SNAP Cats

Zoonotic Diseases

Provided by the Cornell Feline Health Center, Cornell University

What is a zoonotic disease?
While most feline infectious diseases affect only cats, and most human infectious diseases affect only humans, it is important to be aware that some of these diseases-called zoonotic diseases-can be transmitted between cats and people. You are much more likely to contract ailments from other humans than you are from your cat. However, simple precautions, common sense, and good hygiene, including careful handling of litter boxes and treating cats with fleas and other parasites, can further reduce the risk of zoonotic disease.

How are zoonotic diseases transmitted?
Transmission of a zoonotic disease can potentially occur when a person comes into direct contact with secretions or excretions-such as saliva or feces-from an infected cat. Additionally, a disease may be contracted through contact with water or food that has been contaminated by an infected cat. Many zoonotic diseases can be transmitted from fleas or ticks (called vectors) to a person or a cat from another animal.

Who is at risk?
Most zoonotic diseases pose minimal threat; however, some humans are particularly at risk. Those with immature or weakened immune systems, such as infants, individuals with acquired immunodeficiency syndrome (AIDS), the elderly, and people undergoing cancer therapy, are more susceptible to zoonotic infections than others.

What are some common zoonotic diseases?
Bacterial Infections
Cat-scratch disease, also called bartonellosis, is by far the most common zoonotic disease associated with cats. Approximately 25,000 people are diagnosed every year in the United States. Cat-scratch disease can occur when a person is bitten or scratched by an infected cat. Fleas may also play a role in the transmission of infection. People with cat-scratch disease usually have swollen lymph nodes, especially around the head, neck, and upper limbs. They may also experience fever, headache, sore muscles and joints, fatigue, and poor appetite. Healthy adults generally recover with no lasting effects, but it may take several months for the disease to go away completely. People with compromised immune systems may suffer more severe, even fatal, consequences.

Some healthy cats are continuously or intermittently infected with cat-scratch disease bacteria, but antibiotics do not reliably cure infection in these cats and are not currently recommended. However, avoiding scratches and bites (for example, by not allowing children to play roughly with cats), controlling fleas, and keeping cats indoors all reduce the risk of cat-scratch disease. Because most cases of cat-scratch disease result from contact with kittens, immunosuppressed people should avoid such contact.

Salmonellosis, another common bacterial disease, can cause diarrhea, fever, and stomach pain beginning one to three days after infection. Salmonellosis usually resolves on its own. However, some people require medical attention because the diarrhea is severe or the infection is affecting other organs. People usually get salmonellosis by eating contaminated food, such as undercooked chicken or eggs. However, cats and other animals-even those that appear healthy-can carry and pass salmonella bacteria in their stool. Salmonella bacteria are more commonly harbored by cats that feed on raw meat or wild birds and animals. Feline infection can be prevented by keeping cats indoors and feeding them cooked or commercially processed food. Human infection can be prevented by wearing gloves and washing hands thoroughly after cleaning litter boxes (especially if used by a cat with diarrhea).

Parasitic Infections
Fleas are the most common external parasite of cats. While fleas cannot thrive on humans, their bites can cause itching and inflammation. Fleas may also serve as vectors for cat-scratch and other zoonotic diseases. Flea-infested cats may become infected with tapeworms from fleas ingested while grooming. Children, albeit rarely, can also become infected with tapeworms from inadvertently ingesting fleas.

Some feline intestinal parasites, including roundworms and hookworms, can also cause disease in people. Children are particularly at risk due to their higher likelihood of contact with contaminated soil. Visceral larva migrans, a potentially serious disease that can affect the eyes and other organs, results from inadvertent consumption of roundworm eggs (e.g. when soiled fingers are placed in the mouth). Cutaneous larva migrans, an itchy skin disease, is caused by contact with hookworm-contaminated soil. Proper hygiene, including washing hands before meals, cleaning soil from vegetables, and reducing exposure to cat feces (e.g., by covering children’s sandboxes when not in use) can prevent infection. Anti-parasite medications for kittens and annual fecal exams for adult cats can reduce environmental contamination and the risk of human infection.

Fungal Infections
Ringworm is not caused by a worm at all; it is a skin infection caused by a group of fungi. Infected cats most often come from environments housing large numbers of animals. In cats, ringworm appears as a dry, gray, scaly patch on the skin. In humans, ringworm often appears as a round, red, itchy lesion with a ring of scale around the edge. Ringworm is transmitted by contact with an infected animal’s skin or fur, either directly or from a contaminated environment. Infected cats continuously drop fungal spores from their skin and fur; these spores, which remain capable of causing infection for many months, are difficult to eradicate from a household. Children are particularly at risk of infection. To reduce environmental contamination, confine infected cats to one room until they are free of infection; then thoroughly clean and disinfect the household.

Protozoal Infections
Protozoans are single-celled organisms. The three most common protozoal diseases in cats and humans are cryptosporidiosis, giardiasis, and toxoplasmosis. Cryptosporidiosis and giardiasis can cause diarrhea in both cats and people, who usually become infected by a common source-for example, contaminated water-not by each other. To prevent the spread of infection, schedule annual fecal examinations for your cats, and medicate infected cats as directed by your veterinarian. Other preventive measures include wearing gloves while handling feces-contaminated material, washing hands afterwards, and boiling or filtering any surface water used for drinking.

Toxoplasmosis is caused by the parasitic protozoan Toxolasma gondii. People with weakened immune systems, or infants whose mothers are infected during pregnancy, can develop severe illness. People commonly become infected by eating undercooked or raw meat, or by inadvertently consuming contaminated soil on unwashed or undercooked vegetables. Unfortunately, pregnant women or immunosuppressed individuals are often mistakenly advised to remove cats from the household to reduce the risk of toxoplasmosis. However, people are highly unlikely to become infected from direct contact with their cats.

Cats can become infected by eating infected rodents, birds, or anything contaminated with feces from another infected cat. An infected cat can shed the parasite in its feces for up to two weeks. The parasite must then mature for one to five days before it becomes capable of causing infection. However, it can persist in the environment for many months and continue to contaminate soil, water, gardens, sandboxes, or any place where an infected cat has defecated.

Basic hygiene can prevent toxoplasmosis. Wear gloves when handling potentially contaminated material (for example, when gardening or handling raw meat), and be sure to wash your hands afterwards. Avoid eating undercooked meat, and thoroughly wash fruit and vegetables before eating. Surface water should be boiled or filtered prior to drinking, and children’s sandboxes should be covered when not in use to prevent wandering cats from defecating in them. Scoop litter boxes daily while wearing gloves, and wash your hands afterwards. Pregnant women or immunosuppressed individuals are safest when other household members clean the litter box.

Viral Infections
Most viruses infect only their natural host species. Human viruses, like those that cause the common cold, infect only humans, while feline immunodeficiency virus, feline infectious peritonitis virus, and feline leukemia virus infect only cats. However, one virus that can be passed from cats to humans is rabies, a viral disease resulting from the bite of an infected animal. Cats are highly susceptible to rabies, which attacks the central nervous system, causing a variety of signs. Rabies is almost always fatal. In people, rabies infections usually occur when an infected animal bites a person. In order to protect human health, rabies vaccination of cats is required by law in many areas. Even if your cat is kept indoors, it is important to keep rabies vaccines current because cats occasionally escape outdoors, and because rabid animals such as bats and raccoons occasionally enter houses. To further reduce your risk of rabies, avoid contact with wildlife and stray animals. See a doctor immediately if you have been bitten by an animal.

What can I do to protect my cat and myself?
Common sense and good hygiene will go a long way toward keeping you, your family, and your cat free of zoonotic diseases. Here are a few simple precautions:

Wash hands before eating and after handling cats.

Schedule annual checkups and fecal exams for your cat.

Seek veterinary care for sick cats.

Keep rabies vaccinations current.

Maintain appropriate flea and tick control.

Avoid letting your cat lick your face, food utensils, or plate.

Consider keeping cats indoors.

Seek medical attention for cat bites.

Feed cats cooked or commercially processed food.

Scoop litter boxes to remove fecal material daily.

Periodically clean litter boxes with scalding water and detergent.

Wear gloves when gardening or handling raw meat; wash hands afterwards.

Cover children’s sandboxes when not in use.

Wash fruits and vegetables before eating.

Filter or boil surface water before consuming.

Cook meat to 160°F or 80°C (medium-well-done).

Toxoplasmosis

Leave a comment

Provided by the Cornell Feline Health Center, Cornell University

What is toxoplasmosis?
Toxoplasmosis is a disease caused by a single-celled parasite called Toxoplasma gondii (T. gondii). Toxoplasmosis is one of the most common parasitic diseases and has been found in nearly all warm-blooded animals, including pets and humans. Despite the high prevalence of T. gondii infection, the parasite rarely causes significant clinical disease in cats-or any species.

What causes toxoplasmosis?
The life cycle of Toxoplasma gondii is complex and involves two types of host-definitive and intermediate. Cats, both wild and domestic, are the only definitive hosts for Toxoplasma gondii. This means that the parasite can only produce oocysts (eggs) when infecting a cat. When a cat ingests an infected prey (or other infected raw meat) the parasite is released into the cat’s digestive tract. The organisms then multiply in the wall of the small intestine and produce oocysts during what is known as the intraintestinal infection cycle. These oocysts are then excreted in great numbers in the cat’s feces. Cats previously unexposed to T. gondii will usually begin shedding oocysts between three and 10 days after ingestion of infected tissue, and continue shedding for around 10 to 14 days, during which time many millions of oocysts may be produced. Oocysts are very resistant and may survive in the environment for well over a year.

During the intraintestinal infection cycle in the cat, some T. gondii organisms released from the ingested cysts penetrate more deeply into the wall of the intestine and multiply as tachyzoite forms. These forms then spread out from the intestine to other parts of the cat’s body, starting the extraintestinal infection cycle. Eventually, the cat’s immune system restrains this stage of the organism, which then enters a dormant or “resting” stage by forming cysts in muscles and brain. These cysts contain bradyzoites, or slowly multiplying organisms.

Other animals, including humans, are intermediate hosts of Toxoplasma gondii. These hosts can become infected but do not produce oocysts. Oocysts passed in a cat’s feces are not immediately infectious to other animals. They must first go through a process called sporulation, which takes one to five days depending on environmental conditions. Once sporulated, oocysts are infectious to cats, people, and other intermediate hosts. Intermediate hosts become infected through ingestion of sporulated oocysts, and this infection results in formation of tissue cysts in various tissues of the body. Tissue cysts remain in the intermediate host for life and are infectious to cats, people and other intermediate hosts if the cyst-containing tissue is eaten.

How will toxoplasmosis affect my cat?
Most cats infected with T. gondii will not show any symptoms. Occasionally, however, clinical disease-toxoplasmosis-occurs. When disease does occur, it may develop when the cat’s immune response is not adequate to stop the spread of tachyzoite forms. The disease is more likely to occur in cats with suppressed immune systems, including young kittens and cats with feline leukemia virus (FELV) or feline immunodeficiency virus (FIV).

The most common symptoms of toxoplasmosis include fever, loss of appetite, and lethargy. Other symptoms may occur depending on whether the infection is acute or chronic, and where the parasite is found in the body. In the lungs, T. gondii infection can lead to pneumonia, which will cause respiratory distress of gradually increasing severity. Toxoplasmosis can also affect the eyes and central nervous system, producing inflammation of the retina or anterior ocular chamber, abnormal pupil size and responsiveness to light, blindness, incoordination, heightened sensitivity to touch, personality changes, circling, head pressing, twitching of the ears, difficulty in chewing and swallowing food, seizures, and loss of control over urination and defecation.

How is toxoplasmosis diagnosed in cats?
Toxoplasmosis is usually diagnosed based on the history, signs of illness, and the results of supportive laboratory tests. Measurement of IgG and IgM antibodies to Toxoplasma gondii in the blood can help diagnose toxoplasmosis. The presence of significant IgG antibodies to T. gondii in a healthy cat suggests that the cat has been previously infected and now is most likely immune and not excreting oocysts. The presence of significant IgM antibodies to T. gondii, however, suggests an active infection of the cat. The absence of T. gondii antibodies of both types in a healthy cat suggests that the cat is susceptible to infection and thus would shed oocysts for one to two weeks following infection.

Sometimes the oocysts can be found in the feces, but this is not a reliable method of diagnosis because they look similar to some other parasites. Also, cats shed the oocysts for only a short period of time and often are not shedding the oocysts when they are showing signs of disease. A definitive diagnosis requires microscopic examination of tissues or tissue impression smears for distinctive pathologic changes and the presence of tachyzoites.

Can toxoplasmosis be treated?
Most cats that have toxoplasmosis can recover with treatment. Treatment usually involves a course of an antibiotic called Clindamycin. Other drugs that are used include pyrimethamine and sulfadiazine, which act together to inhibit T. gondii reproduction. Treatment must be started as soon as possible after diagnosis and continued for several days after signs have disappeared. In acute illness, treatment is sometimes started on the basis of a high antibody titer in the first test. If clinical improvement is not seen within two to three days, the diagnosis of toxoplasmosis should be questioned.

No vaccine is as yet available to prevent either T. gondii infection or toxoplasmosis in cats, humans, or other species.

Can I “catch” toxoplasmosis from my cat?
Because cats only shed the organism for a few days in their entire life, the chance of human exposure is small. Owning a cat does not mean you will be infected with the disease. It is unlikely that you would be exposed to the parasite by touching an infected cat, because cats usually do not carry the parasite on their fur. It is also unlikely that you can become infected through cat bites or scratches. In addition, cats kept indoors that do not hunt prey or are not fed raw meat are not likely to be infected with T. gondii.

In the United States, people are much more likely to become infected through eating raw meat and unwashed fruits and vegetables than from handling cat feces.

How are people infected with Toxoplasma gondii?
Contact with oocyst-contaminated soil is probably the major means by which many different species-rodents, ground-feeding birds, sheep, goats, pigs, and cattle, as well as humans living in developing countries-are exposed to Toxoplasma gondii. In the industrialized nations, most transmission to humans is probably due to eating undercooked infected meat, particularly lamb and pork. People also become infected by eating unwashed fruits and vegetables. The organism can sometimes be present in some unpasteurized dairy products, such as goat’s milk. Toxoplasma gondii can also be transmitted directly from pregnant woman to unborn child when the mother becomes infected during pregnancy.

There are two populations at high risk for infection with Toxoplasma gondii; pregnant women and immunodeficient individuals. Congenital infection is of greatest concern in humans. About one-third to one-half of human infants born to mothers who have acquired Toxoplasma during that pregnancy are infected. The vast majority of women infected during pregnancy have no symptoms of the infection themselves. The majority of infected infants will show no symptoms of toxoplasmosis at birth, but many are likely to develop signs of infection later in life. Loss of vision, mental retardation, loss of hearing, and death in severe cases, are the symptoms of toxoplasmosis in congenitally infected children.

In immunodeficient people-those undergoing immunosuppressive therapy (e.g., for cancer or organ transplantation) or those with an immunosuppressive disease such as AIDS-enlargement of the lymph nodes, ocular and central nervous-system disturbances, respiratory disease, and heart disease are among the more characteristic symptoms. In these patients-especially those with AIDS-relapses of the disease are common, and the mortality rate is high. In the past, immunodeficient people and pregnant women were advised to avoid cats. However, the Centers for Disease Control (CDC) now advises that this is not necessary.

What can I do to prevent toxoplasmosis?
There are several general sanitation and food safety steps you can take to reduce your chances of becoming infected with Toxoplasma:

Do not eat raw or undercooked meat. Meat should be cooked to a temperature of at least 160°F for 20 minutes.

Do not drink unpasteurized milk.

Do not eat unwashed fruits and vegetables.

Wash hands and food preparation surfaces with warm soapy water after handling raw meat.

Wear gloves when gardening. Wash hands after gardening.

Wash hands before eating (especially for children).

Keep children’s sandboxes covered.

Do not drink water from the environment unless it is boiled.

Do not feed raw meat or undercooked meat to cats. Also, do not give them unpasteurized milk.

Do not allow cats to hunt or roam.

Do not allow cats to use a garden or children’s play area as their litter box.

Remove feces from the litter box daily and clean with boiling or scalding water.

Pregnant women, and persons with suppressed immune systems, should not clean the litter box.

Control rodent populations and other potential intermediate hosts.

Feline Parasites

Leave a comment

Provided by the Cornell Feline Health Center, Cornell University

Gastrointestinal parasitism is a common problem in cats, with prevalence rates as high as 45 percent. The parasites can be wormlike (e.g., stomach worms, roundworms, hookworms, tapeworms) or one-celled (e.g., Isospora, Giardia, Toxoplasma) organisms. The signs associated with parasite infections are fairly nonspecific, such as a dull hair coat, coughing, vomiting, diarrhea, mucoid or bloody feces, loss of appetite, pale mucous membranes, or a pot-bellied appearance. The vomiting, diarrhea, anemia, and dehydration caused by intestinal parasites will weaken a cat, making it more susceptible to viral and bacterial infections and diseases; thus robbing your cat of good health. Furthermore, some parasites have the potential of infecting humans.

Wormlike Parasite

Roundworms
Roundworms (Toxascaris leonina and Toxocara cati) are the most common intestinal parasite of cats, with an estimated prevalence of 25% to 75%, and often higher in kittens. The adult roundworms are 3 to 5 inches long, cream-colored, and live in the cat’s intestine. The adult female worm produces fertile eggs that are passed in the infected cat’s feces. The eggs require several days to several weeks to develop into the infective larva stage.

Cats become infected with Toxocara cati by ingesting eggs or by eating rodents (transport hosts) that have larvae in their tissues. Kittens can become infected by larvae that are passed through an infected queen’s milk. In those cases, it is possible for kittens to become infected soon after birth. Cats become infected with Toxascaris leonina in a manner similar to Toxocara cati, but unlike Toxocara, the parasite is not transmitted through the milk.

Roundworm infections can potentially become life-threatening if the numbers are so great that intestinal blockage occurs. Usually, roundworm infections are relatively benign when compared to other intestinal parasites. However, infected kittens are in serious danger if left untreated. Diagnosis is confirmed by finding parasite eggs in the stool during microscopic examination. Many medications are effective, but reducing exposure to the feces of an infected cats and prohibiting hunting are the best means of prevention. Treatment of queens prior to breeding reduces the likelihood that the parasite will infect kittens.

Visceral larval migrans and ocular larval migrans are diseases caused by the migration of Toxocara larvae through the tissue of people, particularly children. Although these diseases are rare, they can be quite serious, especially when they occur in young children. They can be easily avoided by preventing ingestion of Toxocara eggs in contaminated soil or on the hands.

Hookworms
Hookworms (Ancylostoma and Uncinaria) are less than 1/2 inch long, slender, thread-like worms that as adults live in the cat’s intestine. Because of their small size, they usually are not visible in the feces of infected cats. Hookworms are long-lived and are capable of living as long as the cat. Less common than roundworm infections, the prevalence of hookworm infections in North America is estimated to be between 10% and 60%.

Adult cats usually become infected by larvae that penetrate their skin or that are ingested. Once the larvae gain entrance into the host, they migrate to the lungs and then to the intestines to develop into adult worms. It is uncertain whether cats can become infected by eating rodents containing larvae in their tissues, or ingesting queen’s milk that contain larvae.

Severe parasitism can cause anemia due to blood loss from the intestines where the worms attach themselves. The cat’s feces will appear black and tarry due to blood in the feces. If too much blood is lost, the cat can become anemic and may die if left untreated. Fortunately, like roundworms, these worms are easily diagnosed and treated. Good sanitation and daily cleaning of the litter box are keys to controlling hookworm infections.

Hookworm larvae can penetrate human skin. As they migrate under the skin, they cause a dermatitis called cutaneous larval migrans.

Tapeworms
Tapeworms (cestodes) have long flattened bodies that resemble a tape or ribbon. The body is comprised of a small head connected to a series of segments that are filled with eggs. The adult tapeworm lives in the small intestine with its head embedded in the mucosa. As the segments farthest from the head become fully mature, they break off and are passed in the feces. These segments can be observed near the cat’s tail and rectum, or in the feces. The segments are about one-quarter inch long, flat, and resemble grains of rice when fresh or sesame seeds when dry. When still alive they will usually move by increasing and decreasing in length. Microscopic examination of fecal samples may not always reveal the presence of tapeworms, because eggs are not passed singly, but as a group in the segments. Although the discovery of tapeworm segments can be quite alarming to cat owners, tapeworm infections only rarely cause significant disease in cats.

Cats usually become infected with tapeworms by ingesting infected fleas while grooming or by eating infected rodents. Fleas and rodents become infected by eating the tapeworm eggs that are in the environment. Modern medications are highly successful in treating tapeworm infections, but reinfection is common. Controlling the flea and rodent populations will reduce the risk of tapeworm infection in cats.

Some tapeworm species that infect cats can cause disease in humans if the eggs are accidentally ingested; but good hygiene virtually eliminates any risk of human infection.

Whipworms
Whipworms are an uncommon parasite of cats in the United States. Adult whipworms reside in the large intestine of infected cats but do not cause serious disease.

Stomach Worms
Ollanulus tricuspis and Physaloptera species are worms that can inhabit the feline stomach. Ollanulus infections occur only sporadically in the United States and are more common in free-roaming cats and those housed in multiple-cat facilities. Cats become infected by ingesting the parasite-laden vomitus of another cat. Chronic vomiting and loss of appetite, along with weight loss and malnutrition may be seen, although some infected cats show no signs of disease. Diagnosis of Ollanulus infection can be difficult, and depends upon detecting parasite larvae in the vomitus. The most effective treatment is not known; avoiding exposure to another cat’s vomitus is the most effective means of controlling infection.

Physaloptera infections are even more rare than Ollanulus infections. Adult female worms attached to the stomach lining pass eggs that are subsequently ingested by an appropriate intermediate host, usually a species of cockroach or cricket. After further development within the intermediate host, the parasite is capable of causing infection when a cat ingests the insect or another animal (a transport host), such as a mouse, that has eaten an infected insect. Cats infected with Physaloptera may experience vomiting and loss of appetite. Diagnosis relies upon microscopic detection of parasite eggs in the stool, or seeing the parasite in the vomitus. Effective treatment exists, and infection can be prevented by limiting exposure to intermediate and transport hosts.

Neither Ollanulus nor Physaloptera are capable of causing disease in humans.

Protozoan Parasites

Isospora
Isospora sp. (coccidia) are microscopic one-celled organisms causing the disease coccidiosis. Virtually all cats become infected with Isospora felis during their life. Cats become infected with this parasite by eating the cyst (thick-walled, egg-like stage) that has been passed in the feces and has matured in the soil. The cysts can be infective within six hours after being excreted in the feces.

Isospora infections usually cause no problems in adult cats, but evidence suggests that the parasite can cause significant disease in kittens. In infected kittens, the coccidia destroy the lining of the intestine and cause diarrhea with often contains mucous. Serious infections may develop in crowded environments. Good sanitation and hygiene will help control coccidia, but accurate diagnosis and effective treatment can only be achieved with your veterinarian’s assistance. Isospora of cats cannot cause disease in humans.

Giardia
Giardia are flagellated protozoa (one-celled organism) that parasitize the small intestine of cats. The prevalence of feline giardia infection (giardiasis) is estimated to be less than 5% but can be much higher in some environments. Cats become infected by ingesting giardia cysts present in the feces of another infected animal, usually a littermate or chronic carrier cat. Giardiasis is more common in multiple-cat households and catteries due to its mode of transmission. Also, the infection rate is greater in cats less than one year old.

The cysts are very resistant to freezing. Also chlorination of municipal water does not destroy the cysts. After ingesting of Giardia cysts, it takes 5 to 16 days before the cat will show signs of diarrhea. Acute or chronic, and continuous or intermittent diarrhea is the most common sign of infection, although the majority of Giardia-infected cats are free of disease. They do, however, remain a source of infection to other cats. The cat probably requires several exposures to the organism before infection actually occurs.

Diagnosis of giardiasis depends upon microscopic identification of cysts in the stool. For accurate diagnosis, several fecal samples may need to be evaluated since cysts are not continuously shed in the stool. Several effective medications are available, but resistance is common. Elimination of Giardia infections from households of cats may be difficult and depends on proper treatment and sanitation.

It is uncertain whether species of Giardia that infect cats are contagious to humans or vice versa. Careful hygiene will eliminate the risk of accidental ingestion of cysts.

Toxoplasma
Cats are the definitive host for the Toxoplasma organism. Infection with this protozoan parasite is fairly common, but actual disease caused by this parasite is relatively rare in cats. Cats can become infected by Toxoplasma by eating any of the three infective stages of the parasites. The most common route of infection is probably by ingestion of tissue cysts in infected prey or in other raw meat. Toxoplasma multiply in the small intestines and in approximately two to three weeks the oocysts are excreted in the infected cat’s feces. (For more detailed information on this parasite, see Toxoplasmosis.)

Treatment
Treatment may require administering one or more dosages of the medication prescribed by your veterinarian. Whenever using medications, be sure to carefully follow the directions provided by your veterinarian.

Parasite re-infections are very common, but can be prevented. Parasite control begins with good sanitation procedures. This includes daily removal of feces; washing the litter box with a disinfectant (e.g., diluted household bleach) on a regular basis; avoiding overcrowded conditions; avoiding diets with raw meats; and controlling intermediate hosts (fleas, ticks, and rodents). Good parasite control is the key to a healthier cat.