Podcast: Mosquitos, Mo-Problems for Pets (Episode 4)

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Cat Heartworms Suck This is part two of our discussion about parasites, and apparently it came just in time!

There's a new CDC warning about the dangers of fleas, ticks and mosquitos for humans, and a new study saying most pet owners are oblivious to tick-borne illnessesThey're not oblivious, they just haven't listened to our podcasts yet!


Play Paws & Play episode Mosquitos, Mo' Problems
Paws & Play Mosquitos, Mo' Problems

Full Paws & Play podcast transcript:

Mia: Welcome back to another episode of Paws and Play with Dr J. I'm Mia and I'm here with Dr. J, how you doing?

Dr. J: I'm doing great Mia. Thanks. How are you?

Mia: I'm doing all right. Except for actually last night I ended up needing to take Marshall to the emergency vet, thankfully all as well. He's doing fine. While we were waiting though, actually a couple brought in their puppy who had a tick removed earlier that day and was starting to present with some symptoms. So, um, I guess another reminder that it's important to check your animals for ticks and pay attention so you know, when they're not acting like themselves.

Dr. J: Indeed, and use preventatives too! Which we talked about last week. Where was that story last week, Mia?

Mia: It was out there! But speaking of preventatives, we're going to be doing part two today, and it's a really important conversation. Specifically, we're starting out with heartworms, which, I am just realizing how ignorant I have been my entire life up until starting at Preventive Vet.

Dr. J: Let's just say unaware, not ignorant.

Mia: Thank you, thank you. But it actually blew my mind learning that heartworms come from mosquitoes.

Dr. J: Yeah. So, they're transmitted by the bite of an infected mosquito, a mosquito bites an infected dog and sucks up some of the little baby worms, if you will. And then there's some development that happens there. And then when they next bite, another dog or the other thing that tends to blow people's minds, is cats are susceptible as well. So if an infected mosquito bites a cat or a dog, then there's the risk of transmission of heartworm to that cat or dog.

Mia: I was thinking about this recently because the weather has gotten really nice lately, which you and I were just celebrating. And so we have opened our windows and it lets a really nice cross breeze in and Mazel, our cat, loves to stare at everything out the window and stalk all the insects on the outside. But of course he's also really great at stocking the animals on the inside and I don't know how these insects get in here. They're much larger than mosquitoes most of the time. So obviously it's not like they can't get in here, which is really troubling.

Dr. J: Yeah. I mean, and I think a lot of people think that window screens are super protective and they do have a protective effect obviously. But window screens get torn, windows get opened that don't have screens on them perhaps. Then of course we're constantly opening our front door and even if it's got a screen door in front of it, you've got to open it to get in as well as sliding patio doors, deck doors, balcony doors even in, higher apartment buildings. So there's always a way for mosquitoes to get in and where there's a will, there's a way. And where there's a way, there's a mosquito, um, you know, I think we've all been bitten by a mosquito in her own home or apartment. So yeah, our indoor only pets, cats and dogs are also at risk.

Mia: Yeah. Well if there really was a way to keep all the bugs out, then my Swiffer wouldn't have a tupperware attached to it with rubber bands and being used to get rid of spiders on the ceiling, which by the way it works really, really well. Lifehack. Really great for getting them on the ceilings and then just throwing them out the door, (once you get it open).

Mia: So you, you had said that what happens is the infected mosquito, is it that they're somehow laying eggs in the bloodstream and then somehow surrounds the heart?

Dr. J: No, no. So when a mosquito takes a bite, sucks blood from an infected dog, they suck up these little, you know, an immature, very early development stage of the heartworm.

Mia: So they're getting it from a dog that is already infected. Or a cat.

Dr. J: So basically it's a reservoir that the mosquitoes are basically taking it from and then there's some development that happens within the mosquito. And then these little baby worms again, if you will, I keep calling them baby worms. They're larvae or microfilaria. Baby worms tends to be a bit more palatable for most people, understandably. So, when they then bite the next dog or cat that's not on a preventative, I guess either way. Then they inoculate, they put these little baby worms into the bloodstream of the dog or cat.  A dog or cat that's on a preventative, that preventative will kill those baby worms before they have an opportunity to develop into adult worms and caused heartworm disease. If they're not on a preventative then those baby worms will continue to mature, grow into adult worms and then produce more baby worms. And that's when we then start having a lot of worms within the circulatory system. Um, you know, uh, that can cause some extremely, extremely significant problems in both cats and dogs.

Mia: You know, a lot of places when I first moved here, I was told actually by a veterinarian that I didn't need to have Marshall on a heartworm preventative, which I had never heard before in my life, I guess because it's not, it's not as prevalent here as Chicago apparently, or I've just never even heard of that.

Dr. J: Well, I would say it hasn't been as prevalent, perhaps would be more correct. The mosquito habitats, if you will, and the length of time that they're sticking around is changing. And so we're seeing an increased prevalence, around the country, and it's difficult to know because there's also a lot of cats and dogs that are walking around out there with heartworm infections that are strays and so aren't brought to the vet, aren't tested, or even dogs and cats that aren't strays that are owned but haven't been tested in a while.

It is recommended to test cats and dogs every year just to make sure that we know what we're dealing with and we can start treatment if necessary as early as possible. Because again, those are reservoirs, right?

So if you've got a stray dog in your neighborhood that is heartworm positive, a mosquito bites that dog and then it comes over and bites your dog, your dog is at risk because there are other dogs, strays or owned, in your neighborhood that are not on preventative and are potentially harboring and acting as a reservoir host for heartworm disease and infection to affect your dog.

Mia: Well, you know, it's really important that you brought that up. And it also just made me think about, and I had forwarded to you the story of, Henri le Frenchie and he's just this adorable Frenchie who has been dealing with a lot of health issues actually lately.

He just had spinal surgery and, so he ended up, thank God it ended up being a false positive that he tested for, but his owner had posted that he had been tested for heartworm and it came up positive even though he had been on preventatives his whole life. Again, this ended up being, thankfully a false positive.

But she had also mentioned that a lot of it was coming into California because after Hurricane Katrina, there were a lot of dogs that had been relocated to California. And they had it. So, you know, that's something also to think about because there's been unfortunately a lot more natural disasters and a lot more rehoming lately.

Dr. J: And even if we were to test all those dogs coming in, which is really impractical, it takes roughly six months from the time of a mosquito bite to get a positive test result because we're depending on adult worms and it can take that long for them to mature once they get into the bloodstream.

So with all these natural disasters and rehoming and you know, more dogs travel with their owners and sometimes those dogs escape. So if they're coming from an area where heartworm is not very prevalent, and again, that's changing, and then they go to a heartworm endemic area and they escape and they get or they don't escape and they just get bitten by a mosquito and then they come back, and six months later, now they could be a reservoir in the town that they live in where perhaps it wasn't previously endemic. So mosquitoes don't respect, uh, you know, state borders.

Mia: Those (meow)holes

Dr. J: Right? The nerve!

Mia: Well, I can say, looking at the heartworm heat maps over time study from the American Heartworm Society, it looks like there's consistently cases of heartworm diagnosed all over the country actually, but things look especially wormy over in the southeast and midwest, like parts of Texas, Louisiana, Tennessee, creeping up into Illinois. And then of course, you know, some parts of California look pretty bad. So just definitely something in general to think about when traveling with your pets. And speaking of traveling with your pets, I forgot to ask you on the last episode so I'm happy that we're bringing it up right now — let's say that you don't have your animals on a preventative because you feel comfortable doing that in the area that you live.

Dr. J: Which you shouldn't. You shouldn't feel comfortable.

Mia: Well, right, but let's say that that's happening and you're going to travel and be taking them with you. What are some of the guidelines, like should there be some months leading up to the trip for them to start preventatives or what? Can they just take it? Well, first of all, are there rules against, I guess bundling? Let's say that their animals are on a flea and tick preventative, is it necessarily safe to bundle a heartworm?

Dr. J: Yeah. I mean it depends and, these are definitely conversations for people to have individually with their veterinarian because there are so many factors involved. And also because if you're going to start a heartworm preventative, your pet should be tested before starting it ideally. Because you there's no sense in giving a heartworm preventative to a dog that's already heartworm positive, in which case you need to start treatment. But you really want to test beforehand and that could take, if they run it in-house, that could take a matter of, you know, 20, 30 minutes. If they send it out, which most practices do and I think it's a good idea to do so, if they send it out, can take anywhere from 24 to 72 hours to get back. So ideally having the conversation earlier with your vet, but let's say that your pets on a flea tick only preventative, there are medications that are just heartworm preventative and fortunately those also then give you, oftentimes, some intestinal parasite protection as well.

Dr. J: So those things can be added on as necessary. And usually they're effective, for the most part, from the time you give them, so you don't necessarily have to build up, you know, two, three months beforehand, but again, I mean you can avoid these problems by ideally having your pet on what I would call "four quadrant parasite coverage", ideally throughout the year, or at least for fleas ideally for heartworms, which would then oftentimes give you intestinal parasite protection and then honestly, again, ticks, the time that ticks are sticking around or coming out is also getting longer. So really just having them on protection year round and avoiding the problems because the cost of treatment for a lot of these things and the medical problems that can arise are quite significant and often times more costly than parasite preventatives throughout the year.

Mia: Great points. And of course sometimes it's easier said than done because the preventatives can be costly. But, you had brought up something about not being able to give the (preventative), obviously because you haven't prevented it if your dog or cat has tested positive for it, but — so one of the followups to Henri the Frenchie's story is that her vet had put him on Heartgard for heartworm prevention because she said that the medicine isn't dangerous if your pup already has heartworm But as you mentioned, that's not always good. So not every heartworm preventative can do that.

Dr. J: Correct. And I, and I think as a blanket statement, that Heartgard isn't dangerous if your dog has heartworm is a bit too general. I mean Heartgard tends to be part of the treatment protocol for dogs that are diagnosed to be heartworm positive initially before starting the other medications in that treatment protocol because it can kill those baby worms and help increase the likelihood of success of your overall treatment program.

So you know, in a dog that is diagnosed positive with heartworm, some people might be wondering why you then start them on a heartworm preventative. That's part of the reason why it's to prevent additional infections and to start killing those little baby worms so they can't grow into new adult worms while you're doing the adult killing treatment for heartworms in dogs. And again, this might be an opportunity where, where I should mention, a lot of people don't realize that heartworm disease can affect cats.

There are safe and effective heartworm preventatives for cats. There is no safe and effective heartworm treatment for cats though.

And so, you know, we talked about treatment for heartworms we're mostly talking about dogs because there are licensed treatments and treatments that have shown to be safe and effective in dogs, but not really in cats. We're extremely limited in cats that develop heartworm infections and it can take far fewer worms in cats to cause significant problems. And unfortunately in cats, oftentimes the first sign that they have heartworm disease is sudden death.

And so I really want to stress for people, because fortunately the awareness of heartworm disease in dogs and heartworm infections in dogs is thankfully growing, but in cats we're still really behind the eight ball in terms of getting people to realize that heartworm prevention in cats, including indoor only cats is still very important. And again, thankfully if you're treating where something that'll prevent heartworm disease in cats, you're typically also treating with something that will help prevent intestinal worms as well as fleas. So there's really a lot of reasons to have them on this type of preventative. And again, year around.

Mia: So. Okay, well that really sucks. I mean it, it really sucks if the first way that people normally know that it can present with it is that they is the sudden death. And I was going to ask if there was anything to look out for, but you know, just, it sounds like...

Dr. J: That's a, you know, cats with heartworm disease... Oftentimes dogs with heartworm disease will cough. Cats with heartworm disease don't always cough. Cats with heart disease don't always cough, whereas typically in dogs with most heart conditions, they'll cough if they're having a problem, their heart's getting enlarged. But cats don't. I mean even something as seemingly innocuous, although it's not, but seemingly innocuous as just kind of vomiting in cats. I think a lot of people who assume that cats just vomit regularly as a normal everyday occurrence

Mia: We're actually going to have another podcast on that topic later!

Dr. J: Perfect. Yeah. So we'll cover that then, but it's not the case. Vomiting and cats is not normal, you know, even like, daily hairballs is not normal. But anyway, vomiting and cats can actually be a sign of heartworm disease. So cats with heartworm disease or heartworm infestations can show the sign of vomiting. So it's the signs in cats tend to be significantly more subtle.

Mia: As per usual.

Dr. J: Right? Exactly. They're great at hiding. Things are not typically your endurance athlete. It's not like you're taking them out and throwing the ball for them or they're going swimming and tiring more easily. They might just be laying around more, but you know, what's the difference between 20 and 20 and a half hours? Most people aren't going to realize that. So it really, it's important to have preventatives onboard for heartworm protection in both cats and dogs, but I just really want to stress, cats unfortunately, oftentimes get the short end of the stick and this is definitely one of those areas where that's often the case and it really needs to change because of heartworm disease in cats is a real thing and it can be quite devastating.

Mia: Well, and mosquitoes in general are not fun for, for any of us. So if you are going to be outside and of course now a lot of people, and — you might hear Marshall in the background and I'm sorry if you do, he's trying to sit on my lap on my chair. There's a lot of catios being built these days. And of course a lot of people enjoy a, there, the outside with their cats and always their dogs. If we're going to be outdoors, what are some of the things that we can do to make them more comfortable so and ourselves.

Dr. J: You mean as far as mosquitoes?

Mia: Yeah. I mean, I know that lots of puddles of water, extra water is always going to be an issue.  But I guess I'm particularly interested in some of the essential oils or citronella candles and stuff like that that have typically been recommended. But then there's also some other cautions when it comes to using with our animals. So I'd like to, I guess if you have a stance on any of that hear, more about it. Um, and you know, and I know that with essential oils and diffusers and things like that, that indoors can definitely pose a huge health risk. But outdoors, I'm wondering if, if maybe it would be a little bit more relaxed,

Dr. J: Right. So, yeah, I mean essential oils can be effective. I mean, things like mint can be effective in keeping mosquitoes at bay and catnip is actually in the mint family. But as we've sort of seen with the diffusers and such, cats are extremely sensitive to essential oils so they really have to be heavily diluted to be safe and used around cats.

But even planting things like mint around your, around your property may help to keep mosquitoes at bay. Things like Citronella, same type of thing. You know, you hit on one of the biggest ones that I think people underutilize is making sure that, you know, sources of standing water aren't really around on your property. So that includes empty flower pots, tires if you've got them laying around. Pool covers is another big one, right.

Dr. J: So if you've got a pool and then it rains and you have it covered and then that just sort of sags and has a little puddle there, that's a great mosquito breeding ground. Ponds and such. So having those have more air circulation to them and maybe even having fish that would eat the mosquito eggs. So those things can help a lot. There are some mosquito repellents, some of the products out there that have some mosquito repellency activity that you can use on dogs. The problem is that a lot of those use like pyrethrin or permethrins.

Mia: I was actually going to ask exactly that.

Dr. J: Yeah. Well, and that, and that's important. So I'm happy you were going to ask it. I probably should have assumed you were, but I figured out I'll go there.

Mia: Never, assume.

Dr. J: That's right. Especially when it comes to pet safety! So pyrethrins and permethrins, which I think we discussed in last week's episode on fleas, you know, it can be highly toxic to cats at the dosages at which they're safely used on dogs. So again, if you've got cats and dogs that are friendly, which most of them are, don't know how to fight like cats and dogs is such a big saying.

Mia: Mine are big lovers.

Dr. J: Yeah, mine too. So you just, you've got to be really careful using even dog label products on dogs that interact with cats. So just a word of caution there, but it is kind of a two-way street as far as protecting against heartworm disease.

Dr. J: It's keeping mosquitoes at bay as best you can and also having them in a heartworm preventative so that should they get bitten by an infected mosquito, they will have a better chance of not developing a problematic heartworm infection and heartworm disease.

But part of the reason for the repellents for keeping mosquitoes at bay, is it's not just heartworm disease that mosquitoes transmit, as we've talked about, I mean both for people and for pets, West Nile, Zika, all that fun stuff. Mosquitoes are nasty little buggers. So keeping them at bay but also keeping your pets protected specifically from heartworm infections is very important.

Mia: So we've talked about some products that are okay to use on dogs but not on cats. One thing that I guess I also missed asking you, so again, never assume, is there anything that we need to be concerned about in terms of using certain preventatives if you have children at home, and if not the preventatives, some of the stuff that our animals do pick up. Any of those things that we should be particularly concerned about? And maybe this is a topic for another episode.

Dr. J: No, I think it's a good one to interject here and we'll cover it later, maybe in another one as well. But you know, I think for me, though a lot of the topicals are safe, especially once they dry for kids to be touching. I just tend to prefer, and as a father of two young girls with other, they're not toddlers anymore, I tend to prefer the oral parasite preventatives when you can do it on cats and dogs. Just to minimize any exposure, any touch exposure and then fingers the mouth and stuff like that.

But also, again, if you've got them on something, again that's covering against heartworm, a lot of the heartworm preventatives, not all, but a lot of them also protect against intestinal parasites, intestinal worms, and that's very important when you've got young kids, especially toddlers and infants that are crawling around, spending a lot of time on the floor, don't wash their hands very well, liked to stick their hands in their mouths.

Mia: Like to stick their hands in their mouths and then your mouths.

Dr. J: Exactly. Everywhere. And so it's nice to have that additional protection against intestinal worms. So again, these are conversations for people to have with their vet and be very forthright about what other animals they have in the house, whether they've got young kids. And whether those are young kids that live in the house or grandkids that come over and spend a couple of days during the week. Those are things to all keep in mind and those are conversations to have with your veterinarian because they can best help you determine what is the best parasite preventative or preventatives for your pets in your specific household, in the area that you live, and they're your best resource as opposed to going into like a pet store or even an online source or something like that.

Mia: I don't know why this just popped into my head, but something that we may not really think about too often, some of these, you can actually bring it in on your shoes too, right?

Dr. J: Yeah a lot of the intestinal worms, the eggs and such, you can bring in on your shoes.

Mia: So let's talk a little about that because Mazel likes to sit on top of my shoes and I guess maybe I should be a little more concerned than I have been.

Dr. J: Yeah, like when we go out and we walk across fields or dirt or whatever it is. I mean, wherever we're walking, right, we're walking in an outside environment, it's not sterile, it's not clean. Intestinal parasites and worm eggs and such like that, especially if you live in an environment in a community where not a lot of cats and dogs are on routine parasite preventatives, those intestinal worm eggs are going to be prevalent in your environment.

So if you're walking through a field where a dog that's got a hookworm or a roundworm infection or something like that, or a cat with round worms, you may well be bringing that into your house and then getting those eggs into the carpet on your floors where your dog or cat may then lick it up and then they could actually get a, if it's the right infective stage of development of the egg, they can then get an intestinal worm infection as well.

Mia: Well, so maybe we should back up a little and dive headfirst into intestinal worms.

Dr. J: Sounds like fun. Sounds like an episode or a scene out of Indiana Jones. Smaller, smaller scale.

Mia: Yes and, thankfully, because I'm not prepared for that. So what, what are some of the, I guess, most common intestinal worms to be looking out for and is there stuff that we can be looking out for?

Dr. J: I mean, as far as the, so let's say common types, roundworms, hookworms and whipworms are probably some of them, are the most common types for cats and dogs. And actually, sorry, tapeworms as well. And just as an aside, you know, tapeworms oftentimes means that you have a flea infestation problem because that's usually where cats and dogs get infected with tape worms, is by eating fleas that themselves have eaten tapeworm eggs and that's how the cats and dogs and get the tape worm.

So, if you're seeing the little moving grains of rice looking things around your cat or dog's butt or on their poop, those are most likely tapeworms and you definitely want to talk to your vet and also have them evaluated for fleas because those two oftentimes go together.

But as far as the others, the roundworms hookworms whipworms, oftentimes though, not always, if your cat or dog, has a intestinal worm infection, you'll frequently see loose stools, so diarrhea, maybe not complete liquid, but loose stools. You may see some blood in the stool, you may see that they're having larger volumes of stools. They might be defecating outside the litter box.

If it's a cat, they might just be having more urge to go out. Sometimes if they have a really heavy intestinal worm burden, those worms, a lot of them, they suck blood, so you might get an anemic pet who's got a low red blood cell count. They can damage the lining of the gut, which can make it leaky and they can leak proteins. So you may see a dog that's losing weight and losing muscle mass, so you might be starting to see their ribs a little bit more prominently.

They might just be losing weight. They might be voracious, they might be eating a ton, but still losing weight. So they can be pretty bad and some of them can be zoonotic so they can be passed along to people and cause problems.

Typically in people, it's young babies and toddlers again, that aren't very good at hygiene and washing their hands. And then elderly folks, so if you've got an elderly parent that lives with you or someone who's immunocompromised, so someone who's on, you know, cancer chemotherapy or treatment for AIDS or something like that where their immune system is suppressed, they're going to be at greater risk of getting a parasite infection from a pet if they, if they develop it.

Mia: Ugh, lots of stuff to worry about.

Dr. J: Skin crawling?

Mia: Little bit. Yeah. Um, after we did the fleas episode, I could not stop itching. It really felt like the, it was just, it was not good for my brain. Let's just say that.

Dr. J: Yeah, see we vets, we learned to turn that off in probably like second or third year of vet school, just because you see so much of this and you're like, okay, I don't really have fleas. And then we wind up with it. And then, yeah.

Mia: So if you have multiple animals at home and one of them tests positive for any of these parasites, what should you do? And what, if you don't have a lot of different rooms or are sharing an apartment and it's not necessarily easy to — I'm assuming that obviously it would be good to keep them separated, but sometimes I don't know how easy or practical that is.

Dr. J: I mean really, ideally all in-contact animals should be evaluated and treated. One, so that if they have a current infection, you can get rid of it, and two, so that as the treated animals are kind of getting rid of their infection, they're not just passing it along or the one that maybe didn't have an infection then just goes out and gets another infection, becomes a source of reinfection. It kind of becomes a bit of a vicious cycle. So really all in-contact animals should be treated.

And it's not uncommon for people that have multiple cats to, you know, bring in a poop sample — say they've got three cats and they bring in, you know, the cats in for, for their wellness exams and they bring in a poop sample like I don't know whose this is and you test and it comes back positive for worms.

Though we do have a, I should just mention, we do have a trick on the website for figuring out which cat the poop belongs to.

Mia: Yes and it's very colorful and fun.

Dr. J: It is. So maybe we should link that in this podcast because I think that'd be fun for people. But what we'll do is basically send off a batched sample. Right? So if you've got three cats and you bring in, you know, two things of poop, it's probably not from all three of them, but it kinda doesn't matter from the standpoint of if one of them comes up positive, all three of them probably have, you know, they've been exposed, probably are positive, but it regardless should all be treated. So it really is important to have all pets in the household on a safe and effective parasite preventative program regularly.

Mia: One question again that I had that I should have maybe asked in the first podcast on this topic was why are some preventatives available over the counter versus prescription? Like is there a, is there a huge difference? Is it in the...

Dr. J: It's mostly in the formulation so that the topical ones, and not all of them because some of those are prescription, right? So things like Revolution, Advantage Multi because they also protect against heartworm, they've got a different compound in there. So typically, the topicals are more available over the counter, whereas the orals and some of the more, what I guess we should call "advanced topicals", are by prescription only. And that's really because, these are conversations, these are topics that people should be discussing with their vet because there can be contra-indications, so reasons why you wouldn't give a particular medication to a particular pet based on preexisting health conditions or the rest of the home environment. And so that's kind of the main reason why we're typically talking about EPA versus FDA. For the most part, anything that goes on topically, it tends to be regulated by the EPA. Whereas the oral stuff tends to be regulated by the FDA.

Dr. J: And so there's a, there's a difference there as well. And you know, a lot of people, like you mentioned earlier, costs — and I totally, I totally get that. Especially if you've got multiple pets. So a lot of people are tempted to get their parasite preventative from an online pharmacy or some other resource.

One of the advantages, and I think your story about, what's his name? Henri le Frenchie, kind of highlights it, is that if you get your parasite preventatives from your veterinarian, typically the manufacturer will cover the cost of retesting and treatment if they've been on that preventative consistently as per the label instructions. And they still come down with an infection of what it was supposed to be protecting against. So if you've got a dog on say Heartgard or Trifexis and they come down with a roundworm infestation, usually the manufacturer will cover the costs of testing and treatment because they guarantee it.

Same thing with heartworm disease. But if you get your parasite preventatives from an online pharmacy, if you get them from a resource that's not your veterinarian, typically those medications do not come with that manufacturer's guarantee and it's not uncommon for the medications that you're getting from certain online pharmacies to be coming in, say from Canada or Mexico or just be counterfeit. I think there was actually recently a big court case of a guy, I want to say maybe in New York, that was supplying what we would call the "gray market" with counterfeit parasiticides. And that's dangerous.

Mia: That's terrible!

Dr. J: Yeah, and one, because we don't know whether or not they're safe to be giving, and that can be problematic. And two, we don't know whether or not they're gonna be effective at preventing these infestations. And so, you know, if it's heartworm disease that can be fatal.

If it's fleas that can be fatal based on the diseases they can transmit and certainly problematic and quite a bit of a nuisance.

Mia: Great warning. I hadn't heard about that with the counterfeiting, but that's really disturbing. And perhaps I shouldn't be so surprised these days. So let's, unless you have other stuff that you want to jump into with the intestinal worms?

Dr. J: I don't think so. I think just, with the intestinal worms, it's the importance of bringing a poop sample to your vet for testing at least once a year, ideally, every six months, um, is important for checking. But even if you're testing, you know, no test really is 100 percent sensitive so there may be infestations that we don't pick up on, even if you bring us, especially if you don't bring a lot of poop, or maybe if they've got a worm infestation but they're not at the stage of laying eggs, you know, you might get back what will be called the false negative.

So I think it's important to have them on a preventative but still have the poop tested. Again, especially if you've got young children in the house or anybody that's immunocompromised, it will be important to have the poop tested on a regular basis. I mean, how many other people can you say like actually want you to bring them poop?

Mia: (laughing)

Dr. J: We vets and our teams are a weird breed. Like we want you to bring us poop. Ideally your pet's.

Mia: Yeah, I was going to say I don't know if that's necessarily the type of party I want to be invited to, but...

Dr. J: Exactly.

Mia: Let's, I guess move on just slightly. Although we've talked a lot about some communal stuff and when it comes to communal Giardia pops into my head immediately. So not a worm, but another parasite.

Dr. J: Yeah it's what's called a protozoal parasite and it can affect cats and dogs, and people, as well. And, it can cause some pretty nasty diarrhea. Some pretty foul smelling diarrhea. They typically get it from drinking contaminated water or eating mud, which of course is dirt and water, that's been contaminated with the effective stage of the Giardia organism.

And it can be passed between cats and dogs in the same household as well. And so it's definitely something to be on the lookout for.

Mia: I mean, I think one of the big things to think about here, because obviously a lot of people may be listening to this and thinking, well, my dog doesn't lick from puddles or he doesn't roll around in mud...

Dr. J: They've gotten a perfect dog.

Mia: Well, I mean, Marshall's up there, but, the thing is, I would say at this point in time, one of the biggest cautions would be the communal water bowls that are, you know, at the dog parks or outside of (restaurants and shops), which is great. It's a really sweet, great gesture, but you don't know what's happening, you know, in between.

Dr. J: Yeah it's 100 percent something else to be aware of because they are out there. So you're right, that should be on the list of risk areas along with puddles and mud and the communal water bowls, because you're right, that is a really nice gesture. Especially as the temperatures go up and more shops are putting water bowls outside. I mean it's a nice marketing tactic, but it's also just a really nice thing to do because dogs need water.

But at the dog park and the communal water bowls, definitely it's a potential source for Giardia infection. And unfortunately a lot of people don't realize that their dogs are infected, which they still bring them to the dog park or some people know that their dogs infected, they're on treatment, they still bring them to the dog park that puts every other dog at risk there as well.

So being on the lookout for Giardia. There is a vaccine or was a vaccine, I don't even know if it's made anymore. It's not terribly effective. Typically not recommended.

There is safe and effective treatment, but it is important that while they're under treatment that you keep them isolated in terms of where they're pooping and make sure to pick that up immediately so it's not a source of reinfection. Uh, and then typically on the last day of treatment, you want to give your dog a bath, at least a butt bath, so that you can be sure to remove any of the cysts that could potentially be a source for reinfection.

Mia: So what are, what are these cysts that you talk of? And are they butt cysts?

Dr. J: No, no they're not butt cysts, you won't see them. They're microscopic, but they are basically a lifecycle stage of the Giardia organism that can be a little bit resistant to things that might otherwise kill protozoa so you can make them more resistant to dehydrating and things of that nature. So it's a way that they exist in the environment that helps them survive under less than ideal conditions and they can develop into, or they are, the infective stage of Giardia.

So if your dog, and the reason why I mentioned the butt bath and the cysts on there is that when your dog's defecating and they've got Giardia infection, those cysts can, these tiny microscopic little lifecycle stages of the Giardia, can stick to their little butt fur or under their tail or whatever, and then fall off or their dog, your dog can groom themselves back there and ingest the cysts and become reinfected again. So you may have just spent all this time and money on doing the treatment for Giardia, only to then have them turn around and become reinfected. And then you're back to square one.

Mia: I mean, you had said, you know, to look out for Giardia, is there anything really that you can look out for? Like I guess maybe some message boards or something? Maybe there are some veterinary practices that are putting notices out there for prevalent outbreaks  in the area. But beyond that, is there anything else you know to really be looking for?

Dr. J: Not really, unfortunately, I mean because seasonally, I think we'll see spikes, but honestly, I mean it can kind of happen whenever. I mean, you know, spring, summer, fall. Winter, perhaps less likely, and it depends on what part of the country you're in. Our winters here, we don't typically freeze, but we still get a lot of mud so it can kind of happen anytime, you know. But yes, I mean if, if you know that there's been an outbreak of Giardia already in the dog park that you typically go to, then I would avoid that dog park for awhile.

Mia: Well, and also it's probably an important note to make sure that when you look around your dog park, there's not poop everywhere, right? Because it sounds like a lot of this stuff getting transferred is through poop.

Dr. J: That's left to sit there and then just kind of get worked back into the soil, if you will. Um, yeah, yeah. So making sure that you're going to a dog park that's hygienic looking. Clean. If you go to the dog park and there's a dog that's having diarrhea all over the place, that might be a good thing to avoid. And if your dog is diagnosed with Giardia, really, keep them away from the dog park until they get the all clear from your vet.

And even in your yard, restrict them to a specific area so you know that you were able to pick up that poop as quickly as possible because you just, you don't want to get into this vicious cycle that a lot of people wind up in, where they spend the money, they spend the time on treating Giardia only to have it reinfect because they haven't done the butt bath or the picking up the poop and taking care of the environment.

Because that can get understandably frustrating for people, as well as for the vets and the vet teams that are doing the treatment, because we don't want animals getting continually sick or reinfected. We want to treat them if they get sick or infected and we want to get them better and we want to get them out there enjoying life and just see people in their pets for social visits if we can.

Mia: Yeah, that would, that would be the best wouldn't it?

Dr. J: Then vet med can be what most people think it is, which is just playing with puppies and kittens all day, which unfortunately very much is not, but if we can get a little bit closer to that, I think there's plenty of people, plenty of my colleagues that would be psyched to have a little more time playing with puppies and kittens.

Mia: And that would be better really for all of us. And I'm very fortunate that I get to do that, but it's, it's never enough. Never enough. Well thanks again Dr. J, this has been great and we'll be back with another podcast shortly.

Dr. J: Sounds good, Mia. Thank you.

About the author

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Mia Horberg

Mia Horberg is a Digital Strategist at Preventive Vet, and when she's not working she is watching Jeopardy! with her wife, planting flowers and veggies, and hanging out with her senior rescue pug Mabel Petrillo, and exotic shorthair kitty, Mazel von Schmear Visage. A lover of all animals, Mia is also lucky enough to volunteer at a rescue where she gets to hang out with goats and sheep every week.

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