The Feline Patient

Fourth Edition

Editor
Gary D. Norsworthy, DVM, DABVP (Feline)

Founding Authors
Gary D. Norsworthy, DVM, DABVP (Feline)
Mitchell A. Crystal, DVM, DACVIM (Internal Medicine)
Sharon Fooshee Grace, MAgric, MS, DVM, DABVP (Canine-Feline),
DACVIM (Internal Medicine)
Larry P. Tilley, DVM, DACVIM (Internal Medicine)

A John Wiley & Sons, Inc., Publication

 CHAPTER 195
Roundworms
Mitchell A. Crystal and Mark C. Walker
Overview
Roundworms, also called ascarids, are robust small intestinal nematode
parasites. There are two types of roundworms found in the cat: Toxocara
cati (most common) and Toxascaris leonina. T. cati and T. leonina are
acquired via ingestion of infected paratenic hosts (i.e., mice, birds, or
insects) or feces. Kittens may also acquire T. cati from ingestion of
infected queens milk during nursing. Roundworms have a 2- to 3-week
life cycle. The life cycle of T. cati involves migration through the lungs
and liver and, in some cases, through somatic tissues. The life cycle of
T. leonina has no extraintestinal migration. Transplacental infection does
not occur with either T. cati or T. leonina. Clinical signs are more severe
in kittens than in adult cats and include vomiting (with or without
worms), diarrhea (with or without worms), abdominal distention or pain
(kittens), weight loss or failure to gain weight (kittens), coughing (i.e.,
pneumonitis or pneumonia from T. cati due to larval migration), and
rarely, intestinal obstruction. However, infections are often asymptom-
atic. Physical examination may be normal, reveal evidence of abdominal
distention or pain (kittens), weight loss (kittens), or diarrhea. Unlike the
canine roundworm Toxocara canis, T. leonina has limited public health
significance. However, contrary to prior belief, T. cati is zoonotic because
it does have potential to cause visceral and ocular larval migrans in
humans who ingest embryonated eggs.
Diagnosis
Primary Diagnostics
History: The owner may report seeing worms in vomitus or feces.
See Figure 195-1.
Fecal Flotation: Eggs are seen on microscopic examination.
Figure 195-1 Roundworms may be vomited or pass in the stool. These worms show
the characteristic curling that they assume.
Image courtesy Dr. Gary D. Norsworthy.
The Feline Patient, 4th Edition, Gary D. Norsworthy, 2011 Blackwell Publishing
Ltd.
468
Secondary Diagnostics
Direct Saline Smear: Eggs are sometimes seen on microscopic
examination.
Chest Radiographs: These may suggest verminous pneumonia.
Diagnostic Notes
Clinical signs may develop in kittens before eggs are detected in
feces.
The most common cause of coughing in kittens is due to pulmonary
larval migration of Toxocara.
Treatment
Primary Therapeutics
Pyrantel pamoate (Strongid, Nemex, generic): Give 20 mg/kg
PO; repeat in 2 to 3 weeks. It is also effective for hookworms.
Praziquantel/Pyrantel Pamoate (Drontal): Give per label instruc-
tions; repeat in 2 to 3 weeks. It is also effective for hookworms and
tapeworms.
Roundworm and Heartworm Prevention Combination: milbemycin
oxime (Interceptor, give per label instruction or 2 mg/kg PO once
a month; also effective for hookworms); selamectin (Revolution,
apply per label instruction or 6 mg/kg as a spot-on topical once a
month; also effective against hookworms, ear mites, and fleas); imi-
dacloprid and moxidectin (AdvantageMulti for Cats, give per label
instruction or 10.0 mg/kg imidacloprid and 1.0 mg/kg moxidectin
once by topical application).
Emodepside and praziquantel (Profender): Topical therapy. Give
3 mg/kg emodepside and 12 mg/kg praziquantel. Treat at 8 and 12
weeks then 3 months later.
Secondary Therapeutics
Fenbendazole (Panacur): Give 25 mg/kg q24h PO for 3 days; repeat
in 2 to 3 weeks. It is also effective for hookworms, whipworms,
Giardia, and Ollulanus tricuspis.
Ivermectin (Ivomec): Give 200 g/kg PO; repeat in 2 to 3 weeks. It
is also effective for hookworms.
Therapeutic Notes
Treat kittens routinely or if roundworm infection is suspected, even
if the fecal floatation is negative.
A second treatment is needed 2 to 3 weeks following initial therapy
to kill new adults arising from eggs and larva that were initially
resistant to therapy.
Prognosis
The prognosis is excellent for cure, although roundworm eggs often
persist in the environment for years and lead to reinfection. This may be
a problem in outdoor cats.