Prison Protocol For Treating Hookworms?

[Greydawg]

Help... I have read a lot of references to the success of the Prison Protocol for treating hookworms on this forum, but I cannot find actual protocol.

 

We adopted Fargo in December, and he came with hookworms. We just completed our first round of intensive treatment, and unfortunately, our poor boy still has hooks. We were advised that it could take several rounds of treatment to get rid of them.

 

Since many of you have had success with getting rid of hooks using the Prison Protocol, would you direct me to it?

 

Many thanks!

[LaFlaca]

Here you go:

 

https://prisongreyhounds.org/Hookworm%207-2018.pdf

 

My Lola battled hooks for 18 months. This protocol is what finally worked for us. Good luck!

[Greydawg]

Thank you, LaFlaca!

 

Wow, 18 months? Yikes.

 

I am so glad this protocol worked for you. We will suggest this treatment with our vet, and I hope we have the same success.

[MP_the4pack]

Be prepared to work on them for a year.

[Bizeebee]

We did the Prison Protocol to the letter (some people prefer a variant where doses are staggered) and have had two negative tests, we're waiting a little longer to do the antigen test (as opposed to fecal). We started as soon as we got him and did the protocol for just shy of six months.We'll also be keeping him on Advantage Multi, or an alternative moxidectin topical, monthly to keep any stray larval leak in check.

[smt]

Has anyone had success with Dr. Jennifer Ng's slightly altered version of the prison protocol? She does NOT dose with Advantage multi every two weeks. Instead, she keeps with the regual motnhly dosing of Advantage Multi, and doses with Drontal Plus or Panacur at only at mid month. Here is what she recommends. If I am reading this correctly, it is essentially half of the medication that is being administered in a month as compared to the Prison Protocol.

 

 

Treatment

After trying various combinations of dewormers and protocols over the past 2-3 years, I have had good results with using monthly Advantage Multi, along with a standard dewormer given in the middle of the month between doses of Advantage Multi. For the standard dewormer, I usually use Drontal Plus (or compounded equivalent), or a 5-day course of Panacur (fenbendazole) with a dose of pyrantel pamoate given on the last day. I add the pyrantel for added effect because it works synergistically with fenbendazole. For dogs that are asymptomatic for the hookworms, I will often just treat with monthly Advantage Multi and only add another dewormer if the dog develops diarrhea or other GI signs.

Even with an effective protocol, because of larval leak, it can take 6-8 months or more before the hookworm infestation can be fully eliminated. Often, even getting one or two negative fecal flotation results doesn't mean the dog is clear. I usually recommend continuing monthly Advantage Multi until a minimum of 2-3 negative results on fecals done several weeks apart. The IDEXX fecal antigen test may be more accurate, but it would still be prudent to continue Advantage Multi for a few more months past a negative result.

**A note on a couple other hookworm treatment protocols that have been shared and discussed on various groups. I would not recommend using Advantage Multi every 2 weeks as described in what is called the “prison protocol”. With monthly administration of Advantage Multi, the active ingredient of moxidectin reaches steady state in the bloodstream after the 3rd dose. Steady state means that there is an effective level of the medication in the blood constantly, so it provides continuous deworming activity, and there is no need to administer it more frequently. Using Advantage Multi every 2 weeks, especially for an extended period of time, will result in blood levels of moxidectin that are significantly higher than what has been proven to be safe in the product approval studies.

[Bizeebee]

 

Has anyone had success with Dr. Jennifer Ng's slightly altered version of the prison protocol? She does NOT dose with Advantage multi every two weeks. Instead, she keeps with the regual motnhly dosing of Advantage Multi, and doses with Drontal Plus or Panacur at only at mid month. Here is what she recommends. If I am reading this correctly, it is essentially half of the medication that is being administered in a month as compared to the Prison Protocol.

 

 

Treatment

After trying various combinations of dewormers and protocols over the past 2-3 years, I have had good results with using monthly Advantage Multi, along with a standard dewormer given in the middle of the month between doses of Advantage Multi. For the standard dewormer, I usually use Drontal Plus (or compounded equivalent), or a 5-day course of Panacur (fenbendazole) with a dose of pyrantel pamoate given on the last day. I add the pyrantel for added effect because it works synergistically with fenbendazole. For dogs that are asymptomatic for the hookworms, I will often just treat with monthly Advantage Multi and only add another dewormer if the dog develops diarrhea or other GI signs.

Even with an effective protocol, because of larval leak, it can take 6-8 months or more before the hookworm infestation can be fully eliminated. Often, even getting one or two negative fecal flotation results doesn't mean the dog is clear. I usually recommend continuing monthly Advantage Multi until a minimum of 2-3 negative results on fecals done several weeks apart. The IDEXX fecal antigen test may be more accurate, but it would still be prudent to continue Advantage Multi for a few more months past a negative result.

**A note on a couple other hookworm treatment protocols that have been shared and discussed on various groups. I would not recommend using Advantage Multi every 2 weeks as described in what is called the “prison protocol”. With monthly administration of Advantage Multi, the active ingredient of moxidectin reaches steady state in the bloodstream after the 3rd dose. Steady state means that there is an effective level of the medication in the blood constantly, so it provides continuous deworming activity, and there is no need to administer it more frequently. Using Advantage Multi every 2 weeks, especially for an extended period of time, will result in blood levels of moxidectin that are significantly higher than what has been proven to be safe in the product approval studies.

 

Have you joined the "Getting rid of parasites" facebook group? It has a vague name, but it's basically about greyhound hookworm. Jennifer Ng is pretty active there and it's an all around decent (if overwhelming) resource for info.

 

I think you also need to be careful when evaluating any protocol based on the experience of other dogs whose medical histories you won't necessarily know. This protocol is more conservative and might be fine for a dog that's not super-infested. For a dog whose count/symptoms are high/intense, the increased dosage of the as-written Prison Protocol may be worth the risk.

[smt]

Good tip, Bizeebee. I will check out the fb group. And point taken re: varibility of infestation amongst dogs.

[MaryJane]

Good tip, Bizeebee. I will check out the fb group. And point taken re: varibility of infestation amongst dogs.

 

My dog was hookworm free using heartworm meds once a month and strongid every 2 months (and 2 weeks from the heartworm med) for three treatments.

 

From my research, I have not found the vet that was responsible for creating that protocol. Make no mistake about it, the manufacturers would not support the prison protocol the way it was originally written.

 

Use the protocol Jennifer Ng noted - this protocol has a vet backing it up.

[Daks]

 

Has anyone had success with Dr. Jennifer Ng's slightly altered version of the prison protocol? She does NOT dose with Advantage multi every two weeks. Instead, she keeps with the regual motnhly dosing of Advantage Multi, and doses with Drontal Plus or Panacur at only at mid month. Here is what she recommends. If I am reading this correctly, it is essentially half of the medication that is being administered in a month as compared to the Prison Protocol.

 

 

This is the treatment I've been using, we're 2 months in, but I don't plan on retesting until we're at 6 months, so I can't say if its working or not. It seems like we're having less bouts of bloody/mucus stool and stomach rumbles, but I also switched food a month ago, so that might have contributed.

[LBass]

Jennifer Ng's revised protocol is the one Greyhound Crossroads gave me when I adopted Nate in December and is the one I am currently using with my vet's approval.

[Time4ANap]

We started Petunia on Dr. Ng's version of the hookworm protocol on Tuesday of this week. We applied the Advantage Multi that day. Yesterday and today she has had pretty bad liquid diarrhea, and most of the output since Tuesday are what I have always referred to as "worm poops" with a distinctive odor. I'm assuming that the Advantage is just doing it;s thing and killing parasites. I'm curious if anyone else has had the liquid diarrhea issue after giving the first Advantage Multi application and how long it lasted.

 

She is doing fine but has lots of tummy gurgles today, even after eating. We do have her on a probiotic as well,

Edited March 22, 2019 by Time4ANap

[Bizeebee]

We started Petunia on Dr. Ng's version of the hookworm protocol on Tuesday of this week. We applied the Advantage Multi that day. Yesterday and today she has had pretty bad liquid diarrhea, and most of the output since Tuesday are what I have always referred to as "worm poops" with a distinctive odor. I'm assuming that the Advantage is just doing it;s thing and killing parasites. I'm curious if anyone else has had the liquid diarrhea issue after giving the first Advantage Multi application and how long it lasted.

 

She is doing fine but has lots of tummy gurgles today, even after eating. We do have her on a probiotic as well,

We did the Prison Protocol (so, AM and Drontal on the same day) and did usually notice not-great poops, though not ever liquid, the day after dosing. But Bismarck also didn't have a super high parasite load, so I'm not sure if that makes a difference. We always throw some olewo carrots in the mix if we run into poops like that.

[Time4ANap]

We did the Prison Protocol (so, AM and Drontal on the same day) and did usually notice not-great poops, though not ever liquid, the day after dosing. But Bismarck also didn't have a super high parasite load, so I'm not sure if that makes a difference. We always throw some olewo carrots in the mix if we run into poops like that.

Thanks. I have Olewo carrots here. I will add them to her meals for a couple days. Can't hurt. Due to Petunia's age, the vet and I decided to try Dr. Ng's modification of the protocol first. I was a little worried about throwing so much into her system in a short time.

 

She came off the farm in November and tested Hook Positive at the adoption group vet in December. The group was just using the standard dewormers. I also did a round of Panacur when she arrived because it was what I had on-hand. I can tell that she is feeling much better, but we definitely needed to step up the game to the 2 different meds to get rid of these hooks.

[Bizeebee]

Thanks. I have Olewo carrots here. I will add them to her meals for a couple days. Can't hurt. Due to Petunia's age, the vet and I decided to try Dr. Ng's modification of the protocol first. I was a little worried about throwing so much into her system in a short time.

 

She came off the farm in November and tested Hook Positive at the adoption group vet in December. The group was just using the standard dewormers. I also did a round of Panacur when she arrived because it was what I had on-hand. I can tell that she is feeling much better, but we definitely needed to step up the game to the 2 different meds to get rid of these hooks.

I just wanted to include the protocol we used so that my anecdote was accurate

[Time4ANap]

I just wanted to include the protocol we used so that my anecdote was accurate

Thanks - we happen to have the carrots because we used them for Rocket's stomach issues for years. He did much better if the carrots were added to his food daily. Forgot I had them until you mentioned them.

[Time4ANap]

For those using Dr Ng's modified protocol - have you given the Drontal Plus even when there is a bloody stool? Petunia had the first application of Advantage Multi in mid-March and has been due for the Drontal Plus for a few days, but she has bloody diarrhea. I have been reluctant to add Drontal Plus into mix due to the bloody stool. I currently have her on a bland diet as well.

 

Currently waiting to hear back from my vet for a decision on whether to give it or not, but wondering what others have experienced. I'm pretty sure that the bloody diarrhea is just another cycle of eggs being eradicated, but was curious what others have experienced using the modified protocol. We went with the modified protocol due to Petunia's age.

[Bizeebee]

For those using Dr Ng's modified protocol - have you given the Drontal Plus even when there is a bloody stool? Petunia had the first application of Advantage Multi in mid-March and has been due for the Drontal Plus for a few days, but she has bloody diarrhea. I have been reluctant to add Drontal Plus into mix due to the bloody stool. I currently have her on a bland diet as well.

 

Currently waiting to hear back from my vet for a decision on whether to give it or not, but wondering what others have experienced. I'm pretty sure that the bloody diarrhea is just another cycle of eggs being eradicated, but was curious what others have experienced using the modified protocol. We went with the modified protocol due to Petunia's age.

Has she had diarrhea (bloody or non) pretty consistently since the last time you posted about it (a couple weeks ago)? Because, while I know some dogs have had bad poops the whole time they were dealing with hooks (we didn't but others can weigh in on that), if the diarrhea was a new thing and still going on I'd be wondering if she could use a course of metronidazole or if something else was up. Especially if you're doing a bland diet and it isn't helping.

[Time4ANap]

Has she had diarrhea (bloody or non) pretty consistently since the last time you posted about it (a couple weeks ago)? Because, while I know some dogs have had bad poops the whole time they were dealing with hooks (we didn't but others can weigh in on that), if the diarrhea was a new thing and still going on I'd be wondering if she could use a course of metronidazole or if something else was up. Especially if you're doing a bland diet and it isn't helping.

 

She has been on metronidazole for about 10 days from the time of the first bloody output. She has had lots of gas and the runs off and on since then, with some good stools thrown in as well. She was staying with a friend for 10 days while we were gone, but they are a very experienced greyhound person. She only had a mix of runs and good stools during that time until the blood showed back up yesterday. That's what makes me think it's a hookworm egg cycle.

 

I restarted her bland diet this morning. She had gone back to kibble for a few days before the bloody stools showed back up yesterday.

 

Friday - evening Editing to clarify - she had one or 2 small bloody bowel movements after the Advantage multi was administered in mid-March. The rest of the time since she has had a combination of regular diarrhea and good stools, has been on metronidazole the whole time, and was on a bland diet for about a week in there. I went back to a bland diet this morning. She does not appear to be sick or suffering any effects, but so far today we have had 3 large puddles of bloody diarrhea along with one yesterday, bright red, and looks similar to other images I've found online that show bloody output from hookworms.

 

Unfortunately, my vet is at a conference so I have very limited access to her for a few days.

Edited April 6, 2019 by Time4ANap

[Jakeoregano]

Here is our experience with Hooks - We have had our Max since Jan 2018. He was given a course of panacur prior to our adoption, but in March 2018 discovered he was still infested with hooks. At that time, his stools were like pudding and he had a noisy stomach but at least a good appetite. We started on the monthly Advantage Multi, with Panacur given mid-month, in March 2018...and we still have hooks as of yesterday. We have never missed a treatment in 13 months. Our vet now has increased the frequency of the panacur to every 2 weeks in hopes of finally getting rid of them. It makes sense to do every 2 weeks, since I read somewhere the lifecyle of the worm is every 14 days.

But we were warned last year that treatment could take more than a year, and that we may never be able to get rid of them, only control them. The good news is that Max is healthy otherwise, and is a blood donor. He doesn't show any adverse signs from the hooks, so at least we feel like they are being controlled. For additional information, we feed him Science Diet Advanced Fitness - a bit more than 2 cups in the morning with probiotic powder, and about 2 cups in the evening with both a tablespoon of pumpkin and probiotic powder. On this diet his stools are firm enough to easily pick up and he always finishes his bowl. He weighs 73 lbs, and our vet wants him to gain a couple more pounds. He gets a couple of small milk bone treats a day. We find the greenies and any of the dental treats loosen his stool, so we don't give him those often.

 

Although we have read about other treatment protocols, I trust our vets - we are fotunate here in Central Ohio that there are folks in the field that are very familiar with our breed.

 

If we ever do get rid of the hooks, I'll let you know

[Time4ANap]

Here is our experience with Hooks - We have had our Max since Jan 2018. He was given a course of panacur prior to our adoption, but in March 2018 discovered he was still infested with hooks. At that time, his stools were like pudding and he had a noisy stomach but at least a good appetite. We started on the monthly Advantage Multi, with Panacur given mid-month, in March 2018...and we still have hooks as of yesterday. We have never missed a treatment in 13 months. Our vet now has increased the frequency of the panacur to every 2 weeks in hopes of finally getting rid of them. It makes sense to do every 2 weeks, since I read somewhere the lifecyle of the worm is every 14 days.

But we were warned last year that treatment could take more than a year, and that we may never be able to get rid of them, only control them. The good news is that Max is healthy otherwise, and is a blood donor. He doesn't show any adverse signs from the hooks, so at least we feel like they are being controlled. For additional information, we feed him Science Diet Advanced Fitness - a bit more than 2 cups in the morning with probiotic powder, and about 2 cups in the evening with both a tablespoon of pumpkin and probiotic powder. On this diet his stools are firm enough to easily pick up and he always finishes his bowl. He weighs 73 lbs, and our vet wants him to gain a couple more pounds. He gets a couple of small milk bone treats a day. We find the greenies and any of the dental treats loosen his stool, so we don't give him those often.

 

Although we have read about other treatment protocols, I trust our vets - we are fotunate here in Central Ohio that there are folks in the field that are very familiar with our breed.

 

If we ever do get rid of the hooks, I'll let you know

 

Thanks. i know we are in for the long haul.

[Jakeoregano]

Wanted to update in this post (and I posted on the Hooks thread too) - Since we've doubled up on the panacur giving it every two weeks, we finally got our first negative fecal test back in late August.  We are going to continue with the bi-weekly appliication of panacur for at least 2 more months for 2 reasons:

1) we want to get two more clean fecal tests 

2) we just brought another grey into our home this weekend and confimed he is positive for hooks as well - he will start the advantage multi and bi-weekly panacur protocol and hopefully we won't have to go 17 months for results. 

For these reasons we'll continue to treat our first grey - he continues to tolerate the treatment very well and we want to ensure he does not get re-infested.  

I'll post again on progress in the future.

 

 

[LunaGirl]

Does anyone worry about the prison protocol because it is double the dose of toxins compared to the conventional regimen? It may get rid of the hooks better but could it have adverse long-term effects? Have there been scientific vet studies on the impact of this double-dose of medication on greyhounds or other breeds?  Thanks in advance for any feedback/info.

[MaryJane]

44 minutes ago, LunaGirl said:

Does anyone worry about the prison protocol because it is double the dose of toxins compared to the conventional regimen? It may get rid of the hooks better but could it have adverse long-term effects? Have there been scientific vet studies on the impact of this double-dose of medication on greyhounds or other breeds?  Thanks in advance for any feedback/info.

Both treatments should not be given at the same time which the prison protocol does - a vet has put together another protocol that alternates each (not sure which ones she recommends) at once a month (two weeks apart). It is available on Facebook - not sure if she has placed it on this forum.

I found a link - it was mentioned earlier in this thread.

 

https://www.greyhoundfriends.com/wp-content/uploads/2019/02/Hookworms.pdf

Edited September 25, 2020 by MaryJane

[Time4ANap]

1 hour ago, LunaGirl said:

Does anyone worry about the prison protocol because it is double the dose of toxins compared to the conventional regimen? It may get rid of the hooks better but could it have adverse long-term effects? Have there been scientific vet studies on the impact of this double-dose of medication on greyhounds or other breeds?  Thanks in advance for any feedback/info.

As MaryJane said - take a look at Dr. Ng's paper which expresses the same concern.  

We adopted 2 11 year old broodies last year who came from a racing farm.  One in particular was loaded with hooks and took almost a year of alternating the treatments before she was cleared, but the difference was night and day. Both dogs are doing so much better and we think the second dog has probably eliminated the hooks after about 8 months.  Here test will be next month. 

Our vet had us alternate the treatments due to their age, so on the first of the month we would give the Drontal Plus.  On the 15th, the topical was used. This went on for 8 months for one dog so far, and the other dog took a full year. They are both in so much better shape and health than when they arrived, that it is hard to completely describe.  Everything from coat, to tummy isuues to general health is just better. 

In the case of our first arrival who was severely load with hooks, we had several months of bloody diarrhea with the treatments because there were so many hooks.  The poor girl had terrible tummy isuues during that time, and after one particularly bad round of bloody stools, the issue cleared up.  We did supplement her meals with some of the RxClay products per our vet's instructions to help relieve the tummy stress, and also treated with Metronidazole during a few of the worst occurrences. 

It is important that any of this you do should be in conjunction with your vet.  In our case, Our vet agreed that we needed to use these strong meds, but modified the plan as we went along, and in a few of the months we moved things to 3 or 4 weeks between treamtents due to whatever was happening at the time with tummy issues. This will be an ongoing process for a while where your vet should be involved before you make any changes to the plan so that they can take any other health conditions into consideration.  Good luck.