Parasite control scenario: What would you do?

Brooke Simpson is a cat owner in Plainfield, Ill., who's expecting her first child in July. When she found out she was pregnant, her obstetrician explained the risk of toxoplasmosis and advised her to ask someone else in the family to clean the litter box. Before this recommendation, Brooke had not heard of zoonotic diseases.

Her two cats, Isabella and Coco Chanel, are indoor cats that aren't on a parasite prevention program. As an expectant mother, she's concerned because rambunctious, 10-month-old Coco tends to bite. She's also worried the cat might jump into the baby's crib.

Her pets are due for their annual exam in June, a month before her due date. She says she likes and trusts you as her veterinarian, so she's ready to listen to your recommendations. What would you say?

Here's what our experts would do.

Dr. Jay Stewart

President, Companion Animal Parasite Council (CAPC)

Owner, Aumsville Animal Clinic in Aumsville, Ore.

First, we need to review the information Brooke received from her physician on toxoplasmosis to make sure it fits with our understanding of the disease and its zoonotic potential. I'd also send her to the CAPC pet owner website (petsandparasites.org) for additional information on Toxoplasma. There's a new brochure coming out soon, so I'd let her know to watch for that.

It's a good idea to have someone else clean the litter boxes. If Brooke is forced to change them herself, I would suggest a mechanical litter box or a schedule of cleaning the box every day-it takes 48 hours for Toxoplasma cysts to become infective to people.

A young cat is more playful and inclined to bite than an older cat. As Coco matures, the biting problem may resolve on its own. Nevertheless, some counseling on behavior modification for the kitten is also appropriate. Certainly Brooke can keep the baby's door closed if she's concerned about the cat getting in the crib. She needs to feel comfortable about her cats without feeling like she has to get rid of them.

At the cats' annual exam, I'd recommend fecal exams to test for internal parasites as well as evaluate for the presence of fleas and other external parasites. Then I'd recommend a monthly deworming program and a monthly parasite prevention product that controls both internal and external parasites.

It's important not to discount Brooke's concerns about her baby. Once pet owners feel their veterinarian has acknowledged their concerns and listened to them, they're receptive to solutions. As veterinarians we need to be good listeners.

Dr. Mike Paul

CAPC executive director

Here's what I'd say to Brooke: “First of all, congratulations on your expected addition! Secondly, I'm happy that your obstetrician is informed about cats and pregnancy. Now let's try and put your mind at ease.

“Although it doesn't eliminate risk, the fact that your cats are indoors greatly reduces the chances of them impacting your pregnancy or your baby. Since you've had your cats for some time and do a good job controlling their environment, the risk of toxoplasmosis is limited. Make sure you continue to keep your cats indoors and feed them only commercial foods or cooked meats. Have someone else empty the litter pan every day and avoid the dust from the litter.

“When it's time for your cats' exam, collect stool samples from both cats and take them to your veterinarian for a fecal floatation examination for parasite eggs. Be sure your veterinarian uses a centrifugation technique to maximize the test's accuracy. If the test shows any parasites, the cats should be treated and the stools rechecked. Once the results show the cats are free of parasites, start them on a monthly parasite control product that will control internal parasites as well as prevent heartworm infection. If you have a dog, please test and treat that pet as well.

“As for your concerns about the younger cat's behavior, we'll need to take a little time to evaluate the situation. Certainly you need to protect your baby from an aggressive cat, but keep in mind that there are a lot of old wives' tales about cats and infants that simply aren't true. Try socializing your kitten in the next few months. Expose her to activity and noise to simulate a baby's presence in the house. Most likely, if your cat is stressed, she'll simply hide-overt aggression is less common. We can start working on some behavior strategies to help your cat adjust and consult an expert in feline behavior if necessary. This may help you avoid any difficult decisions about removing your cat from the household.”

Julie Legred, CVT

CAPC board member

Practice manager in Bricelyn, Minn.

Here's what I would tell Brooke: “Congratulations on your exciting news! I understand that your obstetrician recommended talking with us about the zoonotic risks involved with your cats at home. I can assure you that even though there's always zoonotic potential with owning our furry friends, you can minimize those risks when you provide your pets with routine prevention measures and follow the veterinarian's recommendations. All of us here at the hospital work as a team to ensure that you understand these recommendations and help you follow them to the best of your ability. We're here to help you and welcome any questions you may have.

“I think it would be best to bring your cats in right away and get them started on a parasite prevention program. Even though they're indoor cats and aren't due yet for their vaccinations, we recommend doing fecal examinations two to four times in their first year and one to two times a year when they're adults. This will ensure that your cats are getting their preventive medication and that they haven't picked up any parasites the medication doesn't target. After we've run the diagnostic tests, we'll get the veterinarian's recommendation on a prevention program. We like to use products that cover a wide range of parasites with zoonotic potential.

“Another thing we should talk about is the risk of toxoplasmosis, which can harm your baby if you contract it while you're pregnant, as your obstetrician mentioned. We can drastically minimize this risk with a few simple suggestions. If at all possible, have another family member take over litter box duty and clean the box at least daily. If you must do it yourself, wear gloves and wash your hands afterwards. Another risk is undercooked meat, so make sure to cook your meat thoroughly. If you do any gardening, wear gloves or make sure to wash your hands thoroughly and clean the dirt from under your nails. Be sure to wash dirt off vegetables before eating. It's also a good idea to wash knives and cutting boards used to prepare meats with hot soapy water after use.

“You also mentioned that Coco is somewhat of a handful. When bringing a new baby into a home with pets, it's always a good idea to anticipate their needs-this is a big change for them as well! There are several good books that can offer more information and animal behavior specialists who will be happy to advise you on how to prepare for this change. I can give you phone numbers to get started.

“We'll also want to bring you back before the big event. At this visit we'll do another fecal examination and administer the cats' vaccinations. This way we can touch base with you on any last-minute questions as well. And we're here for you any time. Don't be surprised if we check in with you now and then to make sure you don't have further questions. This is a lot of information, and we know there's a lot happening in your life.”

Karyn Gavzer, CVPM

Veterinary consultant in Springboro, Ohio

Poor Brooke! She's probably feeling frightened and confused about what to do. She doesn't say whether the father of her baby is living with her; if he is, the good news is that now's a great time to get him to help with the litter box. As a new dad-to-be, he should be highly motivated to do so!

No matter what help she has at home, Brooke also needs to call her veterinarian right away and set up an appointment well before June to discuss how to manage Coco's biting behavior and to learn more information about how to protect herself, her baby, and her kitties from parasites. Good information will calm her fears, and she may be surprised to find out about feline parasite protection products and tests that her veterinarian can suggest to keep everyone healthy and safe.