Hello, it's Anthony Chadwick from the webinar vet welcoming you to another episode of Vet Chat. Very fortunate today to have Ian Wright on the line. Ian is a veterinary surgeon in Fleetwood, also holds the position of chair and lead at SCAP.
But perhaps tell us a little bit about that, you know, as well as doing all of the stuff that you do on parasitology, you also have your own practise as well, so tell us a little bit about how the practise is going and. A bit about what being chair of SCAP entails. OK, well thanks for the invite first of all, it's been a little while since we've we've caught up, so it's wonderful to see you, albeit virtually, but always, always a pleasure.
So, yeah, for those who don't know me, I am, I'm a vet in first opinion practise. So, you know, working at the coalface in Fleetwood, which is a lovely little, seaside town, it's a peninsula. So we have reps that always visit us and say, oh, we were just passing through.
No one passes through Fleetwood. This is the edge of the world. It's like Irish Sea, that's it, essentially.
So it's a lovely, lovely little town, and we're just a small two-ve independent practise. But alongside that, you know, I have my love, you know, in no way an obsession. It's my gentle love of parasites.
So, you know, I did it way back in crikey, 1997. Is that, is that 25 years ago, can't be. 25 years ago, I, I did a master's in parasitology, trying to get into vet school and just loved it.
So carried on doing some research, wrote some articles, and now I find myself as, as head of SAP nationally. And guideline director for SAP. So SSCAP gives guidance on, on parasites, it publishes guidelines, we give free advice through our websites.
So yeah, every, every day there's another parasite adventure, which, you know, some of it's exciting, some of it's a little bit scary sometimes, you know, but Parasites is never, never a dull moment. Well, I, I think similarly share your love of parasites as a dermatologist. It was always great fun to scrape a dog, find a scabies mite that nobody else had found.
There was always it was always a bit of a eureka moment in the, in the back office with me looking down my microscope. It is, isn't it? You, you just can't beat that moment of deep satisfaction when you find something that's crawling around under the microscope.
It's like results. Yes, we know what the dog's problem is. It's probably not A to B.
We can get this dog better, which is, which is fabulous. Ian, obviously, you know, at that chat, we, we do talk a lot about sustainability and things and global temperatures are rising, we're starting to see some diseases that we've. Not seen before in the UK and some unusual ticks and so on like Ripocephalus.
Obviously, partly some of this is coming from the increasing temperature, but also from a lot more pets are being imported, in fact, it's becoming such a big problem, it's kind of becoming almost criminal, isn't it, with some of the gangs importing pets over because of the shortage of dogs that we've certainly experienced during the pandemic. Obviously from the perspective of travelling pets going on holiday to places like France and Germany, that particular element just sort of disappeared during the pandemic, but I know that it's sort of coming back up again, and I must admit as a vet who's who's not been in practise for quite a while, I'd love perhaps first to start by just talking a little bit about that animal health certificate situation that we're having and. You know, what does that entail?
What should we be treating, and do you think there's areas that in fact we're, we're not treating appropriately and this is why some of these new parasites are being seen. Yeah, yeah, so there is, you know, what, what we describe as a sort of cocktail of risk that that's making sort of a new novel parasites arriving in the UK more likely. So it it's absolutely not just a UK phenomenon.
So, you know, right across Europe, globally, that the range of many parasites and the vectors like mosquitoes, fruit flies, ticks, that transmit them are are increasing. So their range is increasing, their activity year round is increasing. So that makes the, the likelihood of encountering them if you're abroad or if you're adopting a pet from abroad, you know, that the chances of encountering them becomes more likely.
And that's coupled with the frequency. So have you visiting all these pets being imported. So, you're absolutely right, Global warming, increased humidity across large areas, increased habitat, so increased forestation has led to sort of more ticks.
More mosquitoes, more fruit flies, extending their ranges. But coupled with that, you've got more and more pets and people are being moved around, you know, through choice or, you know, through necessity. And part of that in the UK is, is definitely pet travel and and importation.
So on the pet travel side, you know, before COVID, you had a pet passport, and none of us enjoyed filling out pet passports, but there were at least one document and you filled it out, and the client had it for a few years and you sent them off on their way. Animal health certificates are a completely different ballpark, so you have to fill one out. I mean, these are like 9 to 12 page documents, you have to fill one out every time the pet goes abroad.
And the, the sort of health requirements that go with them are still the same, so you need your, your rabies vaccination, you have to be microchipped and crucially, you still have to have the tapeworm treatment to prevent Echinococcus multilocularis, which really nasty zoonosis that we don't want in the UK. That compulsory treatment is still in place coming back in. So those, those requirements haven't changed, it's just the sheer volume of, of paperwork.
I mean, I, you know, cry tears of joy, you know, every time one lands on my desk that that I have to do. And I thought, I thought it would put people off. I thought the increased cost, you know, would put people off.
But just gradually I've, I've noticed over the past sort of 68 months this year, really, that numbers have started to creep up. So we need to be up to speed with the advice that we're giving, because there's no real sort of compulsory parasite elements apart from the tapeworm. So we need to be up to speed with the advice we're giving when people are going on holiday with their pets as to, you know, what tick prevention they need, whether they need heartworm prevention, prevention against leishmania, but we also have to be very, very aware that lots of the pets that are being imported, mostly dogs.
Being imported into the UK as sort of charity rescues, can also, I mean they've been living in, in countries that have many pathogens that aren't endemic in the UK. So we need to make sure that sufficient sort of vigilance and sort of screening for those parasites, really, because they're, they're likely to already have them, is in place for when those pets arrive on the consulting room table. I mean, in an ideal world, that the charities would have done some of this testing before they come across, and we are, we are working, SSCAP's working with charities to try and, you know, help them put the right testing in place.
But there's, there's a spectrum there as to the degree of sort of finances, you know, investment, desire to do it that that the charities have. I think, I think it is important to say, sorry, sorry, go on, Anthony, you've got me on a roll, yeah, it's a few questions come up, the AHC how much . You know, what's the sort of standard charge for doing one of those now then?
It's massively variable, and I don't say that to be diplomatic, but it's massively variable. So I've seen individual ones as cheap as I say as cheap, but you know, given the amount of paperwork there is, as, as cheap as sort of 100, 150 going wrong. Through to sort of 350, 400 pounds.
But the, the thing is, practises charge in different ways because you can add pets on. So up to 5 pets can travel, and you can add the 2nd, 3rd, 4th, 5th pet onto the same animal health certificate, so. So most practises tend to charge a fee for the first pets and then a sort of surcharge for additional pets.
So it is hugely variable, but what is, you know, absolutely certain is that it's much more expensive than just having anti pet passport that you can just use once. And this AHC as, as we say, can only be used once, so it's for that one trip, and then if you go back a month later, 2 months, 3 months later, you have to do another one. The trick is that you can use it to move around the EU for sort of 3 or 4 months.
So, you know, once you're out there, you want to really make the most of it and go on a bit of a road trip or you know, have a tour. But no, if you come back into the UK you've then got to get another one and you know, off, off you go again. One of the things that was in the pet passport was very much, you know, that worry about some of the tick-borne diseases that animals would be treated on the way back, and of course sometimes just treating them on the way back was foolhardy because of course they'd had the disease already while they were there, so they could catch the disease before, so it makes sense still doesn't it, to treat, Before the animal goes out and then to treat as it comes back in again, provided obviously you're not overtreating, you know, it's monthly treatment or whatever.
I, I mean, do you feel that that's been a loss within the system that we're not treating for, for ticks routinely as part of this AHC? Yeah, it's, it's a danger because you've you've lost that compulsory element and you know, you're absolutely right, just having a compulsory tick treatment for coming back into the UK isn't going to stop exotic pathogens and ticks coming in, because no, no tick treatment is 100% effective. And you know, it depends which one you put on, and it depends when you put it on in relation to the pet coming back.
No, I mean, ideally you want to treat a pets, you want to start before you go, and then you want to treat while you're out there, and then you want to treat before they come back. And, you know, that's to try and minimise the risk of exposure to exotic pathogens. What, what dropping the compulsory element did unfortunately I think was, was send the wrong message.
You know, you drop the compulsory treatments and that is a signaler to pet owners that perhaps it's just not that important to to have tick prevention. Why do you think that the government actually dropped that in the first place, because it to me from the outside. Not, you know, as expert as you are in parasitology, just seems a really silly thing to do.
Well, I think in terms of the messaging, it was, and it made the messaging very difficult. So you've got the, you know, off the record reason, and you've got the on the record reason. So the, the on the record reason is actually very sensibly thought out.
So the reason it was introduced was because of something called Mediterranean spotted fever, which I think, you know. Anything called Mediterranean spotted fever, you want to avoid if you can. It's transmitted by ripocephalus ticks.
And the argument was that because it was a significant zoonosis and these dogs might be carrying ripocephalus, then, you know, you should have that compulsory treatment in place. The reason it was dropped officially was because tick treatments aren't 100% effective, and because of our ambient temperatures, it was felt that ripocephalus was unlikely to establish in the UK and be a permanent problem, which is, is fair. .
Yeah, I mean the, the off the record reason was it was political horse trading. It was like, well, you wanna keep your compulsory tapeworm treatment, we're gonna have the compulsory tick treatment taken off, and you know it was, it was a negotiation. That the problem with it is that actually ripocephalus can persist in the UK but it's in people's centrally heated homes.
So, you know, if, if any ticks get through, but certainly if a goodly number get through, they like our houses. They can feed on anything that moves. So the larvae, the nymphs, the adults can all feed in the house, and complete their life cycle in the house.
So before you know it, you've got hundreds of them climbing out of the skirting boards, down the back of your sofa and. Oh my goodness. And is this, is this becoming a problem because it is, you know, Ripocephalus was a very rare parasite.
Is it establishing itself? Through the country presumably starting in the south, but maybe as you said, if people are travelling, it can be all over if they're living in people's houses. Well yes, so this is happening throughout Europe, so ripocephalus outdoors needs a bit of a tropical, you know, it likes an umbrella in its drink, it likes a bit of a sunbird, it doesn't really like our cold ambient temperatures.
But it is surviving in Northern Europe in people's houses and can do that here. I mean, it, it's risk of long term establishment in the UK is actually still very low. The, the problem is that, you know, ticks get into the house, they start feeding on things in the house, and then they can transmits, yeah, including humans.
So then they can transmit zoonotic disease and that, that, that is a big concern. So, you know, just because my, my take home message would be is just because the compulsory treatment's been dropped. You know, doesn't mean that, you know, really good solid tick treatment and checking for ticks while pets are abroad, you know, is, is still really important.
It's interesting, obviously Mediterraneaner spotted fever, a cousin of Rocky Mountain spotted fever presumably. And yeah, absolutely. There are a sea of riettsia that ripocephalus can transmit, and whichever sort of, you know, country where ripocephalus is endemic, you find your own fascinating version of a rickettsial pathogen that can be.
Admitted, so in North America, it's Rocky Mountain spotted fever, Africa has a, has a range of rickettsia that is zoonotic, that can be transmitted up in the Mediterranean, it's, it's Mediterranean spotted fever, and on it goes. So they they're very, very well adapted ripocephalus, to transmitting a range of pathogens, and unfortunately some of those are, are ones that we can catch. You mentioned a really challenging disease before that I'd be interested to know how that is doing in the country and obviously very much a problem with imported animals, obviously rescue animals coming from the south of Europe, and that's leishmania.
It's a really difficult disease to sort of diagnose because pretty much any dog that you bring out of Spain or Portugal will probably have leachmania won't it, so. How is that going? Are we seeing more cases in the UK of Leishmania, and, and is that a big increase or just a small increase?
Well, unfortunately, because there's no official recording of leishmania cases, we don't know how big the increase is. I don't think there's any vet in the land that hasn't got a feeling of they're seeing more leishmanias. Than they did before and that just those sort of anecdotal case recordings, and I mean that the number of queries that we get into to SCAP about Leishmania cases would, would suggest that there are significantly more than there were before.
I mean, most of them, not all of them, but, but most of them are in imported or travelled pets. But one of the, the sort of, you know, misunderstandings, one of the misnomers about leishmania is that people believe that you have to. Have the san fly for it to be transmitted.
And there's a number of ways that leishmania can be transmitted, you know, mostly vertical transmission, you know, sort of horizontal transmission through, mating, but also through dog bites and cases where, where we just don't know. You know, we, we just don't know how that transmission has occurred, so. It it is, I mean, it's more at the moment, it's more of a concern for the individual patient.
I mean, leishmania is serious and it, it needs a lifetime of management, so diagnosis is important early on for the individual patient, but I, I don't think we can be complacent about the risks of it establishing, at least vocally in, in the UK when, you know, horizontal transmission is, is possible. And obviously has a zoonotic implication, and I think as you said, I, I, I think it was Susan Shaw early on, probably 1020 years ago, seemed to suggest that fleas might be involved in that transmission from dogs who had travelled to those that hadn't. So we're, we're beginning to see more and more cases.
Are we of of dogs that simply haven't left the country as well? Yes, yeah, and in, in the vast majority of those we know how, so. You know, you, you have to get the thing with leishmania, suspected leishmania cases is you do have to get a really good history.
So, like I say, there's vertical transmission. So, you know, mum might have had it, but there's also venereal transmission, so it might be that Dad had it and gave it to mum. So you know, you might have travelled dad and not have had travelled mum or travelled offspring.
So that's the most common way, but it's also transmitted through blood transfusions, so it can occur that way. The big question is, there have been a couple of cases in the UK where we don't know where none of those things as far as we know have occurred, and we don't know what the transmitting mechanism is now. You know, there are trippanosomes that have moved into biting flies.
Tripanosome or vivax jumped from Tetsy flies to to biting midges and and horse flies in, in South America. So we know that's possible, but it hasn't been confirmed that Leishmania has moved into another vector yet, so fingers crossed, yeah, we, we don't know. I mean, it is really from the zoonotic aspect, it is really important to say that there hasn't been a confirmed case worldwide of someone contracting the disease from a dog in the absence of the sam 5 vector.
So, you know. Although there is a theoretical risk there, it is incredibly low. I mean, as long as everyone's, you know, hand hygiene is good.
As long as staff are very careful, you know, veterinary staff are very careful with needles, where blood samples have been taken and sort of, you know, sort of bodily fluid spillage, you know, you have to be a bit careful there, but. I'm saying this, I'm gonna catch it next week, aren't I? I'm saying this, you know, on a, on a podcast, but you do have to work quite hard to contract leemania if there are no sandflies around, so, you, you were also talking before about the geneticist's favourite insects, which of course is Drosophila.
What's the story there? What, what's the worry with Drosophila, because I, I am seeing them in the house as well. So I don't, I don't want.
So, you know, slander fruit flies. They're actually, they're actually fortika fruit flies that that are the problem. They, they trans they transmit Falasia caloppia, the eye worm.
So that, that is something that really could establish in the UK. So, Fortia loves warm weather, it loves trees, it loves to, you know, hang out in an apple grove where it is living the dream, you know, it's nice, it's warm, it's humid. And as a result, it's been able because of global warming, it's been able to expand its range across Europe very quickly.
And it's aided by mechanical movement, so, you know, Fortica will catch a lift in people's trucks, you know, they'll, you know, but also wind dispersed very easily, the tiny flies. So are we seeing them in the UK already? So yeah, so now we are starting to see okai in the south of England of of Fortica establishing.
But the worry is that climate modelling shows that it is going to spread. So it's going to establish very widely over, certainly England over the next 5, 10 years. And you'd say, well, you know, it's a cute little cuddly fruit fly, you know, why, why should we worry about that?
But fortica also feeds on eye secretions. So they like to gather around the eyes of, of animals and people. And, you know, they, they're so small, you, you just wouldn't know they were doing it.
You might rub your eye while you're out for a walk, but you wouldn't. I know they'd ever been there. And in doing that, they can transmit this eye worm, which is, is really quite unpleasant.
So, like, like many of these things, it's not a direct risk from dogs. But if we have imported dogs that come in with the infection, our native fruit flies feed on them, there's the risk of establishment. And then they'll feed on us and we'll get eye worm cases.
And this has happened in every country where fortic has gone, Fallazi has followed, and then you get human cases. So, you know, again, we just need to be very, very vigilant for possible clinical cases. Or, you know, carriers coming into the UK, and then if we can identify the parasite quickly, it's much better, you know, much better for the individual patient to get those eyes shift, to get those worms shifted out of your eye.
But also, you know, to try and prevent that establishment. How do we treat that, that in humans with ivermectin for the eye worms? So I mean it's very similar idea in dogs and cats, so there there are products now that are licenced for treatments, sort of oxidectin and milbamycin products, but also physically under sedation, local anaesthetic, just flushing the, the worms out physically makes a big difference as well.
Right, so they're in sort of tear ducts and mybomian glands and things like that, but they, they just, just live in the conjunctible sack. So you know, you can see them conscious if you, if you've got a really compliant patient, you can lift the eye down, but if they're not so compliant, you sedate them, pull it round, you can see the worms crawling out across the surface. There there are some wonderful photos on the internet that you can check out of some lovely juicyellaia infections.
Have you, have you seen any of these yourself in practise yet? I haven't seen a case personally, I've been sent plenty of Falasia worms, which are actually very quickly free plug, er, so you know, surveillance for these parasites is really important. And the APHA working with with SAP in in England, has a service now, a free service, so if you think you have these worms, so Falasia, diophylaria ripens, or the nasal pentastomid lingula serrata.
If you think you've got any of those free, you can send them to the APHA to be identified, to have their identification confirmed, but then they'll also be registered as part of UK surveillance. So we can watch out for where, sort of, you know, imported pets are staying, you know, whether there's on travel cases, you know, if, if there's the risk of crossover into, you know, national insect populations. Mhm.
Just a final one in, . You know, there's obviously a lot of press and publicity at the moment around our treatments of parasites, and, you know, disclosure for myself, I was probably one of the first practises that did a a VIP plan back in 1999. Do you think is there a danger that we can be overtreating animals and how would you advise practises now, perhaps with health?
Care plans, should we be doing more surveillance first, so things like doing faecal leg counts and obviously flea combings. Or do you think it's OK to just continue to treat, you know, across a sort of blanket population? Wow, well that, I mean that that's quite a big question.
So I'm gonna, I'm gonna try and you know. Yeah, if you got time, I'm gonna try and pick that apart a little bit. So first of all, there's the issue of what we, what we call what's been described as blanket treatment.
So blanket treatment. Implies that you treat everything all of the time, without thought. And, you know, there's, there was a colleague of mine who said this on on webinars recently, but a colleague of mine that just said, well, you know, parasitology is easy, you just kill all the parasites all of the time and everything dies, and then everyone feels better and you know, you're all good.
And, you know, that's tongue in cheek, but, you know, that is one extreme view. But, you know, we have to, when we take that approach, we have to consider the consequences. So the consequences may be that overtreatment will occur, that some of these pets don't need that treatment all of the time, that environmental contamination might occur.
And then there's the, the thorny question of resistance, which we've got time, I'll I'll speak about briefly cos there's a bit of, I think there's a little bit of sort of confusion about what we're trying to achieve there. So, but I think we can agree as a whole, I think, I think most people in the profession agree that we need a risk-based approach. So you, you only want to treat the pets that need the treatment preventatively.
And some parasites lend themselves really well to a risk-based approach. So if we take tapeworm, or if we take long worm or ticks, then they're not present. Certainly not present uniformly throughout the whole country.
So, you know, there's geographic risk factors and there's certain lifestyles that might put you at more risk. So cereal, slug and snail consumption, you know, being on an unprocessed raw diet, having dogs that munch their way through sheep carcasses, you know, you've got, you know, you've got lifestyle risk factors. Lots of things going on there.
Yes, with, with those, because, you know, like I say, they are a parasite that lends themselves to that type of risk assessment. So we absolutely. Be making those risk assessments.
So yeah, so lung worm and tapeworm and ticks really lend themselves well to to risk assessment. But the key, or two of the key parasites that we deal with on a daily basis, Toxoara, the intestinal worm that's zoonotic, and fleas, unfortunately are, are ubiquitous throughout the country. In fact, well, in the case of Toxicara, ubiquitous throughout the world, apart from Antarctica.
So, you know, wherever you go, you know, those worms and fleas are going to be present. In the case of Toxicara, there is a sort of, you know, certain lifestyles like living with young children, hunting, being a puppy or kitten that make infection more likely. But again, because of the way it's transmitted, transplanally, transmammary.
There's no, throughout a cat and dog's life, any cat or dog could be exposed to toxicara at any time. And similarly with fleas, because of the way fleas are moved around mechanically, even completely indoor cats can and are regularly exposed to fleas. So, you know, because both fleas and toxicara cause significant sort of zoonotic and in the case of fleas, you know, things like flea allergic dermatitis, you know, we can't, we can't just ignore them, you know, we have to have control in place for them and it's much, much more difficult to apply sort of risk assessments to them.
So. AirA UK and Ireland currently still recommends a minimum of 4 times a year deworming year round for Toxicara because of the zoonotic risk and monthly for for high risk, perhaps with the exception of indoor cats that poo in their litter tray and then the the poo is removed and you know, hygiene's really good. It's all taking place, you know, in an enclosed system.
Perhaps with that exception, you know, 4 times a year minimum. And because of flea allergic dermatitis, because of the zoonotic risks with things like Bartella. And because no, no cat or dog is safe from, from infestation, we recommend year round flea control.
Now I mean it, it may be, you know, for all cats and dogs. I mean it may be that that evidence will change. I mean there are countries, you know, Spain, Scandinavia, where because of, you know, more significant climate shifts, fleas aren't year-round problems.
So, you know, this isn't, you know, things can change, but at the moment on the current evidence, I believe that's where we are. So, you know. I guess that the summary message is that risk assessment is really important, but just because you risk assess doesn't mean that cats and dogs don't need year-round treatment for some parasites.
And, you know, you need to establish which ones those might be. So, you know, that's, that's risk assessment. Practise plans have come in for a lot of knocking.
You know, so, you know, poor old practise plans, you know, people say, oh, you know, practise plans are terrible things because you just, you know, you have the routine treatment and you have a lack of choice, you know, all year round. But the big advantage of practise plans is that they improve compliance, you know, because the clients are locked in to picking up whatever treatments you decide them to pick up. They can be combined with reminder systems, but also they can be hugely flexible.
We're still using relatively few products, so. You know, you can have bespoke practise plans. I mean, at our practise, we focus on sort of 3 or 4 main products, but if one, if that's not suitable on the basis of a risk assessment, we can order in in 24 hours, pretty much any, you know, any product that that anyone needs.
So, you know, practise plans don't have to be inflexible, and they can include testing, which is, is also, you know, a sort of, you know, big sort of point of conversation at the moment. So, so I don't, I don't think we should be dismissives of practise plans, I think they're actually quite useful. But they're a tool, you know, and like all tools, they depend on how you use them.
They're not inherently bad or or good themselves. Just Ian, going back, obviously with the testing, faecal leg counts, does that allow us to perhaps limit, you know, our toxica use, which, you know, obviously again, you know, in practise, when I had my practise, I would talk about. The risk of ocular toxicar in in children and young adults.
I'm saying it whilst it was quite rare, you know, if it's your child that gets affected in their sight, then that's something that is really, really difficult, so. Do, do you think that if we're testing twice a year for, for eggs or, or perhaps because 4 times seems a lot that, you know, we'd need a lot of nurse involvement to do that, wouldn't we? We'd need to have a nurse involved in doing a lot of faecal egg flotations.
How do you think that might fit in or do you just don't think it's very practical? OK, so, so again there's, there's a lot of points there, so I'll try and briefly just sort of break them down. So, you know, in, in terms of testing, you know, you have to say, well, what, what are you aiming to achieve by the testing.
So in ruminants and horses, testing has been incredibly successful, and that's because you're trying to limit resistance mostly. I mean, you know, environmental contamination's good, but it's mostly resistance you're trying to limit. And you, you try to limit that by identifying through testing load shedders.
So not, not negative animals, but load shedders, and you're gonna deliberately allow them to shed. So then you get refusia in the environment and you limit resistance as a result. The problem with cats and dogs is that toxicara is zoonotic.
So, you know, you don't limit resistance by not treating negative animals. So you don't limit resistance by finding a cat and dog that isn't infected and saying, well, we've discovered that, so we're not going to treat them. You know, you only limit resistance by deliberately allowing shedding.
So, you know, it's much more difficult conversation to have to go to a client and say, well, you know, your cat and dog's only shedding, you know, really small numbers. So, you know, there's still a risk, you know, I mean, you might still get sick, but it's really low risk, so we're gonna let you take one for the team, so we can limit resistance in the longer term. It is a very difficult ethically a very difficult conversation to have, so.
The the aims for livestock faecal egg counts are not the same as they would be in small animal practise, so in small animal practise we'd be looking for cats and dogs that aren't shedding to to reduce use overall. The problem there again is it's zoonotic nature, so shedding is intermittent, it comes and goes. So testing every year or every 6 months doesn't tell you what's happening in between.
So you would have to, so if you're going to use it as an alternative, you would have to test much more frequently, so 4 to 12 times a year. And that may be an option. Some people may want to do that, and that may be something that you can put on practise plans, maybe as an alternative option, but that frequent testing, you know, does have an expense component, it has a time component associated with it.
Where I would like to see testing, especially on practise plans, is alongside that treatment. So one of the ways that we can limit resistance is to detect it early, and the only way that you're gonna do that is by doing some testing to demonstrate that your regimes are actually working. So, you know, is, is resistance present, I compliance good?
Is your treatment frequency, if you've done a risk assessment, is it frequent enough? You know, you can only assess those things by doing faecal testing. Alongside treatment, but that can be done less frequently, so that could be done on a practise plan, say once, twice a year, even once a year would would give you useful information.
So what, what's the, you know, obviously you treat 4 times a year with a milvermycin type product or, or, you know, whichever wormer you want to use. How long is it before Toxicara could appear again because. Milurycin doesn't stay in the system for 3 months, does it?
No, it doesn't, and that's, that's the issue. So 4 times a year does not guarantee elimination of of shedding. I mean, even monthly doesn't, but it's probably 90% plus if you're doing it monthly.
So, you know, there is a shedding risk once you go below monthly. So, you know, what you're having to do when you're making your risk assessment is you're balancing zoonotic risk against the other things that you might be wanting to limit, like environmental risk. So it is, it is a balance, and I, I have to pick up, Anthony, you said that ocular toxicorosis is rare, ocular toxicorosis is rare, but it's just one of many forms that toxic, toxicorosis can take.
And the others are much more difficult to diagnose and reporting, it's not a notifiable disease. So, you know, GPs actually have to pick these up, they have to diagnose them, which isn't easy, and then they have to report them. So, you know, it's very, very likely that any reported toxic cara cases are huge underestimates of the number of us that have been exposed in the population.
Similar to to Leishmania. Yeah, yeah. Yeah, yeah.
Ian. This has been fascinating as always, parasitology is such an interesting topic and you, you talk about it with greater passion. Well, thank you for letting me roll on, roll on.
You've got to stop me at some point, haven't you, otherwise we'll be. But it's been, it's been good and I hope people who've been listening have enjoyed it and . Yeah, I'm Anthony Chadwick.
This was that chat and hopefully see you on another episode very soon. Thank you very much. Take care.
