Indoor-Outdoor Cats and the "One Health" Perspective: Veterinarian Insight and Influence.

Veterinarian and client discussions about indoor-outdoor cats, although challenging, can impact decisions made regarding cat care and outdoor access. An online survey, exploring topics discussed with clients regarding indoor-outdoor cats and One Health, was made available to veterinarians practicing in the U.S. in 2022. The importance of topics by practice location and to the veterinarian versus what the veterinarian perceived as important to the client were analyzed. Of 280 responding veterinarians, 95% discussed indoor-outdoor cat activities with clients. Cat-associated disease (81%), cat population control (64%), and cat-associated trauma (53%) were discussed most often. With the exception of population control, rural, suburban, and urban veterinarians did not significantly differ in the frequency of topics discussed. Danger to the cat (e.g., trauma and diseases) was the most important topic when addressing indoor-outdoor cats with clients; 57% of veterinarians considered it important to themselves and 61% considered it important to the client. Only 13% of the veterinarians were extremely comfortable discussing One Health with clients and several One Health-related topics (zoonoses and wildlife impacts) were discussed least often. Less focus on One Health topics is potentially a missed opportunity to educate clients, enable more informed client decisions, and improve overall the care of cats.

Trematode Cercariae from Lymnaea gedrosiana in the Caspian Sea Littoral in Iran: a one health concern.

Introduction: Lymnaea gedrosiana snails are hosts to a variety of trematode cercaria of public and veterinary health importance. In Guilan Province, Iran, a region with a high level of fish and bird farming and wetlands important for migratory birds, little is known about the trematode cercaria from L. gedrosiana. Methods: From April 2020 to October 2021, six freshwater sites in Guilan Province were sampled for Lymnaeidae snails three times per season (spring, summer, autumn and winter). Snails were exposed to light and heat to induce cercaria shedding and shredded cercaria were identified morphologically and molecularly. Results: In total, 5,712 Lymnaeidae snails were collected of which 3,288 (57.6%) were identified to be L. gedrosiana with 54.3% containing trematode cercaria. Snail and cercaria recovery were highest in the spring and summer. Trematode cercaria identified included Telorchis assula, Hypoderaeum conoideum, Apharyngostrigea pipientis, Sanguinicola cf. inermis, Opisthioglyphe ranae, Diplostomum pseudospathaceum, and Australapatemon burti. Discussion: The four trematodes D. pseudospathaceum, S. inermis, A. burti, and A. pipientis have not been previously reported in Iran; all four of these can infect migratory birds. The most common cercaria found, H. conoideum (18.3% of the snails) is of zoonotic importance. The third most common cercaria found, S. inermis (10.0% of the snails) is detrimental to fish production. Given the importance of the wetlands in the region for wildlife and migratory birds as well as the number of fish and bird farms in the area, efforts to control L. gedrosiana snails are needed to protect wildlife and human health. In addition, monitoring programs should be implemented to identify and prevent introductions of new trematode species.

Identification of Cotylophoron cotylophorum (Fischoeder, 1901) in cattle on St. Kitts, West Indies and its relationship with African and Asian populations.

There is limited information about the species of rumen fluke (Family Paramphistomidae) in the Caribbean. However, knowledge of species distribution is needed to better understand disease risk and epidemiology. Morphological identification is challenging with more recent DNA sequencing enabling a better understanding of rumen fluke distribution. In this study, rumen fluke specimens, collected between 2015 and 2016 from cattle on the island of St. Kitts, West Indies, were analysed. The ribosomal internal transcribed spacer 2 (ITS-2) region of rDNA was amplified using generic trematode primers. Results from Sanger sequencing were compared to reference sequences in GenBank and indicated the species was Cotylophoron cotylophorum with 100% sequence identity and 91% query cover. The ITS2 sequences were then compared to previously published ITS2 sequences for the Cotylophoron genus. When all the St. Kitts C. cotylophorum ITS2 sequences were compared with all other Cotylophoron sequences from India, Kenya, and Zimbabwe, three variable nucleotide sites, resulting in five unique haplotypes, were identified. Nine ITS2 sequences shared haplotype 1, which included all those from St. Kitts and single representatives from India and Kenya, potentially indicating global movement of this species.

Genetic characterization of Strongyloides fuelleborni infecting free-roaming African vervets (Chlorocebus aethiops sabaeus) on the Caribbean island of St. Kitts.

Human strongyloidiasis is an important neglected tropical disease primarily caused by the nematode Strongyloides stercoralis, and to a lesser extent Strongyloides fuelleborni which mainly infects non-human primates. Zoonotic sources of infection have important implications for control and prevention of morbidity and mortality caused by strongyloidiasis. Recent molecular evidence suggests that for S. fuelleborni, primate host specificity is variable among genotypes across the Old World, and consequently that these types likely vary in their capacity for human spillover infections. Populations of free-roaming vervet monkeys (Chlorocebus aethiops sabaeus), introduced to the Caribbean Island of Staint Kitts from Africa, live in close contact with humans, and concern has arisen regarding their potential to serve as reservoirs of zoonotic infections. In this study, we sought to determine the genotypes of S. fuelleborni infecting St. Kitts vervets to explore whether they are potential reservoirs for human-infecting S. fuelleborni types. Fecal specimens were collected from St. Kitts vervets and S. fuelleborni infections were confirmed microscopically and by PCR. Strongyloides fuelleborni genotypes were determined from positive fecal specimens using an Illumina amplicon sequencing-based genotyping approach targeting the mitochondrial cox1 locus and 18S rDNA hypervariable regions I and IV of Strongyloides species. Phylogenetic analysis of resultant genotypes supported that S. fuelleborni from St. Kitts vervets is of an exclusively African variety, falling within the same monophyletic group as an isolate which has been detected previously in a naturally infected human from Guinea-Bissau. This observation highlights that St. Kitts vervets may serve as potential reservoirs for zoonotic S. fuelleborni infection, which warrants further exploration.

Global prevalence of Trichinella in pigs: A systematic review and meta-analysis.

BACKGROUND: Investigating the global epidemiological patterns of Trichinella in pigs is required for accurate recognition and to establishing proper control programmes and preventive measures, as well as to decrease human exposure. OBJECTIVES: To obtain a better understanding of the global prevalence of Trichinella in domestic pigs and factors that might influence the prevalence, a systematic review and meta-analysis was performed. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Multiple databases were used to identify literature published between January 2000 and December 2021, representing studies from 1985 to 2021, on Trichinella prevalence in domestic pigs. Prevalence was calculated on a global and country level, by country Human Development Index (HDI), climate, pig management system, and diagnostic test. RESULTS: The global pooled prevalence based on 60 manuscripts representing 32 countries and 65 pig populations was 2.02% (95% confidence interval [CI]: 0.88-3.62) and the estimated pooled prevalence in different continents ranged from 0.00% to 11.8%. Trichinella was highest in low HDI countries (21.6%; 95% CI: 4.3-47.2), tropical wet climates (20.9%; 95% CI: 10.3-34.1), and non-intensive pig farming systems (6.1%; 95% CI: 1.0-15.5). CONCLUSIONS: While there were regional differences in Trichinella prevalence in domestic pigs, these were likely driven by country HDI and pig farming systems versus climatic factors. Increased biosecurity in outdoor pig production systems, focused meat inspections and promoting awareness could potentially decrease risk of infection.

Commercial Extruded Plant-Based Diet Lowers Circulating Levels of Trimethylamine N-Oxide (TMAO) Precursors in Healthy Dogs: A Pilot Study.

Elevations in circulating trimethylamine N-oxide (TMAO) and its precursors are observed in humans and dogs with heart failure and are associated with adverse outcomes in people. Dietary intervention that reduces or excludes animal ingredients results in rapid reduction of plasma TMAO and TMAO precursors in people, but the impact of diet in dogs has not been studied. The objective of the current study was to determine the effect of diet on plasma TMAO and 2 of its precursors (choline and betaine) in dogs fed a commercial extruded plant-based diet (PBD) or a commercial extruded traditional diet (TD) containing animal and plant ingredients. Sixteen healthy adult mixed breed dogs from a university colony were enrolled in a randomized, 2-treatment, 2-period crossover weight-maintenance study. Mean (SD) age and body weight of the dogs were 2.9 years (± 1.7) and 14.5 kg (± 4.0), respectively. Eight dogs were female (3 intact, 5 spayed) and 8 dogs were male (4 intact, 4 castrated). Plasma choline, betaine and TMAO were quantified by LC-SID-MRM/MS at baseline, and after 4 weeks on each diet. Choline and betaine were also quantified in the diets. Plasma choline levels were significantly lower (P = 0.002) in dogs consuming a PBD (Mean ± SD, 6.8 µM ± 1.2 µM) compared to a TD (Mean ± SD, 7.8 µM ± 1.6 µM). Plasma betaine levels were also significantly lower (P = 0.03) in dogs consuming a PBD (Mean ± SD, 109.1 µM ± 25.3 µM) compared to a TD (Mean ± SD, 132.4 µM ± 32.5 µM). No difference (P = 0.71) in plasma TMAO was detected in dogs consuming a PBD (Median, IQR, 2.4 µM, 2.1 µM) compared to a TD (Median, IQR, 2.3 µM, 1.1 µM). Betaine content was lower in the PBD than in the TD while choline content was similar in the diets. Our findings indicate consumption of a commercial extruded PBD for 4 weeks reduces circulating levels of the TMAO precursors choline and betaine, but not TMAO, in healthy adult dogs.

Ancylostoma in dogs in the Caribbean: a review and study from St. Kitts, West Indies.

BACKGROUND: Little is known about the prevalence of Ancylostoma in dogs in the Caribbean. In view of the number of owned free-roaming and feral dogs within the islands and the ideal subtropical climate for parasite development and environmental survival, Ancylostoma could pose a threat to the health of the dogs as well as a zoonotic risk to people. METHODS: To determine whether generalities about Ancylostoma in dogs in the Caribbean could be made and to obtain a better understanding of the prevalence, published (Scielo, Scopus, and PubMed databases) and gray (e.g., student theses, conference presentations) literature was reviewed. Retrieved manuscripts were screened, and relevant data (year, location, dog population, method of diagnosis, positivity rate) were extracted. Data from two dog populations on St. Kitts also were included: a 2014 field study involving dogs with limited veterinary care and data from the Ross University School of Veterinary Medicine's Veterinary Clinic records for 2018-2019. RESULTS: Fourteen manuscripts from the 1950s to 2019, representing ten of the Caribbean islands/countries and the Bahamas, were identified. Methods of diagnosing infection status ranged from simple qualitative or quantitative flotation methods to centrifugation with Sheather's sugar flotation solution or necropsy. Dog populations sampled included stray, owned free-roaming, and owned confined. Reported rates of Ancylostoma infection ranged from 10 to 91%. Studies from the last 10 years indicate positivity rates of 21 to 73%. Ancylostoma positivity rates in the St. Kitts' populations were 61% and 10% for the 2014 and 2018-2019 populations, respectively. CONCLUSIONS: There was no indication that hookworm prevalence has changed over time in the Caribbean, and there were no obvious differences between owned and unowned dogs or free-roaming and confined dogs. The data from St. Kitts were on par with positivity rates from the other islands within the last 10 years and reflective of the impact that veterinary care, including anthelmintic treatment, is expected to have on parasites in pets. There is a clear need to expand the available data for the region and improve control programs for Ancylostoma infections to protect both canine and human health.

Global prevalence and epidemiology of Strongyloides stercoralis in dogs: a systematic review and meta-analysis.

BACKGROUND: Strongyloides stercoralis, a soil-transmitted helminth, occurs in humans, non-human primates, dogs, cats and wild canids. The zoonotic potential between these hosts is not well understood with data available on prevalence primarily focused on humans. To increase knowledge on prevalence, this review and meta-analysis was performed to estimate the global status of S. stercoralis infections in dogs. METHODS: Following the PRISMA guidelines, online literature published prior to November 2020 was obtained from multiple databases (Science Direct, Web of Science, PubMed, Scopus and Google Scholar). Prevalence was calculated on a global and country level, by country income and climate, and in stray/animal shelter dogs versus owned dogs. Statistical analyses were conducted using R-software (version 3.6.1). RESULTS: From 9428 articles, 61 met the inclusion criteria. The estimated pooled global prevalence of S. stercoralis in dogs was 6% (95% CI 3-9%). Infection was found to be the most prevalent in low-income countries with pooled prevalence of 22% (95% CI 10-36%). The highest pooled prevalence of S. stercoralis in dogs was related to regions with average temperature of 10-20 °C (6%; 95% CI 3-11%), an annual rainfall of 1001-1500 mm (9%; 95% CI 4-15%) and humidity of 40-75% (8%; 95% CI 4-13%). Prevalence was higher in stray and shelter dogs (11%; 95% CI 1-26%) than in owned dogs (3%; 95% CI 1-7%). CONCLUSIONS: As with S. stercoralis in humans, higher prevalence in dogs is found in subtropical and tropical regions and lower-income countries, locations which also can have high dog populations. While this study presents the first estimated global prevalence of S. stercoralis in dogs, it is potentially an underestimation with 15 of 61 studies relying on diagnostic methods of lower sensitivity and a paucity of data from most locations. Standardized protocols (e.g. quantity of feces and number of samples for a Baermann) in future studies could improve reliability of results. More prevalence studies and raising veterinary awareness of S. stercoralis are needed for a One Health approach to protect humans and dogs from the impact of the infection.

Case report: Assessment of a quarantine treatment for sheep on the Caribbean Island of St. Kitts.

Quarantine treatments can be used to prevent bringing resistant parasites onto a farm. However, in the face of growing anthelmintic resistance and variations in farm practices, assessing efficacy of such treatments before full implementation is needed. In this case report, a combination treatment of ivermectin (injectable formulation) and fenbendazole (both approximately double doses) administered orally within minutes of each other was assessed in 19 sheep. The mean pretreatment Strongylid eggs per gram of feces, determined using a McMaster, was 2639. The mean post treatment count (at 14 days) was 2663 with 12 animals having a decrease in egg counts. There was an average increase of 0.9% using pre and post treatment egg count means. This combination treatment was not effective as a quarantine treatment.

Short-term amino acid, clinicopathologic, and echocardiographic findings in healthy dogs fed a commercial plant-based diet.

Consumer demand for commercially prepared plant-based (PB) dog food is increasing, but studies evaluating the short- or long-term effects of PB diets on canine health are lacking. The objective of this study was to assess the short-term amino acid (AA), clinicopathologic, and echocardiographic findings in 34 client-owned dogs fed a commercial extruded plant-based diet (PBD) in which pea protein was the primary protein source and 4 control dogs fed a commercial extruded traditional diet (TD). Plasma AA and whole blood taurine concentrations were measured in dogs at baseline and after 4 weeks on the PBD or the TD. Hematologic, serum biochemical, and echocardiographic testing were performed at baseline and after 12 weeks on the PBD or the TD. Four dogs in the PBD group did not complete the study. All essential AAs, except methionine, were higher in dogs after 4 weeks on the PBD compared to baseline. Taurine (plasma and whole blood) was also higher after 4 weeks on the PBD compared to baseline. A meaningful difference was detected in whole blood taurine between the PBD group and the control group at 4 weeks (P = .026) with the PBD group being higher. Median hematologic and biochemical results for the PBD group were within normal limits at baseline and at 12 weeks. In the PBD group, left ventricular internal diastolic dimension (LVIDd, P = < .001) and normalized LVIDd (P = .031) were higher 12 weeks post-PBD compared to baseline. There were no meaningful differences in left ventricular internal systolic dimension (LVIDs), normalized LVIDs, or fractional shortening 12 weeks post-PBD. There was no statistical evidence of difference between the 2 groups of dogs for any of the echocardiographic parameters at baseline or at 12 weeks. Essential AA or taurine deficiency was not observed in this cohort of dogs fed a commercial extruded PBD. Additionally, clinically relevant hematologic, serum biochemical and echocardiographic alterations were not detected. Further research is required to determine if long-term static feeding of PB diets can meet and maintain AA and other nutrient targets in dogs.

Identification of Schistosoma mansoni Infection in a Nonhuman Primate from St. Kitts More than 50 Years after Interruption of Human Transmission.

Transmission of Schistosoma mansoni was interrupted on St. Kitts, a Caribbean island, in the 1950s. With no reported cases since that time and most Biomphalaria spp. snail populations eliminated based on surveys in the 1970s, S. mansoni has been considered eliminated on St. Kitts. In 2019, S. mansoni eggs were found in an African green monkey (Chlorocebus aethiops sabaeus) that originated from St. Kitts. Nonhuman primate (NHP) infections have been considered incidental to human infections, with infections in NHPs resolving with the elimination of S. mansoni in the human population. An NHP with S. mansoni infection suggests that the NHP may be able to maintain a reservoir sylvatic cycle. Alternatively, S. mansoni transmission was not eliminated or S. mansoni has been reintroduced to St. Kitts. The occurrence of an infected NHP from St. Kitts supports the need for continuous monitoring in areas where S. mansoni is considered eliminated.

Serologic and Molecular Diagnosis of Anaplasma platys and Ehrlichia canis Infection in Dogs in an Endemic Region.

Anaplasma platys and Ehrlichia canis are obligate intracellular, tick-borne rickettsial pathogens of dogs that may cause life-threatening diseases. In this study, we assessed the usefulness of PCR and a widely used commercial antibody-based point-of-care (POC) test to diagnose A. platys and E. canis infection and updated the prevalence of these pathogens in dogs inhabiting the Caribbean island of Saint Kitts. We detected A. platys in 62/227 (27%), E. canis in 84/227 (37%), and the presence of both in 43/227 (19%) of the dogs using PCR. POC testing was positive for A. platys in 53/187 (28%), E. canis in 112/187 (60%), and for both in 42/187 (22%) of the samples tested. There was only a slight agreement between A. platys PCR and POC test results and a fair agreement for E. canis PCR and POC test results. Our study suggests that PCR testing may be particularly useful in the early stage of infection when antibody levels are low or undetectable, whereas, POC test is useful when false-negative PCR results occur due to low bacteremia. A combination of PCR and POC tests may increase the ability to diagnose A. platys and E. canis infection and consequently will improve patient management.

Toxocara canis and Toxocara cati in domestic dogs and cats in the United States, Mexico, Central America and the Caribbean: A review.

Toxocara prevalence ranges from 0 to >87% and 0 to >60% in dogs and cats, respectively, within the United States, Mexico, Central America and the Caribbean. Higher prevalence occurs in animals less than 1 year of age. Overall, prevalence is higher in cats compared to dogs. The lowest prevalence occurs in the US owned dog population. Specific populations in this industrialized nation, in animal shelters or resource-limited locations, have prevalences similar to those seen in populations from other regions reviewed here. Conversely, subpopulations in Central America and the Caribbean have very low prevalence. Apparent contributors to prevalence, excluding animal age and climate, are socio-economic factors, attitudes towards pet management and animal population density. The lack of data from some regions pose a challenge in assessing trends; however, with the exception of the US owned dog population, there is no strong indication of any decrease in prevalence from historical levels.

Typhlitis Associated With Natural Trichuris sp. Infection in Cats.

Trichuris spp. infections can cause typhlitis or typhlocolitis in many species, but there are no published studies about its pathology in cats. Trichuris sp. infection in cats appears to be rare in most parts of the world but is frequent in some tropical and subtropical regions. The purpose of this study was to describe intestinal lesions associated with natural Trichuris sp. infections in cats of St. Kitts, West Indies. Comprehensive autopsies, histopathological assessment of small and large intestine, and total worm counts were performed in a cross-sectional study of 30 consecutive feline mortalities. Trichuris were found in 17 of 30 (57%; 95% confidence interval, 39%-74%) of the study cats with a median worm count of 11 (range, 1-170), indicating most cats had a low-intensity infection. Trichuris infection was associated with typhlitis but not consistency of feces or body condition score. In most cats examined, the typhlitis was categorized as mild (10/15, 67%) and, less frequently, moderate (2/15, 13%) or marked (3/15, 20%). The inflammatory infiltrate varied from predominantly eosinophilic (5/15, 33%) to neutrophilic (4/15, 27%), a mixture of eosinophilic and neutrophilic (2/15, 13%), a mixture of neutrophilic and lymphoplasmacytic (1/15, 7%), or a mixture of eosinophilic, neutrophilic, and lymphoplasmacytic (3/15, 20%). In some cats, surface erosions and catarrhal exudate were adjacent to adult worms. These findings are similar to those reported with low-intensity Trichuris infections in other species.

First report of Aelurostrongylus abstrusus in St. Kitts.

A 4-month-old intact male domestic shorthair kitten living in St Kitts, West Indies presented with respiratory distress, cachexia, and mucopurulent nasal discharge. Thoracic radiographs revealed a diaphragmatic hernia. The diaphragmatic hernia as well as subpleural pulmonary nodules suspicious for verminous pneumonia were identified during a postmortem examination. Histology showed multifocal to coalescing pyogranulomatous and eosinophilic pneumonia centered on larvae and morulated eggs. The lesion and nematode morphology were consistent with Aelurostrongylus abstrusus. Although Aelurostrongylus abstrusus has been reported worldwide, this is the first report of a metastrongyloid lungworm in cats in St. Kitts and for the West Indies. This case report should increase the awareness of A. abstrusus pneumonia in cats from St. Kitts and other locations in the eastern Caribbean.

Comparison of fecal analysis methods for the detection of Platynosomum fastosum in naturally infected cats.

OBJECTIVES: Diagnosis of Platynosomum fastosum Kossack 1910, a liver fluke of cats, can be challenging, with infections potentially not identified depending on the fecal analysis method used. The aim of this study was to compare three methods for identification of P fastosum eggs in feces. METHODS: Feces from 50 cats with unknown infection status from a location endemic for P fastosum were analyzed. The methods used included double centrifugation with Sheather's sugar flotation solution (specific gravity 1.28); the Mini-Parasep (Apacor) flotation kit with ZnSO4 (specific gravity 1.20); and the Mini-Parasep sedimentation kit with Triton X/ethyl acetate solution. RESULTS: Thirty-four cats were identified as positive for P fastosum. Of these cats, 33 were identified with the double centrifugation method, 16 with the Mini-Parasep flotation kit and 11 with the Mini-Parasep sedimentation kit. Using the total number of samples identified as positive by at least one method as the true positive, the sensitivity of the methods was 97.1% for double centrifugation, 47.1% for the Mini-Parasep flotation kit and 32.4% for the Mini-Parasep sedimentation kit. Other parasite eggs (eg, Ancylostoma tubaeforme, Trichuris species and Toxocara cati) also were detected more frequently with the double centrifugation method. CONCLUSIONS AND RELEVANCE: Of the three methods tested, double centrifugation with Sheather's sugar flotation solution was the most effective in identifying cats with P fastosum and other helminth eggs in their feces. The lower specific gravity of the flotation solution in the Mini-Parasep flotation kit likely influenced the results. A primary drawback of the Mini-Parasep sedimentation kit was the amount of sediment. While more sediment was examined than recommended in the manufacturer's instructions, this was still only a small portion of the total sediment. In addition, reading the slides took longer than with the other methods.

Strongyloides spp. in cats: a review of the literature and the first report of zoonotic Strongyloides stercoralis in colonic epithelial nodular hyperplasia in cats.

BACKGROUND: Four species of Strongyloides, Strongyloides felis, Strongyloides planiceps, Strongyloides stercoralis and Strongyloides tumefaciens, have been identified in cats based on morphology and location in the host with limited data on the prevalence and disease potential of these different species. Strongyloides tumefaciens adults are located in colonic nodules while the other three species are in the small intestine. The literature on Strongyloides in cats is scattered and has never been compiled. The aim of this article is to provide a short review of the existing literature on Strongyloides spp. in cats, to describe the pathology of colonic nodules containing Strongyloides sp. seen at necropsies of cats in St. Kitts, West Indies, and to provide the first unequivocal report of zoonotic S. stercoralis in cats based on sequencing analysis of a portion of the cytochrome c oxidase subunit 1 (cox1) gene, and supported by phylogenetic analysis. RESULTS: Colonic nodules containing sections of nematodes, histologically compatible with Strongyloides sp. were seen during necropsy in six cats in St. Kitts, West Indies. Sequencing of the cox1 gene of the mitochondrial DNA extracted from colonic nodules from two of these cats matched sequences of the zoonotic strain of S. stercoralis. CONCLUSIONS: The morphological similarities between S. stercoralis-associated colonic nodules and previous reports of S. tumefaciens, together with the insufficient defining criteria for S. tumefaciens raises questions about the validity of the species. Further sampling and genetic characterization of isolates is needed to understand the species in cats and their zoonotic potential.

Aberrant and accidental trichomonad flagellate infections: rare or underdiagnosed?

The clinical significance and frequency of human infections with trichomonad flagellates in aberrant locations (locations other than the predilection sites) and accidental infections (infections with non-human trichomonads) are unclear. The total number of case reports in the literature is low, with the identification of the infection largely the outcome of investigations for the cause of clinical signs. At least seven species have been identified in either aberrant or accidental infections, with these infections occurring worldwide. Results of prospective and retrospective surveys of adults with respiratory disease suggest that aberrant and accidental trichomonad infections are less rare than the number of case reports suggest, with Trichomonas tenax being the most frequent. Surveys of neonates and infants suggest that aberrant Trichomonas vaginalis infections can be higher and more serious than suggested by the few case reports. The density and location of infection might be as important, if not more so, than species in determining pathogenicity. Molecular diagnostic methods including DNA sequencing can be used to better diagnose infections and enable identification to assist in determining the clinical significance of different species. Raising awareness of these infections among clinicians and adding them to their differential lists are strongly suggested.

Efficacy of Praziquantel in the Treatment of Platynosomum fastosum in Cats with Natural Infections.

Treatments for Platynosomum fastosum-the liver fluke of cats-have been developed based on fecal egg counts. Post mortem fluke counts are required to understand true efficacy. In this study, two praziquantel treatment regimens were evaluated using post mortem fluke counts: a high-dose treatment (HT) of 20 mg/kg body weight (BW) administered intramuscularly (IM) once a day for three consecutive days and a low-dose treatment (LT) of 5 mg/kg BW administered once (IM) and repeated 14 days later. A continual enrolment study design was used with 16 naturally infected cats randomly allocated in blocks of four to the HT (eight cats) or LT (eight cats) group. Treatment success, defined as absence of live flukes post mortem, was determined 10 days after the last treatment. Pre- and post-treatment fecal egg counts (centrifugation with Sheather's sugar flotation solution) and bile egg counts (obtained via percutaneous ultrasound guided cholecystocentesis) were evaluated as supportive efficacy data. Twelve cats completed the study with two cats withdrawn from each group. Neither treatment was 100% effective. In the HT group, three of six cats had live flukes, albeit low numbers, at post mortem, while all six LT group cats had live flukes. While fecal and bile egg counts were reduced in both group, they were not reflective of the true infection status of the cats post mortem.