Giardia and Coccidia Infections in Dogs with Dr. Trisha Rettig, PhD

During this webinar Dr. Trisha Rettig explains what Giardia and Coccidia are, as well as how to protect your dogs from these infections. Dr. Nate Ritter then answers commonly asked questions on this topic.

Transcript

Dr. Mikel Delgado [0:00] Thanks everyone for being here. I am Dr. Mikel Delgado. I’m Good Dog’s Standards and Research Lead. Thank you so much for joining us today for our webinar with Trisha Rettig. If you would like to ask any questions, feel free to put them into the Q&A box at the bottom of your screen. Just to tell you all a little bit about Good Dog: Good Dog is on a mission to build a better world for our dogs and the people that love them by advocating for dog breeders, educating the public, and promoting canine health and responsible dog ownership. We are a secure online community, created just for dog breeders, and we are completely free for dog breeders, too. Now, as part of Good Dog’s mission to promote canine health, I’m really excited to share that we just announced our first annual Health Symposium. This is a one-day virtual symposium. We’ll be bringing together leading experts in canine veterinary medicine, talks about health testing, talks about genetics—to help your breeding programs excel. This event is completely free. It’s going to be on Saturday, September 18. Hope to see you all there. We have dropped the registration link in the chat. If not, it will be in there right now. Please register and join us on September 18. If you are not yet a member of our community, we invite you to learn more about Good Dog’s mission and apply at www.gooddog.com/join. With that, I’m going to hand things over to Dr. Trisha Rettig. She is going to be talking about two of everybody’s favorite topics, I’m sure: Giardia and Coccidia. 

Dr. Trisha Rettig [1:32] Hi! Thank you everybody for having me. Let’s do this. I wanted to give you a brief introduction about who I am. I got my PhD in immunology, and I specifically focus on the immune response to vaccinations. But I’m also a general immunologist. When I am not busy being a scientist, I am also a dog lover. I own a Pembroke Welsh Corgi and a Golden Retriever. I’m active in multiple dog sports. I’m also a professional dog trainer. That’s just a little background about me. All opinions expressed here are my own and not necessarily those of my employer. 

[2:15] Before we get into this, I just want to have a general reminder: While we’re here to provide some basic background information, you need to be really working with your veterinarian on how to deal with treatments or how to deal with specific plans. Your vet knows your dog’s history and your local issues, if there’s anything specific to your region. This is general information, so you can go in with some background, but you really need to be working with your vet if you believe that you have an infected dog. For breeders and buyers, if you’re bringing home a new puppy, this is a good time to schedule some time to speak with your vet, either while you’re getting ready to plan for a litter or you’re going to bring home a new puppy. You can come with questions and concerns ahead of time. Maybe just a phone consultation or maybe actually going in without your dog—however you can arrange this to go in with some information already ahead of time: What do you think about this? How can this work? Just a general reminder that this is general information. Please speak to and work with your vet.

[3:26] We’re going to start by talking about Giardia. Some basic information: it’s a protozoan infection. It can infect both wild and domestic animals, so we can see this in birds and we can also get it in people. There are multiple species, and most of them have very specific hosts. You may see non-dog-specific Giardia in your dog’s stool sample, so just be aware that you can see these. Giardia duodenalis is the one that infects dogs specifically. On the right-hand side, you can see the 2020 cases that we see for infection risk. About 1/15 animals who were tested tested positive. We saw almost ¾ of a million cases around the country in 2020. It has two forms that are actually detectable in the stools: the cyst, which you can see with these blue rings here, and also the trophozoite; this is the more mobile version, and we’ll talk about that on the next slide. 

[4:30] Basically what happens is your dog will become infected with the cyst. These will be from waste (it’s the most common) or infected food, water, soil. Those cysts are ingested and once they’re inside the gut, they actually form into those trophozoites. So the outer part of the cyst is digested. The trophozoites are going to come out and multiply within the intestine. They feed off the host and absorb their nutrients. When they’re able to reproduce, those cysts leave the body. Those can then survive in the environment for months. That’s how we can spread the infection to others. These cysts are shed intermittently. You can see shedding for a couple of days and then you don’t see shedding and then you see shedding for a couple of days and then you don’t see shedding. That’s going to happen over the process of several days to weeks. The really difficult part about this is these can survive in the environment for several weeks. While it’s usually transmitted fecal–oral, direct contact and also contaminated environments are also a problem. This Giardia also has a very low dose required for infection. With some infections, you really need to see a lot of it to actually get infected. Giardia doesn’t take a lot. So even if you have just a little bit in your area, it can be enough to cause problems. 

[6:13] For signs and symptoms, there may honestly be no outward signs of infection. Your adult dogs who are not particularly stressed or don’t have anything going on may not show any signs of infection at all. When you do start to see signs, you can see things like weight loss and chronic diarrhea. This may be either continuous or intermittent in puppies. Stools are usually soft, poorly formed. They can be pale and have either mucus or a fatty appearance. They may also have blood in the stool. You can see this really yellow, mucus-y looking stool. But you can also see darker stool that may have blood in it as well. 

[6:54] For diagnosis, you usually do a fecal examination under a microscope. If you see the cysts or the actual protozoan itself, it does show that the dog has it. It doesn’t mean the animal is infected. Shedding is intermittent. What is important is that not all positive tests require treatment. Again, going back and working with your vet if you have a dog that is showing no symptoms, you may necessarily not want to treat that dog. Again, go back and work with your veterinarian to go through your dog’s life and your dog’s lifestyle and your dog’s history to really make those calls. There’s also an ELISA test that detects Giardia antigen in the stool sample so we can test for the presence. 

[7:44] For treatments, we use anthelmintics, usually or possibly in combination with antibiotics. The number one treatment is fenbendazole, which most of us know as panacur. You may need multiple rounds of treatment to be able to actually clear the infection. When possible, you really want to work on also bathing your animal during infections and during treatments to remove any of the cysts from the coat, so that way we can prevent it from spreading. When you’re starting to test post-treatment to see whether your treatment worked, you want to collect samples from multiple stools across multiple days. Again, we’re looking at this intermittent shedding. You don’t have to keep them separate. They can be combined. But to really get a good example of whether the cysts are still present, you want to select across multiple days. 

[8:37] The best method of prevention is preventing it from getting it into your environment if at all possible. This includes removing feces as soon as possible, bathing and separating infected dogs to try and keep it localized to one area if it does come in. You can clean surfaces using soap or a detergent and water. Follow with disinfectant if possible. For things that can go in the dishwater or be submerged in boiling water, this will also help with sanitation. If you need to do soft items, you can launder them with detergent and dry in high heat, at least 30 minutes, or you can let them air dry in direct sun. Disinfecting grass is pretty much impossible. It should be considered contaminated for at least one month after an infected animal has access. But again these are really hardy cysts that can persist in the environment. Obviously do your best to prevent it from getting on your property.

[9:38] We’re going to go over Coccidia next. This is, again, another single-cell protozoa. It can infect multiple animals, including cattle, sheep, goats, birds, pigs, rabbits, cats, dogs, and horses. The most common one is Isospora that we see. This is an example of what it looks like under the microscope. There’s four different genera that can infect dogs, but again this covers a large area. 

[10:06] Basically what happens is we have non-sporulated (or non-infective) oocysts that are shed in the feces. Once, after the animal is infected, these oocysts are shed in the feces, from there, they’re sporulated. This is when they’re actually able to be infective again. They need to have adequate moisture, oxygen, temperature to be able to do that. These then remain in the environment, where they’re eaten by an animal. They can enter the reproductive stage in that animal. Again, in the small or large intestine. They create the oocysts, which are then set back in the feces. This is how we see this cycle of transmission. 

[10:52] Signs and symptoms are pretty generic. You can see diarrhea, anorexia, vomiting, weight loss, and dehydration. But often dogs are asymptomatic. These dogs are infected, but they aren’t necessarily having problems unless something specific happens. 

[11:11] Diagnosis is fecal examination under a microscope, the same as we saw with Giardia. Positive is diagnostic but negative doesn’t mean the animal isn’t infected since shedding can be intermittent. Again, not all positive animals need to be treated. You need to follow up with your vet to determine what the best route for you is. There are some blood tests available as well, but most of the time, we’re just using a fecal examination. 

[11:41] For treatment, usually the number one is Albon, but there are some other examples as well. Repeated treatment (again) may be necessary for these. And then supportive care, depending on symptom severity. Again, work with your veterinarian to determine your best course of treatment for your animals. 

[12:04] For prevention, reducing stress as much as possible is really goal number one. If the animals aren’t stressed, they’re less likely to develop symptoms. Again, proper sanitation as far as removal and disposal of feces. You can steam or heat treat surfaces where possible. There are some either ammonia solutions or bleaches that can help with this infection. Again, these are extremely hardy cysts when they’re in their environment. We have a hard time getting rid of them. 

[12:40] Quickly I just wanted to cover a few things, considerations for our breeders that are on here. This is just general, high-level. Obviously your number one goal is trying to prevent infections from entering the property where at all possible. This may be bathing dogs after a high-risk situation. This may be doing fecal exams prior to bringing dogs on the property, trying to prevent it from getting there in the first place. If you do know that you have cysts on the property, if you do know that you’re infected, sun and heat are the most effective at degrading these things. Consider placing puppy areas where they’re safer, in sunny and dry areas. Obviously you have to balance this. If it’s sunny and dry, it’s also probably really hot. You have to be careful that you’re balancing where it’s safe for your puppies and where it’s less likely to be infective. You can look around your property and perhaps use some of that to your advantage, especially with your younger puppies when you’re starting to bring them out. 

[13:42] Finally, just briefly: treatments for pregnant bitches and puppies. Panacur and metronidazole if needed for Giardia. For Coccidia, you usually want to treat only if it’s symptomatic. Shedding is usually a result of stress. Try to reduce that as much as possible. Again, treatments really need to be individualized. Some options are not available for pregnant bitches here. With that, I’m going to hand it over to Nate. I was just here to provide a brief introduction, and I’ll let Nate handle most of the questions from here. 

Nate Ritter [14:29] Hello, everyone. 

MD [14:35] I’ll be throwing the questions to Nate and Trisha. For those who have not met Dr. Nate Ritter, he is Good Dog’s Veterinarian. He’s on our Health, Standards, and Research team. Please welcome Nate if you have not met him yet! Some of you submitted a few questions ahead of time. Let me get a few of those ready. One question: why does Giardia show up more during wet years or seasons? Why is it more difficult to treat in those years, and what can be done to combat it? 

NR [15:14] That’s a fantastic question. That’s really where it thrives, in the wet, cooler environments. Oftentimes, in terms of prevention, what we want to do is expose it to direct sunlight to make it as dry as possible. I know that’s not always possible, especially if we’re in places where we have particularly rainy seasons or where it is particularly wet. But to the best of our abilities, especially when we’re talking about the yard, which is a very difficult environment to disinfect, we want to limit shade, limit water accumulation in our best attempts to prevent that from happening. 

MD [15:49] And then on a related note, I think this is probably going to have a similar answer, but how to get rid of persistent Giardia? Multiple treatments of Panacur, stools for pups are still coming back positive. Bleach has been used outside. Simple Green Pro on puppy surfaces. Also using rescue toys are cleaned. Using washer/dryer and bleach. Not having a lot of luck!

NR [16:18] We’re trying our best. With that, oftentimes, the fenbendazole alone may clear the infection, sometimes in conjunction with metronidazole. As Trisha spoke to you earlier, obviously speak to your veterinarian. You’re obviously doing a lot of things right. But it can be particularly hardy and difficult to treat. In some cases, as she spoke to as well, if we’re not exhibiting clinical signs here, we need to determine whether that’s appropriate to treat or not, or if it’s in our best interest. Obviously if you have other animals in the area and are concerned about spreading that contamination, it may be in our best interest. I would bring that up with your veterinarian, but there may be conjunctive medications you can use, some different disinfectant types that you can use. Bleach—I know you tried that. But steam cleaning. Immersed in boiling water. Other different things to try. I’m sure you’re frustrated, but just keep on keeping on. You’re doing the right things.

MD [17:17] There’s no giant tent they can put over their house? 

NR [17:21] We wish! 

MD [17:23] I think Trisha touched on this briefly, but maybe you can elaborate a little bit. Do you always need to treat Giardia? I’ve had puppies diagnosed with non-shedding Giardia, and the vet did not have me treat them. We’re fine. No loose stools or symptoms. I’m going to re-test in 6 months. 

NR [17:40] I think that course of action is completely appropriate there. It’s really dependent on your individual circumstance. If we’re going to be bringing these puppies home—we just received the puppy. It’s the only animal in the house. They’re not symptomatic. It can be completely appropriate to not treat that animal. It can lead to resistance. As we’ve already seen, these can be quite difficult to treat. I know a lot of you are going through multiple rounds and haven’t been able to properly clear it. If the animal is not affected, it may be in your best interest not to, but just keep in mind that when you dispose of that animal’s feces, keep it away from areas where there are a bunch of other animals or dogs where it can be transmitted, like dog parks and what have you—as long as that infection is present, or if it’s not necessarily an infection but appreciated in a sample. 

MD [18:30] This is related to another question: If an otherwise healthy puppy keeps getting Giardia again and again, and no other dogs in the household are catching it, is it just that they’re not getting it out of their environment or is the dog possibly getting exposed to it somewhere else? 

NR [18:48] Big problem is re-infection. Whether it’s coming from that animal itself, not entirely clearing the infection in the first place, or if it’s picking it up someplace else. It’s really difficult to appreciate with just samples alone. As Trisha spoke to you, just because it was a positive sample, it doesn’t necessarily mean the dog is infected. It just means that sometimes that is appreciated within the stool sample. It may just be passing through. We really look for cysts in the stool sample to see if it’s in the infective stage. She spoke to the ELISA, where we just appreciate the protein of the Giardia. It’s difficult to appreciate where that’s picked up. Keeping your area clean is so important. Disposing of the feces, disinfecting the environment to the fullest extent possible—I completely understand it’s really hard to do in the yard. But those other areas where we have a handle over, let’s try to keep those as clean as possible. 

MD [19:48] Any differences with Giardia and Coccidia infections in dogs versus puppies?

NR [19:53] The immune system is a little hardier in the adults. Less likely for them to be impacted as severely. As Trisha spoke to, symptomatically, most of the times they’re asymptomatic. If you appreciate some diarrhea, it may be somewhat mild in the adults. It can be quite severe in the puppies. If they are impacted by that and they’re exhibiting those signs, supportive care might be necessary, outside of this regular treatment. Those get a little more advanced. Once again, speak with your veterinarian. Hope that that doesn’t happen to y’all. 

MD [20:28] Can you treat your bitch with anything prior to whelping to prevent Giardia or Coccidia? 

NR [20:34] It’s a difficult question. As I spoke to earlier, a big issue is resistance. A lot of veterinarians (and it’s my opinion as well) will tell you, in terms of prevention, the best thing we can do (and Trisha spoke to it) is decrease stress level and really keep the environment clean to the best of our ability. We don’t like to treat things that aren’t necessarily there. It’s a different case if your animal is testing positively. It’s a different story. But if we have clear fecal exams, they’re asymptomatic, and there’s no history of it in the environment or on your property, it’s not something that I would necessarily recommend. Once again, you can always have that conversation with your veterinarian if you have concerns.

MD [21:14] How important is preventative treatment versus just waiting for a positive test? 

NR [21:22] Keep the area as clean as you can, and keep the stress levels as low as you can, and deal with it when a positive test comes about in the way that you’re directed to by your veterinarian. Trisha spoke to a lot of the most common first-line treatments that do take care of it, the majority of the time, I will say. I’ve utilized the Panacur as well as Albon, and in both cases, I’ve had very good luck. I’ve had some persistent cases, but not to where it was of any detriment to the animal, just more frustration to the owner. 

MD [21:53] We’re getting a couple of questions about Coprophagia, or eating feces, both as a possible cause of infection but also as a symptom or sign that maybe the dog has Giardia or Coccidia. Can you speak to if that’s true? 

NR [22:14] Definitely in terms of infection! You don’t even necessarily need to eat it. If you come in contact with it, and it’s ingested, that can be an issue. Regarding it as a symptom, I’m not familiar with. It can be considered mental in some cases. I wouldn’t necessarily say that it’s a symptom. But if you do recognize a pattern with your own individual dog, that’s only a benefit. Let the veterinarian know. It may be helpful for you, in terms of treating that animal, if an infection has come about, but not to my knowledge.

MD [22:53] I’m getting a few questions about neonatal puppies. How early can they show symptoms? Should they be treated if they’re super tiny and young?

NR [23:04] They can show symptoms whenever they contract and become infected. In terms of treatment, if they are impacted and showing signs, I would say yes. As I spoke to, neonates unfortunately can be impacted much harder than other animals, and those symptoms can be more severe. It may involve not just clearing the infection, but keeping the animal alive and healthy. More supportive care, in that respect, there. Definitely work with your veterinarian if that would be the case. As I mentioned previously, I hope that doesn’t happen to anyone. 

MD [23:42] What about resistance to some of the medical treatment? Albon is kind of the go-to, but Angelique is asking about it. She’s hearing it’s not working as well, or maybe that Coccidia is becoming resistant? Is that a problem that we have to become concerned about? 

NR [24:00] Resistance is definitely an issue. If Albon isn’t working—once again, work with your veterinarian. I know Ponazuril is another medication that can be used extra-label for dogs, but I would speak with your veterinarian in that specific instance. Not a whole lot has been researched in terms of safety and dosage and what have you. But those medications are available. They’re alternative treatment options to try if Albon is not working. 

MD [24:31] Someone wants to know if you have a recommendation of the powder versus liquid fenbendazole?

NR [24:39] With Panacur, we always utilize the granules because that’s the FDA-approved product for dogs. It would be off-label, so I would speak with your veterinarian in that respect. But I always utilize the granules for that reason. 

MD [24:54] We’re getting some questions about Baycox. It sounds like some breeders are using it to prevent Coccidia from getting out of control, and then we have a question about the timeline for using it. Can you speak to that treatment? 

NR [25:13] Toltrazuril It’s similar to Ponazuril. Once again, it was initially created for horses. It’s being used off-label for dogs, so I would work with your veterinarian specifically in terms of what they recommend or length of treatment and how often to give, just because it is not labeled for dogs. 

MD [25:36] Is there a lower risk in the hotter states? How does the weather play in? I know you said the dampness and the tree cover, but is this a regional issue? 

NR [25:46] Trisha had a map up earlier, and when this is reposted, you can relate back to that. But, yes, certainly. Where there’s more sun, more heat, I would say it’s definitely less likely to occur, or less often—versus the areas where it is more damp, more shady, and a little bit cooler. 

MD [26:08] I’m just going through. Plenty of questions coming! Keep them coming! If a dog has already been exposed to Coccidia, and their immune system has taken care of it, if they ingest spores from the environment, will they shed the o-cysts for a period of time after ingesting them? So, they’ve already been exposed. The immune system took care of it. But then they are ingesting spores from the environment. Can they later shed?

NR [26:34] They can continue to pass along those o-cysts. It might not affect that particular animal, but they may lay those o-cysts back into the environment. The ones that are hardy in the environment, where they wait for (as Trisha spoke about) that perfect environment where they become sporulated/infected when they’re ingested—they can certainly pass that along, even if it wouldn’t necessarily affect that animal. 

MD [26:59] Here’s a question from Natasha. She wants to know if you would recommend prevention methods if a previous litter had Coccidia? Environment’s been cleaned by now, and a new litter is coming, and she wants to make sure that they will not be infected. Is it worth treating preventatively, or do you just keep your fingers crossed and hope you did a good job of cleaning?

NR [27:17] A little more complicated than getting your fingers crossed. I would, of course, test with the fecal exams to test the parents or any animals that are in the environment that those puppies will come into to see. To the greatest extent that we can, I would clean the environment as best we can. I would discuss with your veterinarian and maybe come up with a plan there. But I would really try to clean. The biggest issue is, as we spoke to earlier, the yard, which is really difficult to disinfect. To the best of our abilities, these animals and areas that we have disinfected or sterilized, to some extent, we cross our fingers. As long as we have negative fecal samples and the area has been cleaned to the best of our ability, we have lowered stress as much as we can. Hopefully that will not reoccur. But once again, speak with your veterinarian to come up with a plan and see if they have any recommendations for your specific case. 

MD [28:10] You kind of touched on the outside area, so we have a question: Is it better to make outdoor areas gravel as opposed to grass or dirt, or is there another alternative that she should be considering as well? 

NR [28:25] I’d definitely say gravel, preferred to grass and soil. Concrete as well. It’s easier to clean in terms of those areas that you can’t completely clean. It’s personal, right? I don’t want to tell you how to put together your home environment. If we’re looking at ease of cleaning and chances of it becoming infected, I would say a flat concrete surface would probably be easiest to take care of. 

MD [28:57] What’s the best way to clean things like water bowls?

NR [29:02] Disinfecting them, washing them appropriately. Submerging them under boiling water. Be careful, obviously, with your hands. I saw some comments with people having the automated water bowls, where they can’t necessarily take them off. But I would disassemble it as best as you can and clean the individual pieces, and then clean them where they are stationed. Let some time go by before refilling. 

MD [29:29] Thank you. Any thoughts on whether or not probiotics are going to be helpful with this kind of stuff? 

NR [29:37] Probiotics—the thought there is to help with the gut floor. It may be able to help in terms of limiting the infection. Not to my knowledge in terms of treating that or any research behind that, necessarily. But the thought behind that is to improve the gut floor and gut health, which relates to these two protozoans that are ingested. 

MD [29:59] And you brought up stress a few times. Can you elaborate a little bit on what the effects of stress would be on an infection with Giardia or Coccidia? 

NR [30:11] I’ll give a quick little talk, but I’ll throw it back to you, Mikel, because I know this is your area of expertise. Compromising their immune status: when we’re under stress (same as in any animal or person), our ability to become sick or compromised is higher. Lowering that enables them to stave off any possible infection, in their infective stage. But I’ll throw it back to you in terms of these individual environments and what people can do to lower that. 

MD [30:44] Of course we also know that maternal stress can affect the puppies (even in utero), so we don’t want those puppies exposed to the mom’s stress hormones either. It does get down to providing a safe, quiet, calm, comfortable place for the mom to whelp in. Of course, things like providing enrichment, where dogs can express species-typical behaviors like chewing and digging, appropriate and fun human interactions, protection from the elements. Providing your dogs with a very comfortable environment, exercise, and things to keep them busy and happy will definitely help. For the reasons that Dr. Nate mentioned, which is just being able to prevent that interaction between stress and immunity that we know can wreak havoc on the body. We’re getting some more questions about specific medications. Is there a difference between Panacur and SafeGuard?

NR [31:45] The active ingredient within both of those is fenbendazole. I know the brand names can be confusing. I would really look at the drug name on the packaging, whether you get your hands on it over the counter or through your veterinarian. We want to look at the drug name there, not the brand name. But those are both fenbendazole. 

MD [32:05] Can you mention again what the name is? Baycox?

NR [32:16] Similar to Ponazuril, I believe it’s Trazaril. 

MD [32:19] Okay, because someone asked about it, and I wanted to make sure we had addressed it But we did talk about that. Great! Sonya has a pup who cannot have Panacur or metronidazole. What should they do for Giardia? 

NR [32:34] That’s a difficult case. I’d speak with your individual veterinarian. I don’t know if they would maybe consult a specialist in terms of that, in terms of other recommendations there. If your animal can’t have it for allergy purposes (I can’t speak to those reasons), I’d work with your individual vet there. That’s a specific case.

MD [32:58] We’re getting a couple of questions about a product called Wishy Washy. I think we chatted about this before, not having a ton of personal experience with it. I know, Trisha, you also were familiar with it. Do either of you have anything to say about Wishy Washy and how it works, if it works?

NR [33:16] To my understanding, it can be attached to the hose and sprayed over the environment. I can’t speak to efficacy or familiarity. I know of the product, but not instantly, so I don’t know if you have anything to add, Trisha, there? But I would look on the manufacturer’s page, in terms of what they claim to cover. And discuss that with your veterinarian. Say, “This is something I’m utilizing in the home environment.” See what their recommendations are there.

TR [33:42] I saw that pop up, so I went to the website real fast. It’s a low PH cleaner. It’s basically working with acid to neutralize and basically break stuff down. I don’t know enough about their data behind it, but the logic is sound. I don’t have a situation where I would need to use it, so I haven’t personally used it. 

MD [34:10] Someone was also saying that they’d heard that bleach was not that effective with Coccidia. I’m seeing mentions of Kennel Salt, Rescue, Bleach, Ammonia. Any of these? All of these? None of them? 

NR [34:25] I think that’s a good point. I think it may have just been repeated in terms of the Giardia prevention, but Ammonia solution would be recommended there. Also, the steam. Submerging under boiling water, depending on the size of what we’re trying to disinfect. I would recommend Ammonia product there. I believe 10% or so should be effective. 

MD [34:44] Bleach? No? 

NR [34:48] I wouldn’t recommend it necessarily for Coccidia, moreso for Giardia.

MD [34:53] Thank you. Is there any way to determine if there’s Giardia or Coccidia on a property, other than waiting for your dogs to get infections? So, if you’re moving to a new property, should you just assume it’s there and treat or wait? Or what?

NR [35:17] That’s a great question and outside of my realm of knowledge! I treat the animals, not necessarily the environment. I know, as Trisha spoke to, in terms of length, obviously it would be safer to assume it’s there, but I don’t want everyone living in fear. You can be cautious and maybe assume it’s there. Like I said: expose to direct sunlight, make sure it’s dry, disinfect the areas that we can. I know, as we spoke to, that the yard can be more difficult, but in terms of testing soil or whatnot, I would have to look into that further.

MD [35:55] Does diatomaceous earth help?

NR [36:09] I am cautious with that, in terms of laying that down. Like I said, I’m not so much on treating the environment. I’m more used to treating the animals. I know it can be a respiratory irritant. In terms of its efficacy relating to its protozoans, I can’t necessarily speak to that in terms of the environment, but I would just be cautious in its use because of its possible irritant effects on the respiratory system. 

MD [36:34] Can you speak to the difference between shedding and non-shedding and how that would affect treatment?

NR [36:43] Touched on this a little bit earlier, specifically in the Giardia case, when we’re looking to see if they’re actively getting the cyst or if they’re actively infected and whether we need to treat it or not. So it’s a great question. That’s why with some of those animals, if they’re asymptomatic (not showing any signs and there’s no cyst present) sometimes we will go for no treatment, depending on the circumstance. We obviously don’t want to expose other animals. But if I was treating a lot of animals in the city where they could be isolated, they forgo treatment. Three tests to see if it clears, where you’re just really detecting the presence. If we have symptoms, if there are cysts present, sometimes treatment is necessary.

MD [37:27] Getting some more questions about prevention methods: what do you think about Decoxx CocciGuard 10x as a preventative? Any thoughts? 

NR [37:41] I would speak with your individual veterinarian there. I prefer disinfecting and low stress if we don’t have it present. Once again, different story if it has been present/if you’ve dealt with this issue over and over. That’s not a product that’s labeled for dogs, so it would be extra-label. I would discuss it with your veterinarian there. 

MD [38:05] Can we beef up puppies’ immune systems from 5 to 9 weeks of age so that they don’t go home with a problem?

NR [38:12] As you spoke to earlier, we want to make sure they’re eating appropriately. Low stress. The transportation is particularly difficult, right? Because that brings along a lot of those things that can be more impacted by, these things that they come across. But keeping the areas clean, if you have another puppy in the litter or an animal in the home: isolating them, to the extent possible. In terms of beefing up, I wouldn’t necessarily say so, but doing our best to keep them adequately healthy to stave that off would be recommended.

TR [38:53] Real quick, I have a thing! I found a paper about testing for o-cysts in the environment. The answer is yes. But I don’t think you’re going to find it. It’s not easy to do. You’re going to have to go to a super specialized lab. It’s going to be expensive, if you have to do all of this stuff. It’s going to be very expensive. So I would go with no. 

NR [39:21] That was my assumption, but I didn’t want to upset anyone. Yes, I think unfortunately, the juice is not worth the squeeze there.

MD [39:30] I’ve never heard that! We’re getting a few questions about alternative or herbal treatments. Are essential oils helpful? Do you have any evidence that these herbal or non-western or non-traditional medical treatments are effective?

NR [39:51] It’s a great question. Not to my knowledge. In my experience and in my opinion, I would go with the medications recommended. 

MD [40:02] Great, thank you. Is it common for a puppy to arrive at their new home with a Giardia infection? Can the transition to a new home cause an eruption of a problem? 

NR [40:18] Unfortunately, it can. When I was practicing, our recommendation on any new puppy visit was to bring a fecal that first visit, to test. Unfortunately, a majority of them were positive. Once again, they may not be symptomatic. You look into that further, in terms of that individual circumstance and how to handle that, but it certainly can be common. As Trisha showed earlier, unfortunately, it’s prevalent and becoming hardier and hardier and more difficult to treat. But I don’t want to scare everyone! As we spoke to before, most oftentimes, it does not cause significant issues if handled appropriately.

MD [41:01] Is Coccidia carried by birds? 

NR [41:07] Coccidia, as Trisha spoke to, can be chickens. It’s varied. Different species are specific. With Coccidia, the one that affects dogs and cats and can be passed back and forth between them but not necessarily to the other species. There are different strains for species that can affect different hosts. They are specific.

MD [41:27] Related note: goats. 

NR [41:29] Goats, I would believe so, in relation to some of the other ruminants. But once again, it would be specific. I wouldn’t be too concerned with transmission, but once again, practice good hygiene. Isolate the animal if you are concerned with that. But I wouldn’t be overly concerned. 

MD [41:49] Should they test their goats and chickens? 

NR [41:53] I would. For their own wellbeing, not necessarily in relation to our pups. 

MD [42:02] How can an owner know if diarrhea and vomiting is Coccidia or if it’s Parvo? 

NR [42:09] Unfortunately, with a lot of the things that we’ve discussed and with a lot of the things that we’ve come across, the clinical signs can be pretty vague. When we’re talking about vomiting, diarrhea—those, unfortunately, are signs for so many issues. That’s why we come in and have specific testing. The fecal test can give you a better idea. There is a Parvo test as well, whether it be a fecal or a snap test, that can give you a better idea of what’s going on. I need to look at it holistically, with all the different signs, the animal’s presentation. It’s really hard to say just from diarrhea what may be going on. Further testing is definitely needed. 

MD [42:49] Have you seen any relationship between metronidazole use in seizures or liver functions when given to 6-8 week old pups at a dosage recommended by a veterinarian?

NR [43:02] The neurotoxicity (one of the side effects) is more related to overdosing. In my experience, from what I’ve utilized, I’ve never had an issue with any neurological side effects when used appropriately. Metronidazole is a very safe medication. There’s a wide dosing range. If you have concerns with that, you can speak with your veterinarian and maybe start with the low end of the dosing range. Once again, a lot of the hospitals have medications in different amounts. Dosages/concentrations that may not fall on the lower end of that scale. Also, I would listen to your veterinarian as well because we want to make sure that we treat these appropriately. If we continue to utilize something and not clear it effectively, it may lead to resistance. I have not had experience with this. Metronidazole has been a safe one when I’ve used it at the appropriate dosages. The neurotoxic side effects are more related to overdose. 

MD [43:55] Is the Giardia blood antigen test result insensitive to shedding versus non-shedding episodes? 

NR [44:05] For Giardia, I’m familiar with the fecal testing and the ELISA, which is the antigen, so recognizing the protein. That’s just its presence, not necessarily whether it’s shedding or not. Within the fecal, we do a flow, preferably with zinc in these cases. If you appreciate the cyst, it’s more indicative of it as infective.

MD [44:34] Okay! Do you have a recommendation for an alternative probiotic than Fortiflora ?

NR [44:53] In terms of probiotics, it depends. I utilized one that I really liked, and it was more so with treatment, not necessarily preventative. I’ll come right back to you if you want to bring up another. I had another list on my computer here. 

MD [45:20] I know we’re getting a lot of questions about CocciGuard. You can always reach out to our breeder advisors as well, for their experience using some of these products. We have various avenues on our website for getting in touch. Definitely feel free to utilize those. Some questions in the comments, and some questions in the Q&A, so I’m just trying to sort through them… Someone asked about Purina Calming Care and puppy adaptive collars as a potential treatment for stress. I think those are all in the low risk/possible benefit category. Not necessarily going to help every individual dog or puppy but probably will not be harmful and certainly will help some. Someone else also asked about small stress problem solving games with puppies: will that help build up their stress tolerance so they’re less likely to be stressed when going to their new home? Does that make it less likely to cause infections? We’re kind of talking about that transition period, of a puppy going from their breeder’s home into their new owner’s home. There are some things that can help reduce that stress. Bringing some familiar, scented items home with the puppies, like a blanket that smells like their nest may help. It’s always going to be a big transition to go from living with mom, siblings, and the people that you’ve grown up with into a new environment. I think certainly having a lot of patience with the puppy—not overwhelming your puppy and having all your friends come the first weekend that you bring your puppy home. Try to keep things pretty stable for them. Feeding the same diet that they were fed at the breeders. Definitely talking to your breeder about what are this puppy’s favorite ways to be handled? What do they like to play with? What are their favorite toys? Can some of those items come with them when they go home to their new home, so that you’re easing the transition as much as possible? Problem solving games are a great strategy, as long as you’re not overwhelming them. It’s like scaffolded learning with children. You don’t want to just throw heavy problems at them right away. You want them to build up their tolerance for a little bit of frustration (what we might call positive frustration). Ease them into that. But I think it’s good to give them those problem solving opportunities. I think it does help resilience, personally. Nate, you got an answer for us?

NR [47:58] In relation to pre-any issues and we’re looking for regulating the flora, Proviable, and after the fact, if we’re experiencing diarrhea and we’re trying to offer something in addition to medications we’re giving, I really like Pro-Pectalin. I’ll keep the list short, but prior to issues/post issues, those are the two that I’ve utilized outside of the Fortiflora 

MD [48:25] Someone suspects their puppies have Coccidia but they have not tested them. Is it okay if they treat with Albon anyway, or is that not indicated? 

NR [48:33] Not indicated. Definitely not. If we’re looking at the clinical signs, which is diarrhea as we spoke to earlier, can be pretty vague. We really want to affirm that we have a positive result prior to treating. That can lead to resistance. Unfortunately, specifically with Albon and sulfa-drugs, as Trisha spoke to: not offering it to pregnant animals. They have side effects that can lead to conjunctivitis (dry-eye), a lot of things that we want to be very careful of. I definitely would not treat unless we have a positive animal that is symptomatic. 

MD [49:10] If a puppy is diagnosed with Giardia, do they need to stay out of puppy classes and for how long?

NR [49:15] During that time, I would recommend it. I know that’s not ideal for everyone. The usual course of treatment that I did was I would treat with the Panacur. I would give it a 3-week break, then do a second course of treatment. Then we would collect a fecal sample. The really important thing here (as Trisha spoke to earlier) is shedding can be intermittent, so you don’t want to just take one fecal sample from one stool sample and bring that into your appointment. What you want to do is over the course of a couple of days, take a couple of fecal samples. I know it’s gross and not ideal, but you want to mix that, keep it at home, and bring in that mixed sample to really give us a best chance to see if it’s appropriately clear. Once that is the case, you can reintroduce to other animals. 

MD [50:02] This is getting back to that moving to a new property/assume the property is infected: They want to know if they should treat their dogs preventatively before they move?

NR [50:13] I wouldn’t. If they’re uninfected, I would not. I would clean as best you can. I know it can be difficult to clean at a time before exposing the animals to that environment, but I would do our best to keep that clean before introducing them. If they’re showing no signs and having no issues, I would not treat before being exposed to a new environment.

MD [50:32] We got a request to drop the names of those pre and probiotics in the chat. If you could…

NR [50:43] I can definitely write that in.

MD [50:43] Should you treat the mother at the same time as the pups for Giardia or Coccidia? Is this a family affair?

NR [50:52] It depends. If we’re having samples that are positive with both the pups and the mom, possibly. Once again, it’s an individual circumstance where I would speak with your veterinarian. But if both animals are positive and symptomatic, yes. I would recommend that. 

MD [51:10] Do working dogs tend to be more exposed to Coccidia than other pets?

NR [51:15] It depends. Unfortunately, I’m in Manhattan, in the city. If you take an animal out on the sidewalk, there are a ton of dogs and things aren’t really being cleaned. Even if they are being picked up, organic matter continues to reside on the sidewalk. They’re being exposed in the environment, but there may not be other animals present. It depends. If it is in the environment, in that soil, it’s more likely, because they’re working outside. But once again, not necessarily more so than other animals that are exposed to it frequently in other environments. 

MD [51:56] I personally love questions about poop, so I’m pretty excited: Can a fecal sample be frozen? Does it have to be fresh? You mentioned mixing samples together. What are they supposed to do with those samples in between puppy poops? 

NR [52:12] It would be over the course of two days. To the best of your ability, at least two or three different fecal movements. Keep it in the refrigerator. I wouldn’t freeze it. Try to keep it as fresh as possible. Obviously difficult to do when you’re collecting multiple samples. But that would be my recommendation there.

MD [52:31] Ziplock baggie fine? 

NR [52:34] Ziplock baggie is fine. When you go in your initial puppy visit, or if you go as a breeder, they have a lot of those. Just take a bunch home. They’ll be happy to give those to you. But, yes, a Ziplock bag is perfectly appropriate as well.

MD [52:49] What do you do for puppies who have diarrhea but their fecals come back negative? 

NR [52:55] Unfortunately, diarrhea can be a pretty big clinical sign, and there can be a lot of different things going on there. I would speak with your individual veterinarian that has done physical exams on those animals, see if they would recommend further testing and what have you, to try to get to the bottom of that and try to get to the solution. 

MD [53:14] How many times can you safely do the 10-12 day regiment of the fenben for recurring cases, and at what point should you be switching to a different treatment, such as metronidazole? That’s question one, and then I have a follow-up question.

NR [53:26] Fair enough. Like I spoke to, I like to do an initial course. Wait 3 weeks, return a secondary course of that fenben, and test. If it’s still positive, that’s when (in my opinion) I would try to use metronidazole in conjunction. It depends on the treatment course. I wouldn’t do it for necessarily that long. I would start with 5-day treatment courses at a time. But like I said, speak to your individual veterinarian. Which treatment course would they recommend? If you’re frustrated and it’s coming back continually positive, if after one or two treatment courses, that’s when you can talk about alternative treatment methods. Once again, to determine whether it’s even necessary to continue, if it’s something where your animal is not symptomatic or you can try to affect the stool quality with food or probiotics or what have you, you can try that. As long as the animal is otherwise doing well. I understand these are very frustrating infections to deal with. There’s a lot of different ways to go about treating it. 

MD [54:35] Not a one-fits-all kind of treatment. You really need that personal treatment plan. The second question is: should vaccinations be withheld if a puppy is being treated for Giardia or Coccidia?

NR [54:45] That’s a great question. I would say if they’re not symptomatic, I would say that it’s appropriate. Obviously we don’t want to vaccinate animals that are showing clinical signs or that are not doing well. If diarrhea is present along with that, I would recommend withholding the vaccination. It’s really, once again, up to your individual circumstance and that veterinarian’s advice. With the core vaccines, we don’t want to delay for too long. It’s important to keep them protected. We have to weigh the risks and the benefits. Hopefully some mild diarrhea as a result of some of these infections—much less concerning than some of the others, if they’re not properly vaccinated or protected. If possible in terms of the schedule and the timing of those vaccines, if you’re able to wait when they’re showing clinical signs, I definitely would. 

MD [55:36] You are treating the dam and the pups at the same time. Is the fenben crossing over from the breast milk into the puppies? Are the puppies getting double-dosed?

NR [55:47] Fenbendazole is safe. I know with Albon, that’s certainly possible, and that’s why I do not necessarily recommend it. I would be more concerned with the Coccidia in that case. That’s why (as Trisha touched on) you need to be very, very careful when going about that infection in our dogs. But fenbendazole would be safe to use. I would discuss it with your veterinarian, in terms of double-dose, but no, I believe it would be safe for both. 

MD [56:21] We are almost at the end of our webinar. I’ll probably squeeze in one or two more questions. Sonya says two of her dogs ate some nasty-looking wildlife stool a couple of days ago, before she could stop them. How soon should she take a stool sample in to get checked?

NR [56:37] That’s up to you. In that case, if we’re not showing clinical signs and the dog is seemingly doing well, you do not have to. If you are concerned with that, you can bring that in at your convenience. Honestly, dogs get into a lot of things that aren’t particularly pleasant. If they’re doing well otherwise, you may not necessarily need to test. But if you’re worried and concerned, always appropriate to do. 

MD [57:07] And what would be too soon? The next day would probably be too soon, I assume? As far as expecting when something might actually show up if it’s going to.

NR [57:12] Maybe the tail-end of that week. Give it a few days, if there were anything to be concerned about to show its face. 

MD [57:25] On that note, we’re going to wrap! Thank you so much! I should never have doubted that our community would give us 40 minutes of questions. We probably could have kept going, so thanks, everybody. Great questions! Really great to see you all so engaged. Of course, this recording will be available later. 

NR [57:43] One last point: when we’re talking about discussing this with your veterinarian, this isn’t to be dismissive. I know it’s frustrating to hear. It’s not even necessarily saying go in and have an appointment with your vet. As Trisha spoke to earlier, getting them on the phone or emailing them. After my day of appointments, one or two hours would be used for callbacks and responding to emails. It’s really to get individualized care for your dog. Everyone here has an individual circumstance. Different breeds. Different home environment. Different number of dogs. I would love to give that specific advice. I’m just not in a position to, over something like this. That’s why it’s so important to have a working relationship with your veterinarian, to give the best care you can. 

MD [58:30] That’s a great point. Everyone comes here, and we all want a specific answer. Sometimes we have to give more generalities. But again we really appreciate your involvement and questions. Keep them coming! We’ll see you at our next webinar, and don’t forget to register for our symposium: September 18! We’ll see you there. It’s free. It’s going to be all day. It’s going to be amazing. Thanks from all of us at Good Dog! Ciao!