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Coccidiosis, Intestinal 187

Coccidiosis, Intestinal Client Education
Sheet
VetBooks.ir Diseases and Disorders

oocysts on routine fecal flotation examination
BASIC INFORMATION
in the presence of appropriate clinical findings. duration of diarrhea and the length of shedding
in young kittens in two separate studies in an
Definition animal shelter environment.
A diarrheal disease caused by intestinal tract Differential Diagnosis
infection with Apicomplexan parasites in the • Viral diarrhea: parvovirus, coronavirus, Drug Interactions
genus Cystoisospora rotavirus Sulfonamides with cyclosporin, ACE inhibitors,
• Bacterial diarrhea: Clostridium, Campylo- warfarin
Synonym bacter, Salmonella enteritides
Isospora • Other gastrointestinal parasites Recommended Monitoring
• Dietary indiscretion Adult animals with documented coccidiosis
Epidemiology should be evaluated for other causes of
SPECIES, AGE, SEX Initial Database intestinal disease (e.g., inflammatory bowel
• Dogs and cats • Fecal flotation examination and demonstra- disease, lymphoma) or immunocompromise
• Generally very young animals or animals tion of characteristic oocysts. False-negative (e.g., hyperadrenocorticism).
that are immunosuppressed results are uncommon, but erratic shedding of
oocysts can necessitate repeat examinations. PROGNOSIS & OUTCOME
RISK FACTORS • Presence of oocysts in immunocompetent
• Recent weaning or overcrowded conditions adult animals is most likely incidental. Good to excellent; most animals respond readily
• Immunosuppression • Parvovirus ELISA is indicated for affected to treatment.
• Co-infection with other intestinal organisms puppies and kittens with severe diarrhea to
investigate concurrent parvoviral enteritis PEARLS & CONSIDERATIONS
CONTAGION AND ZOONOSIS and panleukopenia, respectively.
Cystoisospora spp are host specific and do not • Kittens (>4 months) should be tested for Comments
infect people. feline leukemia virus or feline immunode- • It is virtually impossible to prevent exposure
ficiency virus. to coccidia in dogs and cats.
GEOGRAPHY AND SEASONALITY • Rarely, regenerative anemia may develop from • Clinical disease often develops around
Worldwide distribution, present year round excessive intestinal blood loss from heavy weaning or after other stressful events such
parasite burdens. as shipping or rehoming.
Clinical Presentation • The strategic use of newer anticoccidials
HISTORY, CHIEF COMPLAINT TREATMENT (ponazuril) at times when animals are likely
• Vomiting to develop coccidiosis may become common
• Diarrhea with or without blood; often foul Treatment Overview practice in the future. An example of a stra-
smelling, pasty, and semiformed to liquid Goals of treatment are remission of diarrhea tegic treatment would be administration of
• Inappetence and cessation of oocyst shedding. ponazuril a few days before (or at) weaning.
PHYSICAL EXAM FINDINGS Acute General Treatment Prevention
• Weight loss (or poor growth) Drug of choice: sulfadimethoxine (Albon oral Coccidiosis tends to be a problem in unsanitary
• Dehydration suspension 5%): environments.
• Possible abdominal discomfort • 50-60 mg/kg PO q 24h for 5-20 days • Prompt removal of feces is important.
• To prevent dehydration, adequate water • Do not allow fecal contamination of food
Etiology and Pathophysiology intake must be maintained during treatment. and water bowls.
• Intestinal coccidiosis in cats is caused by • Supportive care includes fluids; providing a • Treatment of dams and queens before
Cystoisospora felis and Cystoisospora rivolta. warm, dry environment; and a high-quality, parturition can decrease prevalence.
Intestinal coccidiosis in dogs is caused by highly digestible diet. • Cockroaches and flies may serve as mechani-
Cystoisospora canis, Cystoisospora ohioensis, Off-label: cal vectors of oocysts.
Cystoisospora neorivolta, and Cystoisospora • Ponazuril (Marquis) 20 mg/kg PO twice,
burrowsi. 1-7 days apart, or 50 mg/kg PO once Technician Tips
• Infection follows ingestion of sporulated • A combination of sulfadimethoxine with • Oocysts are very resistant and can survive
oocysts; sporozoites infect intestinal epithelial ormetoprim (Primor) 55 mg/kg PO q 24h freezing temperatures and environmental
cells. (for up to 21 days) is also effective. conditions for many months.
• Intestinal damage is caused by rupture of • Amprolium (Corid) 300-400 mg/DOSE PO q • Cages and fomites should be disinfected
infected host cells lining the small intestinal 24h for 5 days in dogs, with the lower dosage with steam cleaning, boiling water, or 10%
villi. Villous atrophy and villous erosions recommended for puppies; 60-100 mg/DOSE ammonia solution.
occur secondary to parasite multiplication. PO q 24h for 5 days in cats. Amprolium
is bitter, and care should be taken that the SUGGESTED READING
DIAGNOSIS dose is ingested and not spit out. Litster AL, et al: Use of ponazuril paste to treat
coccidiosis in shelter-housed cats and dogs. Vet
Diagnostic Overview Nutrition/Diet Parasitol 202:319-325, 2014.
Diagnosis is suspected in pups or kittens with Highly digestible diets with the addition of a AUTHOR: Katherine D. Scott, DVM, DACVIM
diarrhea. Diagnosis is confirmed by finding probiotic has been helpful in shortening the EDITOR: Rance K. Sellon, DVM, PhD, DACVIM

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