Article available at http://www.parasite-journal.org or http://dx.doi.org/10.
1051/parasite/2000073221
EFFICACY OF OXFENDAZOLE FOR THE TREATMENT OF GIARDIOSIS IN DOGS.
EXPERIMENTS I N DOG BREEDING KENNELS
VILLENEUVE V.*, BEUGNET F.** & BOURDOISEAU G.*
Summary :
Giardiosis is one of the most frequent parasites of dogs and cats.
Since several years, the treatment is based on the use of
metronidazole. A coproscopic study in four dog kennels was
conducted to demonstrate, at a significant level, the efficacy of
oxfendazole (Dolthène®, Merial). At the posology of 11.3 mg/kg
each day during three days (D1, D2 and D3), no dogs eliminated
Giardia cysts and all dogs are clinically cured. The importance of
hygienic measures is underlined. In kennels 1 and 2 where
hygienic conditions were poor, dogs reexcreted cysts again after
treatment. In kennels where the boxes were disinfected, no dogs,
treated with 2 2 . 6 or 1 1 .3 mg/kg, reexcreted Giardia cysts.
KEY WORDS : Giardia duodenalis, dog, oxfendazole.
INTRODUCTION
G
iardiosis is an infectious disease o f the small
intestine due to Giardia duodenalis (= Giardia
intestinalis = G. lamblia) clinically showing the
development o f an enteritis with chronic diarrhoea with
steatorrhea (Barr & B o w m a n , 1994; Bourdeau, 1993;
Leib & Zajac, 1999; T h o m p s o n & Reynoldson, 1997;
T h o m p s o n et al., 2000; Zajac, 1 9 9 2 ) . Infections are
associated with a decrease o f microvillus surface area,
reduced intestinal e n z y m e activity and increased intes-
tinal transit (Deselliers et al, 1 9 9 7 ) . T h e s e pathological
c h a n g e s result in a malabsorptive diarrhea, w h i c h is
the major clinical sign o f giardiosis. This protozoan is
the most commonly identified pathogen of humans and
animals (livestock and pets) throughout the world
( T h o m p s o n et al., 2 0 0 0 ) . Giardiosis is frequent in car-
nivorous c o m p a n i o n animals, showing living s o u n d
carriers that form the parasite tank (Barr & B o w m a n ,
* Service de Parasitologic, ENVL, 1, avenue Bourgelat, F-69280 Marcy
l'Étoile.
** Merial, 29, avenue Tony Gamier, F- 69348 Lyon Cedex 07.
Correspondence: F. Beugnet.
Parasite, 2000, 7, 221-226
Mémoire
Résumé : EFFICACITÉ DE L'OXFENDAZOLE DANS LE TRAITEMENT DE
L'INFECTION DES CHIENS PAR GIARDIA DUODENALIS. ESSAIS EN ÉLEVAGES
DE CHIENS
La giardiose est l'une des parasitoses digestives les plus fréquentes
chez le chien ou le chat. Le traitement a longtemps reposé sur
l'emploi du métronidazole. Un essai conduit dans quatre élevages
de chiens démontre significativement l'efficacité de l'oxfendazole,
Dolthène . Employé à la posologie de 11,3 mg/kg pendant trois
®
jours de suite (J1, J2 et J3), l'oxfendazole négative l'excrétion des
kystes de Giardia duodenalis et entraîne une guérison clinique.
L'importance des mesures sanitaires de désinfection des box,
empêchant les réinfections, est soulignée. Dans les deux élevages
où les conditions hygiéniques sont médiocres, les chiens traités
réexcrètent des kystes de protozoaires. Dans les élevages où des
mesures de désinfection ont été mises en œuvre avant les
traitements, aucun chien, traité à 22,6 ou 11,3 mg/kg, n'a
réexcrété de kystes de Giardia.
MOTS CLÉS : Giardia duodenalis, chien, oxfendazole.
1994; Bourdeau, 1993; Leib & Zajac, 1999; T h o m p s o n
& Reynoldson, 1997; Zajac, 1 9 9 2 ) . Giardiosis is also o f
great importance in livestock and is frequently asso-
ciated with diarrhea in dairy cattle (O'Handley, 2 0 0 0 ) .
It is considered b y several authors to b e a zoonosis,
even though various adjusted strains host species are
genetically singled out (Capon, 1989; Gasser, 1990;
Hopkins, 1997; T h o m p s o n et al., 2 0 0 0 ) . S o m e strains
s e e m to be able to infect human from livestock or dogs
and vice versa, and, in the opposite, other strains s e e m
to b e very specific. Further genetic studies are n e e d e d
to understand these variations (Gasser, 1990; Hopkins,
1997; Meloni et al., 1995; T h o m p s o n et al., 2 0 0 0 ) . Giar-
diosis is the most c o m m o n l y non viral reported intes-
tinal infection in humans. Domestic carnivores could
represent a significant parasite source for their owners.
This digestive parasite is underestimated b y veterina-
rian practice b e c a u s e o f the difficult diagnosis w h i c h
is based on faeces coproscopy (Barr & coll., 1994; Beu-
gnet, 1998; Beugnet, 1 9 9 6 ) . It is considered as a major
cause o f diarrhoea in dogs, in k e n n e l s or at h o m e .
A study on urban domestic carnivores intestinal para-
sitism ( B e u g n e t et al., 2 0 0 0 ) w a s led in Paris suburbs
in 1998/1999. It s h o w e d that 14.7 % of cats w e r e
Giardia duodenalis infected. 30.4 % of dogs under six
months-old w e r e infected versus 7.1 % of adults. This
221
 VILLENEUVE V., B E U G N E T F. & B O U R D O I S E A U G.

flagellate s e e m s to b e o n e o f the most frequent intes- Out o f 199 dogs, 34 ( 1 8 males and 16 females) proved
tinal parasites in dogs and cats, as helminths (Franc et to b e Giardia duodenalis infected. T h e s e w e r e added
al., 1 9 9 7 ) . A first study led b y the Parasitology labo- to the treatment trials. 19 dogs w e r e under o n e year
ratory o f the Lyon Vet School s h o w e d Giardia cysts old, and five a b o v e . S e x and age are m e n t i o n e d in
in 10 % of the faeces by coproscopic studies conducted Table I for e a c h dog.
on carnivores suffering from diarrhoea and having O x f e n d a z o l e (Dolthène®, Merial Laboratories) is a
g o n e to consulting ( B e u g n e t , 1 9 9 8 ) . liquid orally given at a posology of 11.3 or 22.6 mg/kg,
Evolution is favourable after the implementation of a three days running. A coproscopic follow-up shows the
symptomatic and specific treatment. This latter has long possible decrease o f protozoan cysts in faeces. Treat-
b e e n b a s e d on metronidazole ( F l a g y l ) oral use, at a
®
ment is carried out at D 1 , D2 and D 3 . Semi-quantita-
p o s o l o g y of 20 mg/kg, twice a day during 10 days tive c o p r o s c o p i c studies w e r e m a d e b y MacMaster's
(Barr & B o w m a n , 1994; Zajac, 1 9 9 2 ) . S o m e experi- technique at DO, D5, D7, D9 and D 1 2 . After experi-
ments stated a p o o r efficacy and existing intolerance mental infection with Giardia cysts, the dogs e x c r e t e d
signs such as nausea, vomiting or ataxy ( T h o m p s o n & cysts in 4 8 to 72 hours (Leib & Zajac, 1999); s o a survey
Reynoldson, 1992). Metronidazole chemoresistant para- during 10 days will s h o w if dogs are cured or not.
sitic strains s e e m recrudescent in the field and could There is n o description in dogs of long periods without
explain human medecine therapeutic failures (Johnson, excretion, and three c o p r o s c o p i e s at 4 8 hours interval
1993; Upcroft & Upcroft, 1 9 9 7 ) .
Benzimidazoles activity was demonstrated more recently
with an efficacy a b o v e 90 % (Barr et al., 1993; Barr et Oxfendazole use at a posology of 11.3 mg/kg each day during
al., 1994; Barr et al., 1998; Morgan et al., 1993). T h e use three days
of these molecules could b e favourable due to their tole- Age
rance, even at a high posology. Albendazole seems the- Kennel 1 Sex (M/F) (month) DO 1» D12
Mean 6 dogs: 4.67 5 0* 1.67*
refore effective w h e n administrated to dogs at a poso-
3M, 3F
logy o f 25 mg/kg twice a day during two days (Barr et Sem 2.58 0 0 0.52
al., 1993) while fenbendazole (Panacur 250®, Intervet) U Rank test: significant difference beteween DO and D12 with risk
is also effective at 50 mg/kg during three days (Barr et error of 10 -4

al., 1994). Oxfendazole (Dolthène®, Merial) is an anthel- Oxfendazole use at a posology of 22.6 mg/kg, three days run-
minthic used in several countries like France, Italy, ning
Spain, or Germany for dogs deworming. Its potency on Kennels 1 Age
Giardia duodenalis may prove very interesting joint to and 2 Sex (month) DO D5 D7 D9
the standard anthelminthic spectrum. Oxfendazole is o n e Mean 11 dogs: 3.81 3.64 2 0.82* 1.73*
7M, 4F
o f the anthelmintic most often used in Europe to
Sem 2.08 1.57 2.05 0.87 1.19
deworm the dogs. Febantel, fenbendazole, and oxfen- U Rank test: significant difference beteween DO and D9 with risk
dazole are three benzimidazoles which are based on the error of 2 %
same nuclear and which have the same metabolites after Oxfendazole use at a posology of 22.6 mg/kg, three days run-
administration (Fig. 1) (Towsend & Wise, 1990). As fen- ning. Treatment in disinfected boxes.
bendazole is active against Giardia, it was of great
Age
interest to demonstrate the efficacy o f oxfendazole (the Kennel 3 Sex (month) DO D5 D7 D9
active sulfoxyde metabolite of fenbendazole). Mean 10 dogs: 5 5 0* 0* 0*
In this study, the trials w e r e d o n e b y veterinary prac- 5M, 5F
Sem 0 0 0 0 0
titioners in dog k e n n e l s . A c o p r o s c o p i c s c r e e n i n g
U Rank test: significant difference at D5, D7 and D9 with DO at les:
helped to identify Giardia infected dogs and later to than 10"6

treat them. Both Giardia cysts excretion and these ani-

Oxfendazole use at a posology of 11.3 mg/kg, three days run-
mals clinical state w e r e followed up.
ning. Treatment in disinfected boxes.
Age
Kennel 4 Sex (month) DO D5 D7 1)')
MATERIALS A N D M E T H O D S Mean 9 dogs: 24.11 4.33 0* 0* 0*

I
4M 5F
nfected dogs c o m e from five pup kennels dedicated Sem 21.47 1 0 u (1
to sale. A c o p r o s c o p i c study h e l p e d to identify U Rank test: significant difference at D5, D7 and D9 with DO at less
than 10 -6

Giardia duodenalis infected dogs. 199 dogs (73 males

and 126 f e m a l e s ) w e r e added to the previous study. Sem: standard error of the mean.
T h e s e dogs b e l o n g to various breeds: Scottish, Westie, * Significant difference between the number of Giardia cysts at D0
Lhassa Apso, Poodle, American Cocker, Setter, Alsatian, compare to D5, D7 or D9.
Leonberg, and St Bernard. Table I. - Results of the four successive experiments.

222 Parasite, 2000. 7, 221-226

 EFFICACY OF OXFENDAZOLE FOR THE TREATMENT OF GIARDIOSIS IN DOGS
Fig. 1. - Chemical structures of some benzimidazoles anthelmintics (Towsend & Wise, 1990).
c a n diagnose giardiosis with a sensibility superior to
9 5 % (Barr et al., 1992; Leib & Zajac, 1 9 9 9 ) .
T h e floating technique, using a high density liquid,
especially suits protozoan cysts research, since these
latter are not very dense (Barr et al., 1992). Magnesium
sulfate with 1.28 density up to 25° C (35 g o f m a g n e -
sium sulfate per 100 ml o f water) w a s held. Cysts
n u m b e r quantification is given with an order of size.
Quantification notions:
( 5 ) : m o r e than 1,000 Giardia cysts /5 g faeces,
( 4 ) : b e t w e e n 200 and 1,000,
( 3 ) : b e t w e e n 100 and 200,
( 2 ) : b e t w e e n 10 and 100,
( 1 ) : p r e s e n c e : less than 10,
( 0 ) : n o cysts.
Statistical comparisons have b e e n m a d e b e t w e e n the
n u m b e r o f cysts excreted before and after the anthel-
mintic treatment using non parametric test (Mann &
Whitney U test).
Parasite, 2000, 7, 221-226
Four successive experiments w e r e conducted. T h e first
t w o in two k e n n e l s w h e r e hygienic conditions were
p o o r and with n o disinfection measures before treat-
ment. T h e following two trials w e r e carried out in t w o
other kennels w h e r e dogs are in b o x e s with disinfec-
tion measures before treatment. T h e disinfection was
p r e c e d e d b y a cleaning with high pressure water
(using Karcher). T h e n the disinfection w a s made using
both sodium hypochlorite solution and an a m m o n i u m
IV solution for farms ( T H 4 , Sogeval Laboratory).
+ ®
RESULTS
PRELIMINARY SURVEY
O
ut o f the 199 dogs added to the survey, 136
(68.3 % ) are at least infected b y o n e parasite.
Giardia duodenalis was found in 34 dogs
223
 VILLENEUVE V., BEUGNET F. & BOURDOISEAU G.
(17.1 % ) . This p r e v a l e n c e w a s increased to 4 4 . 4 5 % in
dogs u n d e r six m o n t h s (24/54).
O X F E N D A Z O L E AT A P O S O L O G Y O F 1 1 . 3 MG/KG,
W I T H N O DISINFECTION MEASURES
At first, o x f e n d a z o l e was orally given three days run-
ning (D1 to D 3 ) at a p o s o l o g y o f 11.3 mg/kg to all
animals proved positive at screening.
In k e n n e l 1, Giardia cysts w e r e detected in six dogs
including four pups under three months-old and two
y o u n g a g e d eight months. All these pups had a diar-
rhoeic enteritis. Results are s h o w n in T a b l e I.
A d e c r e a s e in the Giardia cysts n u m b e r is underlined,
alongside with negativation for all puppies at D 9 . In
spite o f a reexcretion o f cysts on D a y 12, the diffe-
r e n c e is significant at 1 0 . All pups showing digestive
- 4
troubles s t o p p e d at D 5 , without later r e a p p e a r a n c e .
H o w e v e r , k e n n e l condition, with p o o r hygiene (ani-
mals in p a d d o c k s with grassy path from w h i c h floor
disinfection is unfeasible), surely results in a fast n e w
infection o f pups. Since D12, a cysts reexcretion is
n o t i c e d in lesser ratio.
T h e following trials w e r e led according to t w o a x e s
so as to cure it all: 22.6 mg/kg posology trial and health
measures implementation to restrict reinfections by
cysts.
OXFENDAZOLE AT A POSOLOGY OF 22.6 MG/KG,
WITH NO JOINT DISINFECTION MEASURES
Animals from k e n n e l 1 that proved positive at the e n d
o f the first trial t o o k part again in the trial with d o u b l e
p o s o l o g y , e x c e p t dogs o n e up to four that w e r e sold
m e a n w h i l e . Other pups, suffering from diarrhoea and
emaciation, and excreting Giardia cysts w e r e included
in this s e c o n d trial. In k e n n e l 2, five d o g s were
detected a m o n g w h i c h four pups under six months-
old and o n e y o u n g adult aged eight months.
All these animals orally t o o k o x f e n d a z o l e ( D o l t h è n e )
®
at a p o s o l o g y o f 22.6 mg/kg, three days running.
At d o u b l e p o s o l o g y there is a significant d e c r e a s e o f
the cysts number, from thousands per gram o f f a e c e s
to n o n e , since D 5 for k e n n e l 2. That is to say a 100 %
efficacy at D 5 . This k e n n e l had higher hygiene condi-
tions than k e n n e l 1. A clinical recovery is noticed o n
all pups.
In k e n n e l 1, the cysts n u m b e r d e c r e a s e is less impor-
tant, going from thousands to f e w hundreds. Reinfec-
tions or Giardia multiplication retakings o c c u r from D7
and D 9 according to experiments, that is to say t w o
up to three days after the e n d o f the treatment. In spite
o f the r e e x c r e t i o n o f cysts, the difference b e t w e e n DO
and D7 counts is significant at less than 1 1 0 - 3
and bet-
w e e n DO and D 9 is significant at 2 %.
224
Mémoire
It appears to b e necessary to carry out a supervised
trial in w h i c h reinfections are restricted to a minimum
b y strict hygiene measures.
OXFENDAZOLE AT A POSOLOGY OF 22.6 MG/KG,
WITH BOXES DISINFECTION
B o x e s disinfection is d o n e on the first day o f treatment.
B o x e s washing followed by a disinfection with a m m o -
nium IV and/or sodium hypochlorite w e r e m a d e in
k e n n e l s 3 and 4.
In kennel 3 with very g o o d hygiene conditions (regular
worming, daily b o x e s cleaning, animals b r e a k d o w n by
a g e groups, maternity placing for pregnant and nur-
sing females) and after b o x e s disinfection o n the first
day o f treatment, there is a 100 % efficacy o n 10 pups
with n o excretion c o m i n g b a c k . T h e s e 10 pups u n d e r
five months-old (five males and five f e m a l e s ) all suf-
fered from a clinical giardiosis. All signs disappeared
since D7, and never r e a p p e a r e d .
OXFENDAZOLE AT A POSOLOGY OF 1 1 . 3 MG/KG,
WITH BOXES DISINFECTION
This e x p e r i m e n t was carried out in k e n n e l 4. Eight
adults infected and a six months-old pup were
detected. B o x e s w e r e w a s h e d and disinfected o n the
first day o f treatment. As in the previous experiment,
dogs did not g o out o f their b o x e s during the w h o l e
e x p e r i m e n t (from D1 until D 9 ) in order to avoid all
reinfection risk. T h e r e is a stop o f cysts excretion in
100 % o f cases.
DISCUSSION
I
n the first e x p e r i m e n t ( k e n n e l 1), dogs have b e e n
treated with o x f e n d a z o l e at the p o s o l o g y u s e d for
anthelmintic treatment. Results s h o w e d a significant
decrease in the n u m b e r o f cysts ( > 95 % ) but n o disap-
p e a r a n c e o f their excretion. T h e r e are two possible
explanations: either the o x f e n d a z o l e p o s o l o g y was not
high enough to o v e r t h r o w Giardia, or dogs got
infected again b e t w e e n the e n d o f the treatment and
c o p r o s c o p i c studies. Reinfection assumption is plau-
sible due to cysts resistance in the outside s p a c e ( t w o
m o n t h s at 8 ° C ; o n e m o n t h at 21° C; partial resistance
at - 13° C during t w o w e e k s ) , and the fact that floor
disinfection w a s not d o n e b e c a u s e o f k e n n e l condi-
tions ( B a r r & B o w m a n , 1994; Thompson & Rey-
noldson, 1993; Zajac, 1 9 9 2 ) . O n the other hand, only
o n e c o p r o s c o p i c study was carried out during s c r e e -
ning, with the result that s o m e carriers animals may
not have b e e n detected and therefore remained sources
o f cysts for dogs o n test (Barr & B o w m a n , 1994; Barr
et al., 1992).
Parasite, 2000, 7, 221-226
 EFFICACY OF OXFENDAZOLE FOR THE TREATMENT OF GIARD.OSIS IN DOGS
T o m e e t these t w o assumptions a double dose c o m -
pared to the previous o n e ( 2 2 . 6 mg/kg) was tested, set-
ting u p o r not hygiene conditions ( k e n n e l premises
disinfection).
In kennels 1 and 2, the d o u b l e d o s e w a s used without
floor disinfection ( p a d d o c k , m u d floor and grass ken-
nels) a n d the efficacy o f treatment remained partial
(decrease o f the emitted cysts n u m b e r ) .
In k e n n e l 3, t h e d o u b l e d o s e o f oxfendazole joint to
floor disinfection h e l p e d achieve a total disappearance
of cysts excretion a n d pups clinical recovery. This
e x p e r i m e n t underlines t h e importance o f the dogs
reinfection risk b y cysts existing in their environment.
F e n b e n d a z o l e is effective in the canine giardiasis treat-
ment at the usual anthelminthic posologies and admi-
nistration rates for dogs (Barr et al., 1994; Zajac et al.,
1998; Zajac et al., 1992). Oxfendazole should have
b e e n tested at anthelmintic posology ( 1 1 . 3 mg/kg) res-
tricting reinfections. T h e experiment in kennel 4 proves
this effect, since n o n e o f the nine treated dogs reex-
creted cysts during the three running controls. Canine
giardiosis treatment c a n b e b a s e d o n oxfendazole use
at a posology o f 11.3 mg/kg per os three days running.
Out o f 3 4 treated dogs, at simple or double posology,
n o n e s h o w e d troubles or signs o f toxicity o f the mole-
cule.
This study being led within dog kennels dedicated to
sale, n o breeder a c c e p t e d untreated sample portion.
Besides, all dogs - infested and showing clinical signs
or not - w e r e w o r m e d . Several studies o n canine giar-
diosis prove that dogs s h o w n o self-recovery inclina-
tion a n d that signs such as excretion c a n continue
months a n d even years (Barr & B o w m a n , 1 9 9 4 ;
T h o m p s o n & Reynoldson, 1 9 9 3 ) . Giardiosis treatment
has long b e e n based o n metronidazole use. Its potency
is still n o t c o m p l e t e , undesirable effects are frequent,
and chemoresistant Giardia strains are n o w described
(Barr & B o w m a n , 1 9 9 4 ; J o n h s o n , 1 9 9 3 ; Upcroft &
Upcroft, 1993). S o m e investigators have pointed out the
potency o f s o m e anthelmintics from t h e benzimida-
zoles group, especially albendazole, f e n b e n d a z o l e or
febantel. Albendazole is not used in dogs and presents
a medullary toxicity in s o m e c a s e s (Meyer, 1 9 9 8 ;
Stokol, 1 9 9 7 ) . Febantel joint to pyrantel a n d prazi-
quantel has s o m e potency o n Giardia w h e n adminis-
trated three days running (Barr et al., 1994; Zajac et
al., 1998), but it is usually used in the field with a
unique administration. F e n b e n d a z o l e is effective three
days running at a posology o f 5 0 mg/kg (Barr et al.,
1994; Zajac et al., 1 9 9 8 ) . O x f e n d a z o l e also has a signi-
ficant effect o n this flagellate protozoan in addition to
its anthelmintic large potency, including Dipylidium
caninum. Health m e a s u r e s are still essential. This
study s h o w s that, without b o x e s disinfection a n d
washing, dogs quickly get infected again.
Parasite, 2000, 7, 2 2 1 - 2 2 6
Mémoire
Giardiosis is nowadays considered b y many investi-
gators as o n e o f the main digestive parasitosis in dogs
and cats, in kennels but also at t h e owner's place.
S o m e strains o f this protozoan have a zoonotic aspect:
s o m e animal strains being able to infect human. There
are populations adjusted to each kind o f host, but
interspecific transmissions are still possible (Capon,
1989; Gasser, 1990; Hopkins, 1997; Meloni et al., 1995).
Screening and struggle measures against this enteritic
parasite are b o u n d to expand. They will join health and
medical measures. T h e treatment o f infected dogs is
o n e point, t h e v a c c i n e d e v e l o p m e n t a n o t h e r o n e
(Olson et al., 1997; Olson et al., 2 0 0 0 ) . Since a few
months, a vaccine h a s b e e n commercialised for dogs
in kennels (Giardia Vax®, Fort D o d g e Laboratories)
(Olson et al., 2 0 0 0 ) . T h e dogs s h o w n o diarrhea but
the excretion o f kysts is still present. Like for other
parasitosis, the control measures will b e integrated and
b a s e d o n both vaccination in collectivities, treatments,
and disinfection in k e n n e l s . As t h e cats are often
infected b y Giardia intestinalis, the possibility o f treat-
ment with benzimidazoles should n o w be investigated
in this species.
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Reçu le 1 1 mai 2 0 0 0
Accepté le 2 7 juin 2 0 0 0

226 Parasite, 2000, 7, 221-226

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