# Chronic Giardia issues?



## AustralianShepherdOwner (Dec 24, 2013)

I own a 7 month old dog. She tested positive for Giardia when she was about 4 months old after I noticed she had an immense amount of diarrhea overnight. (I regret bringing her to a muddy dog park earlier that day where she might have caught the parasite from...and yes, she has all her vaccines and takes Heartguard every month). She was on a 6 day dose of Panacur and Flagyl for 9 days. Even though she did not show symptoms, her fecal re-check sample still came back positive. We treated her only with Panacur a second time, and the third fecal re-check came back negative. About a week later, she showed symptoms of diarrhea again with mucous in the stool. As expected, her fecal test came back positive yet again for Giardia, even though just the previous week it was negative. I haven't taken her back to that dog park since the first incident of Giardia. She was treated again with Panacur and Flagyl, and she appears healthy now.

For the future, I plan on giving her a dose of Panacur for 3 days once per month just as prophylaxis to prevent Giardia. The vet said that this is ok to do since Panacur is a safe medication, but not to give Flagyl prophylactically because it is an antibiotic. Anyway, I was wondering if anyone has chronic issues with Giardia where symptoms come and go. Is there a good chance my dog's immunity to Giardia will improve as she gets older? Did anyone else have issues with chronic Giardia when their dogs were puppies, but it went away once the dog got older?


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## [email protected] (Nov 18, 2013)

A few thoughts:
1) How is your vet diagnosing Giardia? In-house testing (which is how many vets diagnose) is generally less accurate than is send-out testing to the big labs. As I have worked in various hospitals over the years I have come to believe that fecal testing is very often wrong (both false positives and false negatives). If your vet is testing in-hospital they should be performing a zinc sulfate centrifugation technique, which has been proven to be much more accurate for this particular parasite than are other flotation techniques. (FYI, most vets don't have the equipment to perform a proper centrifugation technique, and many use other flotation media besides zinc sulfate). There is also a Giardia ELISA test (picture something much like a pregnancy test), which chemically detects Giardia. Ideally they should be performing BOTH a zinc sulfate centrifugation test and a Giardia ELISA together in tandem, and BOTH tests should give the same result. (Both Antech Labs and IDEXX Labs, the two biggest outside labs in the US, offer these together as a single panel for a reasonable cost.). If this is what your vet is doing, and if both tests are repeatedly showing Giardia, then your dog is likely actually positive. If not, there is a very high chance that your dog is getting misdiagnosed.
2) The Giardia ELISA will test false positive for 30 days after treatment, so we always wait 45 days after treatment to retest. I couldn't tell from your timeline how frequently your vet has been retesting, but this may be an issue if they are using the ELISA test.
3) Although Metronidazole is often used for Giardia, various studies have shown that it actually has very poor efficacy in clearing the parasites (possibly as low as 50%). Panacur is better. You can also use Febentel (in Drontal Plus, among others), which works well. Some of the very efficacious medications (such as Albendazole) are hard to find now and have some safety concerns with their use.
4) At least according to an in-house study performed by IDEXX Labs, many of the dogs who tested positive for Giardia were "backyard" dogs and lacked exposure to the traditional routes of contamination (swimming, etc.). So, assuming that your dog is really positive, she may very well be picking it up in your yard.
5) The Giardia vaccine is garbage, and if it hasn't been removed from the market already, that will occur soon. Don't use it!
6) If your dog is asymptomatic, I would have a hard time rationalizing treating them on a regular basis, particularly for "prophylaxis." (That term, FYI, is incorrect, since it implies that the medication is preventing your dog from contracting Giardia. Panacur is not a prophylactic in any way; it treats existing infections.). If your dog is not having clinical signs, why treat? Assuming that your dog is picking it up from your yard, the medication would clear the infection while it was in the system (3 days) and then they would again reinfect. And if your dog is not routinely being exposed to the parasite, why treat at all? Many dogs (and may people) are asymptomatic carriers for Giardia, and this parasite has not been shown to produce any ongoing intestinal damage, so the real issue is whether you are OK with them potentially being a carrier. But again, treating once monthly for 3 days only ensures that your dog is free of Giardia during the treatment period (even assuming that the medication works, which often it doesn't). So...if it were my dog and she were asymptomatic, I wouldn't worry about it, unless I had other concerns (such as other dogs that she was contaminating).
7) It has been demonstrated over the past few years that Giardia is not a zoonotic disease (people cannot get it from dogs). Although both dogs and people get Giardia, they are infected with different types.


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## Jen1959 (Jan 29, 2014)

pet Alive by Parasite Dr worked wonders for my puppy, who had chronic giardia. She went through many rounds of Panicure and antibiotics and I finally found this online(google it) 60 capsules in a bottle. Her stool test after this herbal treatment finally came back normal!


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## AustralianShepherdOwner (Dec 24, 2013)

Jen1959 said:


> pet Alive by Parasite Dr worked wonders for my puppy, who had chronic giardia. She went through many rounds of Panicure and antibiotics and I finally found this online(google it) 60 capsules in a bottle. Her stool test after this herbal treatment finally came back normal!


Do you continue to keep your dog on that medication to prevent future parasites? As in do you have her on the medication for every day, even though the Giardia is gone?


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## AustralianShepherdOwner (Dec 24, 2013)

[email protected] said:


> A few thoughts:
> 1) How is your vet diagnosing Giardia? In-house testing (which is how many vets diagnose) is generally less accurate than is send-out testing to the big labs. As I have worked in various hospitals over the years I have come to believe that fecal testing is very often wrong (both false positives and false negatives). If your vet is testing in-hospital they should be performing a zinc sulfate centrifugation technique, which has been proven to be much more accurate for this particular parasite than are other flotation techniques. (FYI, most vets don't have the equipment to perform a proper centrifugation technique, and many use other flotation media besides zinc sulfate). There is also a Giardia ELISA test (picture something much like a pregnancy test), which chemically detects Giardia. Ideally they should be performing BOTH a zinc sulfate centrifugation test and a Giardia ELISA together in tandem, and BOTH tests should give the same result. (Both Antech Labs and IDEXX Labs, the two biggest outside labs in the US, offer these together as a single panel for a reasonable cost.). If this is what your vet is doing, and if both tests are repeatedly showing Giardia, then your dog is likely actually positive. If not, there is a very high chance that your dog is getting misdiagnosed.
> 2) The Giardia ELISA will test false positive for 30 days after treatment, so we always wait 45 days after treatment to retest. I couldn't tell from your timeline how frequently your vet has been retesting, but this may be an issue if they are using the ELISA test.
> 3) Although Metronidazole is often used for Giardia, various studies have shown that it actually has very poor efficacy in clearing the parasites (possibly as low as 50%). Panacur is better. You can also use Febentel (in Drontal Plus, among others), which works well. Some of the very efficacious medications (such as Albendazole) are hard to find now and have some safety concerns with their use.
> ...


Thanks for the advice. We paid for the more expensive stool tests (ELISA tests) when checking for Giardia. We also waited the appropriate amount of time before re-testing her stool. The studies you provided me with checking for effectiveness of the medications were helpful.

By the way, does Panacur only treat Giardia if she has active cysts (like that are causing her diarrhea and to be sick)? Or does it also get rid of eggs? Because if I give her Panacur once per month (even without her showing signs of an active infection), it might be able to get rid of any Giardia eggs that are in her intestines before they start causing an infection....if that makes sense. But I don't really know how the medication works, so I am just making an assumption.

I ordered her Panacur from 1800-PetMeds last month and kept it on hand just in case. I noticed she started to get some diarrhea outside for 2 days in a row (nothing too serious, but didn't want it to get worse). I gave her one packet of Panacur just as a precaution, and the diarrhea stopped. I gave her a 3-day course of treatment. So maybe I can just keep Panacur in my cupboard and treat her if she starts to be symptomatic.


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## Jen1959 (Jan 29, 2014)

Nope, once she came back negative, I was almost out, but I believe it's what zapped the big! Could have been a coincidence tho. It wouldn't hurt to use as a preventative tho, since it's safe with no side effects.

PS, no prescription is safe when given often or long term


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## Jen1959 (Jan 29, 2014)

Another thing that helps is keeping their bottom and bedding clean and pick up the poop so she doesn't reinfect herself


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## Rescuemom2017 (Oct 29, 2017)

For AustralianShepherdOwner (or anyone else viewing this thread) -- I am wondering how your pup is now after the dreadful giardia? I just rescued a 7 mo. old greyhound or whippet/lab mix (??) diagnosed with giardia also. I've given 2 rounds of treatment (panacur w/metronidazole) and have an appt. this Friday for an exam and another fecal they send out. Keeping my fingers crossed it is over. I change towels in crate and on her beds daily and wash with bleach. I pick up her poo immediately after she goes and spray the spots with bleach water. I bleach her dog bones (no other toys allowed) and food bowls daily. Her poops are finally firm with the occasional 3 or so looser/soft poos. The first round of treatment did not clear the giardia all the way as there were still active cysts showing in the fecal test. As I said, hoping the 2nd round of treatment did the trick. I'm getting myself prepared for a disappointing fecal test ... if it's negative Hurray, but I cannot get my hopes up. Just curious what worked for you finally?


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