasis in the U.S., but fendbendazole and febantel have shown effectiveness.<sup>18<\/sup> Bathing dogs removes cysts adhered to the hair and helps prevent re-infection.<sup>19<\/sup><\/p>\n<p><strong>Zoonosis<\/strong>. <em>Giardia<\/em> is a common infection in humans, although the most common assemblages found in humans are distinct from those most often found in dogs.<sup>20<\/sup> Human giardiasis contracted from a dog has not been conclusively demonstrated in North America.<\/p>\n<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Screen-Shot-2015-06-19-at-3.35.45-PM.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-5080\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Screen-Shot-2015-06-19-at-3.35.45-PM.png\" alt=\"Screen Shot 2015-06-19 at 3.35.45 PM\" width=\"526\" height=\"401\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Screen-Shot-2015-06-19-at-3.35.45-PM.png 924w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Screen-Shot-2015-06-19-at-3.35.45-PM-300x229.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/Screen-Shot-2015-06-19-at-3.35.45-PM-768x586.png 768w\" sizes=\"(max-width: 526px) 100vw, 526px\" \/><\/a><\/p>\n<h2><span class=\"greenheader\">APPLICATION TO CLINICAL PRACTICE<\/span><\/h2>\n<p>Protozoal parasites of dogs can critically affect canine and human health, with overt clinical disease from canine protozoa most often seen in debilitated or young animals. Infected dogs often present with signs of disease; however, asymptomatic infections also occur, and some protozoa may live undetected within the host for years.<sup>8<\/sup><\/p>\n<h3><strong><span class=\"Gold\">Identification<\/span><\/strong><\/h3>\n<p>Identifying protozoal infections largely depends on awareness so that appropriate diagnostic tests are pursued, particularly with vector-borne infections. Careful history taking and physical examination, along with a judicious use of diagnostic tools, can lead to better management and improved outcomes.<\/p>\n<h3>Prevention<\/h3>\n<p>INTESTINAL PROTOZOA. Prevention of infection with intestinal protozoa requires careful attention to environmental sanitation. Re-infection following treatment often occurs, particularly in canine giardiasis.<sup>19<\/sup><\/p>\n<p>VECTOR-BORNE INFECTIONS. Canine vector-borne diseases are highly prevalent, increasing in distribution, and often difficult to treat; preventing infection by consistent use of insecticides and acaricides and limiting exposure to ticks and other arthropod vectors are the most effective ways to protect dogs from these diseases.<\/p>\n<h3><strong><span class=\"Gold\">Protection<\/span><\/strong><\/h3>\n<p>Protecting dogs from protozoal parasites is critical to human health. Some of these infections, such as <em>Leishmania<\/em> species and <em>T cruzi<\/em>, are well recognized zoonoses, while others, such as canine <em>Cryptosporidium<\/em> or <em>Giardia<\/em> infections, are considered to carry a very low zoonotic risk.<sup>8,12,16,20<\/sup> Veterinarians should pay close attention to:<\/p>\n<ul>\n<li>Limiting protozoal parasite infections in dogs<\/li>\n<li>Staying up-to-date on emerging zoonotic diseases.<\/li>\n<\/ul>\n<p>ELISA = enzyme-linked immunosorbent assay; IFA = indirect fluorescent assay; PCR = polymerase chain reaction<\/p>\n<h3 class=\"references\"><strong style=\"line-height: 1.5\">References<\/strong><\/h3>\n<ol>\n<li class=\"references\">Irwin PJ. Canine babesiosis. <em>Vet Clin North Am Small Anim Pract<\/em> 2010; 40(6):1141-1156.<\/li>\n<li class=\"references\">Sikorski LE, Birkenheuer AJ, Holowaychuk MK, et al. Babesiosis caused by a large Babesia species in 7 immunocompromised dogs. <em>J Vet Intern Med<\/em> 2010; 24(1):127-131.<\/li>\n<li class=\"references\">Di Cicco MF, Downey ME, Beeler E, et al. Re-emergence of Babesia conradae and effective treatment of infected dogs with atovaquone and azithromycin. <em>Vet Parasitol<\/em> 2012; 187(1-2):23-27.<\/li>\n<li class=\"references\">Little SE, Allen KE, Johnson EM, et al. New developments in canine hepatozoonosis in North America: A review. <em>Parasit Vectors<\/em> 2009; 2(Supp 1):S5.<\/li>\n<li class=\"references\">Allen KE, Johnson EM, Little SE. Hepatozoon spp. infection in the United States. <em>Vet Clin North Am Small Anim Pract<\/em> 2011; 41:1221-1238.<\/li>\n<li class=\"references\">Johnson EM, Panciera RJ, Allen KE, et al. Alternate pathway of infection with Hepatozoon americanum and the epidemiologic importance of predation. <em>J Vet Intern Med<\/em> 2010; 23:1315-1318.<\/li>\n<li class=\"references\">Petersen CA, Barr SC. Canine leishmaniosis in North America: Emerging or newly recognized? <em>Vet Clin North Am Small Anim Pract<\/em> 2009; 39(6):1065-1074.<\/li>\n<li class=\"references\">Solano-Gallego L, Miro G, Koutinas A, et al. LeishVet guidelines for the practical management of canine leishmaniosis. <em>Parasit Vectors<\/em> 2011; 4:86.<\/li>\n<li class=\"references\">Otranto D, de Caprariis D, Lia RP, et al. Prevention of endemic canine vector-borne diseases using imidacloprid 10% and permethrin 50% in young dogs: A longitudinal field study. <em>Vet Parasitol<\/em> 2010; 172:323-332.<\/li>\n<li class=\"references\">Kjos SA, Snowden KF, Craig TM, et al. Distribution and characterization of canine Chagas&#8217; disease in Texas. <em>Vet Parasitol<\/em> 2008; 152:249-256.<\/li>\n<li class=\"references\">Esch KJ, Petersen CA. Transmission and epidemiology of zoonotic protozoal diseases of companion animals. <em>Clin Microbiol Rev<\/em> 2013; 26:58-85.<\/li>\n<li class=\"references\">Barr SC. Canine Chagas&#8217; Disease (American Trypanosomiasis) in North America. <em>Vet Clin North Am Small Anim Pract<\/em> 2009; 39:1055-1064.<\/li>\n<li class=\"references\">Dubey JP, Lindsay DS, Lappin MR. Toxoplasmosis and other intestinal coccidial infections in cats and dogs. <em>Vet Clin North Am Small Anim Pract<\/em> 2009; 39:1009-1034.<\/li>\n<li class=\"references\">Gates MC, Nolan TJ. Endoparasite prevalence and recurrence across different age groups of dogs and cats. <em>Vet Parasitol<\/em> 2009; 166:153-158.<\/li>\n<li class=\"references\">Lappin MR. Enteric protozoal diseases. <em>Vet Clin North Am Small Anim Pract<\/em> 2005; 35:81-88.<\/li>\n<li class=\"references\">Lucio-Forster A, Griffiths JK, Cama VA, et al. Minimal zoonotic risk of cryptosporidiosis from pet dogs and cats. <em>Trends Parasitol<\/em> 2010; 6(4):174.<\/li>\n<li class=\"references\">Carlin EP, Bowman DD, Scarlett JM, et al. Prevalence of Giardia in symptomatic dogs and cats throughout the United States as determined by the IDEXX SNAP Giardia test. <em>Vet Ther<\/em> 2006; 7(3):199-206.<\/li>\n<li class=\"references\">Barr SC, Bowman DD, Heller RL. Efficacy of fenbendazole against giardiasis in dogs. <em>Am J Vet Res<\/em> 1994; 55:988-990.<\/li>\n<li class=\"references\">Payne PA, Ridley RK, Dryden MW, et al. Efficacy of a combination febantel\u2013praziquantel\u2013pyrantel product, with or without vaccination with a commercial Giardia vaccine, for treatment of dogs with naturally occurring giardiasis. <em>JAVMA<\/em> 2002; 220:330-333.<\/li>\n<li class=\"references\">Covacin C, Aucoin DP, Elliott A, Thompson RC. Genotypic characterisation of Giardia from domestic dogs in the USA. <em>Vet Parasitol<\/em> 2011; 177:28-32.<\/li>\n<\/ol>\n<p class=\"references\"><span class=\"author-bio\"><strong><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/C_CPAC_Little.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-7065\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/C_CPAC_Little.png\" alt=\"C_CPAC_Little\" width=\"100\" height=\"122\" \/><\/a>Susan E. Little<\/strong>, DVM, PhD, Diplomate ACVM, is the Director of the National Center for Veterinary Parasitology at Oklahoma State University&#8217;s Center for Veterinary Health Sciences, where she serves as Regents Professor and the Krull-Ewing Chair in Veterinary Parasitology. Her research focuses on zoonotic parasites and tick-borne diseases. She has been recognized for teaching excellence, receiving the Pfizer (Norden) Distinguished Teaching Award (1999, 2010) and national Student AVMA Excellence in Teaching Award (1998, 2005), and for her outstanding research with the Pfizer Award for Research Excellence (2012). Dr. Little received her DVM from Virginia Tech and completed her PhD at University of Georgia.<\/span><\/p>\n<p class=\"references\"><span class=\"author-bio\"> <a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/c_CPAC_DeBess.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-7064\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/c_CPAC_DeBess.png\" alt=\"c_CPAC_DeBess\" width=\"100\" height=\"105\" \/><\/a><strong>Emilio DeBess<\/strong>, DVM, MPVM, is the state public health veterinarian with the Oregon Health Authority. His primary job is to track zoonotic diseases in both humans and animals in Oregon. He has received 2 Director Excellence Awards from the Department of Human Services in Oregon. Dr. DeBess conducts surveillance projects related to zoonotic diseases, including leptospirosis, toxoplasmosis, cryptococcosis, West Nile virus, and tick-borne illnesses. He received his DVM from University of California\u2013Davis.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Recommendations from the Companion Animal Parasite Council Susan E.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":1265,"footnotes":""},"categories":[372],"tags":[],"class_list":["post-1233","post","type-post","status-publish","format-standard","hentry","category-september-october-2013","column-parasitology","clinical_topics-parasitology"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Parasite Protocols: Canine Protozoa | Today&#039;s Veterinary Practice<\/title>\n<meta name=\"robots\" content=\"noindex, follow, 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