DOI
https://doi.org/10.18849/ve.v4i4.263Abstract
PICO question
In cats infected with Tritrichomonas foetus, does treatment with oral ronidazole compared to an alternative antiprotozoal treatment or placebo result in successful resolution of clinical signs and eradication of disease?
Clinical bottom line
Ronidazole use appears to be efficacious in eradicating infection with Tritrichomonas foetus and resolving diarrhoea associated with infection. A dose range of 30–50 mg/kg 12–24 hourly has been suggested, with evidence suggesting that a dose of 30 mg/kg 24 hourly for 14 days may be effective. However, some cats may require higher doses and some may not respond to treatment, and relapse may occur during a protracted period following completion of the treatment course. Neurological side effects appear to be uncommon but may occur with doses of 30 mg/kg and above.
A total of six studies are reviewed: Three randomised, controlled studies, one cohort study and two case series (one retrospective). Findings indicate efficacy of ronidazole treatment in eradicating infection and resolving diarrhoea, however many studies involved small sample sizes and limited follow-up. Therefore, evidence to support the use of ronidazole in Tritrichomonas foetus infected cats remains relatively limited.
References
Grellet, A., Makhlouf, S.E., Desquilbet, L., Hovhannessian, F., Boogaerts, C., Dore, V., Anthony, M., Espana, B., Prouillac, C., Kirilov, P., Polack, B., & Perrot, S. (2017). ‘Efficacy of guar gum-based ronidazole capsules as a treatment for Tritrichomonas foetus infection in cats’, Journal of Feline Medicine and Surgery, 19 (2), pp. 177–184. DOI: https://doi.org/10.1177/1098612X15621353
Gookin, J.L., Copple, C.N., Papich, M.G., Poore, M.F., Stauffer, S.H., Birkenheuer, A.J., Twedt, D.C., & Levy, M.G. (2006). ‘Efficacy of ronidazole for treatment of feline Tritrichomonas foetus infection’, Journal of Veterinary Internal Medicine, 20 (3), pp. 536–543. DOI: https://doi.org/10.1111/j.1939-1676.2006.tb02893.x
Gookin, J.L., Stauffer, S.H., Dybas, D., & Cannon, D.H. (2010). ‘Documentation of in vivo and in vitro aerobic resistance of feline Tritrichomonas foetus isolates to ronidazole’, Journal of Veterinary Internal Medicine, 24 (4), pp. 1003–1007. DOI: https://doi.org/10.1111/j.1939-1676.2010.0534.x
Gookin, J.L., Hanrahan, K., & Levy, M.G. (2017). ‘The conundrum of feline Trichomonosis’, Journal of Feline Medicine and Surgery, 19 (3), pp. 261–274. DOI: https://doi.org/10.1177/1098612X17693499
Koster, L.S., Chow, C., & ChaoQun, Y. (2015). ‘Trichomonosis in cats with diarrhoea in Hong Kong, China, between 2009 and 2014’, Journal of Feline Medicine and Surgery Open Reports, 1 (2), pp. 1–4 ref.28. DOI: https://doi.org/10.1177/2055116915623561
LeVine, D.N., Papich, M.G., Gookin, J.L. (2011). ‘Ronidazole pharmacokinetics after intravenous and oral immediate-release capsule administration in healthy cats’, Journal of Feline Medicine and Surgery, 13, pp. 244–250. DOI: https://doi.org/10.1016/j.jfms.2010.12.001
LeVine, D.N., Gookin, J.L., Papich, M.G., & Davidson, G.S. (2014). ‘Twice-daily dosing of RDZ no longer recommended for treatment of intestinal Tritrichomonas foetus infection’, Journal of Feline Medicine and Surgery, 16 (2), pp. 198. DOI: https://doi.org/10.1177/1098612X13506430
Lim, S., Park, S.I., Ahn, K.S., Oh, D.S., & Shin, S.S. (2012). ‘Efficacy of ronidazole for treatment of cats experimentally infected with a Korean isolate of Tritrichomonas foetus’, Korean Journal of Parasitology, 50 (2), pp. 161–164. DOI: https://doi.org/10.3Trea347/kjp.2012.50.2.161
Reinert, J., Gerold, S., Scheurlen, U., Daniels, R., Wolm, M., & Iglauer, F. (2016). ‘Treatment of Tritrichomonas foetus in a cat colony with delayed release ronidazole tablets in the small intestine’, Praktische Tierarzt, Berliner und Münchener tierärztliche Wochenschrift 128(9–10), pp. 362–369.
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