Giardia hell, part 2

So, what is Giardia?

It is a small, nasty one-cell parasite (protozoa) that exist on the intestines (intestinum tenue) and the intestinal membrane and thus, the feces.
Statistically, it is more likely that a cat from a pedigree cattery is affected, than a moggie. This due to the higher concentration of cats sharing the same litterbox and living area. The Swedish veterinary institute, SVA, confirms that 10% of all feces they have tested are positive for Giardia. However, they estimate that the actual number of cats with Giardia is greater since not all cats show symptoms. The estimated number is 30% of all pedigree kittens sold could be affected by Giardia. Despite this the knowledge about this parasite remains rather low, so therefore I have tried to write down what I've gathered from the internet and the SVA.

Symptoms

Believe it or not but many cats go through life with Giardia without showing any symptoms, or just minor ones. Usually Giardia is discarded (like Styx was) as a "troubled tummy" or "stress" and kept "in check" with active carbon and expensive veterinary digestion food. This only stop the diarrhea and will do nothing to cure the cat.
It is believed that untreated Giardia can lead to Inflammatory Bowel Disease (IDB) and permanent damage to the cat's digestive system.

The symptoms for Giardia are: diarrhea, lethargy, possible vomiting, weight loss, very strong smelling feces

It is normal that the kitten appear healthy at the breeder and develop symptoms first when arriving in their new home. This because Giardia intestinalis can be triggered by stress, change of diet or other illnesses. 

The diarrhea goes in cycles due to the life cycle of the Giardia parasite, we noticed that Styx managed roughly 1.5 cycle per week. One cycle starts with Styx looking a bit more healthy and slightly more active during playtime. He also starts to eat ferociously. This goes on for two to three days. Then he started to go low on energy again, eat less and is not as keen on playing. This usually lasted a day. After this, the days with diarrhea starts where he refused to eat, usually 2-3 days until the cycle repeats itself. This makes it horrible to be a pet owner, because you think there is improvement (maybe you tried a new brand of food, or the vet food, or maybe the vet was right saying it would "sort itself out") and feel hope just to get thrown back into this hellish cycle.
Skadi, who showed no real symptoms of Giardia also experienced the diarrhea cycle, but slower and without ever refusing to eat.

Also, you start to recognise the smell. There is a distinct smell with that comes with the Giardia.

Does it affect humans?

There are several different versions of Giardia intestinalis, some that only target specific animals and some that are cross species. This means that your cats Giardia could be transferred to humans. It is possible (at least in Sweden) to test for the Giardia genome, if Giardia is confirmed, this will tell if the strain is possible to transfer to humans or not.
A normal healthy adult human, should not be possible to infect but elderly or children could be at risk. Giardia infections in humans usually occur in areas where hygiene is poor or where there are constant contact with feces and children, such as daycare centres.
The symptom for Giardia in humans are similar to the symptoms of cats.

Giardia intestinalis genotypes/assemblages (from SVA)
A      l     human, mammal
A      ll    human, mammal
A      lll   mammal
B      lV   human, mammal
B      V    human, mammal
C/D        dog
E            ruminant, horses
F            cat
G           rodents

Giardia exist in two stages, one is as a parasite inside your cats intestines the other is as a cyst which is the stage the parasite is in when dropped in the feces.
When an infected cat goes to the litterbox it will release a large number of cysts. These cysts can get stuck in fur, paws and taken on to the rest of the apartment, furniture, toys, surfaces, water bowls etc. If one cat is tested positive for Giardia all other cats in the house are definitely affected as well. This also means that infected cats that meet during shows, breeding etc can transfer the parasites.

Diagnose

The way we had to do it was to collect feces samples during three consecutive days and send in to the laboratory. The reason why three samples are required are because the parasite can come and go, as indicated in the cycles and one sample might turn out clear even if the cat is infected. The cost for the test is manageable (at least here in Sweden) and for us the insurance covers most of it.

How to treat it?

Well, here comes the good and bad part. The good part is that it is relatively easy and cheap to treat. Usually normal de-worming medicine is used, containing fenbendazole or metronidazole. The dosage and duration of the treatment differs from normal de-worming, so do not try to medicate any cat without consulting your veterinarian.
The bad news is that whilst it is easy to kill the actual parasites, it is pretty damn hard to get rid of the cysts. They are resistant to many disinfectants so many cleaners will not work against the little f*ckers. On top of this, the cysts can survive for pretty long depending on temperature and humidity.
What does work is: high temperatures, above 60 degrees Celsius. The easiest way to obtain this is by getting a steam cleaner. You need to clean e v e r y t h i n g. All textiles. All surfaces. All furniture.

How to make sure to not get Giardia?

First of all I want to say that I do not blame my breeder for this. She did all health checkups and veterinary visits expected and recommended by SVERAK (Swedish national pedigree cat club association). The information about Giardia is poor, even amongst veterinarians, this is why I have decided to make this wall of text. To at least try and raise awareness about this parasite. We can make sure our cats are healthy and avoid suffering if we just get the information and can act on it.
So, what to do? Well, we - cat lovers, that are thinking about buying a cat should start to ask the breeder if the cats are Giardia tested. If not, tell the breeder everything about Giardia and hopefully they will make it into their own interest to check their cats. Any serious breeder should.
If you still want to buy and untested kitten, put it into quarantine when taking it home and observe it during one to two weeks. Or even better, send in a feces sample yourself to have it tested, the cost is not very high and could prevent other diseases later on.

I will never ever buy a kitten from a untested cattery again, now when I know what I know and have seen my kitten suffer for weeks.

There is plenty of information about Giardia intestinalis on the internet if you want further reading or suspect your kitten might be affected. Don't swallow the veterinarians talk about special food and active carbon if your kitten display symptoms, fight for a test (regardless of how they try to disregard it). Better safe than sorry.

Pawz out, furry friends! <3