Quick Question About Poops, Etc

[Guest sorenkkg]

I keep Kaopectate (plain flavor) in the house, give about 20ml (that one tablespoon and a half just about) 2x a day, seems to help firm things up... canned pumpkin (about 1-2T, and I freeze little balls of the rest).

 

My guys pick up worms at least 1x every 2 yrs or so. Last year, they annual fecal picked it up before I saw any symptoms. We gave panacur but I never saw anything, thankfully.

 

Aleeya came to us with TAPEworm (ick) and she got 1 big needle for that, all gone. Our vet never makes comments like they're surprised to see stuff... how weird? I agree that maybe grey-savvy vets (or some that have them in their practices, even a few) just know they are dealing with a whole different thing.

 

When we got them last year and didn't know it, I did email the organizers of the one and only dog park we go to-- for greyhound only hour, but other dogs use it other times. So we do still go, and thus I'll continue to be vigilant...

 

re: food. Everyone's got their own thing that works for them, their dogs, their feeding philosophy. Up to now, we've been doing Eagle Pack Holistic (name changed to just Holistic) in a mix of Duck and 5 fish blend, kibble. I found that it firmed up Haka's poop a LOT, and both dogs like it.

I also found that they go back to normal much faster if I start them on this kibble again after an "episode" than if I stay on rice and boiled meat for longer. The probiotics in the food help my guys quite a bit.

 

Anyway, ymmv, just remember to go slow when switching foods, cuz that can cause issues as well.

 

Glad you have a solution and hope Sage puts on some weight soon!

[Guest LindsaySF]

I have tested several thousand dog and cat fecal samples in my research, and I can tell you, hookworms and roundworms are NOT rare in adult animals. Where are the vets getting this stuff?! Geez.

 

Hookworms and roundworms don't usually cause symptoms in adult animals, most healthy adults can handle a pretty heavy worm burden before showing symptoms or side effects. Puppies are more seriously affected by large infestations because hookworms can cause anemia (they suck blood) and roundworms can actually obstruct their tiny intestines and/or cause absorption issues.

 

If you actually do random fecal sample tests of dogs, many dogs ("most" dogs in some high-risk areas) have worms. They are just asymptomatic carriers. Parasites thrive on asymptomatic carriers, that's how they continue their life cycle and are able to spread undetected. Harming your host does you no good in the long run.

Some areas (someone mentioned Seattle) don't often see certain species of worms, that's true. But Virginia? You guys have all the good bugs. Most dogs are probably only lightly infected, so they don't show symptoms. The dogs that do show symptoms of worms are either just unlucky, stressed for another reason, have another illness at the same time, etc.

 

 

Sounds very much like the way Spencer was shortly after arriving in 2005. Turned out to be hookworm; however, it took nine months to find that out because the first two fecals were negative. Finally, in deperation, we went to another vet; his fecal found that he was "loaded" with hookworm.

If Spencer really was "loaded", I'm guessing the first vet just didn't know what they were doing (sorry). Unlike whipworms, hookworms and roundworms don't really shed eggs in cycles. (Whipworms only shed a few thousand eggs at a time, and in cycles, so they often get missed. Hookworms shed around 20,000 eggs per day I think. Roundworms shed something ridiculous like 200,000 eggs per day). If he had symptoms for 9 months the first vet should have caught it. Unless the first two fecal samples were within the first month or so?

 

It's possible that their fecal flotation solution was expired or the wrong concentration, they didn't let it float long enough for the eggs to stick to the cover slip, etc. Do you know how they were testing the sample? Direct smear, flotation with salt solution, centrifuge, etc?

 

In my experience with doing samples in my area (I'm doing my master's thesis on intestinal helminths), most vets know squat about parasites. (You think vets know nothing about nutrition? Quiz them on parasites sometime. ) They get false negatives all the time. There have been some samples where I have literally viewed 1 or 2 eggs on the slide, so in light infections like that sure it is easy to miss. But I have seen some samples where the slide is so covered in eggs that they are literally on top of each other with no empty space, yet the vet "missed" it. I did multiple samples too, and got the same result every time.

 

One vet missed an extremely heavy case of coccidia in some young kittens brought in by a local rescue group. By the time I called them with my results most of the kittens were dead. (I would get the samples about a week after they did). They started treatment immediately and were able to save 2 of the kittens. The rescue group stopped using that vet. That vet's fecal sample results were wrong so often that they started shipping their samples out to some laboratory to test for worms rather than get someone competent behind the microscope. Testing fecal samples is not rocket science.

 

Speaking of which, DevilDog did the vet say why it will take until tomorrow to get the full results of the fecal sample? Are they sending it off somewhere? Fecal flotation takes 10 minutes to float and then a few minutes to scan the slide. They also have a SNAP test for Giardia, that only takes a few minutes too. Are they testing for bacteria or something else as well?

 

 

 

The Panacur will take care of the worms. I would give Interceptor monthly to prevent reinfection (roundworm and whipworm eggs are viable in the soil for several years). Both hookworms and whipworms suck blood and can cause some nasty intestinal inflammation. Once the worms are gone she will feel a lot better.

 

 

 

 

 

~Lindsay~

 

 

 

Edited May 7, 2010 by LindsaySF

[Guest sorenkkg]

That was great information Lindsay, thank you!

 

as an aside, my vet sends their samples out, so we always get the results in a day or 2 I think at the most. We usually start treatment before getting results.

 

One time, the results were negative, but the vet listened to me b/c I knew something was up-- intermittent "issues" and we went off my imperical (sp?) evidence instead of what the negative tests said... and I was right, and after treatment, the dogs went back to normal.

 

Anyhoo... back to the OP. Hope all goes well!

[greyhead]

 

Sounds very much like the way Spencer was shortly after arriving in 2005. Turned out to be hookworm; however, it took nine months to find that out because the first two fecals were negative. Finally, in deperation, we went to another vet; his fecal found that he was "loaded" with hookworm.

If Spencer really was "loaded", I'm guessing the first vet just didn't know what they were doing (sorry). Unlike whipworms, hookworms and roundworms don't really shed eggs in cycles. (Whipworms only shed a few thousand eggs at a time, and in cycles, so they often get missed. Hookworms shed around 20,000 eggs per day I think. Roundworms shed something ridiculous like 200,000 eggs per day). If he had symptoms for 9 months the first vet should have caught it. Unless the first two fecal samples were within the first month or so?

 

It's possible that their fecal flotation solution was expired or the wrong concentration, they didn't let it float long enough for the eggs to stick to the cover slip, etc. Do you know how they were testing the sample? Direct smear, flotation with salt solution, centrifuge, etc?

That *was* great info, Lindsay. Seriously, it should probably be pinned on GT somewhere!

 

I was the one that mentioned Seattle. Hooks are here now but mostly weren't in 2005 when Spencer arrived. Within a month he started showing "aggression," if you can call it that, when he felt especially vulnerable and was diagnosed hypothyroid. That had to be a stressor for him, clearly, on top of all the other stressors involved in the haul from Kansas and adjusting to a home. Next he developed stomach rumbling, inappetance in the morning and, most telling, he'd whip his head around toward his intestines or even jump three feet sideways. I told the vets he acted like he was being bitten. (I was a new owner and had no idea that it might be worms and that some worms have teeth.) Their system was flotation, is all I know. After the first negative fecal, I kept calling with concerns. One day a new tech decided in 30 seconds over the phone that "it's the treats," went and told the vet, and came back and said the vet agreed with her. Went to a second vet, in a practice that had been treating several greyhounds at least. Their fecal -- I don't know their method -- also came back negative, and the vet said the problem was "probably emotional, it usually is." I knew that was wrong, but I wasn't getting any support from anyone, and I did not know what to do next. "Discouraged" is an understatement. Two months later I picked myself up and took Spencer to a third vet, who did a centrifuge fecal just as SOP for a new patient. I heard the tech call him from the exam room, "Would you come look at this?" He's the one who said Spencer was loaded with hookworm. This was August and the first fecal had been in January. It was at this point that I learned that the coughing up and swallowing that he had been doing was from worms that had migrated to his lungs.

 

Basically, I think that apart from the methological problem, the first two vets just didn't take take the possibility of worms seriously. And they had too much confidence in their methods. And they didn't tell me what a negative fecal means and doesn't mean, nor do I think they gave it much thought themselves. Our current vet, which is now the fourth (because we moved) just automatically sends the samples to the lab for processing because the centrifuge equipment costs more than they can afford and they don't trust the other methods.

 

It really bothers me to think how many people are told that the fecal results are negative and are left thinking that that's all they need to know. Which is why I think what you wrote should be pinned on GT.

[Guest Stripeyfan]

 

Sounds very much like the way Spencer was shortly after arriving in 2005. Turned out to be hookworm; however, it took nine months to find that out because the first two fecals were negative. Finally, in deperation, we went to another vet; his fecal found that he was "loaded" with hookworm.

If Spencer really was "loaded", I'm guessing the first vet just didn't know what they were doing (sorry). Unlike whipworms, hookworms and roundworms don't really shed eggs in cycles. (Whipworms only shed a few thousand eggs at a time, and in cycles, so they often get missed. Hookworms shed around 20,000 eggs per day I think. Roundworms shed something ridiculous like 200,000 eggs per day). If he had symptoms for 9 months the first vet should have caught it. Unless the first two fecal samples were within the first month or so?

 

It's possible that their fecal flotation solution was expired or the wrong concentration, they didn't let it float long enough for the eggs to stick to the cover slip, etc. Do you know how they were testing the sample? Direct smear, flotation with salt solution, centrifuge, etc?

That *was* great info, Lindsay. Seriously, it should probably be pinned on GT somewhere!

 

I was the one that mentioned Seattle. Hooks are here now but mostly weren't in 2005 when Spencer arrived. Within a month he started showing "aggression," if you can call it that, when he felt especially vulnerable and was diagnosed hypothyroid. That had to be a stressor for him, clearly, on top of all the other stressors involved in the haul from Kansas and adjusting to a home. Next he developed stomach rumbling, inappetance in the morning and, most telling, he'd whip his head around toward his intestines or even jump three feet sideways. I told the vets he acted like he was being bitten. (I was a new owner and had no idea that it might be worms and that some worms have teeth.) Their system was flotation, is all I know. After the first negative fecal, I kept calling with concerns. One day a new tech decided in 30 seconds over the phone that "it's the treats," went and told the vet, and came back and said the vet agreed with her. Went to a second vet, in a practice that had been treating several greyhounds at least. Their fecal -- I don't know their method -- also came back negative, and the vet said the problem was "probably emotional, it usually is." I knew that was wrong, but I wasn't getting any support from anyone, and I did not know what to do next. "Discouraged" is an understatement. Two months later I picked myself up and took Spencer to a third vet, who did a centrifuge fecal just as SOP for a new patient. I heard the tech call him from the exam room, "Would you come look at this?" He's the one who said Spencer was loaded with hookworm. This was August and the first fecal had been in January. It was at this point that I learned that the coughing up and swallowing that he had been doing was from worms that had migrated to his lungs.

 

Basically, I think that apart from the methological problem, the first two vets just didn't take take the possibility of worms seriously. And they had too much confidence in their methods. And they didn't tell me what a negative fecal means and doesn't mean, nor do I think they gave it much thought themselves. Our current vet, which is now the fourth (because we moved) just automatically sends the samples to the lab for processing because the centrifuge equipment costs more than they can afford and they don't trust the other methods.

 

It really bothers me to think how many people are told that the fecal results are negative and are left thinking that that's all they need to know. Which is why I think what you wrote should be pinned on GT.

 

I second your info being pinned somewhere, Lindsay SF!! It took our old vet a month to even think of testing for worms - even though they'd detected lung noise and raspy breathing on our first 2 visits after Kelly's D started (which we now know was roundworm larvae in his lungs) - and then they were adamant that it was food allergies causing his intestinal problems, not damage from the worms, which has made everything (malabsorption etc) so much worse now. And WE had to research how often we should worm him in future as they seemed to think one dose would be enough. Our vet now is much more savvy, thank goodness.

 

DevilDog - how is Sage doing today? Hope she's feeling a lot better.

[Batmom]

Great post, Lindsay!

 

Hope Sage is starting to feel better.

[DevilDog]

I agree, great information!

 

Sage never really acted sick to begin with, beside the diarrhea and occasional vomit , I really wouldn't have known. She didn't poop this morning so I can't yet tell if the full day of meds yesterday did any good. I will keep you all updated.

 

It's funny, but my vet is very grey-savvy. So I have no idea what the deal is. And yes, they were sending the sample out.

[rebeccamcl]

Just found this thread, my friend. I am so glad to hear Miss Sage is doing better. A Neighbor's dog also had lots of worms recently and I have been keeping an eye on Davis to be sure he's OK.

I really am hoping & praying that Miss Sage continues to do better and that soon she will be in top form and keeping Roscoe in line.

[greyhead]

I second your info being pinned somewhere, Lindsay SF!!

Please go to the Technical Questions forum and second the thread I started to ask about doing just that!

[Guest Fini]

Hook worms are evil.

 

Mojo came from the track with them. Our vet felt confident that treating them for three days in a row with Panacur would do the trick. Well what we eventually found is that we needed to treat for three days, then wait ten days and then treat three more days, then wait ten days and do it one last time for three days. After this he finally tested free of Hookworms. Make sure once you have rid your grey of these nasty beasties that you give them Heartguard Plus once a month as this has enough anti-worming capacity in most cases to keep them gone.

[Guest Stripeyfan]

I second your info being pinned somewhere, Lindsay SF!!

Please go to the Technical Questions forum and second the thread I started to ask about doing just that!

 

Done!

[DevilDog]

Sooo, Got Sage to poop for the first time since yesterday at noon. It was better.. but not enough. It was still total mucous-y sludge, but the color was no longer black. It was a much better shade of medium brown. Is it too soon to see more improvement?

[Guest LindsaySF]

Sooo, Got Sage to poop for the first time since yesterday at noon. It was better.. but not enough. It was still total mucous-y sludge, but the color was no longer black. It was a much better shade of medium brown. Is it too soon to see more improvement?

Glad the color is more normal. It's good that it's no longer black (that was from the blood the worms were sucking). She will still have soft poop or diarrhea for a little while until the intestinal inflammation goes away. It could be a day or two, could be a week or two. Depends on the dog and on how heavy the infection was. In some cases chronic worm infections can lead to IBD and other issues, so just watch for that.

 

Teagan had a bout of hooks and whips and his stool didn't firm up for about a month after treatment. His intestines were just really irritated. We also ended up changing foods to something that better suited him, so that played a part as well.

 

 

 

~Lindsay~

[DevilDog]

Thank you Lindsay.

 

So.. if she still has soft poo or diarrhea for a while, how will I know if the infestation is gone and she's recovering, or if she needs more treatment?

 

She's still on rice and chicken.. when can I change her kibble? Or was her old kibble ok...? Ack!!

[Guest LindsaySF]

Our vet felt confident that treating them for three days in a row with Panacur would do the trick. Well what we eventually found is that we needed to treat for three days, then wait ten days and then treat three more days, then wait ten days and do it one last time for three days. After this he finally tested free of Hookworms. Make sure once you have rid your grey of these nasty beasties that you give them Heartguard Plus once a month as this has enough anti-worming capacity in most cases to keep them gone.

Yeah the little suckers can become a chronic problem. Hookworm larvae can "hide" in the tissues, and deworming meds that work on the intestines won't kill them. That's how mother dogs pass them on to their pups, in roundworms the larvae ends up in the breastmilk and in hookworms the larvae gets to the puppies in-utero. The larvae eventually migrate out of the tissues and into the intestines, so cycles of deworming a few weeks apart will eventually do the trick. Heartguard and Interceptor do work on the larval form though, so using that along with your intestinal dewormer is your best bet.

My dogs are on Interceptor year-round, but I still deworm a few times a year. While Interceptor will work on intestinal worms, it's not always 100% effective, especially for hooks. Most package labels say "remove roundworms, whipworms, and control hookworms". Hmmm... Also, the hookworms it works on are Ancylostoma caninum, it doesn't really work on Uncinaria stenocephala.

Speaking of Heartguard and Interceptor, I have heard some vets and some owners say that Interceptor is more effective. (Interceptor gets whipworms too, but what I mean is that Interceptor is more effective against rounds and hooks than Heartguard). I know Teagan still got hooks when he was on Heartguard. I just did some searching and I found a study that compared some different heartworm preventatives and their efficacy against roundworm and hookworm. In regards to decreasing fecal egg counts, Heartguard did the worst, Interceptor was in the middle, and Filaribits (the old school daily heartworm preventative) did the best. Interesting!

 

All this worm talk, you guys are making me miss being at school.

 

 

 

 

 

~Lindsay~

Edited May 7, 2010 by LindsaySF

[Guest LindsaySF]

Thank you Lindsay.

 

So.. if she still has soft poo or diarrhea for a while, how will I know if the infestation is gone and she's recovering, or if she needs more treatment?

 

She's still on rice and chicken.. when can I change her kibble? Or was her old kibble ok...? Ack!!

The only way to know if she needs more treatment is to see if there are eggs shedding into the feces. You'll need to test another fecal sample. She can be false negative though while larvae is moving into the intestine and growing into adult worms, they need a few weeks to grow before they can start producing eggs. Like someone above said, you should deworm her 1-2 more times a few weeks apart to make sure you get them all, especially the hooks.

 

If the stool already looks better and her vomiting and such is gone you are on the right track. I would do a few days of the bland diet and then go back to kibble. If she has explosive D from it, you'll know it was too soon.

 

For what it's worth, I never had Teagan on a bland diet when he had hooks and whips. I tested a fecal sample (I have my own equipment and microscope ) because he had mucusy diarrhea with a lot of blood in it (on a WAG walk no less ). Other than that he was acting fine. I dewormed him and he was eating normally (well normal for him ) and his stool was semi-solid, so I kept him on kibble. I do think he had some lingering irritation though, he does have a sensitive tummy, so we eventually changed foods to something with less grains/carbs. His stool went from semi-solid to pretty firm with the food change. If he had kept having blow-out D after that one time on the walk, I would have done a bland diet for a few days.

 

 

 

~Lindsay~

[DevilDog]

Thank you Lindsay.

 

So.. if she still has soft poo or diarrhea for a while, how will I know if the infestation is gone and she's recovering, or if she needs more treatment?

 

She's still on rice and chicken.. when can I change her kibble? Or was her old kibble ok...? Ack!!

The only way to know if she needs more treatment is to see if there are eggs shedding into the feces. You'll need to test another fecal sample. She can be false negative though while larvae is moving into the intestine and growing into adult worms, they need a few weeks to grow before they can start producing eggs. Like someone above said, you should deworm her 1-2 more times a few weeks apart to make sure you get them all, especially the hooks.

 

If the stool already looks better and her vomiting and such is gone you are on the right track. I would do a few days of the bland diet and then go back to kibble. If she has explosive D from it, you'll know it was too soon.

 

For what it's worth, I never had Teagan on a bland diet when he had hooks and whips. I tested a fecal sample (I have my own equipment and microscope ) because he had mucusy diarrhea with a lot of blood in it (on a WAG walk no less ). Other than that he was acting fine. I dewormed him and he was eating normally (well normal for him ) and his stool was semi-solid, so I kept him on kibble. I do think he had some lingering irritation though, he does have a sensitive tummy, so we eventually changed foods to something with less grains/carbs. His stool went from semi-solid to pretty firm with the food change. If he had kept having blow-out D after that one time on the walk, I would have done a bland diet for a few days.

 

 

 

~Lindsay~

 

Oh good! Thank you soooooooooooooooooooo much!

[Guest LindsaySF]

Their system was flotation, is all I know. After the first negative fecal, I kept calling with concerns. One day a new tech decided in 30 seconds over the phone that "it's the treats," went and told the vet, and came back and said the vet agreed with her. Went to a second vet, in a practice that had been treating several greyhounds at least. Their fecal -- I don't know their method -- also came back negative, and the vet said the problem was "probably emotional, it usually is." I knew that was wrong, but I wasn't getting any support from anyone, and I did not know what to do next. "Discouraged" is an understatement. Two months later I picked myself up and took Spencer to a third vet, who did a centrifuge fecal just as SOP for a new patient. I heard the tech call him from the exam room, "Would you come look at this?" He's the one who said Spencer was loaded with hookworm. This was August and the first fecal had been in January.

I'm really glad you got him to another vet. Shame on the first two vets. I will say that Greyhounds seem to have sensitive stomachs, food allergies, IBD, etc, at higher rates than some other breeds. Some dogs will have chronic diarrhea just from stress, and vets tend to view Greyhounds as pretty fragile. (It's hard not to, every Grey we had into our clinic would shake like a leaf the entire time ). But for your vets to just assume the problem was emotional or food-based, just because of a negative fecal, for shame. They should know that false negatives happen all the time! It is always advisable to deworm anyway. Ask any parasitologist and they'll tell you that the risk of having a chronic infection, or an asymptomatic carrier spreading millions of eggs into the environment, far outweighs the potential risk of deworming them.

 

Centrifugation with a flotation solution is one of the best methods. The centrifuge spins down the debris from the sample, and the flotation solution (usually salt or sugar-based), being at a higher density than the eggs, allows them to float. At the vet clinic where I used to work though we did a modified centrifugation method and we got a ton of negative results. Maybe it was his filter gauze, maybe it was the flotation solution, I don't know. Something didn't seem right there. (And I often said so at that place, so I didn't last long there ).

 

At the lab at school the method I use is the OVASSAY^® Plus system with a zinc sulfate flotation solution (specific gravity 1.2 or 1.3). The cover slip sits on top of the little plastic device for at least 10 minutes and the eggs float and stick to it. You put the cover slip on your slide and view it under the microscope. Many of my classmates would rush through their samples, removing the cover slip after only 5 minutes or so, not long enough for the eggs to float and stick. They got false negatives all the time. Maybe some vets or vet techs are doing the same thing, rushing through the samples? I line up all of my samples and go down the line, so some of mine sit floating for up to 20 minutes before I get to them. The longer the better, as long as the liquid doesn't dry out and salt crystals don't form.

 

Here is an interesting link I just found comparing different methods: http://veterinarycal...p.jsp?id=568408

 

 

 

Basically, I think that apart from the methological problem, the first two vets just didn't take take the possibility of worms seriously. And they had too much confidence in their methods. And they didn't tell me what a negative fecal means and doesn't mean, nor do I think they gave it much thought themselves. Our current vet, which is now the fourth (because we moved) just automatically sends the samples to the lab for processing because the centrifuge equipment costs more than they can afford and they don't trust the other methods.

I agree with you. I suppose vets see many more "serious" diseases on a daily basis like cancer, metabolic disorders, etc, that worms are the last thing on their mind. And because most healthy adult animals don't get seriously ill, maybe vets are not taking the possibility of worms seriously. They should though, because every once in a while you come across a bad case that goes undetected. (They have described a waxing and waning illness due to chronic whipworm infection that involves weight loss and symptoms similar to Addision's Disease. It can actually be fatal if left untreated). But even if the dogs aren't showing symptoms, they are contaminating the environment and making it that much more likely that other animals (and people) will become infected.

 

 

 

 

 

 

~Lindsay~

[galgrey]

Sounds very much like the way Spencer was shortly after arriving in 2005. Turned out to be hookworm; however, it took nine months to find that out because the first two fecals were negative. Finally, in deperation, we went to another vet; his fecal found that he was "loaded" with hookworm.

 

Moral: a negative fecal doesn't mean there are no worms. It just means the worms are not shedding eggs that day. Now, I'd test once a week for a month.

 

I've had this same thing happen. It's not uncommon at all.

[greypuppyluv]

From what I remember with Hallie and her hookworm, you need to be careful about potty habits also. I'm sure Lindsay can help me out here, but I've heard that hookworm can live in the soil for a year or two, so I've been told you should let your dog potty (poop) somewhere different than your yard if you want to avoid reinfestation. A friend had to kill all of the grass in her yard because she had such a bad infestation of hookworm after getting a foster dog in with it. I've heard of other people whose dogs kept getting hooks even though they kept treating for it and I think it's because the hooks were in their yard.

[DevilDog]

ew. evil hooks! Luckily I don't have a yard.

 

So we're 3 days in, and her poops seems to be improving, but only slightly. This mornings output was brown, less mucous-y and a tiny bit of blood. The first poop out was formed, but totally fell apart apon pick up. Volume was about half of what it was.. so I'm assuming she's beginning to absorb the food into her system. She's acting very hungry as well!

[greyhead]

A friend had to kill all of the grass in her yard because she had such a bad infestation of hookworm after getting a foster dog in with it. I've heard of other people whose dogs kept getting hooks even though they kept treating for it and I think it's because the hooks were in their yard.

Even killing the yard won't help if the hookworms have migrated through the dog's body, which they do pretty easily, and taken up residence in their individual cysts. (If I were a hookworm, I'd encyst at the first sign of Panacur!) In any case, they continue their life cycle in this manner for years. So monthly Interceptor and possibly annual Panacur or Drontal may be the only answer.