Giardia Questions

Hopefully this thread can be a "go to" and be an all encompassing source for questions regarding Giardia. 

How long does it take for a cat to catch Giardia after ingesting a Giardia cyst(s)?

Can healthy adult cats catch Giardia? And if so, is it because of multiple exposures, stress that causes a weakened immune system, just bad luck, etc?

If a healthy cat does ingest Giardia cysts does the immune system handle it and remove them if cysts are somehow not ingested again or are those cysts always going to be in the cat if left untreated? Does it depend if the cysts burts and release the cells or not?

How long do Giardia cysts and cells live in a dry environment (hardwood floor, carpeting, tile, etc)?

What are the long term health risks to a cat that has Giardia (if untreated)?

Since some vet tests do not always catch Giardia and a cat may not show symptoms a cat may be living in households around the world without the owners knowing it. In this environment is there a reasonable risk of the owners catching Giardia? I would assume long term exposure does increase the risk but is it still rare?

Can Giardia cysts and cells become airborne if disturbed by scooping litter, a cat grooming themselves, petting the cat, etc? 

Does the risk of reinfection differ if the cat is having diarrhea vs having solid stools? Is there a statistically significant difference in the reinfection rate given these different stool consistencies?

How does Panacur (a common treatment for combating Giardia) work? Does it kill the Giardia cysts and cells in the body or does it just cause them to loosen their attachment to the intestines and pass in the feces?

How long does the Panacur work after the last dose? 

How often should the litter be removed and the litter box be bleach cleaned during and after treatment with Panacur?

How often should the area a cat with Giardia is living in is be wiped down with bleach? After every bowel movement? 

Where do the Giardia cysts and cells reside after a bowel movement? What percent (approximately) of cysts and cells remain in the stool and what percent separate and end up in the litter? (I ask this as it is recommended to remove all litter after a bowel movement so there must be some separation risk). Are the Giardia cysts and cells that are passed in the stool still alive and able to infect others?  

What is the real risk of carrying Giardia cysts and cells on your clothes into other areas of the home if you have not been exposed to the cat's stool? How can this be avoided as clothes or your body will always be exposed in some way to the area that may have Giardia contamination? Even if you change your clothes your hands may have cysts or cells on them and while changing to new clothes the new clothes may not be contaminated. 

If the cat is not able to be bathed how does the owner clean the fur in order to remove any Giardia that may reside in their fur?

How can one really be certain if the area that a cat infected with Giardia is free of Giardia? No matter how much one scrubs with bleach, disinfects with steam etc it seems like Giardia will always "slip through the cracks" and reside in the area where the infected cat was held? The Giardia may be on the cats fur, on their feet, on the owners feet, etc?

How many times after treatment does the cat stool need to be tested to make sure the cat is free of Giardia? It seems to me that since Giardia is not always passed in the stool multiple tests should be conducted to be confident that the cat is free of Giardia?

Can the cat after treatment with Panacur really be totally free of any Giardia cysts given the risk of high reinfection?

Is it close to a "miracle" for a new addition cat infected with Giardia not to pass the Giardia along to any existing cats in the house even with proper quarantine, throwing out litter, cleaning, etc? Not being able to bath the cat would increase the risk of this I would assume, any guess as to how much?

Can a multiple cat household infected with Giardia really be eradicated and if so what is the best way to rid the family of that mass infection given not all use only their litter box, they don't always take their medicine etc? 

Given that Giardia seems to be everywhere, if a person has ferals in their yard and Giardia and worms etc can live in soil for long periods of time, how does one really prevent bringing these issues into the house and infecting the indoor cats? Even if one changes shoes any contamination could be on the entryway floor and constant bleaching (which maybe is the answer) is time consuming.

Is Giardia really as bad as my questions suggest? I am guessing that there are more cats than one would think (given some test are not great at finding Giardia) that are living in households around the world that have undiagnosed Giardia and it doesn't seem to be a huge problem for the cats and/or the owners. Or is it?

Hopefully we can find answers to these questions and hopefully others will add additional questions that I have not thought of so that this can be a helpful go to thread for future cat owners dealing with a cat or cats with Giardia and that their experience with Giardia is shortened and less stressful. There are so many great threads on this site about Giardia but there is no centralized source and hopefully this can bring answers all together.

Thank you for all your help.

Lots of excellent questions there! Some would definitely need an expert to answer. I don't mind approaching such an expert and offering to hold a guest expert forum, as we do occasionally.

I'll try and see if I can look up such veterinary experts. Of course, anyone else who'd like to tackle any of these, is welcome. I may try later on when I have some time.

Almost forgot the most important thing! 

We have an article on Giardia that does answer a few of these questions - 

 [article="31569"]Giardia And Giardiasis In Cats​[/article]  

Anne,

Thank you very much for the posts, the offer to help with an expert and for the link.

I emailed the CDC these questions and am hoping they have some answers. I am guessing some questions are unanswerable but the more knowledge we have the better off we all will be.

I have been reading some academic papers but sadly have not found answers to some of these questions.

Thanks again for your post, it is greatly appreciated.

CRS 

Hi

My colleagues and I been around many (very many!) cats with active cases of Giardia and speaking personally, i have never caught it nor can i say have any of my co-workers.  And since its not airborne, so long as the infected cat is kept apart from other cats the other cats should not be at risk although its best to keep Giardia cats in their own "ward" if possible.

For a definitive stool test (and in house tests are not always definitive) I would recommend a stool sample be sent our for a PCR test.  It amplifies any giardia DNA and provides a definitive answer.  See this link.  https://www.idexx.com/small-animal-...ces/reference-laboratories/realpcr-tests.html

i have never seen quarantined cats give Giardia to other cats. 

This article by the CDC is really great, and explains many things including why human infection by animals is very rare.

http://www.cdc.gov/parasites/giardia/prevention-control-pets.html

StephenQ,

Thank you very much for your post. The PCR test sounds like a great idea, I will talk to my vet about making sure we use this test.

I did have the new cat tested with what the vet called the "diarrhea" test which sounds like one of these PCR tests. Luckily she only came back from that test with giardia. Sadly, we did this test a week after she came into the house and after the first test did not show the giardia. So my handling of her was lax compared to what I am doing now (removing all litter and the box after bowel movement, bleaching, steaming, etc.) My weak link is not being able to bathe her. I understand giardia can be in the fur and be a source of reinfection. My fear is that I gather some giardia cysts on my clothing or shoes after being in the quarantine room which then could be tracked into other rooms. I would guess a remote possibility of transmitting to the others but something I still fear. 

Did you bathe all the cats with active cases of giardia? And if so, how often and when (during treatment, after treatment,?) Also, what did you use?

Since the existing cats all drink and eat from each others bowls I assume if one has giardia then they all would. reasonable assumption? Since the diarrhea test is expensive I would like to limit the expenditures if at all possible.

Thanks for your post, it is very helpful.

CRS

Hi CRS,

You have more than one cat is that correct?  If yes, and if you keep the infected cat in a different room, that's really about all you have to do to keep the other cats from getting it.  We really don't talk about Giardia vectors as an illness that goes from animal to surface to other animal if general cleanliness is practiced and fecal matter is kept away from the other animal.

As to bathing, i work for a large shelter and we never bathe any of the cats that have Giardia.  It just isn't part of any protocol I've heard of, and not necessary to prevent transmission.  Bathing wouldn't kill the parasite, and since contaminated water is a common source of infection i might be concerned that bathing would increase the risk of transmission, not reduce it.

Giardia is very common in shelters, but we prevent the spread entirely by keeping our giardia cats in a different room, and for extra safety we wear gloves and disposable booties in those rooms.

All of our cat cages are disinfected with Accel which we much prefer to bleach.  Bleach works for most pathogens (10% solution) but it requires a 10 minute air dry and then a rinse as it is toxic to cats, Accel is a 5 min air dry and no rinse needed.  Having said that, giardia is very difficult to kill so most of our work is focused on preventing its spread until the cat or dog is cured.

Here are 2 links to accel:

http://www.viroxaccel.ca/index.html

StephenQ,

First off thank you very much for this post, it is very helpful!

Yes, I have more than 1 cat and the giardia cat is quarantined in a separate room. Fecal matter is removed as soon as possible (she is going over night so it is in her litter for a few hours until I can remove it in the morning). All litter and the box are thrown out. Fecal matter is kept away from the other cats. I do not wear gloves or booties when removing the litter box which I probably should.

I totally understand the points on bathing. Thank you.

I have been bleaching the surfaces but I didn't realize that I must rinse after bleaching. I thought once it dried that it would be safe for the cat to walk on. I will look into purchasing and using this Accel. Thank you for the links. That is extremely helpful.

I have also been steaming but I worry about not having the appropriate time on each area.

Thank you verr much for all this advice, it is extremely helpful.

CRS

StephenQ,

I had a question on the water and food bowls. I am steam cleaning them once a day. Is that enough or should I be steam cleaning them more often? I change the water 3 times a day but just rinse the water bowl with hot water on the other 2 occasions. 

Would appreciate your advice on how to reduce the risks from these bowls.

Thanks for all your help.

CRS 

Hi there CRS

As to the steaming, the bowls etc, i am going to make an analogy using another illness cats get called taxoplasmosis.  This is an illness, not serious in cats that is transmitted by parasites in feces but is very serious for unborn children in pregnant women.  Just like with Giardia it shares the following qualities: it is a parasite, it is shed in feces, it is contagious by the same route or vector - fecal to oral.  Like Giardia it is hardy in the environment.  And it is very dangerous to unborn children.  For that reason alone you might imagine that the CDC and doctors in general would advise pregnant women not to have a cat in the home, and certainly not a cat who tested positive for taxoplasmosis, but actually that is not the recommendation as it isn't necessary. See CDC link below.  All that is advised is that either the pregnant woman have someone else scoop the litter, or wear gloves and wash their hands after if they do it themselves.  That guarantees that they will not become infected by that route (they could get infected by eating undercooked meats and other non-cat related vectors.  Link: http://www.cdc.gov/parasites/toxoplasmosis/gen_info/pregnant.html

Routes of transmission for an illness are very consistent. As examples, you cant get rabies by breathing the air near a rabid animal, nor can you get rabies by touching a surface that a rabid animal has touched.  You have to get bit as it is a saliva to blood vector.  

Having said the above I will tell you that shelters don't steam clean bowls on a daily basis.  Yes we clean and disinfect them before giving a used bowl to another animal, but that's a different situation.  But cleaning a bowl that is in a cage isn't needed because for the infected cat, they are already infected, and since they are quarantined, the infected bowl isn't going outside of the room.  Giardia have no independent means of transportation, in other words unlike say a mosquito, the Giardia parasite can't move, walk, fly or get around at all on their own.  So how does an uninfected cat get Giardia?  They share a litter box, they groom an infected cat, they share a water bowl or food bowl with an infected cat, or they somehow have another form of access to fecal material (example: someone mops the floor of an infected room with poop on the floor, and then takes that mop and goes and cleans the floor of a clean room, a dog walks through and licks the floor.) 

So for your uninfected cats, if they don't touch the infected cats litter box, food and water bowls, if they can't play with each other under the door (an unlikely chance of transmission but one that can be avoided by blocking the bottom of the door with a towel, and if you don't track fecal material around the house with contaminated shoes (also unlikely but if you wear specially designated socks in that room only then no chance of transmission) then your other cats really can't catch it. 

As far as you catching it, as the CDC makes clear, the type of Giardia that infects cats typically doesn't make people sick, but to be safe, don't touch your hands to your face or mouth while cleaning the litter or after handling the cat and wash your hands after.

So that is a very long winded answer.  The short answer is i wouldn't worry about steaming the bowls as it isn't contributing any added protection in my opinion.  I would keep the cats apart. I would prevent them from playing with each other under the door.  I would (best practice) wear disposable gloves when handling the cat or cleaning the litter (or at least wash my hands after) And i would either wear disposable booties (like these ) or just keep some socks in the room to be only worn in the room.

Anything that you do to prevent the spread of transmission that isn't actually helping to prevent the spread of it is labor lost, and might inadvertently increase the risk of transmission.

Once the cat's stool was solid i would re-test with a PCR test as per my vet's instructions, and if it came back negative then i would end the quarantine.

Good news, your cat will get over it, and then it will be finished!

Stephen

Stephen,

Thank you very much for taking the time to write such a detailed response. This is very helpful.

This point you write " Anything that you do to prevent the spread of transmission that isn't actually helping to prevent the spread of it is labor lost, and might inadvertently increase the risk of transmission" really makes me think about what I am doing. I was taking the food and water bowls and steaming them outside of the room. The risk of inadvertently contaminating really resonates with me. Excellent point.

I mainly did that to try to reduce the risk of reinfection of the quarantined cat. She went through 5 days of Panacur but everything I have read and have been told by my vet suggests that she will reinfect herself and have to go through another round of panacur because the cysts might reside in her fur or elsewhere. At times I feel like I am fighting a losing battle as I wonder how I can ever prevent reinfection. She is healthy but she got this giardia at some point as an adult or has had it since a kitten (she is 3 now).

The worst part is she really wants out and to meet the other cats etc. So I am almost a week past the last dose of the 1st round of panacur, waiting until day 10 or 11 to do the PCR test and await the results and then depending on that to move to the next steps. 

It sounds like the most important thing to do is too remove any feces and litter as soon as possible after a bowel movement and then to clean the litter box.

One other question if you don't mind. How does the Panacur work? Does it kill all/most of the giardia cysts and cells that reside in the body? Or does it just help loosen them from the intestine walls and allow them to pass easier? Then since they are not dead they reside in the feces and then can cause reinfection.

Thanks for ending the post on the good news. I am trying to stay positive but ignorance definitely causes fear, though your post are definitely helping educate me and helping me see the light at the end of teh tunnel.

Thanks again for all your time and all your knowledge, it truly is greatly appreciated.

CRS

Happy to help!  I've worked with countless Giardia cats and never seen them re-infect themselves once treatment was successful.  However I have read that bathing can help prevent re-infection so as an end of treatment option (bathing) you may want to discuss that with your vet.  Some people think every cat in the home should be treated, sick or not, and since panacur is so safe and well tolerated, you could also discuss that with your vet.

I did some more research and found that there is a specific shampoo that kills external Giardia cycts and contains chlorhexidine.  See http://www.revivalanimal.com/articles/giardia.html

On that site it says the Chlor 4 shampoo will kill giardia on the cat's coat (http://www.revivalanimal.com/Vet-Basics-Chlor-4-Shampoo.html) discuss with vet and that Chlorhexadine solution will kill Giardia on surfaces in the room.  Discuss with your vet the proper dilution.  http://www.revivalanimal.com/Chlorhexidine-Solution.html  Both are also available on amazon.

As to how panacur works, i read that "Panacur contains the ingredient fenbendazole, which works by binding to the proteins in parasites and damaging the transport function of the cells." from here https://www.vetinfo.com/canine-giardia-treatment-panacur.html

Stephen,

Thank you very much for doing the research and finding the info on the shampoo and the solution. This is extremely helpful as I have not found that in my searches.

My new cat is a sweetie but she is still fairly feral. I can pet her but she is not too keen on being picked up. Whether I can bathe her will be a further question. But I can talk to the vet and see what might be possible. This is good knowledge to now have so I am getting closer to getting her onto to her normal life again. Thanks!

I thought about proactively treating the existing cats when she is introduced to them. The problem is they are also ferals and they would have to take the powder with food but they don't always eat the wet food. That is one of the reasons why I am so paranoid about not letting the giardia spread to teh existing healthy cats.

Of the giardia cats you have dealt with, approximately what percentage of cats were cured after 1 treatment, 2 treatments and more than 2 treatments? I have heard that most of the time 2 treatments are needed. I know it is a tough question but I am interested in seeing if my experience is normal. My vet does not really have much experience with giardia so I just like to get second opinions.

I just wanted to say thank you again for doing this research and for all your help. This is so helpful and gives me hope that we will get through this. Thanks!

CRS

Stephen,

Just had a few more questions.

Do you use panacur to treat giardia?

If so, when you use the powder for how long do you use it? Once a day for 5 days? That sounds pretty standard but I have read some other time periods.

How long do you wait to re-test and if still positive for giardia then treat again? I am guessing it is 10 days. Do you ever re-treat sooner than 10 days?

Thanks again for all your time, it really is appreciated.

CRS

Hey there,

We do not use panacur even though it has an excellent reputation, instead we use something called Secnidazol which is a one time treatment dosage based on weight, so there is no re-dosing.  The vast majority come back negative after one treatment and we usually retest within 2 weeks max (or less).  Dogs we are more likely to use Panacur as its easier to give to them in food.  Secnidazol, compounded in flavored liquid is fairly easy to give as you just give one quirt into the mouth one time only.

http://www.ncbi.nlm.nih.gov/pubmed/2900339

and

http://www.revivalanimal.com/articles/giardia.html

Stephen,

Thank you. I will ask my vet about Secnidazol. She is a feral so I may not be able to squirt it into her mouth but it would be a lot easier than trying to feed the panacur for 5 days. I will definitely look into this option.

Thanks for all the help and advice.

CRS

Dr. Cynda Crawford gave this presentation on Giardiasis and discussed the trial of Secnidazole in cats with Giardia. 

CalicosRSpecial said:

 
Dr. Cynda Crawford gave this presentation on Giardiasis and discussed the trial of Secnidazole in cats with Giardia. 

Click to expand...

A good presentation and nice support for Secnidazole.  We've used it in many many cats with good results.

Stephen,

Thanks for sharing your experience with it as well. I agree, I thought the presentation was excellent as well. Thanks again for everything.

 Do you use panacur to treat giardia?

Click to expand...

Just want to say that I treated a sick stray cat with Panacur (paste), She came to me starving but vomited everything back. She was found to be highly infested with giardia. The vet even kept her at the surgery for 60 hours to make sure she didn't vomit too much paste back. I treated her 5 days with Panacur followed by 5 days without, three times. About a week after her last dosage she was tested again - hurray it was negative! 

We may use Panacur simply because it's cheaper but, at least in this case, it was effective. The cat has now gone to a lovely new home.