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<DIV dir=ltr align=left><FONT face=Tahoma size=2><B>Subject:</B> giardia
infection in dogs<BR></FONT><BR></DIV>
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<P><BR>Giardia (Giardia canis)<BR><BR>Holly Nash, DVM, MS<BR>Veterinary Services
Department, Drs. Foster & Smith,<BR>Inc.<BR><BR>Giardia are protozoa
(one-celled organisms) that live<BR>in the small intestine of dogs and cats.
Giardia are<BR>found throughout the United States and in many<BR>other parts of
the world. Infection with Giardia is<BR>called 'giardiasis.<WBR>'<BR><BR>There
are many things we do not know about this<BR>parasite. Experts do not agree on
how many species of<BR>Giardia there are and which ones affect which
animals.<BR>Veterinarians do not even agree on how common Giardia<BR>infections
are and when they should be treated.<BR>Generally, it is believed that infection
with Giardia<BR>is common but disease is rare. There is much about the<BR>life
cycle we do not know either.<BR><BR>How do Giardia reproduce and how are they
transmitted?<BR><BR>Giardia multiply by dividing.<BR><BR>A dog becomes infected
by eating the<BR>cyst<BR>form of the parasite. In the small intestine, the
cyst<BR>opens and releases an active form called a<BR>trophozoite. These have
flagella, hair-like structures<BR>that whip back and forth allowing them to move
around.<BR>They attach to the intestinal wall and reproduce by<BR>dividing in
two. After an unknown number of<BR>divisions, at some stage, in an unknown
location, this<BR>form develops a wall around itself (encysts) and is<BR>passed
in the feces. The Giardia in the feces<BR>can contaminate the environment and
water and infect<BR>other animals and people.<BR><BR>What are the signs of a
Giardia infection?<BR><BR>Most infections with Giardia
are<BR>asymptomatic.<BR>In the rare cases in which disease occurs,
younger<BR>animals are usually affected, and the usual sign is<BR>diarrhea. The
diarrhea may be<BR>acute,<BR>intermittent, or<BR>chronic.<BR>Usually the
infected animals will not lose their<BR>appetite, but they may lose weight. The
feces are<BR>often abnormal, being pale, having a bad odor,
and<BR>appearing<BR>greasy. In the intestine, Giardia prevents
proper<BR>absorption of<BR>nutrients,<BR>damages the delicate intestinal lining,
and interferes<BR>with digestion.<BR><BR>Can Giardia of dogs infect
people?<BR><BR>This is another unknown. There are many species of<BR>Giardia,
and experts do not know if these species<BR>infect only
specific<BR>hosts.<BR>Sources of some human infections have possibly
been<BR>linked to beavers, other wild animals, and<BR>domestic animals.<BR>Until
we know otherwise, it would be wise to consider<BR>infected animals capable of
transmitting Giardia to<BR>humans.<BR><BR>You may have heard about Giardia
outbreaks occurring<BR>in humans due to drinking contaminated
water.<BR>Contamination of urban water supplies with Giardia is<BR>usually
attributed to (human) sewage effluents. In<BR>rural settings, beavers most often
get the blame for<BR>contaminating lakes and streams. Giardia outbreaks<BR>have
also occurred in day care centers fueled by the<BR>less than optimal hygienic
practices of children.<BR><BR>How do we diagnose giardiasis?<BR><BR>Giardiasis
is very difficult to diagnose because the<BR>protozoa are so small and are not
passed with every<BR>stool. Tests on serial stool samples (one stool<BR>sample
every day for three days) are often required to<BR>find the organism. Special
diagnostic procedures,<BR>beyond a routine fecal examination, are
necessary<BR>to identify Giardia. The procedures we use to
identify<BR>roundworms and hookworms kill the active form of<BR>Giardia and
concentrate the cyst form.<BR><BR>To see the active form, a small amount of
stool may be<BR>mixed with water on a microscope slide and examined<BR>under
high magnification. Because these forms<BR>have flagella, you can see them move
around on the<BR>slide. The active forms are more commonly found in<BR>loose
stools. If you ever have the opportunity to<BR>see the active form of Giardia
under the microscope,<BR>take it! It is an interesting-<WBR>looking creature. It
is<BR>pear-shaped and its anatomy makes it look like<BR>a cartoon face, with
eyes (which often look crossed),<BR>nose, and mouth. Once you see it, you will
not forget<BR>it.<BR><BR>Cysts are more commonly found in firm stools.
Special<BR>solutions are used to separate the cysts from the rest<BR>of the
stool. The portion of the solution that<BR>would contain the cysts is then
examined<BR>microscopically.<BR><BR>In spring, 2004, a diagnostic test using
ELISA<BR>technology became available. This test uses a very<BR>small fecal
sample, and can be performed in 8 minutes<BR>in a veterinarian'<WBR>s office. It
is much more accurate<BR>than a fecal examination.<BR><BR>We have done the
tests, now what?<BR><BR>Now we come to how to interpret the test results.
It<BR>can be a dilemma for your veterinarian. What you see<BR>(or do not see) is
not always a correct indication<BR>of what you have. A negative test may mean
the animal<BR>is not infected. However, few, if any, laboratory<BR>tests are
100% accurate. Negative test results<BR>can also occur in some infected animals.
If a negative<BR>test occurs, your veterinarian will often suggest<BR>repeating
the test.<BR><BR>What about a positive test? That should not be hard
to<BR>interpret, right? Wrong. Giardia can be found in many<BR>dogs with and
without diarrhea. If we find<BR>Giardia, is it the cause of the diarrhea or is
it just<BR>coincidence we found it? The animal could actually<BR>have diarrhea
caused by a bacterial infection,<BR>and we just happened to find the Giardia.
Test results<BR>always need to be interpreted in light of the
signs,<BR>symptoms, and medical history.<BR><BR>If we find Giardia, how do we
treat it?<BR><BR>Here we go again; treatment is controversial too.<BR>There is a
question about when to treat. If Giardia is<BR>found in a dog without symptoms
should we treat<BR>the animal? Since we should not know if G. canis
can<BR>infect man, we often err on the side of caution and<BR>treat an
asymptomatic infected animal to prevent<BR>possible transmission to
people.<BR><BR>If we highly suspect infection with Giardia, but can<BR>not find
the organism, should we treat anyway? This is<BR>often done. Because it is often
difficult to<BR>detect Giardia in the feces of dogs with diarrhea, if<BR>there
are no other obvious causes of diarrhea (e.g.;<BR>the dog did not get into the
garbage several<BR>nights ago) we often treat the animal for
giardiasis.<BR><BR>There are several treatments for giardiasis, although<BR>some
of them have not been<BR>FDA-<BR>approved for that use in dogs. Fenbendazole is
an<BR>antiparasitic drug that kills some intestinal worms<BR>and can help
control giardia. It may be used alone<BR>or with metronidazole. Metronidazole
can kill some<BR>types of bacteria that could cause diarrhea. So if
the<BR>diarrhea was caused by bacteria, and not Giardia,<BR>the bacteria can be
killed and the symptoms<BR>eliminated. Unfortunately, metronidazole has
some<BR>drawbacks. It has been found to be only 60-70%<BR>effective<BR>in
eliminating Giardia from infected dogs, and<BR>probably is not 100% effective in
cats, either. It can<BR>be toxic to the<BR>liver<BR>in some animals. It is
suspected of being a teratogen<BR>(an agent that causes physical defects in
the<BR>developing embryo), so it should not be used in<BR>pregnant<BR>animals.
Finally, it has a very bitter taste and many<BR>animals resent taking it –
especially cats.<BR><BR>Quinacrine hydrochloride has been used in the
past,<BR>but is not very effective and can cause side effects<BR>such as
lethargy, vomiting, anorexia, and fever.<BR><BR>But now we come to yet another
unknown. It is possible<BR>these treatments only remove the cysts from the
feces<BR>but do not kill all the Giardia in the intestine.<BR>This means even
though the fecal exams after treatment<BR>may be negative, the organism is still
present in the<BR>intestine. This is especially true of the<BR>older treatments.
So treated animals could still be a<BR>source of infection for
others.<BR><BR>How can I prevent my pet from becoming infected
with<BR>Giardia?<BR><BR>The cysts can live several weeks to months outside
the<BR>host in wet, cold environments. So lawns, parks,<BR>kennels, and other
areas that may be contaminated<BR>with animal feces can be a source of infection
for<BR>your pet. You should keep your pet away from areas<BR>contaminated by the
feces of other animals. This<BR>is not always easy.<BR><BR>As with other
parasites of the digestive system,<BR>prevention of the spread of Giardia
centers on testing<BR>and treating infected animals and using
sanitary<BR>measures to reduce or kill the organisms in the<BR>environment.
Solutions of Lysol, bleach, and<BR>quaternary ammonium compounds are effective
against<BR>Giardia.<BR><BR>How do I control Giardia in my
kennel?<BR><BR>Infection with Giardia can be a big problem in<BR>kennels, and a
multi-faceted approach is needed.<BR><BR>Treat Animals: Treat all nonpregnant
animals with<BR>fenbendazole for 5 days. On the last day of treatment,<BR>move
them to a holding facility while a clean area<BR>is established. When the
animals are moved back to the<BR>clean area, treat them once again with a 5-day
course<BR>of fenbendazole or albendazole.<BR><BR>Decontaminate the Environment:
Establish a clean area.<BR>If possible, this can be the whole
facility.<BR>Otherwise, create a few clean runs or cages, separate<BR>from the
others. Remove all fecal material from the<BR>areas since the organic matter in
feces can greatly<BR>decrease the effectiveness of many disinfectants.<BR>Steam
clean the area. Quaternary ammonium<BR>disinfectants used according to
manufacturer'<WBR>s<BR>directions or a 1:5 or 1:10 solution of bleach
can<BR>usually kill<BR>the cysts within one minute. Allow the area to dry
for<BR>several days before reintroducing the animals. NOTE:<BR>Use extreme
caution when using quaternary ammonium<BR>compounds and bleach solutions. Use
proper<BR>ventilation, gloves, protective clothing and follow<BR>your
veterinarian'<WBR>s recommendations.<BR><BR>Clean the Animals: Cysts can remain
stuck to the<BR>haircoats of infected animals. So during treatment and<BR>before
moving the treated animals to the clean area,<BR>they should be regularly
shampooed and rinsed well.<BR>Especially concentrate on the perianal
area.<BR><BR>Prevent Reintroduction of Giardia: Giardia can be<BR>brought into
the kennel either by introducing an<BR>infected animal or on your shoes or
boots. Any new<BR>animal<BR>should be quarantined from the rest of the animals
and<BR>be treated and cleaned as described above. You should<BR>either use
disposable shoe covers or clean<BR>shoes/boots and use a footbath containing
quaternary<BR>ammonium compounds to prevent people from<BR>reintroducing
Giardia.<BR><BR>Remember, Giardia of dogs may infect people, so
good,<BR>personal hygiene should be used by adults when<BR>cleaning kennels or
picking up the yard, and by<BR>children<BR>who may play with pets or in
potentially contaminated<BR>areas.<BR><BR>References and Further
Reading<BR><BR>Barr, SC; Bowman, DD. Giardiasis in dogs and cats.<BR>Compendium
on Continuing Education for the Practicing<BR>Veterinarian.
1994;16(5):603-<WBR>614.<BR><BR>Barr, SC; Bowman, DD; Frongillo, MF; Joseph,
SL.<BR>Efficacy of a drug combination of praziquantel,<BR>pyrantel pamoate, and
febental against giardiasis in<BR>dogs.<BR>American Journal of Veterinary
Research.<BR>1998;59(1):1134-<WBR>1136.<BR><BR>Georgi, JR; Georgi, ME. Canine
Clinical Parasitology.<BR>Lea & Febiger. Philadelphia, PA;
1992;59-61.<BR><BR>Griffiths, HJ. A Handbook of Veterinary
Parasitology.<BR>University of Minnesota Press. Minneapolis,
MN;<BR>1978;21-22.<BR><BR>Hendrix, CM. Diagnostic Veterinary
Parasitology.<BR>Mosby, Inc. St. Louis, MO; 1998;19-20.<BR><BR>Meyer, EK.
Adverse events associated with albendazole<BR>and other products used for
treatment of giardiasis in<BR>dogs. Journal of the American Veterinary
Medical<BR>Association. 1998;213(1):<WBR>44-46.<BR><BR>Sherding, RG; Johnson,
SE. Diseases of the intestine.<BR>In Birchard, SJ; Sherding, RG (eds.) Saunders
Manual<BR>of Small Animal Practice. W.B. Saunders Co.<BR>Philadelphia,<BR>PA;
1994;699-700.<BR><BR>Sousby, EJL. Helminths, arthropods and protozoa
of<BR>domesticated animals. Lea & Febiger. Philadelphia,
PA;<BR>1982;577-580.<BR><BR>Zajac, AM; LaBranche, TP; Donoghue, AR;
Chu,<BR>Teng-Chiao. Efficacy of fenbendazole in the treatment<BR>of experimental
Giardia infection in dogs. American<BR>Journal<BR>of Veterinary Research.
1998;59(1):61-<WBR>63.<BR><BR>PetEducation.<WBR>com - Information on Pet Care,
Diseases,<BR>Diet, and Behavior<BR>Owned & Operated by Practicing
Veterinarians<BR><BR>Copyright © 1997-2007, Foster & Smith, Inc. All
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}
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#ygrp-vital {
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#ygrp-vital UL LI {
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#ygrp-vital UL LI .cat {
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}
#ygrp-vital A {
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#ygrp-vital A:hover {
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}
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#ygrp-sponsor #ov LI {
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#ygrp-sponsor .ad A {
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#ygrp-sponsor .ad P {
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o {
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.MsoNormal {
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#ygrp-text TT {
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BLOCKQUOTE {
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.replbq {
        
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