What is Coccidia?
How Coccidia is transmitted
Symptoms of coccidiosis
What are the risks?
Treatment of coccidiosis
Baycox
Treatment Chart (Baycox)
Baycox Dose Calculator
Effectiveness of Toltrazuril for Coccidiosis in Cats research article
Procox
Efficacy of Procox against Coccidia in Cats research article
How is coccidiosis prevented or controlled?
Antimicrobial Spectrum of Disinfectants
What is Coccidia?
Coccidia are small protozoa (one-celled organisms) that multiply in the intestinal tract. In cats, coccidiosis is most often caused by Cystoisospora species, previously commonly referred to as Isospora, especially Cystoisospora felis and Cystoisospora rivolta.
Coccidiosis is seen most commonly in kittens, especially those under six months of age. Adult cats may carry coccidia and shed oocysts in the faeces without showing obvious illness, but kittens, stressed cats, cats with other disease, and cats with a suppressed immune system are at greater risk of developing clinical signs.
Coccidia are common in many animal species, including livestock and poultry, but most coccidia are host-specific. The species causing coccidiosis in cats are mainly feline species, so contaminated cat faeces and contaminated cat housing are the main concern in a rescue or cattery setting.
How Coccidia is transmitted
Kittens are not born with coccidia. After birth, they may be exposed to oocysts from their mother’s faeces or from a contaminated environment. If the mother or another cat is shedding oocysts, the kitten may ingest them during grooming, nursing, eating, using litter trays, or contact with contaminated bedding, bowls, floors or hands.
After ingestion, coccidia develop inside the kitten’s intestines. Young kittens, especially those less than six months of age, have limited immunity, so the organisms can multiply in large numbers and damage the intestinal lining.
From exposure to the onset of illness is commonly around 13 days. Most kittens ill from coccidiosis are therefore two weeks of age or older. Although many infections are associated with spread from the mother, this is not always the case. Any infected kitten can contaminate the environment and expose other kittens. In shelters, rescues, breeding facilities and veterinary hospitals, infected kittens should be isolated from uninfected young or vulnerable animals where possible.
Symptoms of coccidiosis
The main sign of coccidiosis is diarrhoea. The diarrhoea may be mild or severe, depending on the level of infection and the health of the kitten. Blood and mucus may be present, especially in advanced cases. Severely affected kittens may also vomit, lose their appetite, become dehydrated, lose weight, become weak, and in severe cases may die.
Most clinically affected kittens are in the four to twelve week age group. Coccidiosis should always be considered when loose stool or diarrhoea is seen in kittens. A microscopic faecal examination by a veterinarian can detect oocysts and confirm the diagnosis. Faecal testing before and after treatment is useful, especially in rescue or cattery situations.
What are the risks?
Many cases are mild, but coccidiosis can cause severe, bloody diarrhoea, dehydration and death. The risk is greater in very young kittens, underweight kittens, kittens with other parasites, bacterial or viral infections, and animals under stress. Coccidiosis can spread rapidly in contaminated environments, especially where many kittens are housed together.
Treatment of coccidiosis
Stress can play a role in the development of clinical coccidiosis. A kitten may appear healthy, move to a new home, rescue pen or foster home, and then develop diarrhoea several days later. If signs develop within less than about 13 days, the kitten was probably already exposed before arrival. If the kitten has been in the new environment for several weeks, exposure may have occurred after arrival.
Fortunately, coccidiosis is treatable. Treatment should be directed by a veterinarian, especially in young kittens, weak kittens, dehydrated animals, pregnant or lactating queens, or cats with other illness. Supportive care, fluids and nutritional support may be needed in severe cases.
Traditional drug treatments may need one to three weeks, depending on the medicine used and the severity of infection. Toltrazuril-based treatments are shorter, but use in cats may be off-label depending on the country and product.
Baycox (toltrazuril) is not licensed for cats in many countries, so use in cats is off-label and should be under veterinary direction. It is commonly supplied as a 2.5% solution, equal to 25 mg/mL. A 5% solution contains 50 mg/mL, so the volume required is half that of the 2.5% product for the same mg/kg dose.
Cats using 2.5% toltrazuril, 25 mg/mL:
For the enteroepithelial cycle of toxoplasmosis/oocyst shedding: 5–10 mg/kg orally once daily for 2 days has been referenced by Dubey and Lappin, 2006.
For coccidiosis: veterinary protocols may use 30 mg/kg orally once daily for 3 days, with repeat treatment one week later where advised by a veterinarian. Always dose by accurate bodyweight and product concentration.
Effectiveness of Toltrazuril for Coccidiosis in Cats
Dosing tip: Draw up the medicine accurately in an oral syringe. If advised by your veterinarian, it may be followed with a very small amount of palatable food or liquid. Give oral medicines slowly into the side of the mouth, allowing the kitten to swallow. Do not squirt fluid directly down the back of the throat, as this can cause choking or aspiration.
Procox
Procox is licensed for dogs, not cats. Published experimental work in kittens showed that emodepside/toltrazuril oral suspension reduced oocyst shedding of Isospora/Cystoisospora felis and Isospora/Cystoisospora rivolta, with the stronger effect at 0.9 mg emodepside + 18 mg toltrazuril/kg bodyweight, equivalent to 1 mL/kg of Procox. Use in cats is off-label and should be under veterinary direction.
Where infection is severe or reinfection risk is high, a veterinarian may advise repeat treatment. Environmental cleaning between treatment and re-testing is important to reduce reinfection.
Efficacy of Procox against Coccidia in Cats
How is coccidiosis prevented or controlled?
Because coccidia are spread through faeces, strict hygiene is essential. Remove faeces promptly and clean litter trays, bedding, food bowls and housing daily. Prevent food and water from becoming contaminated with faeces. Coccidia oocysts can survive for months in the environment and are resistant to many routine disinfectants.
Where practical, physical removal of faecal material, thorough cleaning, drying, steam cleaning, boiling water for suitable items, and heat washing are the most reliable control measures. Ammonia-based disinfectants may damage coccidia oocysts, but they must not be used around animals and require good ventilation and careful handling. Only claim that a disinfectant kills coccidia if the product label specifically supports that use and gives a contact time.
During an outbreak, isolate affected kittens where possible, use separate litter trays and cleaning equipment, clean from healthy animals to infected animals, and avoid moving contaminated bedding, bowls or footwear between pens. Re-testing faeces after treatment may be useful in rescue, shelter or cattery environments.
Anistel is widely used by catteries, kennels and veterinary practices as a general disinfectant. Use it according to the manufacturer’s instructions. For coccidia specifically, do not rely on any disinfectant unless the product label confirms activity against coccidia oocysts and gives the required dilution and contact time.
Antimicrobial Spectrum of Disinfectants
The common coccidia species of cats and dogs are very unlikely to infect humans. However, other intestinal protozoa, including Toxoplasma gondii, Cryptosporidium spp. and Giardia spp., may have zoonotic importance. Good hand hygiene, prompt faeces removal, careful litter tray cleaning and protection of immunocompromised people remain important.
For more information on coccidiosis
References:
* Plumb’s Veterinary Drug Handbook, Sixth Edition, Donald C. Plumb, Pharm.D., Blackwell Publishing, 2008. * Adapted from an article by Race Foster, Doctor of Veterinary Medicine.
Guideline for disinfectant choice in feline veterinary hospitals, shelters and cat households
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