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College of Veterinary Medicine

Tritrichomonas Diagnostic Laboratory

Overview

Trichomonads are protozoa that reside as parasites or commensals of moist, warm and anaerobic body cavities of their hosts. Over 20 years ago trichomonosis of the large intestine of the cat was described and identified as a cause of chronic diarrhea. The trichomonad was identified as Tritrichomonas foetus/blagburni with a genotype that is distinct from venereal T. foetus of cattle.

The infection is now recognized to be distributed worldwide and it is regarded as one of the most common infectious causes of colitis in the domestic cat. The infection is common in catteries and shelters, and while remission of diarrhea may occur over time, persistence of the infection is common and may be lifelong. Diagnosis is based on demonstration of T. foetus/blagburni in feces on the basis of light microscopy, protozoal culture, or PCR amplication using species-specific primers. Feline T. foetus/blagburni is resistant to all commonly used anti-protozoal drugs. Ronidazole is currently the only drug demonstrated to be effective in eliminating T. foetus/blagburni from cats, however this drug has a narrow safety margin and clinical resistance is increasingly recognized. The more we learn about trichomonosis in cats, the more complicated and controversial the infection has become, ranging from what we should call the organism to whether or not we should even bother trying to treat it.

We hope that you will find our website helpful as you navigate the difficulties in diagnosis and treatment of this important feline infection.

We are aware that there is currently an international shortage of Ronidazole. We do not know of any alternative medications that are recognized to be effective for treatment of T. foetus/blagburni. Tinidazole can be considered based on efficacy in at least some cats in the attached study.
This drug has not been approved for use in cats and the pharmacokinetics are not known. Our use was part of an experimental study. Studies have not reported use of tinidazole in clinical feline patients. If you choose to try tinidazole, please be sure to obtain owner consent for this off-label use and be aware of the possibility of side effects akin to those seen with ronidazole or metronidazole.
Tinidazole Study

T. foetus/blagburni PCR Testing 

* Please note that the laboratory cannot provide advice or consultation to cat owners regarding the diagnosis or treatment of T. foetus/blagburni infection. Due to a high call volume the laboratory is unable to return calls from cat owners. Referring veterinarians are welcome to reach out to Dr. Gookin at jgookin@ncsu.edu if a consult would be helpful.

Resources

You can make a difference. Help us in our fight against T. foetus/blagburni infection!

  • Did you know that surveys have suggested that T. foetus/blagburni infects a significant percentage of cats, up to 30% of all purebreds?
  • Did you know that countless numbers of T. foetus/blagburni infected cats were euthanized / given up to shelters prior to our discovery of the only effective treatment, Ronidazole?
  • Do you know that Ronidazole doesn’t always cure a cat of T. foetus/blagburni?
  • The fight isn’t over. We need your help to support our efforts to improve diagnosis and treatment of T. foetus/blagburni infection

Make a tax-deductible donation to STRIVE – by clicking on the button below. You will be directed to the Giving web page. Go to the bottom of the page and search by the fund name “STRIVE”. Select Support for Teaching, Research & Veterinary Education Fund (229256 / 682265). Then add to cart. Enter the amount of your gift and payment information.

Support Our Research

Research Team

Diagnostic Lab Contact: 919.513.6365

JG
Jody Gookin
Jody Gookin PhD

Professor

919-513-6415
JH
Jennifer Holmes

Research Assoc

Gookin Laboratory Tritrichomonas foetus Publications

Our contribution here is a 23 year track record with over 27 original research publications ranging from discovery of this infection, identification of the causative species, proof of Koch’s postulates of disease causation, establishing prevalence and risk factors, development of methods for diagnosis, conducting basic science studies of disease pathogenesis, and identification of the only known treatment. For these achievements, Dr. Gookin received an award of recognition by the American Veterinary Medical Foundation/Winn Feline Foundation for contribution to advancement of feline medicine.

  1. Gookin JL, Papich MG, Meier EK, Enders J,Stauffer SH, Wassack EE, Davidson GS. Auranofin is lethal against feline Tritrichomonas foetus in vitro but ineffective in cats with naturally occurring infection. Vet Parasitol 2024 doi: 10.1016/j.vetpar.2024.110295.
  2. Bierlein M, Hedgespeth B, Azcarate-Peril A, Stauffer SH, Gookin JL. Dysbiosis of fecal microbiota in cats with naturally-occurring and experimentally-induced Tritrichomonas foetus infection. PLoS One 2021 Feb 19;16(2):e0246957. BioProject ID PRJNA692463.
  3. Hedgespeth BA, Stauffer SH, Gookin JL. Association of fecal sample collection technique and treatment history with Tritrichomonas foetus PCR test results in 1,717 cats. J Vet Intern Med 2020;34:734-741.
  4. Dickson R, Vose J, Bemis D, Daves M, Cecere T, Gookin JL, Steiner J, Tolbert MK. Effect of enterococci on feline Tritrichomonas foetus infection in vitro. Vet Parasitol 2019;273:90-96.
  5. Gookin JL, Hanrahan K, Levy MG. The conundrum of feline trichomonosis – the more we learn the “trickier” it gets. J Feline Med Surg 2017;19:261-274. This was a commissioned Premier Review and peer-reviewed article. Article featured by International Society of Feline Medicine social media. One of top cited articles with 19,828 views and downloads.
  6. Tolbert MK, Gookin JL. Mechanisms of Tritrichomonas foetus pathogenicity in cats with insights from venereal trichomonosis. J Vet Intern Med 2016;30:516-526.
  7. Tolbert MK, Stauffer SH, Gookin JL. Cysteine protease activity of feline Tritrichomonas foetus promotes adhesion-dependent cytotoxicity to intestinal epithelial cells. Infect Immun 2014;82:2851-2859.
  8. LeVine DN, Gookin JL, Papich MG, Davidson GS. Twice-daily dosing of RDZ no longer recommended for treatment of intestinal Tritrichomonas foetus infection. Letter to the Editor. J Feline Med Surg 2014; 16:198.
  9. Tolbert MK, Stauffer SH,Gookin JL. Feline Tritichomonas foetus adhere to the intestinal epithelium by receptor-ligand dependent mechanisms. Vet Parasitol 2013;192:75-82.
  10. Papich MG, LeVine DN, Gookin JL, Davidson GS, Stagner WC, Hayes RB. Ronidazole pharmacokinetics in cats following delivery of a delayed release guar gum formulation. Vet Pharm Exp Therap 2013;36:399-407.
  11. Tolbert MK, Leutenegger CM, Lobetti R, Birrell J,Gookin JL. Species identification of trichomonads and associated coinfections in dogs with diarrhea and suspected trichomonosis. Vet Parasitol 2012;187:319-322. 
  12. LeVine DN, Papich MG, Gookin, JL, Davidson GS, Davis JL, Hayes RG. Ronidazole pharmacokinetics after intravenous and oral immediate-release capsule administration in healthy cats. J Fel Med Surg 2011;13:244-250.
  13. Gookin JL, Stauffer SH, Dybas D, Cannon DH. Documentation of in vivo and in vitro aerobic resistance of feline T. foetus isolates to ronidazole. J Vet Intern Med 2010;24:1003-1007.PMID: 20492492..
  14. Gookin JL, Stone MR, Yaeger MJ, Meyerholz DK, MoisanP. Fluorescence in-situ hybridization for identification of Tritrichomonas foetus in formalin-fixed and paraffin-embedded histological specimens of intestinal trichomonosis. Vet Parasitol 2010;172:139-143. PMID: 20447769..
  15. Gray SG, Hunter S, Stone MR, Gookin JL. Assessment of reproductive tract disease in cats at risk for enteric Tritrichomonas foetus infection. Am J Vet Res 2010;71:76-81.
  16. Bissett SA, Coccaro, MR, Malik R, Norris JM, O’Brien C, Gowan RA, Mansfield CS, Nicholls J, Griffin A, Gookin JL. Observed occurrence of Tritrichomonas foetus and other enteric parasites in Australian cattery and shelter cats.J Feline Med Surg 2009; 11:803-807.
  17. Tolbert MK, Gookin JL. Tritrichomonas foetus infection – a new agent of feline diarrhea. Compend Contin Educ Pract Vet 2009;31:374-381.
  18. Bissett SA, Gowan RA, O’Brien C, Coccaro, MR, Gookin JL. Feline diarrhoea associated with Tritrichomonas foetus and Giardia coinfection in an Australian cattery. Aus Vet J 2008; 86(11):440-443.
  19. Stauffer SH, Birkenheuer AJ, Levy MG, Marr H, Gookin JL. Evaluation of four DNA extraction methods for the detection of Tritrichomonas foetus in feline stool specimens by polymerase chain reaction. J Vet Diagn Invest 2008;20:639-641.
  20. Gookin JL, Stauffer SH, Coccaro MR, Poore MF, Levy MG, Papich MG. Efficacy of tinidazole for treatment of cats experimentally infected with Tritrichomonas foetus. Am J Vet Res; 2007;68:1085-1088..
  21. Gookin JL, Stauffer SH, Coccaro MR, Marcotte M, Levy MG. Optimization of a species-specific PCR assay for identification of Pentatrichomonas hominis in canine fecal specimens. Am J Vet Res 2007;68:783-787.
  22. Gookin JL, Stauffer SH, Levy MG. Identification of Pentatrichomonas hominis in feline fecal samples by polymerase chain reaction assay. Vet Parasitol; 2007;145:11-15.
  23. Gookin JL, Copple CN, Papich MG, Poore M, Stauffer SH, Birkenheuer AJ, Twedt DC, and Levy MG. Efficacy of ronidazole for treatment of feline Tritrichomonas foetus infection. J Vet Intern Med 2006; 20:536-543.
  24. Yaeger M, Gookin JL. Histologic features of Tritrichomonas foetus colitis in domestic cats. Vet Pathol; 2005;42:797-804.
  25. Gookin JL, Birkenheuer AJ, St. John V, Spector M, and Levy M. Molecular characterization of trichomonads from feces of dogs with diarrhea. J Parasitol; 2005;91:939-943.
  26. Foster DM, Gookin JL, Poore MF, Stebbins ME, and Levy MG. Outcome of cats with diarrhea and Tritrichomonas foetus infection. J Am Vet Med Assoc 2004;225:888-892.
  27. Gookin JL, Stebbins ME, Hunt E, Burlone K, Fulton M, Hochel R, Talaat M, Poore M, and Levy MG. Prevalence of and risk factors for Tritrichomonas foetus and Giardia infection. J Clin Micro 2004;42:2707-2710. Selected in 2007 by the Faculty of 1000 Biology as “one of the most interesting papers published in the biological sciences, based on the recommendations of over 2000 of the world’s top researchers”.
  28. Gookin JL, Foster DM, Poore MF, Stebbins ME, Levy MG. Use of a commercially available culture system for diagnosis of Tritrichomonas foetus infection in cats. J Am Vet Med Assoc 2003; 222:1-4..
  29. Levy MG, Gookin JL, Poore MF, Dykstra M, Litaker RW. Tritrichomonas foetus and not Pentatrichomonas hominis is the etiologic agent of feline trichomonal diarrhea. J Parasitol 2003; 89:99-104.
  30. Gookin JL, Birkenheuer AJ, Breitschwerdt EB, Levy MG. Single-tube nested PCR for diagnosis of Tritrichomonas foetus in feline feces. J Clin Micro 2002; 40:4126-4130.
  31. Levy MG, Gookin JL, Poore MF, Litaker RW, Dykstra M. Information on parasitic gastrointestinal tract infections in cats (Letter to the Editor) J Am Vet Med Assoc 2001; 218:194-195.
  32. Gookin JL, Levy MG, Law JM, Papich MG, Poore MF, Breitschwerdt EB. Experimental infection of cats with Tritrichomonas foetus. Am J Vet Res 2001; 62:1690-1697.
  33. Gookin JL, Breitschwerdt EB, Levy MG, Gager RB, Benrud JG. Diarrhea associated with trichomonosis in cats. J Am Vet Med Assoc 1999; 215:1450-1455.
  34. Gookin JL, Riviere JE, Gilger BC, Papich MG. Acute Renal Failure in Four Cats Treated with Paromomycin. J Am Vet Med Assoc1999; 215:1821-1823.