Whip Worm Life Cycle

parasiticworms_figure15

Figure 15. Diagram of whip worm life cycle.

Worming Medications

Piperazine (many brand names, e.g., HappyJack® Kennel Wormer® – HappyJack)

  • These wormers are commonly seen in the grocery stores, pet shops and feed stores as worming medications. They have recently been replaced in most instances by the Nemex® brand.
  • The parasites lose the ability to stay in the intestinal tract because of muscular paralysis and are passed live, therefore, the owner will see live roundworms when their pet is wormed.
  • Dogs and cats
    • Kills roundworms
    • Dosage: 25 mg/lb orally, repeat treatment in two weeks
    • For dogs as young as 6 weeks
    • Side effects: nausea, vomiting, muscle tremors
    • Use with caution in animals with kidney disease.

Diethylcarbamazine citrate (DEC) (Carbam® – VedcoTM, Filaribits® – PfizerTM, Nemacide® – FermentaTM)

  • This wormer was the first heartworm preventative. It is still on the market and used by many clients who like to give their pet a daily treat. It will kill roundworms as well, but at a much higher dosage than the heartworm prevention dose.
  • Filaribits Plus: Contains DEC, as well as oxibendazole for treatment of hookworms, roundworms and whipworms. This product has been associated with liver disease – particularly in Doberman Pincers.
  • Dosage:
    • For prevention of heartworms: 3mg/lb orally daily with food
    • For treatment of adult roundworms: 25 mg/lb orally with food
    • Also safe for sea lions and ferrets

Fenbendazole (Panacur®, Safeguard® – Hoechst RousselTM and many other products)

  • Dogs (also lions, tigers, cheetahs, pumas, jaguars, leopards, panthers, grizzly bears, polar bears and black bears)
  • Kills hookworms, roundworms, whipworms and taenia tapeworms. Will not kill Dipylidium caninum tapeworms.
  • Dose: 50 mg/kg daily for 3 days
    • 1. For Cats and Bears : 10 mg/kg daily for 3 days
    • 2. May need repeat-treatment after 4 to 6 weeks

Pyrantel pamoate

  • Dogs: (Nemex®, Nemex-2® – PfizerTM)
    • Kills roundworms, hookworms. Does not kill tapeworms or whipworms
    • Dosage
      • at least 2.27 mg/lb for dogs over 5 lb
      • 4.54 mg/lb for dogs less than 5 lb
    • Strongid-T® is equine formulation of Pyrantel Pamoate – Use at same milligram concentration but is 10 times more concentrated
    • Strongid-T® wormer is one of the safest of the worm medications. It is used for young puppies and kittens to kill hookworms and roundworms.
    • We usually will give this wormer even if we do not see worm eggs on the stool sample, as it is low cost and non-toxic.

IVERMECITNS

  • Ivermectin (Ivomec ® , Ivomec ® Plus, Ivomec Sustained Release Bolus (SRB®), Eqvalan® , Heartgard TM , Heartgard TM Plus – MerialTM, Zimectrin® – FarnamTM)
    • We usually use Ivermectin to kill intestinal parasites such as roundworms, hookworms, and whipworms at the dose of 0.1 cc of the bovine wormer preparation (Ivomec ®) per 44 pounds.
    • Using 0.1 cc Ivermectin and 0.9 cc of propylene glycol the stock solution is made. Use the stock solution at 1 cc per 44 pounds. (0.1cc of mix per 4.4 pounds)
    • This preparation can be given subcutaneously or orally.
    • Ear mites may be killed with one application of Ivermectin to the ears. The above mixture is mixed with DMSO to aid in absorption into the mites.
    • Ivermectin does not kill tapeworms, liver flukes or any flat type worm.
    • Ivermectin is toxic to fish, turtles, salamanders, newts and Collies but has been used in snakes, birds and other reptiles.
    • Ivermectin is used in people in third world countries for eyeworm and other parasite infection. A new preparation is the most effective way to kill fire ants and also there is roach bait that uses Ivermectin.
      • Active ingredient in HeartgardTM
      • Dose 6 mcg/kg (2.72 mcg/lb) orally every 30 days
      • Also available with pyrantel pamoate for roundworms and hookworms but not whipworms or tapeworms, as Heartgard PlusTM
      • Adverse reactions in collies occur at higher doses

Milbemycin oxime (Interceptor® – NovartisTM)

  • Active ingredient in Interceptor®; will prevent heartworms and kill hookworms, roundworms, and whipworms.
  • Dose 0.5 mg/kg orally every 30 days for dogs over 4 weeks weighing 2 pounds or more
  • Safe for any dog over 4 weeks old, safe with other drugs
  • Also sold in combination with lufenuron as Sentinel® – administered monthly

Thiacetarsemide sodium (Caparsolate® – Merial) – may no longer be available

  • Dogs:
    • This is the heartworm treatment used by the veterinary profession for over 60 years. Immiticide® has replaced Caparsolate® in our practice.
    • This drug, while effective, was less predictable than its newer alternative and therefore resulted in deaths associated with the treatment of heartworms.
    • Inflammation and sloughing when perivascular leakage occurs.
    • Causes cough and fever associated with blood clots in the lungs formed by dead heartworms
    • Damages the kidneys and liver
    • If there are adult Dirofilaria in the vena cava, remove surgically before treatment. This is determined by ultrasound.
    • Keep dog confined and quiet 4 to 6 weeks after therapy to avoid blood clots in the lungs.

Melarsomine (Immiticide® – Merial)

  • Kills adult heartworms as well as young L5 heartworms
  • Arsenic based compound
  • Dose: depends on severity of infection, use accurate dosage!!
    • Stage I or Stage II as described in the heartworm handout: 2.5 mg/kg twice at 24 hours apart, repeated 4 months later if necessary
    • Stage III: stabilize dog first, then single injection at 2.5 mg/kg, then one month later two doses 24 hours apart at 2.5 mg/kg
  • Inject intramuscularly into lower back epaxial muscles
  • Closely monitor during treatment
    • Approx. 30% of dogs get injection site reaction with pain, swelling, tenderness and reluctance to move. Firm nodules may persist indefinitely.
    • Side effects include coughing, gagging, depression, lethargy, anorexia, pyrexia, emesis, and lung congestion.
    • If caval syndrome present, do not use this drug. This is determined by ultrasound.
  • Restrict activity following treatment to reduce risk of blood clots in the lungs.

Praziquantel, PZQ (Droncit®, Drontal®, Drontal Plus® – Bayer, RM R Parasiticide-10 – Merial)

  • Causes the tapeworm to be digested by the pet, therefore, the client will not see evidence of dead worms in the stool. Many clients do not think a wormer is effective until they see the worms in the stool.
    • Dogs: Dipylidium caninum, Taenia
    • Cats: Dipylidium caninum, Taenia
    • Subcutaneous or intramuscular injection (the IM injection is not associated with nodules or self-mutilation seen with the subcutaneous route. Oral tablet or paste available as well.
      • Droncit®
      • Drontal® with pyrantel pamoate : Removes roundworms and hookworms as well
      • Drontal® Plus with pyrantel pamoate and febantel to remove roundworms, hookworms and whipworms.
      • A fecal sample is required before tapeworming to check for other parasites and to make sure that tapeworms are the primary problem. Vaccinations and other medications may also be given at the same time.
      • Droncit® may be given to kittens over 6 weeks and to pregnant animals.
      • Many times tapeworms are “flushed” out of a pet with diarrhea by the action of the hyper-motile gut on the worms. The diarrhea is not caused by the tapeworms but the owner sees tapeworms in the stool and assumes that the tapeworms are the culprit. This pet needs other treatment first before the tapeworming.
      • Need to repeat treatment in 3 weeks to be effective.
      • Flea control is necessary for tapeworm control.

ANTICOCCIDIAL DRUGS

  • Coccidiostatic = stasis; does not remove infection; may actually be more effective at control because inactive organisms are present to stimulate the immune system which subsequently keeps the organisms in control.
  • Coccidiocidal = Kills;removes infection totally – used in severe acute infections; action may be due to higher dose levels or to a certain drug type

Amprolium (Amprol®, Amprovine®, Corid® – Merial)

  • This drug blocks the use of the B vitamin, thiamin.
  • Dose: 300-400 mg/kg bwt for 55 days, or 110-220- mg/kg for 7 to 12 days, or as sole source of drinking water at 1.5 tbs./gallon of water for 10 days. We commonly use this drug in our pet shop puppy and kitten water. It is used at the rate of 1 cc per quart of drinking water.
  • Can combine with 25 mg/kg sulfadimethoxine and 150mg/kg amprolium for 14 days (synergistic action)
  • Resistant strains prevalent
  • Adverse reaction – thiamin deficiency with nervous behavior
  • Corid® can cause severe disease and kidney failure if given to a dehydrated animal
  • Amprolium may cause reduction of water consumption in the cat which may lead to problems such as dehydration or even F.U.S.

Sulfadimethoxine (Albon®, Bactrovet®, Tribrissen®)

  • Used to kill coccidia in dogs and cats
  • Albon is a sulfa drug that is used primarily for coccidia infections. It could also be used as an antibiotic for infections of the respiratory tract and urinary tract (as in the past) however, it has been replaced by more effective medications for treatment of those diseases.
  • Ormetoprim may be even better when used with Albon® for this purpose
  • Albon® is the traditional medication and we usually use it first, as it is inexpensive and non-toxic
  • Albon® tastes good and is not offensive to kittens. Albon® comes in an injection, tablets and a liquid.
  • The dose should be doubled on the first day and then single doses are given daily thereafter. An injection is usually given on the first day. Albon® can cause kidney failure in a dehydrated animal. Fluids must be given prior to the Albon®. All sulfa drugs, if given on a long-term basis, can cause dryness in the eyes and reduced tear production.
  • Coccidia can be difficult to treat because of reinfection and self-infection by ingestion of stools. The litter box and food bowls must be scrubbed twice daily to prevent reinfection and perpetuation of the disease.
  • 5% oral suspension @ 55mg/kg bwt 1st day, then 27.5 mg/kg/day for 4 days or until asymptomatic for 48 hours
  • Frequently used at 55mg/kg with ormetoprim at 11mg/kg bwt up to 23 days (synergistic action)
  • Well-tolerated @ 160mg/kg

ANTIFLAGELLATE DRUGS (including amoebae, ciliates)

Metronidazole (Flagyl®)

  • Indicated for Giardia, Entamoeba histolytica, Balantidium infections in dogs, cats
  • Dose:
    • For Giardia and Entamoeba in dogs: 15-30 mg/kg orally BID for 5-7 days
    • For Giardia in cats: 10-25 mg/kg orally BID for 5-7 days
  • Warning – well-tolerated @ 100 mg/kg for 30 days, but higher doses produce tremors, muscle spasms, weakness, incoordination, ataxia; carcinogenic in mice, rats

Albendazole (Valbazen®)

  • Indicated in dogs for Giardia, Entamoeba, Balantidium; May have better efficacy than Flagyl®
  • Effective @ 25 mg/kg bwt BID for 2 days
  • Warning – do not administer to bitches in first trimester of gestation

Furoxone

  • Furoxone is a human medication for giardia and is used to kill giardia resistant to Flagyl®. It is an oral liquid. Cats tolerate the taste.