Ewwww, Gross!

Even though I loved my professor, ( Dr. Hendrix, who interviewed me and called at 6 am one morning to inform me I had FINALLY been accepted after applying to that particular school, Auburn, 3 years in a row) parasitology was one of my worst subjects in school. The internal and external "hitchhikers" on animals (and humans-ewww, gross!) are just nasty. Even though a veterinarian is supposed to love all creatures great and small, worms and fleas and mites are just out of luck as far as I am concerned.

We often get calls from worried owners when they find a worm in their pet's feces or in their bedding. I don't know why, but we tend to describe the way worms look in food terms. I suppose they are just familiar references. "Does the worm look like a spaghetti noodle, round and long, or like rice segments, short and flat?" "Does the thing in the bedding or on his hind end look like a little dried up sesame seed?" We generally recommend that the owner bring in a sample of the pet's feces if there is any doubt so we can test it and see for ourselves. Fecal testing involves centrifuging (spinning) and floating a sample in a solution to allow eggs of worms and other microscopic organisms such as coccidia and giardia, to rise to the top. We then draw a bit of this top fluid off the sample and examine it under the microscope. We also take a smear of the fecal matter and look at that directly, often finding things not evident on the spun sample. Eggs of tapeworms, for example, are often shed in "packets," too heavy to float in most standard solutions. We rely on visual identification of the wiggling "rice-like" segments or the dried up "sesame seeds." in the bedding to make a diagnosis.

Tapeworms (Dipylidium caninum) are an interesting (though still gross-I'm not going back on my original claim!) creature due to the stages of their life cycle. The adult worms live in the small intestine of the cat or dog. Theoretically, they can also infest humans, but they aren't zoonotic or contagious from the pet. They hook into the intestinal wall, but do not "suck" nutrition as do hookworms. Instead, they absorb nutrition through their "skin" as the food passes by the worm on its travels through the digestive tract of the infested animal. All the segments are hooked together, end-on-end, sometimes reaching over 6 inches. There is another species of tapeworms, (Taenia Hydatigena) that can grow up to 5 YARDS long! That is just not right.

As the worm matures, the end segments, which are really just the egg packets we described at this point, detach from the rest of the worm. These are passed in the feces and observant owners see them, bright white, glistening, wiggly "rice." These packets break down and release tiny eggs into the environment or on the animal, usually in the same vicinity where there are fleas going through their life cycles. Larval fleas will eat the flea "dirt" or dried blood passed by adult fleas, along with the tapeworm eggs. When a pet grooms itself or chews its fur because it is itchy, it will often ingest one or more of these infested fleas. Once inside the host animal, the young tapeworm is released, ready to attach to the small intestine and start the cycle all over again. There is no other way a pet (or human) can get the Diplidium tapeworm-it had to eat a flea. The less common Taenia tapeworm is contracted through eating prey animals or rotting carcasses.

Fortunately, the treatment for tapeworms is easy and safe. Praziquantel is the drug of choice, given as a single dose. It can be expensive, but what isn't these days? It is also essential that good flea control is implemented or the pet will immediately become reinfested. The drug rarely "fails." Much more likely is the pet clearing the current adult parasites, ingesting another flea, and starting the life cycle again. It takes 3 weeks for a tapeworm to go from being swallowed by the pet inside the flea to shedding segments in the feces (and thus being seen by the owner.) It is not necessary to deworm all of the pets in one household just because one has the segments-that is, unless you see the segments on each pet or on all of their bedding. We only give medication like dewormers to the animals that need it.

We like to save some of the really "good" parasites that people have brought to us over the years for identification-we have a "chamber of horrors" on an upper shelf that is really popular with the school tours when they come through. All together now, "Ewwwww, gross!"

Peace,
DrReneigh

Congratulations, President-elect Obama

We had a strange season for fleas this year. All summer seemed to be pretty manageable, then when October came, so did the fleas. My staff were trimming Verbal's nails and found some on her. I was mortified! The vet's dog certainly shouldn't have fleas. Granted, her monthly flea control was due that very day, but wasn't over due, so she sure shouldn't have been infested. Yuck. Parasitology was one of my worst subjects in school. I hate those little creatures. We saw two darling little 7 or 8 week old kittens last week absolutely covered in fleas. We gave them a great medication called Capstar, a one-time pill that kills fleas in 30 MINUTES. During those kittens' exams, we just kept picking off the dying carcasses of those nasty bugs, stopping our count after a hundred or so. They were lucky little kittens. Some can be so infested that they become anemic-the fleas actually eat so much of their blood that they can no longer carry oxygen through their blood stream and they can literally suffocate. We had an ADULT cat die from flea anemia last year. How tragic is that, something so preventable?
There are some pretty great flea prevention products available for our cats and dogs. We carry Frontline Plus and Vectra because they not only kill the adult stage of the fleas but also prevent eggs and larva from hatching. No flea product has any efficacy against the pupae (cocoon) stage or keeps the flea from biting at all. Whatever you do, keep the harsh chemicals like pyrethrins away from cats (these are found in some dog products like Vectra and Advantix) and are actually sold as safe for cats in products like Hartz and Seargents drops, collars, and shampoos. They are NOT SAFE. They can cause tremors, seizures, and death in some cats and even some dogs. We lost a 160 pound Mastiff from a flea powder-he started seizuring and never stopped. What's more, these products don't even work. We often see fleas crawling right over flea collars on patients that come in the hospital. There is even an "antidote" page on their manufacturer's website. Wonderful, huh?

Flea allergy dermatitis (FAD) is a condition of the immune system where the bite from a single flea can cause pruritis (itching) and alopecia (hair loss) for up to 6 WEEKS on an affected pet. The hair loss pattern is usually found around the hind end and tail of the dog, and sometimes around the neck and head of cats. Other than moving your pet to Alaska to avoid fleas all together, the only thing you can do to help a pet with FAD is to practice diligent flea control on the pets year round and in the environment (house and yard,) as well as treat allergy symptoms before the pet scratches him or herself raw and makes secondary infections in the skin. Antihistamines can help a small percentage of animals, so can soothing oatmeal/antihistamine baths and topical sprays.
Oh, and did you know that fleas are an important part of the tapeworm life cycle? That's right. Tapeworm eggs are found inside the flea, so when a pet is chewing or grooming themselves and ingests a flea, it eats the tapeworm egg. Most often only segments of tapeworms are passed from the affected animals body. These segments will look like little wiggling grains of white rice stuck to the hairs under your pet's tail or on the fresh feces. They may look like little sesame seeds on the bedding when the segments dry out. I sure don't know why we insist on describing these things with food analogies! Gross.

Call your vet if the symptoms of FAD are becoming evident. Sometimes stronger anti-inflammatory medications are needed to break the cycle of the immune reaction.

Peace,
DrReneigh

Oh, I want to express my sincere sympathies to my head technician, Amber and her husband, Rob, who had to say good bye to their cat, Lucky last night. Remember the blog I wrote called Cancer Sucks? Well, it really does. Lucky was just diagnosed with a fairly rare condition called lung-digit syndrome where he had cancer that occurred in his lung and in his toes. Weird, but then cancer can do any darned thing it wants. Lucky had a strong personality and could be a bit of a butt-head at times. I know that is why he will always have a special place in their hearts. He was much too young to have this happen to. I am so sorry that my dear colleague has to hurt so very much.