Your Pet Has Worms? Here's What to Do!

Worried about worms in your pets? This episode of Vetsplanation is a must-listen! Dr. Z breaks down the different types of parasitic worms that can infect your pets and offers expert tips on prevention and treatment. Learn how to protect your beloved animals from these common yet dangerous parasites. Stay informed and keep your pets healthy by listening now! 

In this episode you will learn:

• Understanding different types of parasitic worms in pets
• Identifying signs and symptoms of worm infestations
• Effective treatment options for various parasitic worms
• Importance of regular deworming and prevention
• How parasites affect pets' health and well-being
• The role of intermediate hosts like fleas in spreading worms
• Differences in worm infections between puppies/kittens and adult pets
• Preventing zoonotic risks from pet parasites
• The importance of fecal tests in diagnosing worm infestations
• Recommended dewormers and their effectiveness against specific parasites

References:
Companion Animal Parasite Council
Center for Disease Control

Images Referenced:
Roundworms
Hookworms
Whipworms

Transcript

Dr. Sugerman: 0:01

Hi, everybody. Welcome back to another episode of Vetsplanation. I have Dr. Z here with me again today. I'm so excited. We're going to be talking about one of your favorite topics. All right. So let's get into it.

Dr. Xenia Zawadzkas: 0:14

Okay. First of all, there's so many types of worms in the world. I was researching before talking to you and the good old Google told me there's about 325 quintillion worms in the world. I was like how much is quintillion and that's 10 to the 18, yeah, 18 zeros. So a lot of worms and like of all the organisms in the world, like one out of four are a worm. If that helps put it in perspective. So there's tons of worms, but luckily only a very tiny portion of these is our parasitic worms. Like a lot of them are just free living worms that don't bother us.

Dr. Sugerman: 0:48

Okay, that's good.

Dr. Xenia Zawadzkas: 0:49

Yeah. But the best guesses are about 300,000 or so are parasitic. Yeah.

Dr. Sugerman: 0:56

Still a lot.

Dr. Xenia Zawadzkas: 0:57

There's quite a few, yeah.

Dr. Sugerman: 1:00

So today we're going to define what a parasite is, how it affects the host, and then discuss the different types of parasitic worms that commonly infect our pets. From roundworms to hookworms, whipworms to tapeworms, we got a lot to cover. So buckle up and get ready to learn everything you need to know about keeping your furry friends healthy and worm free. By the way, don't forget to like and subscribe now. You guys are the ones that help us be able to help more pets. The more likes we get, the more subscribes we get, the more we get this information out to more pet parents. Alright, so listen in.

Dr. Xenia Zawadzkas: 1:36

Um, To define a parasite though, just remember, that's an organism that lives on or in another species called the host. And they derive their nutrients. They have to eat them at the host's expense. So it's not like the host is benefiting from them at all. And obligate parasites are the ones that can't survive or complete their life cycle at all without the host. So they have to have the host to live. There are also facultative parasites. And they can live with or without a host. It doesn't matter to them. Examples of those, I was trying to think of one on my own, but I couldn't find one, but it's actually like fungus. There's like yeast in the dog's ears. They're parasitic in there, but they don't have to be in the air and they can live and eat something else. It doesn't matter to them. And there's some weird amoeba too, that like supposedly can infect people and cause brain damage, scary stuff. But I'm not talking about those. I'm talking about worms, yeah. So there are other parasites that I've already talked about, like that are on the outside, like fleas and ticks and mosquitoes. Yeah, bedbugs and all kinds of fun parasites. But today let's just talk about the worms.

Dr. Sugerman: 2:42

Perfect. What are the most common worms that we see in dogs and cats?

Dr. Xenia Zawadzkas: 2:46

That are parasitic? Yeah. We have let's see, one, two, three, four big worms. And then there's a couple other like single celled organisms that we'll talk about next time. So just focusing on the worms, we have roundworms, hookworms, whipworms, and tapeworms. Those are some of the big ones that we actually look for on a fecal analysis when we're running fecals on puppies or even adult dogs. We're always looking for those types of worms. The other ones that are on the fecal test are Giardia and Coccidia. And then sometimes we're looking for flukes as well. So I thought I'd save those three for another time. Yeah, so those are the big ones.

Dr. Sugerman: 3:23

What are the different worms we find most common in dogs and cats then?

Dr. Xenia Zawadzkas: 3:27

Yeah, so there are different worms. Let's see, some can infect both dogs and cats, but other ones are species specific and only infect cats or only infect dogs. And then there's different strains of the same kind of parasite that only go into dogs and cats. And I'll go into all of that.

Dr. Sugerman: 3:42

Okay. I know many people tell me that they aren't seeing any worms in their dogs and cats. When they do see those worms can you tell the difference between those?

Dr. Xenia Zawadzkas: 3:51

Yeah, just by looking at them.

Dr. Sugerman: 3:52

Just by looking at them.

Dr. Xenia Zawadzkas: 3:53

Yeah the short answer is yes, you can tell what they are by looking at them. They have different anatomical features, but there's a big myth about worms in a dog's poop that I think we need to bust that myth right now. So basically dogs when they have worms or cats when they have worms they're living happily up inside of them, and they're not gonna just come out occasionally in the poop. And so if an owner says oh, I don't need to run a fecal his poops look great I don't see worms in this poop. That doesn't necessarily mean that he doesn't have worms. What we're actually testing for on our fecal analyses are microscopic eggs, and they are laying those in different amounts. But that's what we're looking for and you need a microscope to do that.

Dr. Sugerman: 4:34

Right. Do they always lay those eggs? Do you see it in every stool sample?

Dr. Xenia Zawadzkas: 4:39

It depends if they have the worm or not, right?

Dr. Sugerman: 4:42

Let's say they do have the worm. Will you see it in every fecal sample still?

Dr. Xenia Zawadzkas: 4:45

Some of them, yes. But some of them, no. We'll go over that, because they're all a little bit different. Some of them lay eggs continuously, and some of them only lay them occasionally and other ones don't really release them into the poop at all, like tapeworms. We'll go into that, but, but if an owner does actually see live worms, like they're walking out in their yard and they're picking up their dog's poop and they see worms like wiggling around in their dog's poop, that that probably doesn't mean those were parasites. Those are probably free living worms that went into the poop after the dog pooped.

Dr. Sugerman: 5:15

Yeah.

Dr. Xenia Zawadzkas: 5:15

So like flies, for example, big one, they have maggots, right? And they love poop and they lay their eggs on the poop. And within days, usually they're hatching and they're wiggling around and disgusting. And so if you don't pick the poop up right away, that might be why there's some worms in there.

Dr. Sugerman: 5:28

I also commonly have people bring in the poop with the worm and it ends up being like literally a groundworm.

Dr. Xenia Zawadzkas: 5:34

Yeah. Just one of those quintillion worms that live in the world without being parasitic. Yeah. So there's a lot of them out there. There is an exception like roundworms in particular, if the puppy has a ton of them or a kitten has a ton of them, they can actually burp those up and vomit out adult worms sometimes if they have a ton of them, just because there's so many there.

Dr. Sugerman: 5:54

So they're just living in their stomach at that point.

Dr. Xenia Zawadzkas: 5:56

Yeah. Like throughout their whole intestines and then they get up in their stomach and then the cat just pukes it up. So that you can't actually see a cat or a dog have a worm come out, but usually it's the front end. But most of the time, yeah, the, the microscopic worm eggs are tiny, you can't see them. And then over many, many weeks, sometimes months. They're slowly developing and then hatching out sometimes, depending on which kind. And so maybe you can see them eventually, but it's like a month later after the poop has been on the ground and then the poop's like long gone by then. And it's like a worm in the dirt basically. And they're tiny, even then some of them are still microscopic. So yeah, you can't really tell if your dog has worms by looking at their poop.

Dr. Sugerman: 6:39

Got it.

Dr. Xenia Zawadzkas: 6:40

To make a long story short.

Dr. Sugerman: 6:41

Perfect. Okay. I know a lot of times we will ask to send a fecal out to the lab rather than just doing it in house. Why is that?

Dr. Xenia Zawadzkas: 6:49

Good, we can do either. We can check in house, but it's not as sensitive as sending it out to the lab. The labs that we send the poop out to have trained staff who are really looking for these worms eggs and they have the facilities and the time to spin it properly. You have to do like a sugar centrifugation. I remember doing it in vet school. Did you do it?

Dr. Sugerman: 7:09

I did have to do that.

Dr. Xenia Zawadzkas: 7:09

And then like the sugar just got everywhere.

Dr. Sugerman: 7:11

It was so sticky.

Dr. Xenia Zawadzkas: 7:12

Yeah.

Dr. Sugerman: 7:13

Yeah.

Dr. Xenia Zawadzkas: 7:13

And it takes a long time too, like you have to spin it and mix it in the sugar, and then you let it sit for so long, and then you have to take the side out and look at it. And it takes a long time just to do one fecal properly. So it's a lot easier and a lot more sensitive just to send it out unless we're really trying to figure out if they have giardia or something. Sometimes you can see that pretty quickly. But a lot of times you miss it. If you look at it in house.

Dr. Sugerman: 7:34

And some of the ones that they do, when we send them out to the lab, is actually looking for the DNA of the worm, too.

Dr. Xenia Zawadzkas: 7:38

Yes. Yeah, I didn't even talk about that. But yeah, we can not here, but at the lab, they can do PCR testing on the poop and actually see, like we do PCR testing on all the tick borne diseases and everything. They can actually look for roundworm antigen and hookworm antigen and all of those. And they're getting a lot more specific now and more sensitive.

Dr. Sugerman: 7:58

Yeah, very cool.

Dr. Xenia Zawadzkas: 7:59

Mm hmm. Yeah. So I like to send the poop out. Tells me I'm a little more certain about the results when we send it out.

Dr. Sugerman: 8:05

Yeah, there are definitely times when I've looked at the microscope and I'm like, I'm not 100 percent sure.

Dr. Xenia Zawadzkas: 8:09

Yeah, or you're like, what is this? Is this a worm egg?

Dr. Sugerman: 8:12

Exactly, yeah.

Dr. Xenia Zawadzkas: 8:13

Or maybe it's a piece of pollen. A lot of times I remember in vet school, they're like, no, that's just plant pollen.

Dr. Sugerman: 8:19

Yeah, exactly.

Dr. Xenia Zawadzkas: 8:20

I was disappointed. I thought it was a worm egg.

Dr. Sugerman: 8:22

I will say that plant pollen is really cool because it looks like Mickey Mouse. Like a hidden Mickey is what I always call it. Yeah, for anybody who's from Anaheim. All right let's get into some of these worms. So I wanted to know like, what does a roundworm look like?

Dr. Xenia Zawadzkas: 8:33

Yes. Let's start with roundworms. Roundworms, the adults, they can be anywhere from about two inches to eight inches long. The females are the bigger ones. They are round and smooth and tubular like spaghetti. Really, it's a really good analogy. They look a lot like spaghetti.

Dr. Sugerman: 8:49

Sorry. Hopefully nobody's eating.

Dr. Xenia Zawadzkas: 8:51

I know. They can be anywhere from like cream colored to brownish yellow to pinkish. Like the cat one is a little pinkish. It's super nasty. Oh, and I meant to say also when we actually deworm puppies and they poop out the worms, that's when you'll see them in the poop, right? After they die, then they come out. The dewormer for roundworms just sedates them a little bit, just anesthetizes them, so they kind of like let go of the, of the intestine, but they're still alive. And then they poop them out, because they let go. And then when they come out, they're still like moving a little bit.

Dr. Sugerman: 9:23

Oh my gosh, I didn't even know that.

Dr. Xenia Zawadzkas: 9:24

Yeah, so sometimes they're still alive. Super gross. But it's interesting that they will then die because once they're out of the intestine, they'll die eventually because of exposure. But it's interesting also that these guys are not infectious. Like you could actually eat those and be okay. If a dog were to eat it again, like you wouldn't get more. Yeah, it would just pass on through

Dr. Sugerman: 9:44

Or the next dog. I think that's the most common thing. The other dog eats the stool, right?

Dr. Xenia Zawadzkas: 9:49

Yeah, that's super common. Poop eating is a big thing yeah. So he'd be like, Oh, spaghetti poop. And it would be okay. Don't worry. They can do it.

Dr. Sugerman: 9:56

So tell me more about roundworms. So what about their life cycle? Why is that really important?

Dr. Xenia Zawadzkas: 10:00

Oh yes, so of course we have to talk about the life cycles. We're going to talk about all of them.

Dr. Sugerman: 10:04

Okay, perfect.

Dr. Xenia Zawadzkas: 10:05

And if we know the life cycle, we know the enemy, and then it gives us the power to know how best to fight them, right? If we know where they go and what they do. If we understand that, then all of this deworming and preventatives that we're touting all the time will make more sense. You'll understand why we say you have to deworm this many times. It's because of the life cycle. Let's go into it. Okay. First of all, the names of these roundworms, there's a couple different ones. And I want to touch on them all a little bit because they're all very different. The one that dogs most often get is the Toxocara canis. They cannot infect cats, but they can get into humans. And then there's a cat one called Toxocara cati. And they're a little less common, they only go in cats, but they also can go into humans. And I won't go into that in too much detail, because that's like a whole other thing about human medicine.

Dr. Sugerman: 10:57

Yeah.

Dr. Xenia Zawadzkas: 10:57

But it's a very severe disease in humans a roundworm infection. It's called cutaneous live larva migrans or visceral larva migrans, where the immature worms start to migrate through the human body and they can get into just the skin if you're lucky. And that's not so bad, but then sometimes they get inside your body and go into your, any abdominal organ, or they can get into the eyes too. And you can go blind. It's super nasty. It's more of a problem in like third world countries where they, they don't deworm the pets and the kids are running around barefoot all the time. And so that's where you see those kind of horrible parasitic diseases. So another big reason why the companion animal parasite council recommends deworming all the time. So that we can avoid this problem in the United States anyway. Yeah. And we, for the most part, do.

Dr. Sugerman: 11:48

Yeah. I would like to avoid that.

Dr. Xenia Zawadzkas: 11:51

Yeah. It does make me want to tell my kids not to run around barefoot so much. But we also don't have a ton of dogs running around that are probably not on parasite prevention. So I think our exposure to our kids is pretty rare here, but it is a big problem in other places and worth noting. There is another type of roundworm called Toxascaris leonina, which is also pretty commonly found. It's another roundworm, but it's much simpler than the Toxocara canis or cati. It doesn't do any of the migrating. It's a much easier parasite to get rid of, and that one's not a big deal. And then the last one that I want to touch on, there's tons of types of roundworms, but the last big one is called Baylisascaris procyonis. This one is in raccoons, and we see raccoons everywhere. And this one is especially bad if people get it, because this one will go straight to the brain, and make you die basically. So never touch raccoon poop. They like to poop in they call it a latrine. It's super gross but they'll all kind of poop in one area. And sometimes dogs will get into that and then eat the poop there and then they get the Baylisascaris. And sometimes we'll see it on a fecal and it's a big surprise and we're like, Oh my God, wash your hands, let's deworm, let's deworm. Because it's just such a huge zoonotic risk for people.

Dr. Sugerman: 13:08

And it's really hard to distinguish between a lot of those, like there's such tiny differences between them all just as another reason why we send them out, right?

Dr. Xenia Zawadzkas: 13:15

Yeah, so on the microscope the eggs are all slightly different and that's usually how you diagnose which type it is based on what the worm eggs look like. The adults look a little different too, but, but yeah, the lab will tell you what kind of roundworm it is. Okay, but let's just focus now on the dog and cat ones that we see more often. So Toxocara canis, let's start with the eggs, right? The eggs are microscopic, they're pooped out, they're in the environment. And then it takes about 10 days at the least, but usually more like 3-4 weeks for those little eggs to develop the larvae inside of it basically becomes like an embryo, or like a little infective larva. But it takes weeks and weeks for that to happen. So if you were to eat fresh poop, those worm eggs wouldn't do anything, right? But if a dog eats like an old poop, there's probably, there could be positive, or, infective larva in that poop. And these eggs, by the way, are very hardy. They stay in the environment. They're not, sunlight doesn't kill them, freezing doesn't kill them, they just stay around basically forever, for years, they'll be in the dirt.

Dr. Sugerman: 14:17

So the, so adults, they're not hardy, eggs are.

Dr. Xenia Zawadzkas: 14:20

Correct. Absolutely. Yep, just like I talked about, if you poop out dead adult worms, those don't go anywhere, they're done. But if you poop out eggs, those will eventually become infective after a month or so and then they stay forever until they're picked up again. And so then these are ingested usually by what we call fecal oral transmission. So dogs will run through poop, old poop, lick their paws, lick the dirt off themselves. Cats as well. Very fastidious. They like to groom themselves. So usually ingest the eggs that are infective. And then the craziness happens. This is particularly bad for the roundworms, they like to migrate once they get inside as that infective larva. And they, it seems like they don't really know where they're going, honestly. Sometimes they'll go where they mean to go. I think they want to end up in the lungs. Cause if they get to the lungs, then the dog or the cat coughs them up and then swallows that down.

Dr. Sugerman: 15:19

Mhmm. Yeah. And cough up a little phlegm.

Dr. Xenia Zawadzkas: 15:21

Exactly. We do it too. But anyway, that's how they get then back into the gut, cause they went from the lungs into the gut by the cough swallow mechanism. And then they can grow up from there and keep going. But I want to mention the other places they can go before, besides the lungs, they also go to the liver. And sometimes they just insist in there and stay there for a long time. And they can go to the muscle. In the females, they love to go to the mammary glands, and to the uterus, straight into the fetuses of the puppies that are about to be born. And then inside the fetus, they'll make their way into the gut. They just keep moving. They just migrate like crazy. And then they can also get into the central nervous system and the brain. And that's usually though, in the, the host that they didn't mean to get into like humans they'll like to go crazy places and, they're like, this isn't a dog. Where do I go? Where do I go? And then they're like, Oh, let's go to the brain. This is nice. So they go everywhere, hopefully they get to the lungs at some point, are coughed and swallowed, and then they can get back into the gut once they get, they have to go out of the gut and then back into the gut. That's like what they want to do for some reason. And then they do some stages of maturing along the way. Once they're back in the gut, though, after all of that, then they finally become adults again, and they mate, and they start to lay eggs, and then those are released into the environment and we start all over again. So that's the roundworm life cycle. Super fun.

Dr. Sugerman: 16:47

Yeah. What are some of the signs then that a dog or cat might have roundworms?

Dr. Xenia Zawadzkas: 16:52

Yeah, so puppies, the big ones are vomiting and diarrhea right with or without worms like that you can see. And if they have a really high worm burden and they start getting into the lungs because they're migrating there they'll start coughing. You'll notice a cough in a puppy. And if it's really bad, they can get pneumonia. So like really young puppies with pneumonia might actually be bits of round worms in their lungs, getting infected.

Dr. Sugerman: 17:16

Good to know, we just have to deworm them. Yes.

Dr. Xenia Zawadzkas: 17:18

Yeah. Always deworm the puppies, might just be a roundworm in their lungs. Most of the time, though, the puppies are very unthrifty. We call them like they have a rough hair coat. The worms are stealing their nutrition, right? They absorb the food in the stomach that the puppy's eating and they steal it from them. So they are malnourished or skinny, but yet they have a really big pot belly because they're don't have a lot of muscle and there's a lot of worms in their intestines and it can actually push their bellies out. So they have these big bellies. Oh, really sad in some of the puppies that have big infestations, they can cause an obstruction, like they can form a ball and then they can't move food through at all if they ate a baseball or something, they got an obstruction. And sometimes little puppies are more susceptible to intussusception as well. Like, when they have some of that happening, the gut's still trying to move around it, and one piece of the gut can go into the other, like a glove. Or a sock.

Dr. Sugerman: 18:12

That's definitely the most common thing I've seen when they've been in for an emergency, a worm, like real worm emergency has been into intussusceptions.

Dr. Xenia Zawadzkas: 18:19

And I think sometimes that happens after they're dewormed because some of them will die and then they stop moving and get stuck in a wall and then the intussusception can happen. So it can be really bad when they have a high worm burden and hard to treat them and then they might need surgery to get the intussusception out of there. So that's bad. With kittens, it's not quite as bad. We don't see as many of those problems, but vomiting, diarrhea for sure. Just less of all the other stuff.

Dr. Sugerman: 18:46

Okay. Moving on, how about hookworms?

Dr. Xenia Zawadzkas: 18:50

Okay. Number two, hookworms.

Dr. Sugerman: 18:51

So what do they look like?

Dr. Xenia Zawadzkas: 18:53

Yes. So they are much smaller. They're much shorter. They're short and thick. They are white to reddish brown, and they have a little hook on the end. That's the name hookworms. I think they're, they're about like one to two centimeters long. So they're pretty small, maybe an inch.

Dr. Sugerman: 19:07

Definitely compared to the roundworms.

Dr. Xenia Zawadzkas: 19:09

Yeah, so much, much smaller than the roundworms. Roundworms are like big spaghetti. These guys are like little threads. I think I read somewhere that there can, just think of them as small, thin strings. They also, and there's a good picture, an electron microscope picture of this one. They have these sharp, nasty teeth. There's six of them, apparently. In the picture, it only looks like there's two, but, but there's six of them. And some of the other types of hookworms have plates, like they're called cutting plates instead. And these worms are big on blood sucking, like more than all the other ones. They just want blood. They don't care what's going on in the gut.

Dr. Sugerman: 19:44

Vampire worms.

Dr. Xenia Zawadzkas: 19:45

Exactly. Yep. And they have sharp teeth and they cut, cut, and they drink, drink blood. Yeah. There's a few different names of those. The big ones we see in dogs and cats are Ancylostoma caninum. Caninum is the dog one. There's a braziliense, which is cats and dogs. And then there's a less scary, less pathogenic one called Uncinaria stenocephala. So those are the three main types that we'll see in dogs and cats.

Dr. Sugerman: 20:14

What about the life cycle of the hookworms then?

Dr. Xenia Zawadzkas: 20:16

Yeah, let's do the life cycle.

Dr. Sugerman: 20:18

All right.

Dr. Xenia Zawadzkas: 20:19

All right. So let's start with the eggs again. Again, they're microscopic. They're out in the environment from a dog or cat pooping them out. And they also take, just like roundworms, two to four weeks for the second and third stage larvas to develop inside of that egg. So they're still microscopic. They're slowly like maturing out in the wild. Out in the dirt. The eggs are also very hardy just like roundworms, months to years, they just stay out there. And then they are ingested by licking or the other cool thing about these guys, I don't know if it's cool, but scary, they actually instead of looking like an egg after a while, they do hatch out a little worm, like a tiny larva, and they, they can burrow into the skin. So unlike, unlike the roundworms, where you have to just ingest the eggs, these ones can, you can still ingest the eggs, that's fine, but they also hatch out and are in the dirt, and then if you're touching it with bare skin, they can get under your skin and burrow in there. So they'll just go right under the skin. Again, it's a cutaneous larva migrans. They call it in people. And you get really itchy feet. Or wherever it's touching. There was one picture I saw of this guy's whole belly. Just had them all over. He must have been lying like on his belly. Where they were. But they can get into dogs and cats that way too, just on their belly, wherever they're laying down. They can just get under the skin and enter that way. They can also get into rodents, or birds, or insects. Like cockroaches is a big one. They just burrow into them or, or the, the cockroach can eat it. Eat the worm. And they mention cockroaches a lot because I guess there's places where cockroaches are bad cats will play with the cockroach and eat it. And then they can get hookworm that way. Yeah. Okay. So they're a little different from roundworms in that they can do that. But luckily in people, they don't go anywhere else. They just stay in the skin. So it's not as bad as the roundworm.

Dr. Sugerman: 22:11

Doesn't go to the brain.

Dr. Xenia Zawadzkas: 22:11

No, no brain or livers or anywhere else. Just the skin. But once they're in, then they tunnel their way back into the intestines. And if they're lucky, they make it there and they just stay there because that's where they wanted to go. But they can go anywhere just like the roundworms, the lungs, hopefully they can be coughed up and swallowed. They do like to form those dormant cysts, just like roundworms in the liver and the muscle anywhere, basically. And then they like to reactivate and emerge periodically throughout the dog's life, especially during pregnancy. There's something about the pregnancy hormones that kind of trigger these guys to wake up and start burrowing again, making their way back to their intestine or to their babies. So yeah, somehow they've evolved to the way to that, that'd be a trigger for them to reemerge. It's really creepy.

Dr. Sugerman: 22:58

That's crazy.

Dr. Xenia Zawadzkas: 22:59

Yeah. Only worms in the intestines are susceptible to deworming. I wanted to bring that out. So all of these like insisted hibernating dormant cysts, they, they can't be touched by dewormers. They just stay there forever until they make it back to the gut. And then your dewormer treatments will work.

Dr. Sugerman: 23:16

Got it. That's scary.

Dr. Xenia Zawadzkas: 23:18

Yeah. Yeah. So puppies can be infected in utero or by nursing. It can get into the milk and sometimes both ways they're being infected. Kittens though, they only get it from the environment or by eating infected prey. It's a weird difference about hookworms. Yeah. Kittens seem a little more resistant to them. Cats in general. But once they finally make it back to the intestines, then they mature into adults. They mate, just like everything else, and the females lay the eggs, and then they go out in the stool and start all over again. There's our hookworms.

Dr. Sugerman: 23:51

These are just getting grosser and grosser.

Dr. Xenia Zawadzkas: 23:52

Yeah. Oh, there's lots more.

Dr. Sugerman: 23:55

What are the signs of an infection with a hookworm?

Dr. Xenia Zawadzkas: 23:58

Maybe diarrhea but the big problem with the hookworms, especially for puppies, is the anemia, right? They like to, again, suck blood once they get into the intestines. They drink a lot of blood, so if they have a high worm burden, they can make a puppy very anemic.

Dr. Sugerman: 24:13

It's, it's right over there, Abigail. Yeah. Sorry.

Dr. Xenia Zawadzkas: 24:16

She's so cute. She did the perfect.

Dr. Sugerman: 24:21

Yep. Yep. You always know when they do the potty dance. Yep.

Dr. Xenia Zawadzkas: 24:26

Okay, so diarrhea, but mostly weakness and lethargy from the anemia.

Dr. Sugerman: 24:32

Okay. Is there anything else you want to tell us about hookworms before we move on then?

Dr. Xenia Zawadzkas: 24:35

There are some resistant hookworms. Especially in the racing greyhounds. Apparently, they just have high worm burdens. They've been deworming them for so long that they've actually become resistant. It's hard to get rid of them.

Dr. Sugerman: 24:47

That's

Dr. Xenia Zawadzkas: 24:47

crazy. Moxidectin seems to work better in those cases.

Dr. Sugerman: 24:51

And

Dr. Xenia Zawadzkas: 24:51

what's, what is moxidectin? Can you remind me what that is for? Yes. We'll go over all of the different dewormers at the end of all the life cycles. So don't worry.

Dr. Sugerman: 24:59

Excellent.

Dr. Xenia Zawadzkas: 24:59

But just to remind you, moxidectin is also in Simparica Trio, and NexGard plus and the topical Advantage Multi has it. It also treats heartworms. We went over that last time. It kills a lot of different worms, but it does get hookworms and it seems to work the best on these resistant ones. It's hard to really tell if they're resistant or just infecting themselves over and over. And again, other ones can be reactivating and then they're getting new ones all the time. So there's certain tests that special labs can actually do to see if they're resistant, but I don't know. I've never really run into this before so I'm just trying not to worry about it And it just makes me want to use the moxidectin one.

Dr. Sugerman: 25:42

Yeah.

Dr. Xenia Zawadzkas: 25:43

And the other big thing is because the anemia can get so bad especially in the puppies. When they come to see you, and they're super sick, then that should be on your list of why he's anemic, and they might need blood transfusions to help them survive and get through it, because they can die from their hookworms.

Dr. Sugerman: 25:57

Yeah.

Dr. Xenia Zawadzkas: 25:58

Sad puppies.

Dr. Sugerman: 25:59

I know, they are sad. I think I especially see it the most in kittens.

Dr. Xenia Zawadzkas: 26:03

Oh, okay.

Dr. Sugerman: 26:04

Yeah.

Dr. Xenia Zawadzkas: 26:04

They get anemic from it, too? They get anemic from it. I was only reading about it in puppies for some reason.

Dr. Sugerman: 26:09

We'll have to assume, but I'm sure they always have other problems too. We find fleas and all sorts of stuff.

Dr. Xenia Zawadzkas: 26:13

Yes, I've definitely seen the anemic flea kittens. They'll just drink all your blood.

Dr. Sugerman: 26:19

Let's do whipworms next then. So what does a whipworm look like? And what is their life cycle?

Dr. Xenia Zawadzkas: 26:24

Whipworms, here we go. They're also small, much smaller than roundworms. But, because they look like a whip, like that's why they're called that. I always think of like the whip that Indiana Jones had, like with the big handle and then a really long curly tip. So the handle end is real thick and it's short and that's where they do the reproductive stuff, that's the reproductive end, and then the long thread like tail, or it's called the lash, This is the digestive end. So it just kind of eats and eats and eats through that. The color of them is very similar to the others. Light, light, tan, white, grayish. The names Trichuris vulpis is the big one in dogs. Trichuris serrata is here in cats. In Europe it's called campanula. A couple different ones. Generally these more commonly infect dogs. So it's more of a problem in dogs. If it's found in cats, it's usually a gee whiz incidental thing.

Dr. Sugerman: 27:18

Yeah. I don't think I've ever seen one.

Dr. Xenia Zawadzkas: 27:20

Yeah. I would still deworm a cat if it was positive for it. Cause maybe it would go and infect a dog or something, but it doesn't seem to bother cats that much, which is nice.

Dr. Sugerman: 27:28

That's good.

Dr. Xenia Zawadzkas: 27:29

Yeah. Their life cycle is a lot simpler than the other two. The eggs are in the poop in the environment. They are also hardy. They never go away. They'll stay in the soil for years. Takes them two to four weeks again to form the embryos before they can be infective. The embryo eggs then are ingested by a new host, usually licking them off the fur. Just the same as all the others. But then, it's pretty simple. They just hatch inside the small intestine after they're swallowed. They don't need to go any journeys. Yeah. They don't need to do any of that crazy stuff. They just grow up in the gut, but they do move very slowly throughout the gut. Like it takes them 74 to 87 days to start from the stomach and end up in the large intestine. They go through the whole tract. And they really like the cecum in the large intestine for some reason, that's their favorite spot.

Dr. Sugerman: 28:19

It's a nice little pouch.

Dr. Xenia Zawadzkas: 28:21

Maybe. Yeah, I don't know, they just like it there.

Dr. Sugerman: 28:25

Yeah.

Dr. Xenia Zawadzkas: 28:25

I don't understand why these parasites do these things.

Dr. Sugerman: 28:28

Yeah, who knows?

Dr. Xenia Zawadzkas: 28:30

That's where they like to be. It takes them a couple months to get there. And then they just stick their head into the, flesh of the large intestine, or the cecum, and they stay there forever. They make that their permanent home and then they suck blood there, and I think they absorb the nutrients from the cecum as well, but they don't suck blood as much as hookworms, like they're not causing anemia in the same way. They just cause more of a colitis because they're well, we'll go into that.

Dr. Sugerman: 28:56

So what are the signs then of having whipworms?

Dr. Xenia Zawadzkas: 28:59

Yeah, when there's large amounts of them in the colon or in the cecum area, it causes a lot of inflammation there. And inflammation in the colon is called colitis which basically gives you diarrhea, right? It's usually it's a bloody gooey diarrhea. With this one, it's really nasty. And then occasionally, this is interesting, occasionally they can suck too much of.. Like the colon's job is to absorb water, right? And help us stay hydrated and everything. And so when they're messing that up, it can cause electrolyte problems in those dogs. And sometimes it mimics Addison's disease, which we talked about before. So like the potassium can be really high and the sodium low. And so if you're suspicious for Addison's, you do the tests and it's normal and you're confused, you could think, Hey, maybe. Maybe this is a whipworm infection.

Dr. Sugerman: 29:45

For anybody who's listening that's doing your NAVLE testing, by the way, that is a NAVLE question.

Dr. Xenia Zawadzkas: 29:52

Is it really?

Dr. Sugerman: 29:52

It is.

Dr. Xenia Zawadzkas: 29:53

That's awesome. Do you actually remember that?

Dr. Sugerman: 29:57

Yes.

Dr. Xenia Zawadzkas: 29:57

Were you asked that?

Dr. Sugerman: 29:58

Yes.

Dr. Xenia Zawadzkas: 29:58

Oh man, I don't remember that. This was new for me.

Dr. Sugerman: 30:01

Yeah. Yeah, I remember that, and then I ended up seeing it later in my internship.

Dr. Xenia Zawadzkas: 30:06

Oh, very cool. So you actually saw one that you thought.. That's very cool. So it's a thing.

Dr. Sugerman: 30:11

Yes.

Dr. Xenia Zawadzkas: 30:13

I have more fun facts about it. Okay. Sometimes it can be hard to diagnose them because these are a type of worm, like we were talking about before, that the females don't lay eggs continuously. Like roundworms and hookworms do. They're just Egg machines. They're just constantly putting out their eggs. And so it's easy to find them on a fecal, but whipworm eggs, like the females are like, I don't want to lay an egg today. And they just hang out for a few days or week. And then, then they put out a couple eggs. So it's very intermittent and sometimes it can be missed on a fecal. So unless you're like checking fecals, like every week for a couple of weeks, sometimes you might not necessarily find them. And it can be a false negative. So if you have one of those Addison's dogs, it's not Addison's and the fecal's negative, still deworm them.

Dr. Sugerman: 30:57

Exactly.

Dr. Xenia Zawadzkas: 30:58

Still could be whipworms. Also they take a long time to mature, right? 74 to 87 days or whatever to get from the stomach to the colon. So if you're deworming them one time, usually that's not enough. And you have to remember to try and do it again, like two or three months later, and that's easily forgotten. So it's just another reason to do frequent deworming or maybe a preventative all the time so that you don't even have to worry about it. And you're just constantly treating for them.

Dr. Sugerman: 31:23

Yeah.

Dr. Xenia Zawadzkas: 31:25

And a good thing about whipworms is they don't get into humans at all. Yay!

Dr. Sugerman: 31:28

Good. That's excellent.

Dr. Xenia Zawadzkas: 31:30

Yep. So we don't have to worry about whipworms.

Dr. Sugerman: 31:32

Right.

Dr. Xenia Zawadzkas: 31:34

Just hooks and rounds. Especially rounds.

Dr. Sugerman: 31:36

Especially rounds. Alright, last but not least, let's do tapeworms. What does a tapeworm look like and then what is their life cycle?

Dr. Xenia Zawadzkas: 31:42

Okay, so there's many many types of tapeworms. There's for simplicity's sake I'm just going to focus on the couple that we see in cats and dogs. The biggest one is the Dipylidium caninum.

Dr. Sugerman: 31:54

Yeah.

Dr. Xenia Zawadzkas: 31:54

So dipylidium basically. They're known as a common tapeworm or the flea tapeworm because they have to have, as we'll go into their life cycle, they have to have a flea in their life cycle to complete I'd say over 90%. I, I didn't actually find that number. I'm just anecdotally saying that most of the time, the tapeworms that we see are these kinds, the flea tapeworm. Very, very common. And I think as I describe what they look like, I will tell you about their life cycle. Because it all goes together.

Dr. Sugerman: 32:23

Makes sense.

Dr. Xenia Zawadzkas: 32:23

Yeah, it's a story. So let's start with the head of the tapeworm. If you can imagine like a crazy hat with hooks on it, or when I saw the picture, I thought of a sea anemone. It's like all those little tentacles coming out and the center is blank. And there's a little hole in the middle. That's like where everything goes in. So pretty nasty head. And then there's a neck. And after that there's just egg sac segments. And they can just keep producing those and making the really long worm. And it can be over six inches some of the other types can be yards long. Like really disgusting long worms.

Dr. Sugerman: 32:59

It reminds me of if you were to put flat Lego pieces together. Just like making these long segments.

Dr. Xenia Zawadzkas: 33:05

Yes. Yeah. They just keep adding on. When they're growing, they just make more and more of these segments and they just age and get longer and longer and longer.

Dr. Sugerman: 33:12

Yeah.

Dr. Xenia Zawadzkas: 33:14

And it's very flat. These segments are flat, like it looks like a piece of tape. That's why they're called tapeworms. The head absorbs the nutrients through its skin, so it doesn't suck much blood, it just anchors on there and then all of its nutrients are just from the food that the animal is eating. They just absorb it through their skin.

Dr. Sugerman: 33:32

I didn't know they absorbed it through their skin.

Dr. Xenia Zawadzkas: 33:34

Yes. That's interesting. They don't really eat that much blood. And then the segments, each are very interesting, they're their own little being. Each segment is, it's got its own digestive system and its own reproductive tracts. As they get older, the digestive system kind of atrophies and goes away as they get towards the tip of the tail. And then at the end, like when they're about to break off, they're just basically a reproductive tract full of eggs. So the eggs develop in them as they age and move down the line. And then finally they break off and these make their way out the butt, right? They, they don't necessarily poop them out. They'll sometimes just crawl their way out of the anus. I do say that

Dr. Sugerman: 34:15

Like you'll go to get a temperature and you'll commonly see them just hanging out around the anus.

Dr. Xenia Zawadzkas: 34:20

And they move. They can move at first. They're like wiggling hello at you. I think I like to liken them when they first come out like that as something like a cucumber seed. You know, they're white and flat. And, and wider in the middle. And then, as they move out, they eventually dry and die. And then they get thinner and smaller and dry. More like a sesame seed or a dried grain of rice. And then eventually they'll break open and then all of those eggs that are inside of them will contaminate the area where they ended up. So it's sometimes on the dog or the cat or where they've been laying down their bed or whatever. And then all those little microscopic eggs are just released in that spot. And so the eggs at this point, they're not infectious to mammals. They have to go through a flea before they can reach their next life cycle stage. You could eat a proglottid and nothing would happen. It'd be alright.

Dr. Sugerman: 35:14

We're eating a lot of worms this episode.

Dr. Xenia Zawadzkas: 35:17

But okay, to talk about fleas a little bit again, because they're so important to this tapeworm. Do you remember when I called the animals that have fleas, salt shakers?

Dr. Sugerman: 35:27

Yes.

Dr. Xenia Zawadzkas: 35:27

So all the eggs that the fleas are laying on the pet, they're not sticky, they just roll right off into the environment. And so if we have a dog or a cat that has both fleas and proglottids, those flea eggs are falling into the environment and the proglottids are falling into the environment, like together in harmony. And then the flea larvae will hatch out of the flea egg, right? And so they're like a little worm, too, a little maggot, tiny, tiny. And then they, they just eat whatever they can, whatever is near them. They like to eat dust and flea poop, right? That's like milk for the flea babies.

Dr. Sugerman: 36:03

Yeah, so gross.

Dr. Xenia Zawadzkas: 36:04

And if there happens to be some tapeworm eggs nearby. Delish, let's eat those too. And so they just thrive on eating all of that stuff. And that's how the tapeworm egg gets inside of the flea. So then the flea larva matures into a pupa and then hatches out as an adult flea. And it has the tapeworm inside of it, right? It's like a development stage of that tapeworm that is inside the flea. And it has to do that before it can move on. So then that flea jumps back onto another cat or dog, and eventually gets eaten by the cat or dog. It's very common for them to eat their fleas. And that's how it gets back into the intestines, and then hatches and it starts all over again. Yay. So the Taenia species are the next one that we do see sometimes. These guys, there's a whole bunch of Taenia species. There's the one that we see a lot is the Taenia pisiformis, which gets into rabbits. So instead of the flea eating the eggs, the rabbit or an intermediate host, so besides rabbits, like there's other ones that will get into rats or mice or sheep or cows or pigs or deer. And so there's all these different types of Taenia species that will get into these other intermediate hosts instead of a flea, basically. And so then if the dog or cat eats one of those animals instead of a flea, basically they're eating the rat or whatever. And then these do migrate through the liver. Not in the dog or cat, but in the intermediate host. So like the rabbit will have the tapeworm migrate into its abdomen and the deer too. I remember in vet school, we dissected a deer in necropsy class and it had the hydatid cysts in its belly. I hope they were super nasty.

Dr. Sugerman: 37:45

Yeah.

Dr. Xenia Zawadzkas: 37:45

But now I understand them a little bit more. So that was a tapeworm basically that migrated through the deer and then they fall through the blood vessel into the abdomen basically. And then they form this little, it's like a sack. That's pale colored. And then they just hang out there until the animal dies basically. So once the deer dies, somebody eats that hydatid cyst and then they get the tapeworm that way. And that happens in rabbits too. That's the one we see the most is cause there's a lot of rabbits around here. But there's so many types of tapeworms that will get into these other animals and then they can get them that way. I think we see so many fleas that that's probably why we see that tapeworm flea more often. We don't see as many hunting animals that get the Taenia type of tapeworm, but, but there it is. And then there's one more type of tapeworm that I wanted to talk about which is the Echinococcus multilocularis These are nasty. These are really small tapeworms and their proglottids are very hard to see. Like they're tiny, almost microscopic, and then they mix in with the dirt and you can't really tell they were ever there. And they're similar to Taenia in that they have the intermediate mammal hosts, usually rodents, and a lot of times sheep for some reason. It seems to be a thing. And then if the dog or cat eats that rodent, then they'll get the tapeworm and they can shed those eggs near the people. And it's really dangerous to humans. This particular type of tapeworm will migrate through people. And again, it's not the normal host. So they just go crazy and they usually go into multiple organs and form the hydatid cysts there, which are almost like tumors in the liver and that kind of thing. It's fatal usually for people. It's really nasty. So it's all over the CDC. You can read a lot about echinococcus on there because it's a zoonotic risk. The reporting of it, it's been worldwide. We see it everywhere. On our end of the world, we've seen it in Alaska, up in Canada. There's been reports in New Mexico and Arizona, interestingly. And it seems to be in more areas where there's rural grazing areas, especially for sheep. And then there's sheepdogs. Herding them and a lot of dogs and sheep together.

Dr. Sugerman: 39:53

Yeah.

Dr. Xenia Zawadzkas: 39:53

So I think after reading about that, I think if I ever had a sheepdog or working sheepdog, I would make sure I'm deworming them for tapes frequently. Just to try to avoid that problem.

Dr. Sugerman: 40:02

Yeah.

Dr. Xenia Zawadzkas: 40:03

And there are some, which I'll go into in a bit, but there's some heartworm preventatives that, there's one called Interceptor Plus, that the plus part has Praziquantel in it, which kills tapeworms. So I feel like sheepdogs should be on that. Then you won't have to worry about getting that tapeworm.

Dr. Sugerman: 40:18

Right.

Dr. Xenia Zawadzkas: 40:18

As the owner.

Dr. Sugerman: 40:19

Yeah.

Dr. Xenia Zawadzkas: 40:20

Okay, so there's that.

Dr. Sugerman: 40:21

So what are the clinical signs then for infection with tapeworms?

Dr. Xenia Zawadzkas: 40:26

So maybe some GI upset and malnourishment. They do steal food from the intestines a little bit if they have a lot of tapeworms. But overall, believe it or not, tapeworms are less harmful than all the other ones we talked about. As disgusting as they are, they're not that bad. And you can treat them pretty easily. Usually the scary part is the migrating when they're in the other types of hosts. They don't do a lot of harm to the dogs or the cats themselves. Yeah.

Dr. Sugerman: 40:53

Nice. Are there any more notes that you have on tapeworms before we move on?

Dr. Xenia Zawadzkas: 40:56

They are usually diagnosed by just seeing the proglottids, right? They're very visible, very big, and you can just, oh my god, my, there's a proglottid, my dog has tapeworms. It's hard actually to see the eggs on a fecal test, like when we're sending out those fecals, those proglottid pieces where all the eggs are, are exiting before they release all those eggs. So unless they're like rupturing for some reason inside the intestine, which they don't do, you're hardly ever going to see the eggs on a fecal stool sample. So if the fecal is negative, but you see proglottids you know we have tapeworms. It's okay. Yeah. You don't have to have a positive fecal. And usually you don't, usually it's negative. So yeah. Yeah. So that's just one little tidbit.

Dr. Sugerman: 41:40

Nice. So are any of these worms more common in puppies and kittens than they are in adult dogs or cats?

Dr. Xenia Zawadzkas: 41:46

They have the same types of worms both in adults and the young, but we see them more commonly in the young because again, like with rounds and hooks, they usually start out with them because the mom had reemergence of her cysts. And then they went into the milk and to the uterus. And so they're starting out.. Plus the young puppies and kittens, their immune systems are immature and not very effective and they have a harder time dealing with parasites. And they just can't fight them off naturally at all. And they're just more susceptible to all the effects of harboring those parasites, especially the hookworms. Like they just don't have a lot of blood to begin with. They're tiny. And if the hookworms are eating all their blood, then they get anemic really quick. And so it's just a lot worse in the smaller, younger animals, but it doesn't mean that the adults don't get them too.

Dr. Sugerman: 42:32

We just see it more commonly because we're seeing a lot of those symptoms more commonly in puppies and kittens, it seems.

Dr. Xenia Zawadzkas: 42:36

Yeah, and they're just more apt to get them. We can pretty much assume that they're born with them. Whereas adults, hopefully we get rid of them at some point.

Dr. Sugerman: 42:44

Yeah, hopefully. Unless they like, go and hide like you were talking about.

Dr. Xenia Zawadzkas: 42:48

Yes, yeah.

Dr. Sugerman: 42:51

All right. So there's a lot of worms. I know there's not even all the worms that you want to cover, but there's a lot of worms there.

Dr. Xenia Zawadzkas: 42:56

Yep.

Dr. Sugerman: 42:56

So let's talk about treatment for them. Are there dewormers to treat all of these?

Dr. Xenia Zawadzkas: 43:00

Yes, we can. Luckily we have lots of effective treatments for all of these worms.

Dr. Sugerman: 43:04

Oh, good.

Dr. Xenia Zawadzkas: 43:05

Let me go into it. I'd say the hard part though, just as an overview, Is doing it at the right time, right? During the life cycle or long enough or often enough to keep preventing them from coming back. And they do come back all the time. And we have to consider other parasites too, right? There's fleas and ticks that we've already talked about and heartworms. And it's nice because a lot of these combination products have come about now to help us deal with all of them in an easy way. But for rounds and hookworms there's many different dewormers that will work. I'll just go through them.

Dr. Sugerman: 43:37

Yeah.

Dr. Xenia Zawadzkas: 43:37

Pyrantel is the number one big one that we use all the time. It's also known as Strongid. I think it has a couple other names. It's that yellow sweet liquid that we give

Dr. Sugerman: 43:46

Banana.

Dr. Xenia Zawadzkas: 43:47

to puppies. Yeah. Actually, I think it's more like cake batter. I tasted it.

Dr. Sugerman: 43:50

Yeah. I always thought it tasted like banana.

Dr. Xenia Zawadzkas: 43:51

But it's sweet. It's actually got like maybe sugar in it. I don't know. So puppies really like it. Kittens, interestingly, they don't have sweet taste buds, so they could care less about it. They usually don't like it when I'm squirting it in their mouths, but we do it anyway. So Pyrantel is very safe, very effective on rounds and hookworms. It's often also added to a lot of these combo products. Like it's in Simparica Trio, it's in HeartGard Plus, it's in NexGard. All of them have the Strongid usually mixed in to help control the rounds and the hooks. Over the counter, there's one called Piperazine. It's not as effective, like there's one type of roundworm that it doesn't get very well. So I don't usually recommend that, and that's not really in any of the prescription ones anymore. But it might help, and it's harmless, so you can, you can get that one over the counter. Fenbendazole, it's also known as Panacur or Febantel is like a version of Fenbendazole. Like I think it turns into Febantel or the other way around. Those also kill rounds and hooks and one type of tapeworm, the Taenia species only. And we prescribe that very often. I have a feeling it might be over the counter as well.

Dr. Sugerman: 45:04

I believe that it is.

Dr. Xenia Zawadzkas: 45:05

I think Strongid is as well now I think about it.

Dr. Sugerman: 45:07

Strongid is for sure.

Dr. Xenia Zawadzkas: 45:07

Yeah.

Dr. Sugerman: 45:08

Yeah. I think Fenbendazole is too.

Dr. Xenia Zawadzkas: 45:10

Yeah. So you can find all of these over the counter and they all work against these parasites. Rounds and hooks anyway, for sure.

Dr. Sugerman: 45:15

Yeah.

Dr. Xenia Zawadzkas: 45:16

Milbemycin oxime, that one is in Interceptor and Sentinel and Trifexis and a couple others. It's been around a long time. It's also touted as a heartworm preventative that we went over last time. That does also kill rounds and hooks. And then moxidectin, I already touched on that. It's in Simparica Trio, Nexgard Plus, Advantage Multi, many others are adding it in now because it's very effective for rounds and hooks and also for heartworms and now resistant hookworms, apparently it seems to be better. But it's interesting because a lot of them have moxidectin and pyrantel in them. And I think it's dose dependent. I remember I asked a rep about that. I'm like, why do you bother with pyrantel when moxidectin is also killing rounds and hooks? But they said it has to be a different dose of the moxidectin to get the rounds and hooks. So I don't know. I think using them together, why not? Make sure you get them.

Dr. Sugerman: 46:05

Yeah.

Dr. Xenia Zawadzkas: 46:06

Selamectin is another one that's in Revolution. That's a topical. Kills rounds and hooks. And then there's a couple of others that work for rounds and hooks, but they are more potential to be toxic. So we have to just be careful with them. So Ivermectin is a big one. Emodepside is like a topical one that's in Profender. And then there's one called Eprinomectin. Which is in NexGard Combo, which is a topical for cats and Centragard. It's another topical, I believe. Those last two there is some literature out there saying they can kill the migrating larva of the rounds in the hooks, which is nice. But probably not the insisted ones. If they're moving, they'll get them, but once they make their little cyst, it's hard to get in there. So it still won't get those. But these can be potentially lethal to dogs that have the MDR1 gene mutation. And apparently there's cats also that can have that mutation, which I just learned about. Yeah.

Dr. Sugerman: 47:03

I didn't know that, yeah.

Dr. Xenia Zawadzkas: 47:03

I did not. It's super rare. It's only 4% or less of all cats have the mutation, but it has been shown to kill those cats. So I think there's a blood test, but it's like only a special lab does it. And who's going to want to test their cat for that just to use this product. So I don't know. There's a lot there, but it does work against rounds and hooks too. So I had to mention it. So for whipworms, they're a little trickier. There's only a few that will kill whipworms. So I'll go over it. So Fenbendazole will kill whipworms. Milbemycin oxime will. Moxidectin will. And then there's an older dewormer called Oxantel. It's more common in Australia and Canada.

Dr. Sugerman: 47:44

I was like, I've never even heard of that.

Dr. Xenia Zawadzkas: 47:46

I did see that the compounding pharmacies, they make you can make your own parasite preventative capsule and put whatever dewormers you want in there. It's interesting. And that's one of the options. You can put Oxantel in there if you want. So anyway, those all get whipworms. So Pyrantel will not get whipworms. And some of those others will not either. Ivermectin doesn't touch them. So you have to use one of those for whips and then tapeworms are the trickiest. They need their own special dewormer. The big one that gets all the types of tapeworms is Praziquantel. That's my favorite. It just works the best. I think that's the one we should generally use. But there are some others. Again, Fenbendazole is labeled for tapes, but it can be misleading, especially for an over the counter purchase.

Dr. Sugerman: 48:30

Yeah.

Dr. Xenia Zawadzkas: 48:30

Because it says tapes on there. But it doesn't tell you that it's only the Taenia species. So if your dog ate a rabbit and has that kind of a tapeworm, sure, that'll take care of it. But most likely he's got the flea tapeworm.

Dr. Sugerman: 48:41

So like 90 percent of them, right?

Dr. Xenia Zawadzkas: 48:43

Yep. And it's not gonna get those tapeworms for you. So I wouldn't use it as a dewormer for tapes. I actually never even think of it as one. So there's another one called Epsiprantel. Also known as Cestex, it's like a tapeworm dewormer, but it doesn't work so great in the Dipylidium. Like there's some resistance. Maybe it helps get some of them, but not all of them. So Praziquantel's better. But I'd say for tapeworms, the most important thing to remember is to control those fleas, right? Because if we don't have flea control, they're just going to keep infecting themselves with more and more tapeworms, and then you can deworm them all you want, but they're just going to keep getting more.

Dr. Sugerman: 49:22

You should go back and listen to the flea episode, and how like, how long that life cycle is for the flea, and how long they live in the environment. You definitely want to control fleas.

Dr. Xenia Zawadzkas: 49:30

Yes, absolutely. That's so important for controlling not just the fleas, but for tapeworms, I'd say even more important than the actual dewormer is just controlling the damn flea.

Dr. Sugerman: 49:40

So how often do you feel like we need to deworm our pets?

Dr. Xenia Zawadzkas: 49:45

Yeah, good question. So there's so many types of common worms and they all have different, what we call pre patent periods. To define that, that's the time it takes from infection, like you eat the egg, to when you start seeing the worms manifest however they do, like in your poop or whatever. Or the symptoms, yeah, manifest. And so it can be a long time. Like those whipworms, it's several months before they actually hit the colon and start causing colitis. So yeah, it can be hard to know when to treat. So larval cysts are in the liver and the muscle, and they're not affected by routine dewormers, and they're reemerging and getting new ones all the time. So they're like basically getting cycles of new worms into their intestines all the time, especially the puppies are. So we recommend deworming them frequently for that. Plus they can just reinfect themselves all the time from the environment. So to help with that initial start when they're born with the worms and everything. Right around six to eight weeks, it's just usually when we first see them like breeders could even do it before then if they want, I think as early as four weeks, you can start deworming them if you want. But basically keep giving them that pyrantel every two to four weeks until they're over like four months old at least like 16 weeks when we stop all their vaccines too, and then after that we can use our fecal tests to decide. Okay, did we clear them all? Are we good if it's negative then we can back off those frequent dewormings. But I probably would recommend keeping up a monthly dewormer thereafter. Just because of all of this that we just talked about.

Dr. Sugerman: 51:13

So you like the dewormer through being an adult, or a monthly dewormer like..

Dr. Xenia Zawadzkas: 51:19

Their whole life.

Dr. Sugerman: 51:20

Their whole life.

Dr. Xenia Zawadzkas: 51:21

Yeah.

Dr. Sugerman: 51:21

Okay.

Dr. Xenia Zawadzkas: 51:22

Why not? Yeah. Because we see fleas all the time, too.

Dr. Sugerman: 51:24

Right.

Dr. Xenia Zawadzkas: 51:24

And again, I talked about in the flea and the heartworm preventative talk, the Simparica Trio, for example, has your flea, your tick control. Pyrantel in there for your rounds and your hooks. And then Moxidectin too for heartworm prevention. So it's like an easy way to keep your dog healthy and to not have to worry about whether or not they're getting reinfected or a new one is emerging from a cyst from long ago and all of that.

Dr. Sugerman: 51:50

So my wife is going to ask me if our dogs are on Simparica Trio, and that is, yes.

Dr. Xenia Zawadzkas: 51:56

Excellent.

Dr. Sugerman: 51:57

After she hears this episode.

Dr. Xenia Zawadzkas: 51:59

Have they been on it? I think it's one of the best ones.

Dr. Sugerman: 52:04

I think I started it after you told me you needed to put them on Simparica Trio. And I was like, okay, then that's the one I'll choose. Yes.

Dr. Xenia Zawadzkas: 52:11

There's actually a new one called Credelio Quattro that's coming out. It's not yet here. I just heard about it. I don't know what the Quattro is, like four different parasites, four different ingredients. What's that going to be? But supposedly Credelio, like the isoxazoline in there that kills fleas and ticks and mites and all that, it just works a little bit better on certain types of ticks, like kills them faster than the one that's in Simparica.

Dr. Sugerman: 52:37

Interesting.

Dr. Xenia Zawadzkas: 52:38

So if the data is there and when that comes out, I might be changing my tune.

Dr. Sugerman: 52:43

Right? Yeah. Exactly. We'll have to do a new one just on Credelio after that.

Dr. Xenia Zawadzkas: 52:47

There's always newer and better ones, I'm actually very happy that these newer ones have come out because it really helps us stay on top of these parasites and an easy way for owners too. Like, just give this once a month. You don't have to worry about any of this life cycle stuff.

Dr. Sugerman: 53:00

Exactly.

Dr. Xenia Zawadzkas: 53:02

Yeah.

Dr. Sugerman: 53:02

Okay. So what about indoor pets? Do they get worms as well?

Dr. Xenia Zawadzkas: 53:06

Yeah. I'd say it's less likely in general. But think about those cockroaches, right? That's going to have hookworms.

Dr. Sugerman: 53:13

I wouldn't say I have a lot of cockroaches, but there's like insects and stuff that come to the house.

Dr. Xenia Zawadzkas: 53:17

Yeah. And flies, those land on poop outside and then come inside and land on you and your cat eats them. So it can happen that way. Fleas I've seen in the indoor cats all the time, they find a way into your cat. And those bring tapeworms, so I think it's just a good idea for both indoor and outdoor pets to do a monthly preventative or like Bravecto Plus lasts for two to three months in cats, so just do that every few months is good.

Dr. Sugerman: 53:45

Yeah.

Dr. Xenia Zawadzkas: 53:46

There's many ways to do it. And many great products out there. And every household is different. Every pet's a little different. Life is different. It doesn't have to be exactly that for everybody, and certainly you can back off on the indoor animals, cats a little bit. I think if you have negative fecals all the time, then you can probably stop worrying about it so much. But it's not wrong to just keep it up either.

Dr. Sugerman: 54:07

Okay, so are there any over the counter dewormers that are safe to use for pets? I know you went into a little bit of them.

Dr. Xenia Zawadzkas: 54:13

Yeah, so a lot of those roundworm ones I think are available over the counter. A lot of the heartworm ones are prescription. And they're generally safe to answer the question. Yes. I worry though about them being effective for kind of multiple reasons like, is it the right dose? Are you getting the right dose for your size, weight of pet? Are you treating the right parasite is a big one, right?

Dr. Sugerman: 54:33

So we've named many different parasites, but there's so many more.

Dr. Xenia Zawadzkas: 54:36

Yes.

Dr. Sugerman: 54:37

And it may say tapeworms, but may not be the right tapeworm.

Dr. Xenia Zawadzkas: 54:40

And like I went over, some only get, like whips only need specific ones and tapes need specific ones. So you might be thinking you're deworming your pet when you're not really being effective about it. And then they can just reinfect themselves as well. And so it's like in order to do it right, it's nice to have a vet's guidance, I think. And then like we could even, if money is an issue or whatever, we can say, okay, you need this dose of Pyrantel and you need to try and find Praziquantel which I think I've seen over the counter as well.

Dr. Sugerman: 55:09

I think so.

Dr. Xenia Zawadzkas: 55:09

Yeah, maybe.

Dr. Sugerman: 55:10

Yeah.

Dr. Xenia Zawadzkas: 55:10

And I could just tell them how many milligrams, but they might not know the right dose or whatever. So I think at least asking your vet about it is a good idea.

Dr. Sugerman: 55:17

Yeah. Yeah. And it's not going to get all of those things still, right? Like there's, there's, no over the counter that's going to get every single one of those worms.

Dr. Xenia Zawadzkas: 55:25

Probably not. Unless you tried to do your own special combo and overdid it a bit. I'd be worried about toxicity and stuff too. Just gotta be careful, and I think it helps to understand what parasites your dog or cat has, and then you know how best to prevent and treat them.

Dr. Sugerman: 55:43

Yeah.

Dr. Xenia Zawadzkas: 55:43

Yeah.

Dr. Sugerman: 55:44

Okay. Well, perfect. Anything else you wanted to share with us?

Dr. Xenia Zawadzkas: 55:46

Oh, I got some sources, if anybody cares.

Dr. Sugerman: 55:48

Yes.

Dr. Xenia Zawadzkas: 55:49

I got a lot of this from the CAPC website, so Companion Animal Parasite Council, it's a wonderful website. They have an alphabetical list where you can just go to like W and look up whipworms, or T for tapeworms, all of it's there. The Center for Disease Control, the CDC, also has quite a lot of good information on parasites, mostly focused on the human end though, but if you want to learn more about cutaneous larva mimigrans, and the echinococcus, heartworm, tapeworm, super nasty. You can read more about it there. VeterinaryPartner.com is a great resource as well. They recap all of these things very nicely in one little handout for each parasite. I often email those to clients when I have a positive fecal, then they want to know more about the parasite. And then I looked at Plumb's Veterinary Drug Handbook quite a bit. A lot of the drugs in here, just really helps to know what they're doing, how they're working, what parasites they're covering. And then all of the package inserts for these, especially the prescription parasite preventatives like Credelio or Simparica Trio, they have a little packet inside, unfold it, and it's like a huge document of lots of information about safety studies and what parasites are covered and all of that's in there. It's really good information.

Dr. Sugerman: 57:01

Nice. Good. So the question I was going to ask you, you answered a little bit, but I'm going to ask it again.

Dr. Xenia Zawadzkas: 57:05

Okay.

Dr. Sugerman: 57:06

So I was going to ask you, have any of your pets ever gotten worms?

Dr. Xenia Zawadzkas: 57:10

Yeah, I think my cat's got tapes. They've had fleas a couple of times. Yeah, it's been horrible. My own cats, yes. They've had fleas.

Dr. Sugerman: 57:17

And do you keep up on the flea prevention constantly?

Dr. Xenia Zawadzkas: 57:19

Obviously not. There was a lapse, apparently. I try, but, I'm forgetful.

Dr. Sugerman: 57:25

It's hard. I even put it in my phone to try to remember. I liked Bravecto for a while for the dogs because it lasted for a couple of months. So by the time I remembered, It has already been probably three months. And I was like, Oh yes, I need to give them.

Dr. Xenia Zawadzkas: 57:36

Yeah.

Dr. Sugerman: 57:37

Yeah.

Dr. Xenia Zawadzkas: 57:38

It goes by quick. I have to write it on a calendar and I have reminders and sometimes even those go past them and then I'm like thinking about, I think he's due. And I look and I'm like, Oh my God, we're a month overdue. And then I put it on. So but I try and yeah the tapeworms, I wasn't that freaked out because I know, I just saw the proglattids and I'm like, okay, here we go. And I just dewormed them. It was okay.

Dr. Sugerman: 57:59

Yep. Yep.

Dr. Xenia Zawadzkas: 58:01

So it happens to the best of us.

Dr. Sugerman: 58:02

Yep, exactly.

Dr. Xenia Zawadzkas: 58:03

That's why we have all these wonderful drugs to help us.

Dr. Sugerman: 58:06

All right. Perfect. Thank you, Dr. Z. We appreciate you so much coming on to talk about our parasites.

Dr. Xenia Zawadzkas: 58:10

You're so welcome. My pleasure.

Dr. Sugerman: 58:12

I know. It's one of your favorite things. I think a lot of people are going to be grossed out at this point.

Dr. Xenia Zawadzkas: 58:17

Yeah. Look at the pictures.

Dr. Sugerman: 58:19

Yeah, exactly. Perfect. And then next time we talk, so we'll talk about some more parasites too, right?

Dr. Xenia Zawadzkas: 58:24

Yeah, I wanted to go over like the flukes and the single celled parasites like Giardia and Coccidia. I think it'll be quicker. But I didn't know how else to organize it.

Dr. Sugerman: 58:32

Yeah, yeah, for sure. Yeah, I think this is great with the most common ones. Yeah, absolutely. All right. Thank you again, Dr. Z. And as always, guys, make sure you keep your pets happy, healthy, and safe. Thanks. We'll see you next week. And that wraps up for today's episode of Vetsplanation. We hope you found our deep dive into the world of worms and parasites both enlightening and helpful and maybe a bit creepy if you guys looked at the pictures on YouTube. Remember, keeping your pets healthy is all about prevention and just being informed. A huge thank you to Dr. Z for sharing her wealth of knowledge and expertise, and to Shawn Hyberg for doing our podcast, and for Kelly Dwyer for doing our website. If you enjoyed today's episode, make sure you subscribe and leave us a five star review. We love hearing from you guys. Next week, we'll be back tackling more fascinating topics, including things like how pets can become blind and how they do when they're blind. Like, are they able to get around well? Are they able to live a normal life being blind? You won't want to miss this episode. Until then, make sure you always keep your pets happy, healthy, and safe. Thanks for tuning in and we'll see you next time.