Tritrichomonas foetus infection in purebred cats in Germany: Prevalence of clinical signs and the role of co-infection with other enteroparasites

Gut microbiota and Tritrichomonas foetus infection: A study of prevalence and risk factors based on pet cats

Tritrichomonas foetus (T. foetus) is a protozoal pathogen that infects cats and constitutes a significant cause of chronic colitis and diarrhea. Perturbations in the gut microbiota (GM) are affected by Trichomonas infection. Furthermore, dysregulation of the host GM enhances Trichomonas pathogenicity. However, it remains unclear whether the occurrence of diarrhea is associated with a dysregulation in GM following T. foetus infection in cats. Hence, the primary objective of this investigation was to explore the correlation between T. foetus infection and dysregulation in GM by analyzing fecal samples obtained from pet cats in Henan Province, central China. We randomly collected 898 fecal samples from pet cats living in 11 prefectural cities within Henan Province, and T. foetus was screened with polymerase chain reaction (PCR) amplification based on the 18 S rRNA gene. Subsequently, six T. foetus-positive and six T. foetus-negative samples underwent analysis through 16 S rRNA gene sequencing to evaluate the gut microbiota's composition. The overall prevalence of T. foetus infection among the collected samples was found to be 6.01% (54/898). Notably, a higher prevalence of infection was observed in young, undewormed, unimmunized, and diarrheic pet cats. T. foetus infection was found to significantly alter the composition of the pet cat fecal microbiota, leading to dysfunctions. Moreover, it resulted in a substantial increase in the abundance of Bacteroidetes, Proteobacteria, and Phascolarctobacterium spp., while decreasing the ratio of Firmicutes to Bacteroidetes (F/B) and the abundance of Actinobacteria, Clostridiaceae_Clostridium spp., Phascolarctobacterium spp., SMB53 spp., and Blautia spp. We constructed ROC curves to assess the diagnostic value of specific bacterial taxa in discriminating T. foetus infection. The analysis revealed that Proteobacteria and Clostridiaceae_Clostridium spp. were the most reliable single predictors for T. foetus infection. This finding suggests that alterations in the GM may be strongly associated with T. foetus infections.

Comparison Study of Four Extraction Methods Combined with PCR and LAMP for Feline Tritrichomonas foetus Detection in Fecal Samples

Feline trichomonosis occurs worldwide, with gastrointestinal symptoms such as chronic large-bowel diarrhea and abdominal pain. The inclusion of molecular methods in diagnostic and epidemiological studies has necessitated an effective method for extracting DNA from feces. We tested four extraction commercial kits: ZR Fecal DNA MiniPrep (50 preps) (Zymo Research, Irvine, CA, USA), QIAamp^® DNA Stool Mini Kit (Qiagen Inc., Valencia, CA, USA), UltraClean Fecal DNA Kit (50 preps) (MO BIO, San Diego, CA, USA), and Sherlock AX/100 isolations (A&A Biotechnology, Gdynia, Poland). We assessed the sensitivity of detection of Tritrichomonas foetus in spiked fecal samples for the four kits combined with two molecular assays: PCR and LAMP. The extraction efficacy was quantified using defined aliquots of fecal samples spiked with 5 μL of suspensions containing serial dilutions of trophozoites (0.1; 1; 10; 100; 1000; 10,000), with six replicates for each concentration. In our study, we proved that the ZR Fecal DNA MiniPrep (50 preps) kit combined with LAMP and PCR had the highest efficiency among all the compared methods for the detection of feline T. foetus from fecal samples.

Prevalence, co-infection and seasonality of fecal enteropathogens from diarrheic cats in the Republic of Korea (2016-2019): a retrospective study

Background

Diarrhea is one of the most common clinical symptoms in cats and can be caused by infectious pathogens and investigation of the prevalence, co-infection and seasonality of enteropathogens are not well-established in diarrheic cats.

Results

Fecal samples of 1620 diarrheic cats were collected and enteropathogens were detected using real-time PCR. We retrospectively investigated the clinical features, total/seasonal prevalence, and infection patterns of enteropathogens. The positive infection rate was 82.59%. Bacterial, viral, and protozoal infections accounted for 49.3, 37.57, and 13.13% of cases, respectively. Feline enteric coronavirus (FECV) was the most common pathogen (29.37%), followed by Clostridium (C.) perfringens, Campylobacter (C.) coli, feline parvovirus, and Tritrichomonas foetus. The seasonality of enteropathogens was observed with peaks as follows: bacterial infections peaked in October, viral infections peaked in November, and protozoal infections peaked in August. Viral and protozoal infections showed differences in prevalence according to patient age. In the infection patterns, the ratios of single infections, mixed infections, and co-infections were 35.72, 9.87, and 54.41%, respectively. FECV was predominant in single infections. The most common patterns of multiple infections were C. perfringens and C. coli in mixed infections and C. perfringens and FECV in co-infections.

Conclusions

Infection patterns differed according to the enteropathogen species, seasonality, and age distribution in cats. The results of this study might be helpful to understand in clinical characteristics of feline infectious diarrhea. In addition, continued monitoring of feline enteropathogens is required.

Tritrichomonas foetus in cats from Central Italy: Clinical signs and risk factors

Tritrichomonas foetus (Trichomonadida, Tritrichomonadidae) is a parasitic protozoan which causes a diarrheic disease in domestic cats worldwide. The epizootiological and pathogenic impact of this parasite in many geographic locations is still to be unraveled; thus, the present study has investigated the occurrence of T. foetus in cats from central Italy, along with the analysis of risk factors and clinical signs. One hundred and five cats referred to the University Veterinary Teaching Hospital of the University of Teramo were tested with copromicroscopic techniques for common intestinal and extra-intestinal parasites and a specific PCR for T. foetus. A statistical analysis evaluating associations between T. foetus positivity and possible risk factors was performed. One animal scored positive for Giardia (0.95%), 2 for Toxocara cati (1.90%), 1 for Eucoleus aerophilus (syn. Capillaria aerophila) (0.95%), 9 for Aelurostrongylus abstrusus (8.57%) and 1 for Dipylididum caninum (0.95%), while T. foetus was molecularly recorded in 18/105 (17.14%) of the study cats. In two cats, T. foetus was found in association respectively with Giardia and A. abstrusus. Animals with chronic gastrointestinal signs were more significantly infected by T. foetus (40.90% vs 10.84%; p < 0.01; 95% CI = 1.90-17.04; OR = 5.69) in comparison to cats with no gastrointestinal distresses. No other statistically significant associations were found. This study confirms that T. foetus is enzootic in cats in Italy and that it should be included in the differential diagnosis of feline chronic gastrointestinal diseases.

Prevalence of Tritrichomonas foetus infection in cats in Bangkok metropolitan area and in vitro drug sensitivity testing

Tritrichomonas foetus is a causative agent of feline trichomonosis, resulting in large-bowel diarrhea in cats. Feline trichomonosis has been reported in the USA, Europe and some Asian countries but there is limited information for Thailand. This study investigated the prevalence of T. foetus infection in cats in the Bangkok metropolitan area and evaluated the in vitro efficacy of metronidazole (MDZ) and ronidazole (RDZ) against T. foetus Thai isolates. In total, 215 fecal samples were collected from 121 owned cats and 94 stray cats. All fecal samples were cultivated in InPouch™ TF-feline medium. Afterward, polymerase chain reaction (PCR) assays targeting the 5.8S rRNA gene, the ITS regions and DNA sequencing were used for the confirmation of T. foetus. The overall prevalence of T. foetus infection was 4.18% (9/215) based on cultivation and PCR. The sequencing results showed 100% homology to T. foetus sequences from GenBank. The average minimal lethal concentrations (MLCs) of MDZ were 333.33 and 66.67 μg/ml at 24 and 48 h, respectively. The average MLCs of RDZ were 29.16 and 12.5 μg/ml at 24 and 48 h, respectively. The MLC of the MDZ results revealed that T. foetus Thai isolates had a tendency to be MDZ-resistant. To the best of the authors' knowledge, this study was the first using in vitro cultivation and molecular techniques to report and confirm the presence of T. foetus in cats living in the Bangkok metropolitan area. Further studies are needed to determine the genuine infection rate of T. foetus in a greater population sample and the infection status in cats with signs of diarrhea in Thailand.

Tritrichomonas Foetus: A Study of Prevalence in Animal Hosts in Poland

Tritrichomonas foetus is described as a pathogen of cattle and cats and also exhibits commensalism with pigs. In order to estimate the prevalence and determine the risk factors for parasite infection, specimens from animal hosts (cat, pigs, and cattle) from Poland were investigated. To our best knowledge, this is the first such study to examine samples from wild boars (Sus scrofa) for the presence of T. foetus. Data were collected from 117 cats, 172 pigs, 236 wild boars, and 180 cattle. The sensitivity of T. foetus identification was increased by using two molecular assays: PCR and loop-mediated isothermal amplification (LAMP). The prevalence of feline tritrichomonosis was 20.51%, and statistically significant differences were obtained between groups of animals regarding age, breed, number of cats, diarrhea, and place of living. Positive PCR and LAMP results for T. foetus were estimated for 16.28% of pigs, and the obtained data were significantly correlated with age. Conversely, no significant differences were observed concerning the farm size factor. In our survey, no cases of bovine tritrichomonosis were found, which is consistent with the data from the other countries of the European Union. Similarly, all wild boar samples were also T. foetus-negative according to LAMP and PCR.

Association of fecal sample collection technique and treatment history with Tritrichomonas foetus polymerase chain reaction test results in 1717 cats

BACKGROUND

Fecal polymerase chain reaction (PCR) testing for Tritrichomonas foetus is considered the most sensitive means for diagnosis of infection but results could be influenced by fecal collection technique and prior use of antimicrobial drugs.

OBJECTIVES

To establish any association between fecal collection technique or treatment history and results of fecal PCR testing for T. foetus.

ANIMALS

Fecal samples from 1717 cats submitted by veterinarians between January 2012 and December 2017.

METHODS

This study used a retrospective analysis. T. foetus PCR test results from 1808 fecal samples submitted for diagnostic testing were examined for their association with method of fecal collection and prior antimicrobial treatments. Data were collected from sample submission form.

RESULTS

Positive T. foetus PCR test results were obtained for 274 (16%) cats. Fecal samples collected via fecal loop had increased probability of positive PCR test results (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.31-3.17, P = .002) compared to samples collected by colonic flush. There was no association between PCR test results and treatment history, treatment type, or prior treatment with ronidazole. After an initial positive PCR test, 4/19 (21%; 95% CI 2.7%-39.4%) cats treated with ronidazole had a second positive test result.

CONCLUSIONS AND CLINICAL IMPORTANCE

Results of this study support that fecal samples collected by loop might be better for PCR diagnosis of T. foetus infection. Lack of association of ronidazole with PCR test results and a 21% all-potential-causes failure rate of ronidazole in cats with preconfirmed infection are important limitations to use of this drug.

Behavioral awareness in the feline consultation: Understanding physical and emotional health

Practical relevance: Awareness of the strong connection between observed behavior and physical and emotional health is essential for patient welfare. It is often a change in the individual's normal behavior that informs owners and veterinarians of the possibility of illness, pain and stress/distress. There is ample evidence in the feline literature that medical and behavioral health go hand in hand. In most feline cases, medical and behavioral conditions contribute concurrently to clinical signs. Clinical challenges: Our domestic cats do not express change in physiological and emotional states in a way that is easily recognized. Therefore, it can be difficult to diagnose medical and behavioral illnesses and ascertain contributions from each one to the final diagnosis. When various levels of stress are present, especially distress, this compromises behavioral and physical health, and influences treatment outcomes.

AIMS

This review is intended to help veterinarians recognize physical and behavioral changes associated with acute stress through to chronic distress, including stress-associated diseases. An emphasis on thorough history-taking will allow the clinician to ascertain which signs are behavioral and which are medical, with the understanding that they are not mutually exclusive. Equally important is the contribution of pain, chronic disease and poor environmental situations to behavioral changes and the expression of medical disorders. Evidence base: There is an increasing amount of evidence that stress and distress have profound effects on feline health, behavior and welfare. The authors have drawn on a substantial body of published veterinary research in producing this review.

What is known about Tritrichomonas foetus infection in cats?

Tritrichomonas foetus is a parasite that has been definitively identified as an agent of trichomonosis, a disease characterized by chronic diarrhea. T. foetus colonizes portions of the feline large intestine, and manifests as chronic and recurrent diarrhea with mucus and fresh blood, which is often unresponsive to common drugs. Diagnosis of a trichomonad infection is made by either the demonstration of the trophozoite on a direct fecal smear, fecal culture and subsequent microscopic examination of the parasite, or extraction of DNA in feces and amplification by the use of molecular tools. T. foetus is commonly misidentified as other flagellate protozoa such as Giardia duodenalis and Pentatrichomonas hominis. Without proper treatment, the diarrhea may resolve spontaneously in months to years, but cats can remain carriers of the parasite. This paper intends to serve as a source of information for investigators and veterinarians, reviewing the most important aspects of feline trichomonosis, such as trichomonad history, biology, clinical manifestations, pathogenesis, world distribution, risk factors, diagnosis, and treatment.

Fulminant Tritrichomonas foetus 'feline genotype' infection in a 3-month old kitten associated with viral co-infection

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Marked necrotising to lymphoplasmacytic Tritrichomonas foetus-induced colitis.

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Microabscesses in crypts of the colon with T. foetus.

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Coinfection of Tritrichomonas foetus, FPV and FCoV.

Tritrichomonas foetus is a flagellate protist which commonly causes a waxing and waning large bowel diarrhoea in young cats. We report severe T. foetus infection of the colon, cecum and ileum with concurrent feline enteric coronavirus (FCoV) and feline panleukopenia virus (FPV) in a 3-month-old Bengal kitten with an 8-day history of vomiting, diarrhoea, failure to thrive and coughing. Protozoa filling the lumen and crypts and occasional invading into lamina propria were identified within the affected colon and confirmed by PCR as T. foetus ‘feline genotype’. Assessment of faeces by PCR revealed concurrent infection with FCoV and FPV. It is possible that immunosuppression by FPV played a role in the unprecedented T. foetus infection intensity observed histologically. Studies during and after resolution of FPV infection, will be critical to determine if T. foetus co-infection affects long-term prognosis of FPV survivors.

Detection of natural occurrence of Tritrichomonas foetus in cats in Araçatuba, São Paulo, Brazil

ABSTRACT: The aim of this study was to investigate the occurrence of Tritrichomonas foetus in cats in the area surrounding the city of Araçatuba municipality, State of São Paulo, Brazil. Fecal samples from 129 cats were collected by rectal flush technique. It was compared two diagnosis methods, direct examination of feces and PCR. The presence of T. foetus DNA was verified using PCR by amplification of 347-bp fragment from the primers TFR3 and TFR4 and amplicons of positive cases were sequenced. Statistical analyses were performed investigating the associations between T. foetus infection with gender, age, breed, presence of diarrhea and/or history of diarrhea, previous treatment, lifestyle, origin, environment, and co-infection. T. foetus was observed in one sample (n=129) by direct microscopic examination of feces while PCR was positive in five samples (3.9%). Giardia species and Cryptosporidium species co-infection was also observed. Statistical analyses showed no significant associations between T. foetus infection and all listed factors, although most positive cats were asymptomatic and lived in multi-cat household. The isolates of T. foetus showed 100% identical sequences with other T. foetus isolates from cats around the world. So, the occurrence of T. foetus was confirmed in cats in Araçatuba city (Brazil). This parasite must be considered as a differential diagnosis in cats with diarrhea and also in asymptomatic carriers as source of infection in multi-cat environments.

Trichomonas

The most widely known trichomonad in veterinary medicine is Tritrichomonas foetus. It is the etiologic agent of bovine tritrichomonosis, a sexually transmitted disease in extensively managed herds throughout many geographic regions worldwide. The same trichomonad species is also regarded as the causative agent of chronic diarrhea in the domestic cat, although more recent studies observed molecular differences between bovine- and feline-derived T. foetus. Trichomonosis in cats has a worldwide distribution and is mainly present among cats from high-density housing environments. Other trichomonads are found as inhabitants of the gastrointestinal tract in birds, such as Trichomonas gallinae. Particularly, Columbiformes, Falconiformes, Strigiformes, and wild Passeriformes can be severely affected by avian trichomonads. Diagnosis of trichomonosis is often complicated by the fragility of the parasite. To ensure valid test results, it is essential to collect and handle specimens in the right way prior to analysis. Cultivation tests, the specific amplification of parasites, or a combination of both test methods is the most efficient and most commonly used way to diagnose trichomonosis in animals. Bovine tritrichomonosis is mainly controlled by the identification and withdrawal of infected animals from bovine herds. The control of feline and avian trichomonosis relies mainly on preventive measures.

The conundrum of feline Trichomonosis

Practical relevance: Trichomonosis of the large intestine of the cat was described as a cause of chronic diarrhea over 20 years ago. The trichomonad was identified as Tritrichomonas foetus, with a genotype that is distinct from venereal T foetus of cattle. Clinical challenges: Despite multiple means for diagnosis of the infection, including light microscopy, protozoal culture and PCR amplification using species-specific primers, tests with even greater sensitivity are needed. Feline trichomonosis is resistant to all commonly used antiprotozoal drugs. Ronidazole is currently the only drug demonstrated to be effective in eliminating the infection from cats; however, this drug has a narrow safety margin and clinical resistance is increasingly recognized. The more we learn about trichomonosis in cats, the more complicated and controversial the infection has become, ranging from what we should call the organism to whether we should even bother trying to treat it. Global importance: Feline trichomonosis is recognized to occur worldwide and is regarded as one of the most common infectious causes of colitis in the domestic cat. The infection is widespread in catteries and shelters; and, while remission of diarrhea may occur over time, persistence of the infection is common. Evidence base: This review provides a comprehensive examination of what is currently known about feline trichomonosis and pinpoints areas, based on the authors' opinion, where further research is needed.

Cross-sectional survey on Tritrichomonas foetus infection in Italian cats

The feline genotype of Tritrichomonas foetus is a widespread cause of large-bowel diarrhoea in cats. The aim of this study was to determine the prevalence of the T. foetus infection in cat populations across Italy. Fresh, individual faecal samples were collected from 267 cats, kept in different environments (i.e., private households, breeding structures, municipal catteries and colonies) in three different sites across Italy. The faecal samples were tested by PCR to detect T. foetus. Moreover, the same samples were subjected to a concentration-flotation technique and a commercial direct fluorescent-antibody (DFA) test to detect additional enteric parasites, including Giardia duodenalis. The overall prevalence of T. foetus infection was 5.2%. All the infected cats showed diarrhoea at the time of sampling: 9 out of 14 positive cats were co-infected with G. duodenalis, 1 with Toxocara cati and 3 with Dipylidium caninum. The risk factor analysis showed that not only the breed, but also co-infections with G. duodenalis and Dipylidium caninum were significantly associated with the presence of T. foetus. This study confirms the presence of T. foetus in cats living in Italy, suggesting that this protozoan parasite should always be included in the differential diagnosis of patients referred with large-bowel disease symptoms, especially if they were purebred animals, or affected by other enteric protozoa, such as G. duodenalis.

Coinfection with Tritrichomonas foetus and Giardia duodenalis in Two Cats with Chronic Diarrhea

A Tritrichomonas foetus and Giardia duodenalis mixed infection was diagnosed in two Maine Coon cats aged six months. One of them presented a history of chronic liquid diarrhea and of several unsuccessful treatments. In both cats, G. duodenalis and trichomonads were detected in fecal smears from freshly voided feces; the presence of T. foetus was confirmed by a real-time PCR assay. The cats completely recovered after treatment with ronidazole. In a refrigerated fecal sample collected from the cat with chronic diarrhea, drop-shaped trichomonad pseudocysts smaller than G. duodenalis cysts were detected. They appeared brownish or light-bluish when stained with Lugol's solution or with Giemsa stain, respectively, and their morphological features were similar to those expressed by bovine T. foetus pseudocysts in vitro. Existence of pseudocysts even in feline trichomonads is noteworthy as they could represent a form of protozoan resistance due to unfavorable conditions whose detection in refrigerated feces can be a useful clue for clinicians.

Efficacy of guar gum-based ronidazole capsules as a treatment for Tritrichomonas foetus infection in cats

Objectives The aims of the study were to determine the in vitro drug release of guar gum-coated capsules of ronidazole, and to evaluate the pharmacokinetics and efficacy of this formulation for the treatment of cats naturally infected with Tritrichomonas foetus. Methods The pharmacokinetics of ronidazole were evaluated in five healthy cats and five cats infected with T foetus. In a second step, the clinical efficacy of these capsules was evaluated by a controlled, randomised, double-blind clinical trial performed in 47 infected cats from French catteries. In this study, cats were randomly allocated to either the ronidazole treatment group (n = 25) or a placebo group (n = 22). Ronidazole (30 mg/kg) q24h for 14 days was administered to the treated cats. After 14 days of treatment, the presence of T foetus was tested by conventional PCR assay. Results In the pharmacokinetic study, a delayed peak plasma concentration was observed in healthy and infected cats, with no significant difference between these two groups (mean geometric mean of 9 h for time to maximum plasma concentration [T_max], 21.6 µg/ml for time to maximum plasma concentration [C_max] and 467.4 μg/h/ml for the area under the curve [AUC] in healthy cats; and 9.4 h for T_max, 17.1 µg/ml for C_max and 481 μg/h/ml for AUC in infected cats). In the clinical trial, T foetus was detected in 16% of cats from the treated group and 82% of cats from the placebo group at the end of the study ( P <0.001). No clinical signs of adverse drug reactions were observed. Conclusions and relevance Oral administration of guar gum-coated capsules of ronidazole at a dose of 30 mg/kg once daily for 14 days delays the peak plasma concentration and eradicates infection in most cases.

Trichomonosis in cats with diarrhoea in Hong Kong, China, between 2009 and 2014

Case series summary

Infection of the domestic cat by Tritrichomonas blagburni, previously referred to as T foetus, may lead to a disease called feline trichomonosis, which manifests clinically as large bowel diarrhoea. The disease has a wide geographical distribution, including numerous countries in Europe, North America and Australia/Oceania. Nevertheless, it has occasionally been reported in Asia, South Korea and Japan. A retrospective study was carried out to include all domestic cats with diarrhoea, presented to two veterinary clinics in Hong Kong, China, between 1 July 2009 and 30 June 2014. A total of 29 cats with diarrhoea were diagnosed with Tritrichomonas species infection by means of quantitative PCR and direct microscopy. Tritrichomonas species was more frequently found in young (median age 10 months), male (66%) and purebred cats (86%). Giardia species was found in 31% of Tritrichomonas species-positive cats. The recommended dose of ronidazole (30 mg/kg q24h for 14 days) resolved clinical signs in 83% of diagnosed cats.

Relevance and novel information

This case series describes Tritrichomonas species as a cause for feline chronic diarrhoea in cats in China. The high rate of failure (17%) in those cats receiving a standard regimen of ronidazole might be due to owner or patient compliance rather than protozoal resistance to the drug.

Tritrichomonas foetus infection in cat - first detection in Poland

Tritrichomonas foetus, a parasite of cattle reproductive system, has been recently discovered as a cause of disease in cats in many countries. T. foetus infects and colonizes cat's ileum, caecum, colon and can lead to enteritis. This paper presents the first clinical case of cat intestinal trichomonosis caused by T. foetus in Poland. The material for this study was a smear collected from a 6-month-old male British Shorthair cat. The presence of parasitic protozoan was determined via microscopic examination and confirmed by amplification of T. foetus rDNA using polymerase chain reaction (PCR) technique. In the first PCR reaction, a DNA of Trichomonadidae was identified and in the second PCR, T. foetus was detected. The T. foetus positive products from the second PCR reaction were sequenced. Interpretation of the sequencing results of obtained amplicons by comparing them with the GenBank database proved that the causative agent, in this case, was T. foetus.

Co-infection by Tritrichomonas foetus and Pentatrichomonas hominis in asymptomatic cats

Abstract: Tritrichomonas foetus, a parasite well known for its significance as a venereally transmitted pathogen in cattle, has been identified as a cause of chronic large bowel diarrhea in domestic cats in many countries of the world. In Brazil, several studies on the diagnosis of bovine trichomoniasis have been performed, but until now, no study was made regarding feline trichomoniasis. Thus, this is the first study to report the occurrence of T. foetus and Pentatrichomonas hominis in cats using morphological and molecular analysis. Feces from 77 cats were examined, four of which (5.2%) were positive for the presence of parabasalids. Morphological analysis of stained smears revealed piriform trophozoites showing the three anterior flagella, elongated nucleus and axostyle ending abruptly in fillet, characteristic of T. foetus. In scanning and transmission electron microscopy, identification characters similar to those previously reported for T. foetus were observed. The cultures containing trophozoites were submitted for molecular analysis, which resulted positive for T. foetus DNA using specific primers (TFR3 and TFR4), and all samples were positive and subjected to sequencing in which they showed 99.7-100% similarity with another isolate sequencing of T. foetus (JX960422). Although no trophozoite with consistent morphology of P. hominis has been visualized in the samples, differential diagnosis was performed using specific primers for P. hominis (TH3 and TH5) amplicon. In three of the four samples (3.89%) sequencing revealed 100% similarity when compared with another sequence of P. hominis deposited in Genbank (KC623939). Therefore, the present study revealed through the diagnostic techniques employed the simultaneous infection by T. foetus and P. hominis in the feces of cats. However, it was necessary to use more than one technique for the diagnosis of the co-infection. These results demonstrate the importance of a correct diagnosis to allow an appropriate treatment by the veterinarian.

Tritrichomonas foetus infection, a cause of chronic diarrhea in the domestic cat

Tritrichomonas foetus is a very intriguing trichomonad protozoan with respect to its varied choice of residence in the different host species. It is an obligate parasite of the reproductive and the gastrointestinal tract of bovine and feline host respectively, leading to trichomonosis. Bovine trichomonosis is a sexually transmitted disease whereas feline trichomonosis is a disease with a purported fecal-oral route of spread. Further, the trichomonad is a commensal in the nasal passages, stomach, cecum and colon of swine host. Advances have been exponential in understanding the trichomonad biology and specifically feline trichomonosis since late 1990s and early 2000s when T. foetus was soundly determined to be a causative agent of chronic diarrhea in the domestic cat. It is a challenging task, even for a skilled investigator not to mention the busy clinical veterinarian, to keep up with the vast volume of information. Here we comprehensively reviewed the trichomonad biology, clinical manifestations, pathogenesis, host immunity, world map of distribution, risk factors, diagnosis and treatment. Risk factors associated with T. foetus-positive status in the domestic cat include young age, purebred, history of diarrhea, co-infections with other enteral pathogens. In addition, molecular similarity of bovine and feline isolates of T. foetus in DNA sequence was concisely discussed. The data presented serve as an information source for veterinarians, and investigators who are interested in biology of T. foetus and feline trichomonosis.

A retrospective molecular study of select intestinal protozoa in healthy pet cats from Italy

The feline gut can harbour a number of protozoan parasites. Recent genetic studies have highlighted new epidemiological findings about species of Cryptosporidium, assemblages of Giardia duodenalis and Toxoplasma gondii. Furthermore, epidemiological studies suggest the occurrence of Tritrichomonas foetus in cats is on the increase worldwide. The prevalence of selected intestinal protozoa was determined by PCR using DNA previously extracted from the faeces of 146 privately owned healthy cats from Italy. Molecular genotyping on T gondii, G duodenalis and Cryptosporidium DNA was achieved. PCR assays were positive in 32 (22.9%) samples. Three animals (2.0%) were positive for T foetus and Cryptosporidium DNA, 15 specimens (10.3%) were positive for T gondii and 11 (7.5%) for G duodenalis. Co-infections were never observed. Results of the typing analysis allowed the identification of Cryptosporidium felis in all cases. The specimens positive for T gondii hinted at clonal genotype I (n = 7), genotype II (n = 1) and genotype III (n = 7). The G duodenalis isolates were referable to assemblages F (n = 9) and C (n = 2). In conclusion, the results obtained in this study add to the literature regarding the epidemiology of these parasites by confirming their presence in the faeces of healthy pet cats.

Enteropathogen co-infection in UK cats with diarrhoea

Background

Individual enteropathogen infections in healthy and clinically ill cats are well described, but prevalence and patterns of enteropathogen co-infection have only been reported on a limited basis. We studied enteropathogen co-infection in diarrhoeic UK cats using results of a real time PCR assay for 8 enteropathogenic species; feline coronavirus (Co), feline panleukopenia virus (Pa), Clostridium perfringens (Cl), Salmonella enterica (Sa), Giardia spp. (Gi), Tritrichomonas foetus (Tr), Cryptosporidium spp. (Cr), and Toxoplasma gondii (To). Age, gender, breed and history were recorded. PCR panels from 1088 diarrhoeic cats were available for analysis.

Results

Overall enteropathogen prevalence was 56.9% (Co), 22.1% (Pa), 56.6% (Cl), 0.8% (Sa), 20.6% (Gi), 18.8% (Tr), 24.4% (Cr) and 1.0% (To). Prevalence of Co, Gi and Tr was higher in pedigree cats compared to non-pedigree cats (DSH) and prevalence decreased with increasing age for Co, Pa, Gi, Cr and Tr. Co-infection was common: ≥2 enteropathogens were detected in 62.5% of cats, and 13.3% of cats had ≥4 enteropathogens. Mean ( x¯) enteropathogen co-infection 2.01 (±1.3 SD), was significantly higher in pedigree cats ( x¯ =2.51) compared to DSH ( x¯ =1.68) and decreased with age ( x¯ =2.64 <6 months, x¯ =1.68 for >1 yr). More cats were negative for all 8 enteropathogens tested (12.7%) than expected. When exact combinations of co-infection were examined, Tr tended to be found in combinations with Co, Cl, and Gi.

Conclusions

Multiple infections should be considered the most likely result of faecal testing in cats, and case management needs to take this into account. In contrast, the relatively high percentage of cats negative for all 8 enteropathogens tested could indicate an innate resistance to infection. Alternatively it could indicate a lack of exposure to these 8 enteropathogens or the presence of other enteropathogens not assessed by this assay.

Intestinal Tritrichomonas foetus infection in cats: a retrospective study of 104 cases

The clinical presentation and response to treatment of cats infected with Tritrichomonas foetus have not been sufficiently described in a large number of pet cats. The aim of this study was to collect and analyze clinical data from pet cats diagnosed with intestinal T foetus infection. Clinical information was collected for 104 cats that tested polymerase chain reaction-positive for T foetus. The most common clinical sign was diarrhea (98%) with a median duration of 135 days (range 1–2880 days). Forty-nine of 83 (59%) cats had diarrhea since adoption. Other clinical signs included anorexia (22%), depression (24%), weight loss or failure to gain weight (20%), vomiting (19%), abdominal pain (9%) and increased appetite (3%). A total of 45 cats had completed treatment with ronidazole, 29 of which (64%) showed a good clinical response to treatment. Sixteen (36%) cats had either partial or no improvement, or a relapse shortly after discontinuation of treatment.

Tritrichomoniasis in Cats

Overview:

Tritrichomonas foetus is a protozoan organism that is specific to cats and can cause large bowel diarrhoea. It is distinct from other Tritrichomonas species and not considered to be zoonotic. Infection is most common in young cats from multicat households, particularly pedigree breeding catteries.

Disease signs:

Affected cats show frequent fetid diarrhoea, often with mucus, fresh blood and straining, but generally remain bright and do not lose weight.

Diagnosis:

Diagnosis of infection is usually based on direct microscopic examination of freshly voided faeces. Polymerase chain reaction (PCR) testing is more sensitive but may detect infections unrelated to diarrhoea and, therefore, requires care in interpretation.

Treatment:

The treatment of choice is ronidazole, which should be used with care as it is an unlicensed drug for cats with a narrow safety margin. Clinical signs are generally self-limiting in untreated cases, but may take months to resolve.

Prevalence of Tritrichomonas foetus infections in French catteries

Recently, Tritrichomonas foetus, the known etiologic agent of bovine trichomonosis was identified in domestic cats in many countries around the world. In felids, this parasite would be a significant cause of large-bowel diarrhoea. Therefore the aim of the present study was to determine for the first time the prevalence of T. foetus infection in French catteries. In this epidemiological survey, rectal swabs from 140 cats participating in three international shows were tested for the presence of motile parasites by microscopy after culturing. The prevalence of T. foetus infection was 14.3% among cats (20/140) and 15.9% among catteries (18/117). These values were similar to those previously obtained in other European countries. Except for the age, no significant associations were found between the presence of T. foetus and various risk factors of infection such as the size of the cattery, the type of food, or the vicinity of a dog. Internal transcribed region of the ribosomal DNA unit was sequenced from the 20 T. foetus isolates identified in this study. They exhibited 100% identity and are homologous with other sequences of strains isolated from domestic cats in other countries.

Isolation of Tritrichomonas foetus from cats sampled at a cat clinic, cat shows and a humane society in southern Ontario

Tritrichomonas foetus is a protozoan parasite that has been associated with chronic diarrhea in cats. This study aimed to determine (i) the prevalence of T foetus shedding in cats from three different populations in southern Ontario, and (ii) associations between the presence of T foetus and potential cat management, health and demographic risk factors. A cross-sectional study was conducted involving 140 cats from a cat clinic in Guelph, 46 cats from a humane society in Guelph and 55 cats from two cat shows. Risk factor information was assessed through a questionnaire. The InPouch TF (feline) culture method was used to determine the presence of T foetus in all samples. Polymerase chain reaction was conducted on all samples positive by the InPouch TF, as well as 132 negative samples. The assays were interpreted in series and the prevalence of T foetus shedding and 95% confidence intervals (CI) were estimated at 0.7% (95% CI: 0.0–3.9%; n = 140) from the cat clinic, 0% (95% CI: 0.0–7.7%; n = 46) from the humane society and 23.6% (95% CI: 13.2–37.0%; n = 55) from the cat shows. ‘Attendance at cat shows’ was the only variable significant in both the univariable and multivariable analyses ( P <0.05). No significant association was found between the presence of T foetus and diarrhea at the time of sampling or having a history of diarrhea in the past 6 months. The prevalence of T foetus was highly variable among populations of cats in southern Ontario, with shedding being most common in show cats.

Efficacy of ronidazole for treatment of cats experimentally infected with a Korean isolate of Tritrichomonas foetus

To evaluate the efficacy of ronidazole for treatment of Tritrichomonas foetus infection, 6 Tritrichomonas-free kittens were experimentally infected with a Korean isolate of T. foetus. The experimental infection was confirmed by direct microscopy, culture, and single-tube nested PCR, and all cats demonstrated trophozoites of T. foetus by day 20 post-infection in the feces. From day 30 after the experimentally induced infection, 3 cats were treated with ronidazole (50 mg/kg twice a day for 14 days) and 3 other cats received placebo. Feces from each cat were tested for the presence of T. foetus by direct smear and culture of rectal swab samples using modified Diamond's medium once a week for 4 weeks. To confirm the culture results, the presence of T. foetus rRNA gene was determined by single-tube nested PCR assay. All 3 cats in the treatment group receiving ronidazole showed negative results for T. foetus infection during 2 weeks of treatment and 4 weeks follow-up by all detection methods used in this study. In contrast, rectal swab samples from cats in the control group were positive for T. foetus continuously throughout the study. The present study indicates that ronidazole is also effective to treat cats infected experimentally with a Korean isolate of T. foetus at a dose of 50 mg/kg twice a day for 14 days.

Detection of Tritrichomonas foetus and Pentatrichomonas hominis in intestinal tissue specimens of cats by chromogenic in situ hybridization

In this retrospective study 102 cats were analyzed for the presence of trichomonads in intestinal tissue sections using chromogenic in situ hybridization (CISH). Two intestinal trichomonad species are described in cats: Pentatrichomonas hominis and Tritrichomonas foetus. While P. hominis is considered a mere commensal, T. foetus has been found to be the causative agent of feline large-bowel diarrhea. For the detection of both agents within intestinal tissue CISH assays using three different probes were performed. In the first CISH run a probe specific for all relevant members of the order Trichomonadida (OT probe) was used. In a second CISH run all positive samples were further examined on three consecutive tissue sections using the OT probe, a probe specific for the family of Tritrichomonadidae (Tritri probe) and a newly designed probe specifically detecting P. hominis (Penta hom probe). In total, four of the 102 cats were found to be positive with the OT probe. Thereof, one cat gave a positive reaction with the P. hominis probe and three cats were positive with the T. foetus probe. All Trichomonas-positive cats were pure-bred and between 8 and 32 weeks of age. In one cat positive for T. foetus large amounts of parasites were found in the gut lumen and invading the intestinal mucosa. The species of the detected trichomonads were confirmed by polymerase chain reaction and nucleotide sequencing of a part of the 18S ribosomal RNA gene. In this study, the usefulness of CISH to detect intestinal trichomonads within feline tissue samples was shown. Additionally, the specific detection of P. hominis using CISH was established. Generally, it was shown that CISH is well suited for detection and differentiation of trichomonosis in retrospective studies using tissue samples.