Hookworm Advice Needed For Multicat Home

beckbjj

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Despite having all rescue cats (currently nine!), I've actually never had a cat test positive for parasites before. But I realize sometimes tests are wrong too. I have a bit of a baffling situation here.

I trapped and took in a feral cat (Frank) in March. Frank was treated with Revolution on March 13 when he had his TNR medical. He had tapeworm which Revolution doesn't cover, but he had to be shaved bald due to extremely severe matting, so the vet didn't want to further irritate his skin. They applied the Revolution and gave me Profender to apply at home when his skin calmed down (and when he was handle-able, as he was very feral). During the first half of April (I didn't note the date unfortunately, but less than 30 days after the Rev), I treated him with the Profender. It all got applied and he didn't freak out or anything so he definitely got the full dose. I gave him a different litterbox and all fresh litter.

So now it's July and he needed wellness bloodwork for an upcoming dental, and I brought in a fecal sample as well. Well, no more tapeworm, but turns out he's got hookworm, and I am absolutely baffled. BOTH Revolution and Profender kill hookworms. He got clean, fresh litterbox and litter. He was 100% segregated from the other cats until well after he was treated...April 26 was the first time he would've had access to other litterboxes. None of the other cats have been outside since 2018, and they've all had clear fecals in the past (granted, not tested recently since they don't go out).

What in the world gives here? Did the Rev/Profender combo *still* somehow miss the hookworms? Or do my other cats somehow have them and passed them to Frank even though it's been literally years since any were outside and they've all tested negative? I'm just really confused about this.

FWIW, Frank will be getting Drontal from his vet (although they only gave two tabs and they should've given three as he is 11 lbs), and I have 18 doses of Revolution on their way here. My plan is to give Frank the Drontal as prescribed AND about a week after the first Drontal dose also give him Revolution (I checked...this is deemed safe and effective), AND give the other eight Revolution on the same day as Frank gets the Drontal, AND give all nine of them a second dose of Revolution in 30 days, as well as putting out ALL new litterboxes and litter throughout the house on the same day as everyone gets their first dose. But I'm also wondering, should I use disposable litterboxes for a week or so after everyone gets their first dose? Or will it be okay if I just put out new right away?

Any thoughts/advice on this entire situation would be appreciated.
 

fionasmom

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I have all rescued cats as well, indoor only, former ferals. While I have not had hookworm, last year I had several episodes of tapeworm which required trips to the vet for treatment. In my case, the reason is probably that I use Advantage, which is not as successful in this area anymore, as I had one cat react to Revolution and that concerned me. I am in no way telling you not to use Revolution as I believe it is a good product, but my point is that this kind of thing can happen.

My guess is that Frank was not entirely cured of his case, which can also happen despite having followed all directions carefully. I am not seeing where your others harbored hookworm for a long time with no affects to their health. While you don't normally see hookworms, the effects of an untreated infestation become obvious and that would have tipped you off to get the others to the vet.

Erring on the side of caution, I would use disposable litter boxes partly because you won't have to worry about cleaning them once this passes. Does your vet believe Frank should be isolated again temporarily which you follow this protocol?
 
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beckbjj

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Sounds good. Yeah, none of them are pale or more lethargic than usual, LOL. Frank isn't pale either, but that may be more a result of him having inflamed gums and needing a dental (which is set for the soonest available surgery date they had). His platelets were a bit low (157 vs normal minimum 200) which jives with hookworm infection, otherwise normal bloodwork.

Besides Frank, four of the others have had Revolution already (the other two TNRs, plus two barn cat kittens) with no trouble. The ones who haven't are sort of "no problem" kitties health-wise. So I think I'm pretty safe in that regard.

As far as the vet's advice...it's complicated. This vet has only seen Frank, so she only gave me advice about him. Policy is they'd have to see the others to give advice (I'm getting the Revolution for the others via an out-of-state friend at a shelter). This vet's vet tech runs the TNR group I went through with Frank. Most of the others see a vet in a town 30 minutes away. The other two TNRs see a different vet closer to my house as they needed numerous appointments that I didn't want to drive an hour round trip for. As it turns out, I like Frank's vet the best out of the three, so I will ultimately be transferring them all to her but I am waiting until after Frank's dental to make sure I still like her best after that. But anyway, she didn't say that he needs to be isolated again, so I'm just proceeding as if they all have hookworms now, even if they probably don't. Hence my waiting on treatment until the Rev gets here, so I can do them all at the same time.

So I'll switch to the disposable litterboxes once the meds are all on hand, and I'll make sure to scoop immediately (I fortunately work from home so I can do this). And I'll scrub and disinfect their regular boxes while those are out of commission. Is bleach or vinegar better for parasites, or are they about the same effectiveness for this purpose?

Do you think using disposables for a week is enough? Do I need to throw away the disposables each day while I'm using them, or weekly, or...? (I know it's so weird I've had tons of animals all my life and have never had to deal with worms before, so I've never really taken the time to learn much of anything about them!)
 

fionasmom

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Tips for Cleaning a Litter Box | PetMD

I know that you don't need to read an entire article about litter boxes, but if you scroll down it will clarify cleaning them and suggests hot water and soap, not bleach or ammonia. Most articles I have ever read have said that cats may react, litter box wise, to smelling bleach or a strong commercial cleaner and then you have a whole other issue.

Even though Frank's vet is not the same as for your other cats, I would assume that she might have said to isolate him if that were necessary as that is not exactly giving medical advice to cats she has not yet met....it is just general cat information.

Hookworms and litter cleaning

This thread has a discussion of litter boxes and hookworm which might be helpful as well. It has suggestions about disposables and a couple of tips that might save you money.

Your cats are all very lucky to have found you and to have you take such good care of them.
 
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beckbjj

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Thank you! Good news all around! I will use hot water, mild soap, and probably a touch of vinegar (which my cats don't seem to mind as they're always interested in our pickles, salad dressing, etc.) as the article advises, and I'll also use disposables for a bit once they're treated, out of an abundance of caution. I think both Drontal and Revolution say they start to work within a few hours so I'll start with disposables on treatment day and go for at least a week before putting out the regular boxes. And it sounds like the way hookworms work, since I scoop diligently anyway it's not super likely that the other cats are infected, but I am definitely going to give everyone the two months of Revolution treatments anyway and make sure.
 

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Applying a follow up treatment of revolution is key. Hookworm larvae can encyst into tissues. Unfortunately, Routine deworming only affects the adult hookworms. Thus, reapplying Revolution 4 weeks later will capture the larvae as they emerge from the glands of the small intestine as adults.
 
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beckbjj

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Perfect! I suspected as much, which is why I went ahead and ordered 18 doses instead of just 9. I'm determined to get these little beasties!
 

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Thank you! Good news all around! I will use hot water, mild soap, and probably a touch of vinegar (which my cats don't seem to mind as they're always interested in our pickles, salad dressing, etc.) as the article advises, and I'll also use disposables for a bit once they're treated, out of an abundance of caution. I think both Drontal and Revolution say they start to work within a few hours so I'll start with disposables on treatment day and go for at least a week before putting out the regular boxes. And it sounds like the way hookworms work, since I scoop diligently anyway it's not super likely that the other cats are infected, but I am definitely going to give everyone the two months of Revolution treatments anyway and make sure.
I have started seeing resistance with advantage, revolution and Frontline in my area, but for fleas there is a new thing called Cheristin which is expensive but works. What I do because I foster and have dogs who go in the yard and neighbors and feral cats obviously bringing fleas around despite my cats not going out is I use Cheristin on the ones that have flea allergies and use different treatments on the others. But I buy the large or extra large dog treatments and use a syringe to measure out the amounts. You want to be VERY careful (so for instance advantage makes something called advanTIX which is poisonous to cats, but regular advantage is the same formula for cats and dogs. Frontline and Revolution are almost the same (I think Frontline is a bit different but the dog version is actually a bit stronger, so that's ok).

Anyway I work in a research lab so figuring out the doses per lb or kg is not a big deal for me. Others should be careful but many rescues do this. I can't afford to buy individual doses for 16 cats (not all are fosters and the rescue provides advantage which as I've said is not working as well now).

I buy generic revolution from Australia from Joespetmeds and it works well (called stronghold). The only difference is the amount in the vials so all you really need to do is figure out how much is in a cat vial and use that much. Getting small containers and syringes (no needles of course) can be the hardest part. If your friend works with a rescue and they're not doing this I'm surprised.

I get Frontline Plus at Costco and dose it down too. There is another Frontline I think that is toxic to cats but can't remember what it's called. Also, these things all have different names in different countries so you HAVE to know the ingredients not just the names.

I don't buy generic except for the revolution because I've found Joespetmeds is legitimate (been using it for years) and it is safe. Others may have different inactive ingredients so I don't want to take a chance. I also don't buy on Amazon or eBay because of fakes.

A note about the litter boxes: if you wash them with soap and water that should be fine. Your goal is to REMOVE eggs. If they're washed down the drain it shouldn't matter if they're dead. Everyone worries about KILLING bugs (like coronavirus now) but removing them fixes the problem. I have severe asthma and CANNOT use bleach. I do use something called Rescue (on Amazon, and has to be very diluted so it's expensive but goes a long way--I actually mix it up for other people in spray bottles) for bacteria and viruses with sick animals but mostly I use regular household (I like Method brand) cleaners so I can breathe. In bedding and blankets I put pine sol in the washing machine with the soap rather than bleach. My cats don't seem to be bothered by it but I rinse everything twice so that may be why. I don't use pine sol for anything else. Bleach is hard on fabrics over time anyway.

I mention this because you'll want to wash bedding etc. frequently and not pass the hookworms around that way.

It sounds like you're doing a great job though and I suspect everything will be fine in the end. I have recently had a kitten who came to me very sick with his sibling who died almost immediately. He had hookworms, coccidia, and we don't know about Giardia but figured we would treat for all. It was touch and go (he was about 5 weeks old and is 3 months now) but he is now almost healthy and playing with another kitten I got 3 weeks earlier that had to be bottle fed. They are almost the same age but he is half the size of the bottle fed kitten and still tires more quickly. When we got him his gums were just white and he had SEVERE diarrhea and infection and sloughed skin all around his anus. It was a great relief when he was checked multiple times and declared "clean.". But we treated probably more times/longer than necessary to be sure. With him in one bathroom in a large tote box and the other kitten in the other I'm just happy to have a bathroom again!
 
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