Treatment for Coccidia and Giardia: How to convince my vet I don't needstool 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 ****es 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 ****. 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?

****es 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 **** 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 **** is just too much bother.

Cat Guy wrote:
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 ****es 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 ****. 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?

****es 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 **** 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 **** 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.

Sherri wrote:

Cat Guy wrote:

Active and outwardly healthy female (who has had Coccidia and
Giardia before)
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.

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"
Newsgroups: rec.pets.cats.health+behav,alt.cats,alt.pets.cats
Sent: Saturday, April 15, 2006 1:36 PM
Subject: 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

Cat Guy wrote:
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?

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.

"Cat Guy" wrote in message ...
Sherri wrote:

Cat Guy wrote:

Active and outwardly healthy female (who has had Coccidia and
Giardia before)
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.

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,


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?

MarAzul wrote:

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.

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??

"Phil P." wrote:

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.

~*Connie*~ wrote:

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.