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Cat Forum / General Topics / April 2006Treatment for Coccidia and Giardia: How to convince my vet I don't need stool sample
Active and outwardly healthy female (who has had Coccidia and Giardia before) who is an indoor-outdoor cat (who drinks from bird-bath when we're not looking, and who does bring in a mouse or mole every once in a while but never eats them). We recently observed that her stool (on one occasion) was runny. I want to put her on the same course of meds that she got before (about 2 years ago) and I DON'T want to go through the hassle and expense of a stool sample that will tell us that yes, she has either Coccisia or Giardia or both. My analogy here is that when I have a headache, I don't first go get an MRI or CT scan to tell me I don't have an aneurysm - instead I simply take a tylenol or asprin. Either the Vet will be stubborn about this (because they like the extra revenue from the test) or they won't, but am I out of line to just ask for the meds without a stool sample? We recently had another cat (a stray that we are rehabilitating in a confined room in the house) stool tested and it came back as positive for Coccidia and Giardia. The test cost $61 ($52 for "Ova & Parasite/SAF-Vetguard" and $9 for "vetgard sample collection/prep"). Albendazole 250 mg/ml ($21.80) Sulfadimethoxine (300 mg chew, qty = 1) - $15.82 Sulfadimethoxine (125 mg chew, qty = 25) - $43.35 Now that I look at this bill now, what pisses me off is that I was charged $16 for 1 pill (the initial dose) where I could simply administer 2.5 of the regular pills instead (which cost about $2 each). I wanted to give this cat a combination of Sulfadimethoxine (Albon) and trimethoprim-sulfadiazine (Tribrissen) right off the bat because: ------------------- Trimethoprim is an effective antibiotic that becomes even more effective when combined with a sulfonamide (sulfa drug), such as sulfadiazine and sulfamethoxazole. The combination exhibits a greater spectrum of activity against microorganisms that cause infectious disease. The addition of trimethoprim to a sulfa drug forms a potentiated sulfa. Trimethoprim plus sulfadiazine and trimethoprim plus sulfamethoxazole are the most often-used combinations in veterinary medicine. These are similar in antibiotic function and may be used interchangeably. Trimethoprim-sulfa can kill a variety of bacteria. An additional effect of potentiated sulfa drugs is an ability to kill or suppress certain intracellular parasites, particularly Coccidia spp. and the microorganism responsible for the disease Toxoplasmosis. ------------------ The vet says "we use both sulfadimethoxine and trimethoprim-sulfa as needed". Well bull sh.t. If the combination is a hell of a lot better than just the sulfa drug, and there's no additional risk to add trimethoprim, then why the hell not use them both right off the bat? Who wants to wait for a 2-week couse of this treatment and then find out you've got to repeat it? Pisses me off that (a) they will probably want a $60 poo test for something we already know is there, and (b) they won't add the trimetoprim for the giardia treatment. Comments? I think I'm going to buy this sh.t on the internet so I can administer it as need to our household of 4 indoor/outdoor cats. This back-and-forth with a vet and poo sample sh.t is just too much bother. > Active and outwardly healthy female (who has had Coccidia and Giardia > before) who is an indoor-outdoor cat (who drinks from bird-bath when [quoted text clipped - 66 lines] > it as need to our household of 4 indoor/outdoor cats. This > back-and-forth with a vet and poo sample sh.t is just too much bother. And what school did you get you DVM from? When you get sick, lets say a ear infection can you call up you MD and get meds, or do they usually tell you to come and get checked? If you vet were to just give out meds w/o running test and you cat were to died or get worst who are you going to yell at, the vet? Gonna try to get thier license taking away, sue? Probably not but how do they know that? I dont think any doctor would take that chance, do you see what I mean? You have to look at from their side too. > > Active and outwardly healthy female (who has had Coccidia and > > Giardia before) [quoted text clipped - 5 lines] > And what school did you get you DVM from? When you get sick, > lets say a ear infection can you call up you MD and get meds, I wish I could. > If you vet were to just give out meds w/o running test Look. These meds for coccidia and giardia are safe, even if given to a cat that doesn't have coccidia or giardia, especially if the cat HAS HAD THE MEDS BEFORE. As the cat is displaying NO SYMPTOMS WHAT SO EVER that would indicate some serious problem, and I have reason to believe the cat DOES HAVE coccidia or giardia, then I see no risk in simply obtaining and administering the drugs, AND THEN SEE IF THE LOOSE STOOL GOES AWAY. As far as I can tell, Albendazole and Sulfadimethoxine are to cats what asprin is to us. Headaches are a common for humans, and asprin is a common self-prescribed remedy. Intestinal parasites are a common for indoor/outdoor cats, and Albendazole and Sulfadimethoxine SHOULD BE OBTAINABLE IN A HASSLE-FREE MANNER FOR CATS WHO SHOW A PREDILICTION TO GETTING THE PARASITE. It's criminal that the test: (a) will almost certainly tell you what you already know (that the cat has giardia or coccidia) (b) will practically double the cost of treatment (c) add the inconvenience of a trip to the vet (to deliver the poo sample) and add a few days (or a week) to start the treatment (because it takes that long to get the test results) (d) if you're lucky, you won't have to repeat the test a 2'nd or third time (because the test is notorious for not picking it up the first time). In our case, the vet didn't have one of the drugs, which are supposed to be among the most commonly-prescribed drugs in veterinary medicine. Being a practice in the inner city, I don't think they get much exposure to outdoor cats and these parasites. There are lots of drugs available over-the-counter for people. Drugs for intestinal parasites should also be available FOR OWNERS WHO HAVE EXPERIENCE IN TREATING THEIR CATS for these nuisance problems. Do you give your cats revolution or advantage? Is flea powder available over-the-counter? How many owners would throw a fit if they had to get a prescription for that stuff? ----- Original Message ----- From: "Cat Guy" <Cat@Guy.com> Newsgroups: rec.pets.cats.health+behav,alt.cats,alt.pets.cats Sent: Saturday, April 15, 2006 1:36 PM Subject: Re: Treatment for Coccidia and Giardia: How to convince my vet I don't need stool sample \> Look. These meds for coccidia and giardia are safe, even if given to > a cat that doesn't have coccidia or giardia, especially if the cat HAS > HAD THE MEDS BEFORE. Of course you're right because you studied pharmacology in medical school, yes? And just because a cat has had the medications before, doesn't mean they're safe. It just means that there was no reaction the first time. "While generally safe and effective when prescribed by a veterinarian, trimethoprim and sulfamethoxazole can cause side effects in some animals. The following are known side effects organized by organ system: Hematologic: Agranulocytosis, aplastic anemia, thrombocytopenia, leukopenia, neutropenia, hemolytic anemia, megaloblastic anemia, hypoprothrombinemia, methemoglobinemia, eosinophilia. Allergic Reactions: Epidermal necrolysis, anaphylaxis, allergic myocarditis, erythema multiforme, exfoliative dermatitis, angioedema, drug fever, purpura, serum sickness-like syndrome, generalized allergic reactions, generalized skin eruptions, photosensitivity, conjunctival and scleral injection, pruritus, urticaria, and rash. In addition, periarteritis nodosa and systemic lupus erythematosus have been reported in humans. Gastrointestinal: Hepatitis, including cholestatic jaundice and hepatic necrosis, elevation of serum transaminases and bilirubin, pseudomembranous enterocolitis, pancreatitis, stomatitis, glossitis, nausea, emesis, abdominal pain, diarrhea, anorexia. Genitourinary: Renal failure, interstitial nephritis, BUN and serum creatinine elevation, toxic nephrosis with oliguria and anuria, and crystalluria. Metabolic: Hyperkalemia, hyponatremia. Neurologic: Aseptic meningitis, convulsions, peripheral neuritis, ataxia, vertigo, tinnitus, headache. CNS: Depression, apathy, anxiety. Endocrine: Cross-sensitivity may exist with diuretics (acetazolamide and the thiazides), and oral hypoglycemic agents. Diuresis and hypoglycemia have occurred in human patients receiving sulfonamides. Trimethoprim-sulfamethoxazole combination has been demonstrated to reduce thyroid hormone levels to below the normal reference range. Musculoskeletal: Arthralgia and myalgia. Respiratory System: Cough, dyspnea, and pulmonary infiltrates." Mar --------- VTIT > Of course you're right because you studied pharmacology in > medical school, yes? And just because a cat has had the > medications before, doesn't mean they're safe. It just means > that there was no reaction the first time. And the vet is going to somehow know ->if a cat is going to have a reacion to these drugs?<- How? There is no test. The drugs are prescribed based on poo test (which I say is not needed for the observant owner with experience). The vet IS NOT EXCERCISING ANY SPECIAL VET-SCHOOL KNOWLEDGE IN PRESCRIBING THESE DRUGS. 1) -> Vet asks for poo sample 2) -> sample comes back positive for giardia and/or coccidia 3) -> vet writes script. For the observant owner with experience, I see no harm in this: 1) -> owner knows cat is prone to getting Giardia/Coccidia 2) -> owner sees specific risk behavior being performed by cat 3) -> cat has been treated before 4) -> cat currently has loose stool, no other symptoms 5) -> owner asks vet for 1 round of drugs without submitting poo sample (which would double the price of the entire therapeutic process) The vet is depending on regulatory agencies to certifiy these drugs (and most every other drug) as safe to administer. The vet doesn't perform ANY test (not that there is one available) to see if a cat will have a reaction to these drugs. The vet doesn't even give any directions to LOOK FOR A REACTION when handing it over to the owner. Stop worshiping the vet in this case. They know as much as you or I on the indications in giving these drugs. They know it's safe (or they wouldn't be approved in the first place). > "While generally safe and effective when prescribed by a > veterinarian, And somehow they magically become *not safe* when "prescribed" by the owners? > trimethoprim and sulfamethoxazole can cause side effects in some > animals. The following are known side effects organized by > organ system: If a cat is succeptible to these problems, then how does it differ whether or not the vet writes a script for the drug or if I obtain them on my own? Or even if I ask my vet for them without going throught the hassle of a poo sample? -> It doesn't. There is no difference. <- If a cat is going to have a reaction to these drugs, it will happen regardless if I get the poo tested first, or if I obtain the drugs from a vet or on my own. The vet IS NOT GOING TO KNOW IF A CAT IS GOING TO HAVE A REACTION to these drugs any better than I (the owner) is going to know. > And the vet is going to somehow know ->if a cat is going to have a > reacion to these drugs?<- How? There is no test. The drugs are [quoted text clipped - 15 lines] > poo sample (which would double the price of the entire > therapeutic process) Could be a troll. On the off chance not, I'd say: My vet is much more careful than I am about treating my cats. I've come to be grateful to her for this. And to rely on her judgement. She's come to rely on our observations. I've come to rely on her correction of my jumping to conclusions and arrogance. What you say about the cost, I don't know how to answer. Generally you're paying for professional's opinion and advice. You don't want it, you shouldn't have to pay for it. The cat may want it but she's not paying, eh? About administering the meds: if the cat has coccidiosis/giardiasis, then the meds will work, so administering them would be good. Unless cat has reaction, when the cat would be harmed. If the cat doesn't have coccidiosis/giardiasis, then the meds will not work, so administering them would be useless. If they do no harm, ok. If the meds not only do not work but also do harm, then administering them will cause harm. Also, if the cat has something else that is time sensitive, the delay in diagnosis and treatment could cause the cat harm. How much are you willing to bet that the cat will be ok? > > > Active and outwardly healthy female (who has had Coccidia and > > > Giardia before) [quoted text clipped - 17 lines] > some serious problem, and I have reason to believe the cat DOES HAVE > coccidia or giardia, I hate to burst your little bubble, Einstein, but there's a good chance your cat doesn't have giardia since the symptoms returned. Many cats with recurrent symptoms have been found to have Tritrichomona foetus- which is now considered to be an important emerging intestinal parasite in cats- that's difficult to distinguish from giardia. The reason why your cat's symptoms appeared to resolve after treatment is probably because T. foetus depends on normal gut bacteria- which antimicobials kill- for nutrients. That's why the trichomonads returned when you stopped the antimicobials. By giving your cat drugs for something tou *think* your cat *might* have, the only thing you will be accomplishing is perpetuating multiple drug resistance- if you think you have a problem now... you ain't seen nothin' yet. If you want to save a few bucks on the test, order the InPouch TF test from BioMed, have your vet prepare the test and send it to the Parasitology Lab at KSU. The test, including reading only costs $25- you can handle $25, can't you? > By giving your cat drugs for something tou *think* your cat *might* have, > the only thing you will be accomplishing is perpetuating multiple drug > resistance- if you think you have a problem now... you ain't seen nothin' > yet. My first thought to the OP, was there is no way to know for certain with out the test what your cat has. You say he goes out and about on his own. He might just have a plain ol tape worm or round worms, then you have REALLY wasted your money haven't you? You say those two particular drugs are like aspirin to humans.. Really? that is why they are sold over the counter at your local mega mart, or even at 1800petmeds.com. they are so safe and have no problems what so ever.. Think twice would you? There is a reason these substances are controlled. If you just got the meds, you could be doing more harm than good. see quoted piece above, not to mention masking a more serious problem.. what if your cat has intestinal cancer and these drugs clear up the runs for a while, you'll assume your cat is healthy, when you are really letting him get sicker. Yes, extreme case, but you can't say it hasn't ever happened. LASTLY, those "expensive" vet visits are what keeps your vet in practice. If he started handing out meds with out looking at pets, he would greatly reduce his income (not to mention opening himself up to all kinds of legal problems). with out income, he can't pay for the lights, the rent or taxes, nor his staff... not to mention feed himself. So then he'll go on to be something else, and he won't be there when your cat is "really ill" (cause you don't think he is now). Then what will you do?? > My first thought to the OP, was there is no way to know for > certain with out the test what your cat has. The female cat in question has actually been treated TWICE in the last 3 years for Giardia/Coccidia. Her out-door activities are confined to the back yard, but she manages to find water to drink from (which sometimes is a bird bath). She also catches plenty of mice and voles (which she brings inside the house - absolutely no evidence she has ever eaten one). Absolutely no evidence she has tape worms (which would be visible in areas where she sleeps in the house). The current issue revolves around 1 chance observation of loose stool in the back yard being deposited by this cat. As I said earlier, she is heathy, spunky otherwise. I could simply NOT follow this up with the vet and let her continue to (probably) have the giardia/coccidia. I would rather just simply obtain the same meds and give her another round and then at some point later make some effort to watch her poo and see if it's solid. That's it. Just that simple. A coccidia/giardia infestation in this cat IS NOT LIKE THE CAT HAS CANCER. I see it as more of a nuisance or possibly a mild discomfort for her (does anyone know for sure?). If this cat has something more severe, then there has got to be more severe symptoms to warrant lab work. The way I see it, her current condition DOES NOT WARRANT LAB WORK, and the administration of drugs for giardia/coccidia will either (a) eliminate the giardia/coccidia (until she aquires it again), or (b) will do nothing (because she doesn't have giardia/coccidia) That's why I see no justification in doubling the cost (and hassle) by getting a poo sample. > Think twice would you? There is a reason these substances are > controlled. If Asprin was invented yesterday, it would be a controlled substance and available only with a prescription. Here in Canada, many allergy medications (like Claritin) are sold over the counter (in the USA some aren't). Just because a drug is NOT sold over the counter doesn't mean it's not safe for casual or contra-indicated use. > LASTLY, those "expensive" vet visits are what keeps your vet in > practice. We are providing this vet with TONS of business. We have spent close to $750 on a stray cat we caught 2 months ago (vaccinations, dental work, neutering, etc) and have done similar things for other stray cats in the past 3 years. We have given 2 of our cats the new vaccination against FIV (the first ever given by this vet). Money is not really the issue. It's principle and conveinence. It's not like I'm asking for chemotherapy drugs that I want to administer to a cat just for the hell of it. The vet is a female (not male) and I suspect that is another angle to this issue. Females tend more than males to always "do things by the book" and are resistant to thinking or acting outside the box, even when it's logical or practical. ~*Connie*~ <no@spam.com> wrote in rec.pets.cats.health+behav: >> By giving your cat drugs for something tou *think* your cat >> *might* have, the only thing you will be accomplishing is [quoted text clipped - 27 lines] > else, and he won't be there when your cat is "really ill" (cause > you don't think he is now). Then what will you do?? Execellent post with excellent points. The vet is a professional who invested a lot of years to learn what he knows. He has every right to make a profit and every obligation to examine and test an animal before giving meds. If having cats is so damned inconvenient, get a Furby. But I bet some people would find a way to bitch about the price of batteries.  SignatureBrandy Alexandre --Everything tastes better with cat hair in it. =^.^= > I hate to burst your little bubble, Einstein, but there's a good > chance your cat doesn't have giardia since the symptoms returned. Cat was last treated 2 years ago. Cat has been doing cat things since then, like catching birds and mice and moles in the back yard, drinking from bird bath, etc. Is the treatment supposed to last for 1 month, 6 months, 2 years - regardless of what the cat does/eats? That would be great. > By giving your cat drugs for something tou *think* your cat > *might* have, Is certainly not going to hurt (to give the drugs) and the cost doesn't have to double by adding a poo test which is just as likely to result in a false negative. > Tritrichomona How much is the cost for a Tritrichomona test? > have your vet prepare the test and send it to the Parasitology > Lab at KSU. I'm in Canada. What you are proposing is not likely to cost me any less than I'm paying now. > > I hate to burst your little bubble, Einstein, but there's a good > > chance your cat doesn't have giardia since the symptoms returned. > > Cat was last treated 2 years ago. Cat has been doing cat things since > then, like catching birds and mice and moles in the back yard, > drinking from bird bath, etc. And you don't see anything wrong with that? Not too bright, are you? The cat could have roundworms, hookworms, tapeworms, TF, Cryptosporidia, Cryptocotyle, Alaria, Nanophytes- or even Platynosomum which is particularly nasty- it infests the cat's liver and bile ducts. How about if the cat eats a mouse that ate poison? Got a drug in mind for that? Do you plan to pump antimirobes and antiparasitics into your cat for life? Or do you plan to acquire some common sense in the near future? Do you understand the concept of drug resistance? Since you think you know all the answers (which are all wrong), why did you bother posting? Are you a troll or just an idiot? http://www.audioblogger.com/media/109950/331034.mp3 > As the cat is displaying NO SYMPTOMS WHAT SO EVER that would indicate > some serious problem, and I have reason to believe the cat DOES HAVE > coccidia or giardia, then I see no risk in simply obtaining and > administering the drugs, AND THEN SEE IF THE LOOSE STOOL GOES AWAY. Well, here's my tale. (Those of you I've bored with this previously can move on.) I had classic symptoms of a middle ear infection. Everyone I told about it agreed. My doctor, though, insisted he take a look, but he didn't seem comfortable making a diagnosis. He then sent me to an audiologist, who said, "Yes, you have a middle ear infection. By the way, you have significant sensorineural hearing loss in both ears, moreso on the right." I did not know that. Really. I thought my hearing was just fine. It's really not. She then sent me to an ENT so he could prescribe something. He said, "You don't have an ear infection, but you do have trapped fluid. Your Eustachian tube is blocked." Antibiotics didn't help, so after a month he took a more invasive look, didn't like what he saw, and decided to do a biopsy. So, I had outpatient surgery to have a tube put in to drain the fluid and for a biopsy. Turned out it's nothing more malignant than a swollen adenoid blocking my tube. (A bit unusual in adults.) And that I need hearing aids. See why doctors (and veterinarians) don't take our word for anything? SignatureWeb site: http://www.slywy.com/ Message board: http://www.slywy.com/phpBB2/ Journal: http://slywy.blogspot.com/ > Active and outwardly healthy female (who has had Coccidia and Giardia > before) who is an indoor-outdoor cat (who drinks from bird-bath when [quoted text clipped - 14 lines] > extra revenue from the test) or they won't, but am I out of line to > just ask for the meds without a stool sample? Never hurts to ask. Some vets will sell you meds without confirmation, most will not. Really, a stool sample is what - $15 or something? I'd rather confirm the disease before treatment. Furthermore, you need a follow-up stool exam to make sure you got rid of the parasites. Most vets won't sell you meds without a current (<1 year) exam, anyway. I know it's a PITA if your cat keeps getting the parasites, but not much you can do. What about a country vet - any chance of hooking up with one? They tend to sell meds as needed, more readily. -L. >I want to put her on the same course of meds that she got before >(about 2 years ago) and I DON'T want to go through the hassle and >expense of a stool sample that will tell us that yes, she has either >Coccisia or Giardia or both. But you should still go trough the stool sample thing since other problems could crop up to. If the vet skips the stool sample that ailment may be missed. >Either the Vet will be stubborn about this (because they like the >extra revenue from the test) or they won't, but am I out of line to >just ask for the meds without a stool sample? Yes. If I were the vet i'd insist on the tests and a full exam before any treatment/medicine is prescribed. I'd be leary of anyone who "self diagnoses" a problme since they often laeave out critical details. Let me close with one final question? What vet school did you attend and when did you graduate? There is a reason why the vet goes to school for all those years? You also realize that around here what you want to do is illegal and around here they would arrest you? |
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