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Dr. Gary
Dr. Gary, Veterinarian
Category: Veterinary
Satisfied Customers: 19653
Experience:  DVM, Emergency Veterinarian, BS (Physiology)
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I have rescue mom/ pups diagnosed with Neosporsis. Mom

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I have rescue mom/ pups diagnosed with Neosporsis. Mom doesn't have symptoms but her testing was over 1:200 with testing at A&M. Vet has them on clindamycin/ smz tmp. I have seen some studies that show rebalance in horses has been used. Are there any real studies that show what is best treatment course? Mom and pups are under treatment with 2 different vets, actually 4 vets are seeing mom and 2 pups. And none of them have seen it before.
JA: I'm sorry to hear that. What is the pup's name and age?
Customer: Vida and Vail are approx 14 wks old. We got them at 8 wks old from breeder that was going to kill them bc he thought they had swimmers. Our vets figured it out pretty quick that it wasn't but took a bit to get answer.
JA: How old is Vida?
Customer: 16 wks
JA: Is there anything else important you think the Veterinarian should know about Vida?
Customer: Testing for Neosporsis was over 1:1600 with testing from Cornell, and latest test done at A&M was over 1:200.

Hello, I'm Dr Gary. I've been practicing veterinary medicine since 2007. I look forward to helping with your questions/ concerns.

I'm working on your case right now. It'll just be a couple minutes.

Customer: replied 30 days ago.
One of our vets saw on VIN about a vet that rescued a dog that had neosporsis. He was supposed to send the info to me with meds that he was sending for mom but somehow got lost when our transporter picked up from vet clinic. This disease is so frustrating bc so little info on it and so few vets have even seen cases. It doesn't seem to follow Toxoplasmosis treatment even though very similar, esp since it was diagnosed as such before 1990.

The current treatment recommendations are still Clindamycin + Sulfadiazine. There has been talk of Ponazuril (the horse med) used, but there is no indication that it is more effective than Clindamycin.

Here are the current treatment recommendations:

  • Clindamycin: 12.5-18.5 mg/kg, PO, q12h for 2-4 weeks.
  • Sulfadiazine: 15-30 mg/kg PO q6-12h with Pyrimethamine 0.5-1.0 mg/kg PO q24h for 2 days then 0.25 mg/kg PO q24h for 2-4 weeks.

The problem is that we lose a lot of these puppies due to myocardial infection in the heart. This makes it hard to treat effectively and get good studies. It also takes 1-2 months minimum to treat them. Sometimes longer as they can hang out in muscles and shield themselves from treatment.

If they're improving, then I would continue treatment and hopefully you can get this cleared.

Customer: replied 30 days ago.
We already have them on baycox (similar to ponazuril). Sulfadiazine / pyrimethamine is the horse med I was speaking about. Will this kill the bradyzoites? I cannot seem to find anything in articles that can penetrate the bradyzoites within muscle tissue. Is there any med that can penetrate bradyzoites? If we keep them on clindamycin for 6 months, can we be sure that it will not reappear coming from muscle tissue to attack their heart? They appear totally fine now but their test show them beyond test done by A&M (>1:200), The first testing done by Cornell was (>1:1600). I *think* the testing is more sensitive to be able to test higher level of infection from Cornell but the vets were not totally clear. We have been treating for over a month already.https://www.valleyvet.com/ct_detail.html?pgguid=2187cad3-8cf3-410e-aaeb-d2de2f608af5&sfb=1&itemguid=16e4cb5a-82fa-4918-9d8e-197bb7ce67ad&utm_content=813RX&ccd=IFH003&CAWELAID=120295250000091297&CATARGETID=120295250000179029&cadevice=c&gclid=CjwKEAiAuc_FBRD7_JCM3NSY92wSJABbVoxBahPm1ukcWmll4OXr7WM035GlTRiMMA4ww3qyXrOBbRoC5KXw_wcB

We don't have anything to treat and remove the bradyzoites. This is why we can never fully cure the condition. There is always the chance of relapse. If that happens, then we go through the full Clinda/ Sulfadiazine treatment protocol again. Adding Pyrimethamine is also recommended by some.

I think I would be inclined to stop treatment after 2 months as long as the clinical signs have resolved. I would treat more based on clinical signs and getting out that 1-2 month mark vs trying to get the antibody test lower.

There's always the option to do a CSF PCR test as well to make sure the organisms are cleared from the spinal fluid. It's more invasive, but it's an option.

Dr. Gary and 2 other Veterinary Specialists are ready to help you
Customer: replied 30 days ago.
That is what I am finding in my research...not the answer I wanted though. We will never know if they are clear - and it is really hard to tell if you have a relapse. The mom has no obvious symptoms so if the pups didn't have paralyzed legs, we would not have known to test / treat her. Do you know dosage of folinic acid if using pyrimethamine? I understand that it can suppress proper absorption of folic acid. One of our vets does spinal taps all the time so that won't be a problem to test but blood tests are still off the charts so we know they are high positive at this time. Very frustrating disease!

I think the goals just need to change from clearing the disease to symptom free. If symptom free, then we don't treat. The pups led to a diagnosis, but the overall goal is still a normal quality of life.

I'm sorry, but I don't have enough experience using Pyrimethamine to recommend a certain dose change of the Folic acid. I think I would discuss that with a pharmacologist.