Tritrichomonas Foetus - "TF" in cats
This was posted by my breeder of all three of my Abys. Miley is the only one so far who has had problems.
It may be of interest to all you cat owners. Something more/new to worry about. As if we don't have enough already!
......TF is an emerging parasite in the feline world. Surveys have suggested that approximately one third of all purebred cats are infected. It is rarely tested for and may be responsible for many of the cases of chronic diarrhea (e.g. IBD) in cats. If you are a cat owner please take some time to read this page and acquaint yourself with this 'new' parasite. If we can help answer any questions contact us
Our TF History: We first learned about TF in January 2006. The symptoms of this parasite matched some of the symptoms we were seeing in some of our Abys. We purchased the equipment and tests required to detect TF and began testing in February. We found TF in 10 of our Abys (8 adults and 2 kittens). Working with our vet we have treated our Abys and are now regularly testing to insure our Abys are TF free.
Current TF Status: Since our initial TF test we have performed 110 TF tests. All of our adult female have now repeatedly tested negative. None of our kittens in our current litters have tested positive. We do have one new problem. Two of our young intact male studs have failed treatment. A theory has been proposed by Dr Gookin (TF researcher) that intact males may be able to harbor TF in their sex organs which may be beyond the reach of the drug used to treat TF. We are now treating these males with a different drug. It will take about three weeks before we know how effective this treatment has been. These males have been isolated so they do not pose a threat of infection to our other Abys
Where did TF come from?:Tritrichomonas foetus (TF) is a protozoan that infects bovines (cattle). It is considered a venereal disease in that industry. It was first discovered in felines in 1996 but was not associated with diarrhea in felines at that time. As best as I can learn it appears that Dr Jody Gookin made (or suspected?) this association in 1999. The other researcher investigating TF is Dr Stan Marks at UC Davis. Why TF was not considered more widely as a cause of diarrhea in cats until very recently is a mystery to us.
What is TF?: A TF protozoan organism which looks very similar to Giardia so if viewed by in a fecal smear a misdiagnoses of Giardia is common. Fecal floats and Giardia snap tests are insensitive to TF. TF is a fragile organism whose life span out of the body is normally less than an hour. This lack of hardiness is due to the fact that TF cannot form a cyst (as can Giardia). If TF drys out, if it is refrigerated or if it experiences temperatures above 105F it will die. Obviously bleach will kill it too but it will probably be dead by the time you clean the surface. The primary infection path is probably the litter box where a well timed use by two cats can transfer the parasite fecal/orally. Dr Gookin has commented that TF can live for 3-4 days in a wet stool (wet is the key word).
Symptoms: TF lives in the intestinal lining of the large bowel. It causes cow pie like stool that is often gassy and malodorous. Several breeders have commented that in symptomatic cats that the smell of the stool is a significant clue of an infection. The health of an infected cat is not usually adversely affected. It is important to note that an infected cat may or may not have clinical signs of TF. We had a TF positive female that had good stools.
Testing: There are three testing methods. The least sensitive method is a microscopic examination of a fecal smear. The probability of detecting TF in an infected cat has been estimated to be less than 20%. Additionally two other organisms, Giardia and Pentatrichomonas hominis may confuse the diagnosis.
The gold standard of TF testing is a Polymerase Chain Reaction (PCR) test. A stool sample can be sent to Dr Gookin's vet college (http://www.cvm.ncsu.edu/mbs/gookin_file1.pdf) for a PCR test. This is a very sensitive but unfortunately very expensive ($100/ test) test.
Alternatively you or your vet can use the BioMed InPouchTF test (www.biomed1.com/). This test is about $5/test. This test is simple to perform and if multiple tests are required this is the only sensible economic approach.
Prognosis: Until Dr Gookin published her findings last year there was no effective drug treatment. Dr Gookin has stated that “Most cats have spontaneous resolution of diarrhea in two years. More than half the cats remained positive for presence of the organisms however, up to 4-years after diagnosis and possibly many can carry the infection for life." In a multiple cat environment this could mean an endless cycle of reinfection.
Treatment: The drug of choice is ronidazole (RDZ). The dosage is 30-50 mg/Kg twice a day for 14 days. Their are few suppliers of this drug but one source is Westlab Pharmacy (www.westlabpharmacy.com/). Westlab is a compound pharmacy, they will make up RDZ capsules of the correct dosage. Capsules are preferred as it is not advised to mix RDZ with food as it has a bitter taste. RDZ seems to be well tolerated by felines but there have been some incidences of temporary neurological problems, usually at higher dosages. Those treating with RDZ should also consider the effect of weight gains during this 14 day period, especially in kittens. Weight gains during the 14 day treatment period may cause the dose to go sub-therapeutic (i.e. below 30 mg/Kg). As for other side effects, I have received one email reporting that their cat experienced liver failure while on RDZ. Fortunately it was reversible and the cat returned to normal. It is not known if this cat was treated within the recommended dosage range. Their are some, not necessary the one who had the liver problem, who in an effort to save costs who are using RDZ formulated for pigeons which at a 10% concentration. Accurate measuring and dosing with this form of RDZ may be difficult. We have experienced no adverse side-effects nor has any others been reported to us. Westlab have said that they have had reported to them some temporary neurological symptoms in a few cases but in large side-effects are few.
Post Treatment Testing: We begin testing 10-14 days after RDZ treatment. We wait this time period to make sure that no residual RDZ is present to bias the test. We are repeating the test approximately every 14 days afterward. We expect to lengthen this period slowly until 20 weeks is reached. Since cats have sensitive guts diarrhea (and vomiting) are not unusual occurrences in cats. If we observe any loose stool we test it. So far these events have been transient and these tests have all been negative.
The information sources: Material published by Dr Jody Gookin (www.cvm.ncsu.edu/mbs/gookin_jody.htm) and email correspondences with her. Addition information was obtained from the folks at BioMed (www.biomed1.com) and Westlab Pharmacy (www.westlabpharmacy.com/). Also experiences and the experiences of other breeders who are corresponding with us were included. Neither I nor any breeder I know would suggest that anyone, in matters of feline health, treat there cats independently of their vet.
Additional TF information:
Dr Gookin's TF paper: www.cvm.ncsu.edu/mbs/gookin_file2.pdf
Dr Gookin's June 2005 RDZ treatment paper: www.cvm.ncsu.edu/mbs/gookin_file4.pdf
I have the text now, and waiting for the test kit
The lab is sending a few test kits (free of charge) and I will let everyone know the details. It will be several days until the kits arrive, then I have to work with the Vet. The specimen needs to be incubated, I do believe, and so I am hoping my Vet will take charge from the collection process on. I want to drop off my Miley for the day, have them TAKE the specimen(s) and then pick her up at day's end. I don't want to be digging around in the litter hoping that Miley was the depositor!......
It is interesting.....that so many cats could be at risk. Oh well. I should know for sure if Miley has it or not, within a week or so.
My concern is that she is in the early stages of FIP, as she tested positive for it, although I am hoping she was exposed and thus produced antibodies....giving the result as the same as having it.
The plot thickens. Not the stool, just the plot.
Oh, I gave all the cats a little Medamucil (SP??) with their wet food and I do think it helped Miley a little. It will not, in the long run, help her if she does in deed have a parasite.
Later -
SAS
An email from the breeder where I got Miley
I thought you folks would like to know a little more about TF. It is really scarey to me, to think that this has been around for so long.....going undetected.....
Sallyanne Smith wrote:
Hey Dave,
Sallyanne Smith here. On Friday, I will be dropping Miley off at my vet's along with a few TF kits to be tested for TF. She has had stool issue for years now, off and on, but now mostly on! So, knowing that she was diagnosed with Girardia as a wee kitten, when I first brought Graemer and Miley home, I thought it would make sense to have her tested for TF. The other cats are fine, stool wise.
Dave's Answer:
How was Giardia diagnosed? If microscopically, it may have been TF as TF and Giardia look alike. If Giardia was diagnoses by a snap test then it was likely Giardia. We haven't had a instance or Giardia although TF may have been in our cattery for a while. No way to know for sure.
Cats can be asymptomatically infected, if one is positive test all
1. Is it better to spend the $100 for the first test? rather than do the $5 kit? or is there no difference? Did you go with the more expensive test first?
Dave's Answer:
The InPouch TF test is fine, more than capable. Don't spend the extra money.
2. Do you have any advice for my vet on how to collect the sample or view it? Since you are doing your own testing, I thought might have some advice. My vet is very nice and smart I just don't know if she will know what to look for. The instructions for the kit are included, so I think she will be fine.......
Dave's Answer:
Have your vet use Dr Gookin's technique. Use a fecal loop lubed with a sterile water soluble jelly. Also to guard against bacteria overgrowth I suggest you inoculate two pouches. One with the recommended amount (i.e. peppercorn) and the other with half that amount. The pouches can be incubated at room temperature but the TF doubling rate is slower. Keep and examine for the full 12 days. Alternatively I incubate at 37C. I get responses within 48 hrs but my risk of bacteria overgrowth is higher. I have one advantage though, I have the new feline pouches which I am field testing for BioMed. These will be released for sale July 7th. They have the same growth medium as the current pouches but a better mix of antibiotics for felines. This limits the risk of bacterial overgrowth
3. Miley weighs around 7 lbs. If she does test positive, what is your experience with the dosage? I would use the lab Westlabs in Fla. If Miley is positive, and since my vet is not familiar with this TF thang, may she call you? or call your vet?
Dave's Answer:
You can have your vet call in a scrip to Westlab which compounds ronidazole (RDZ) into capsules (#4 gel caps) or you can get RDZ compounded into a flavored liquid at Roadrunner (http://www.roadrunnerpharmacy.com/). I prefer capsules since you know the cat got all of the dose. Other pharmacies are carrying RDZ now also.
Your vet can call me. In a weird twist of fate I an one of the TF experts now. When I first found out about TF (Jan), tested and then announced our TF positive status I thought other breeders would post their experiences. They didn't. Currently breeders are reluctant to go public so instead they email me privately. I have hundreds of emails and I spend 2-3 hrs a days answering them. Two days ago I got an email from Israel, TF is everywhere. Besides working with BioMed I am now working with Dr Gookin. Our adult males are not responding to treatment like our females. Dr Gookin didn't use males in her RDZ test. I don't know if our situation is unique or common. Frustratingly almost no one performs post treatment tests and the 1 or 2 that have may have done them wrong. All I know now is that one other intact male (not ours) has also failed treatment. I've send cultures to Dr G and today I'm sending swabs and urine samples. I didn't think I would end up doing TF research in my retirement.
All the best, keep in touch,
Dave
Thanks so much.
Sallyanne
