Learning Center

Tritrichomonas

Tritrichomonas is a very common (worldwide) cause of digestive upset in cats and kittens. It is most common in cats that are housed in large groups such as multi-cat homes, catteries, and shelters. Lots of cats infected with “Tritrich” shed the parasite in their stools without showing any symptoms. When symptoms do arise, occasional or ongoing abnormal stools (soft stool or diarrhea, even bloody or with mucus) are most likely. For cats with these or other symptoms of digestive upset, include screening by PCR (ClueJay Cat Stool Test Level 3) as a reliable way to search for Tritrichomonas and other disease-causing microbes found in cat intestines.

A survey of 117 cats from 89 catteries revealed the prevalence of Tritrichomonas blagburni at 31% among cats (36 out of 117) and catteries (28 out of 89). 

Companion Animal Parasite Council (CAPC)

All About Tritrichomonas

What Are Tritrichomonas?

Tritrichomonas are single-celled parasites that can infect and damage the large bowel (cecum and colon) of cats. They are protozoa (like Giardia, coccidia (Cystoisospora spp., Toxoplasma gondii), and Cryptosporidium) and not “worms”, so are not susceptible to “deworming” medications used for roundworms, hookworms, tapeworms, or whipworms. With the naked eye you won’t ever see Tritrich (or other protozoa) in your cat’s stool. This is because all stages of their life are microscopic.

Tritrich most often infects cats and kittens without causing symptoms or only causing mild symptoms. The most common sign is occasional or ongoing diarrhea (sometimes bloody or with mucus). Other signs include increased urgency, straining, or pain when passing stool, anal redness and swelling, and (in bad cases) rectal prolapse.[2,3] These bowel signs can be ongoing (lasting weeks, months, or even years) or come and go with weeks or months in between.[1]

Tritrich is highly contagious between cats and once cats are infected, they are presumed to stay infected and shed this protozoa long-term.[3,4] While the exact mode of transmission is uncertain, it is thought to occur when an uninfected cat ingests Tritrich from contact with stool of an infected cat. This is more likely when cats are kept close together or in large groups in a home, cattery, or shelter. [2,4]

It was originally thought that the species of Tritrichomonas that affected cats was the same one that affected cattle (Tritrichomonas foetus). It has since been determined that cat Tritrich is a different species and renamed Tritrichomonas blagburni, though many people use both names interchangeably.[2] 

Searching for Tritrich in stool samples is best done with microbe testing by PCR (ClueJay Cat Stool Test Level 3).

How Common Are Tritrichomonas?

From surveys in the U.S. and around the world, Tritrichomonas blagburni infections are worldwide and more common in cats that are housed in large groups such as multi-cat homes, catteries, and shelters. “A survey of 117 cats from 89 catteries revealed the prevalence of T. blagburni at 31% among cats (36 out of 117) and catteries (28 out of 89)” based on several types of stool tests.[2] These positive cats were more likely to have experienced recent diarrhea, had coccidia infections as adults, and less square feet of housing per cat.[2]

T. blagburni also appears to be more common in cats and kittens that are less than one or two years of age.[2,4] Since many infected cats shed Tritrich into their stool without showing any symptoms, uninfected cats living in close proximity can get infected. This happens through direct contact with the infected cat’s stool, or from drinking water or canned food that was contaminated with that stool. Cats might also ingest Tritrich during self-grooming or mutual grooming fur that was in recent contact with infected stool.

While Tritrich is common, finding it under the microscope isn’t. On occasion Tritrich is identified on fecal smear or O&P (ova (egg) and parasite) stool tests. However, it cannot be reliably diagnosed this way because it looks like two other common protozoa: Giardia and Pentatrichomonis hominis. Giardia can cause similar symptoms as Tritrich, but each are treated differently. P. hominis are not considered harmful so don’t need to be treated. Most of the time, microbe testing by PCR (ClueJay Cat Stool Test Level 3) is needed to detect the presence of this parasite in cat stool.

What Do Tritrichomonas Look Like?

Tritrichomonas are not viruses, bacteria, or worms. They are protozoa like Giardia and coccidia (Cystoisospora spp., Crypotosporidium, Toxoplasma). These are all single-celled parasites that you will never see with the naked eye and are very difficult to find under the microscope

Tritrich take on two forms: motile, feeding trophozoites (trophs) and pseudocysts. The troph feeding form of the parasite lives within the cat’s large bowel (“troph” means nourishment and “zoon” means animal). Tritrich trophs are shaped like pears with whip-like tails called flagella, which are used like small propellers to swim.[2] Like Giardia, trophs are not designed to survive outside of the cat and quickly die and decompose when passed in the stool. Unlike Giardia, Tritrich do not form hardy, resistant cysts which survive in the environment for weeks to months. Instead for protection, Tritrich trophs enclose themselves in less resistant pseudocysts which survive only for a few hours.[2]

While the parasite may occasionally be found in fecal smear or O&P (ova (egg) and parasite) stool preparations, neither is a reliable method for finding them. They are much smaller than worm eggs and even smaller than coccidia spores. Even more challenging, Tritrich and Giardia look almost identical, and Tritrich also looks like a non-pathogen protozoon called Pentatrichomonis hominis. Therefore, microbe testing by PCR (ClueJay Cat Stool Test Level 3) is needed to reliably test for the presence of Tritrichomonas.

What Symptoms Are Caused By Tritrichomonas?

Tritrichomonas trophozoites cause irritation and inflammation of the cat’s large intestine which explains the typical symptoms. The most common sign is occasional or ongoing diarrhea (sometimes bloody or with mucus). Young adult cats under the age of 2 years old are at highest risk for developing these complications.[4]

Other signs in cats and kittens include increased urgency, straining, or pain when passing stool, anal redness and swelling, and (in bad cases) rectal prolapse.[2,3] These bowel signs can be ongoing (lasting weeks, months, or even years) or come and go with weeks or months in between.[1] Stress may trigger the onset of clinical signs (e.g., overcrowding).

Fortunately for most cats, the infection is never harmful enough to cause noticeable symptoms. However, these cats are highly infectious to other cats because they continue to shed these protozoa long-term in their stool.[4]

How Do Cats Get Tritrichomonas?

Infection occurs when an uninfected cat or kitten ingests the Tritrichomonas parasite from the indoor (more likely) or outdoor environment. This happens when Tritrich in recently passed (fresh) stool from an infected cat is accidentally swallowed by an uninfected cat. Cats might also ingest Tritrich during self-grooming or mutual grooming fur that was in recent contact with infected stool.

While Tritrich does not survive long once passed in stool, it still manages to be very contagious.[4] This is especially true when multiple cats are housed together in a home, cattery, or shelter.[2] These multi-cat situations can make maintaining environmental cleanliness more difficult and stool contamination outside of the litterbox more likely. Tritrich may survive 30 minutes in dry stool, up to an hour in water, and maybe 2-3 hours if it gets in cat urine or canned food.[2] Tritrich does not seem to survive long at all in the litterbox.[2]

Once cats are infected, they are presumed to stay infected and shed this protozoa long-term.[3,4] Thus cats with Tritrich risk infecting other cats and close proximity increases that risk.[4]

What Is The Tritrichomonas Life Cycle?

Tritrichomonas trophozoites inhabit the large intestine of the cat or kitten, mostly in the cecum and colon where they cause bowel irritation and inflammation. This leads to clinical signs in some cats like diarrhea (sometimes bloody or with mucus), increased urgency, straining, or pain when passing stool, anal redness and swelling, and (in bad cases) rectal prolapse.[2,3] These bowel signs can be ongoing (lasting weeks, months, or even years) or come and go with weeks or months in between.[2] Stress may trigger the onset of clinical signs.

Tritrich is highly contagious between cats and once cats are infected, they are presumed to stay infected and shed this protozoa long-term.[3,4] While the exact mode of transmission is uncertain, it is thought to occur when an uninfected cat ingests Tritrich from contact with stool of an infected cat. This is more likely when cats are kept close together or in large groups in a home, cattery, or shelter.[2,4]

Unlike Giardia, Tritrich doesn’t have a hardy, protective cyst form to survive long periods of time outside of the cat in the environment. Tritrich uses a less hardy, pseudocyst which are immediately infectious in fresh stool. Both trophs and pseudocysts multiply their numbers by simply duplicating themselves (binary fission).[2]

Pseudocysts survive for only a very short time after being passed in the stool. They may last 30min in dry stool, up to an hour in water, and maybe 2-3 hours if it gets in cat urine or canned food.[2] Tritrich does not seem to survive long at all in the litterbox.[2] Once infected, cats can start shedding the parasite in about two weeks and keep shedding for months or years.[2] Thus catteries, shelters, and multi-cat households can become and stay contaminated with Tritrich with continued shedding by infected cats.

The rest of the details of the Tritrich lifecycle are still mostly unknown. This parasite is very common worldwide, and while the percentage of cats infected with Tritrich may be surprisingly high (30%), most cats fortunately won’t show symptoms.[3] Young adult cats under the age of 1 or 2 years old are at most risk for clinical signs like soft stools or diarrhea.[2,4]

Can People Or Other Pets Get Tritrichomonas?

Trichomoniasis is not considered a zoonotic disease (animal to human transmission). However, rare cases of human infection have happened and since transmission is possible, people should practice good hygiene (washing hands; avoiding contact with cat stool) around cats that carry Tritrichomonas.[3,4,5]

If your cat had carried or does carry Tritrich and you or a family member that interacts with the cat becomes sick with intestinal problems, then be sure to tell the human healthcare professionals. Presumably, people with immune suppression are at greater risk. While the chance of transmission to humans from a cat is extremely low, it isn’t zero.[5]

Dogs are not considered at risk for Tritrich either. As with people, infection has only been reported rarely in dogs.[2]

How Are Tritrichomonas Prevented & Treated?

While the exact mode of transmission is uncertain, it is thought to occur when an uninfected cat ingests Tritrich from contact with fresh stool of an infected cat. This is much more likely when multiple cats are kept close together in a home, cattery, or shelter.[2,4] These multi-cat situations can make maintaining environmental cleanliness more difficult and stool contamination outside of the litterbox more likely.

Stress may cause infected cats to develop symptoms like diarrhea (maybe with blood or mucus). Cats are stressed by overcrowding and sometimes stressed just living with one or more other cats. Competition for food, litterboxes, attention, and safety can all be day to day stressors of multi-cat living. Diarrhea can get outside of the litterbox and on feet and fur, making transmission of Tritrich to other cats even more likely. When possible, separation of infected cats from uninfected cats is advised until the infected cats can be successfully treated.[3]

Tritrichomonas are infectious immediately upon passing in the stool so prevention is based on keeping the environment clean. Tritrich does not seem to survive long at all in the litterbox but may survive 30 minutes in dry stool, up to an hour in water, and maybe 2-3 hours if it gets in cat urine or canned food.[2] Giving cats constant access to fresh, clean water and food, and quickly picking up and properly disposing of cat stool are the two most practical ways to prevent Tritrich infections. Although preventive measures are helpful, infections are still possible.

Most of the time, Tritrichomonas infections are not discovered unless veterinarians are searching for the cause of diarrhea or other digestive problems in cats or kittens. Once found, vets will often encourage pet owners to treat Tritrich infected cats to remove that potential cause of the symptoms. Once one cat is diagnosed, usually the other cats in the same household are then tested to determine which are infected. Then the other cats (with or without symptoms) can be treated as well.

Treating cats even if symptoms aren’t present is typically used for roundworms, hookworms, tapeworms, whipworms, and coccidia. The rationale for this is threefold: parasite infections can worsen over time and lead to symptoms and disease, cats with intestinal parasites can be expected to shed them in their stools and risk infecting other cats, and some parasites can infect and harm people. These are all sensible reasons to try and eliminate Tritrichomonas infections in cats, even if they don’t have symptoms at the time of diagnosis.

Getting ahead of a Tritrichomonas infection can be a tough task with multiple cats, especially in a cattery, multi-cat household, or shelter. Regularly disinfecting these indoor environments can help kill the parasite to prevent infections of other cats. Diluted chlorine bleach with water (at 1:32 ratio) is very effective at killing Tritrichomonas on hard surfaces.[4] Thoroughly wash the cat’s living and sleeping areas that were contaminated with stool.

There are currently no FDA-approved medications to treat this parasite in the U.S. and response to treatment (elimination of Tritrichomonas) isn’t always successful. This is most likely when the cat remains in an environment where re-infection risk is high, but not always. Other considerations for treatment failure are a poor immune response or drug resistance.[2,4]

Where Are Tritrichomonas Medications Purchased?

ClueJay does not dispense or prescribe medications, and there are no FDA-approved medications in the U.S. for Tritrichomonas treatment.[2,4] There is an off-label medication called ronidazole that is used. Ronidazole is an anti-protozoal in the same family as metronidazole and fenbendazole, which are off-label medications used to treat Giardia in cats. While ronidazole is not approved by the Food and Drug Administration (FDA) for the treatment of Tritrichomonas, it can be purchased through a compounding pharmacy in the U.S. with a veterinarian’s prescription.

While it is always best to consult with a veterinarian prior to administering any medication, even an OTC version, it is especially true for off-label treatment of Tritrichomonas. Ronidazole dosing is at the upper limit safely tolerated by cats and side effects can include neurologic signs.[2,3] Always read the medication administration directions carefully and be on the lookout for potential side effects (like vomiting) when any medication is administered.

When/How Is Cat Stool Tested For Tritrichomonas?

Simply put, include a PCR test for Tritrichomonas whenever a cat has frequent or ongoing abnormal stools (soft stool or diarrhea) or other digestive problems. Need details? Read on.

ClueJay Cat Stool Test Level 3 includes a Tritrichomonas by Polymerase Chain Reaction (PCR) assay along with PCR tests for other disease-causing protozoa, bacteria, and viruses found in cat intestines. These tests are designed to find the DNA of hard to find microbe pathogens. Screen for Tritrich in cats with frequent or ongoing intestinal problems like diarrhea (sometimes bloody or with mucus), increased urgency, straining, or pain when passing stool, anal redness and swelling, and (in bad cases) rectal prolapse.

Most of the time, Tritrichomonas infections are not discovered unless veterinarians are searching for the cause of diarrhea or other digestive problems in cats or kittens. Once found, vets will often encourage pet owners to test the other cats in the same household to determine which are infected. This is because Tritrich is highly contagious between cats.

Veterinarians recommend stool (fecal) testing kittens 2 to 4 times during their first year of life, and 1 to 2 times each year in adult cats (every 6 to 12 months). Veterinarians often call this stool health test a “Fecal O&P”, with the O&P meaning “ova (eggs) and parasites”. It includes special preparations of the stool sample and analysis using a microscope to look for roundworms, hookworms, tapeworms, whipworms, and some types of coccidia. While Tritrich is common, they are only rarely seen using this or a similar test type (fecal smear), so neither are reliable ways to find them. Even when suspected under the microscope, they look very similar to two other common protozoa: Giardia and Pentatrichomonis hominis. Distinguishing them is important because Giardia can cause similar symptoms as Tritrich, but each are treated differently, while P. hominis are not considered harmful and don’t need to be treated. ClueJay Cat Stool Test Level 1, 2, and 3 include a stool O&P, but the O&P is unlikely to identify Tritrichomonas. However, they will get reported if suspected. It’s recommended to use a PCR test (included with ClueJay Cat Stool Test Level 3) for Tritrichomonas screening.

With ClueJay’s simple and intuitive testing solution from home, you can directly access this same professional reference lab testing for Tritrich that veterinary professionals use commonly.

My Cat Tested Positive for Tritrichomonas?

ClueJay Cat Stool Test Level 3 includes PCR assay tests for disease-causing bacteria, viruses, and protozoa found in cat intestines. One of those protozoa is Tritrichomonas. A positive test means Tritrichomonas DNA (called Trichomoniasis) was detected in the stool. Most veterinarians then assume the cat is infected with Tritrichomonas and provide consultation on treating the infection.

A test result is not the same as a veterinarian’s diagnosis, so it’s always best to consult with a veterinarian about your cat’s test results to determine the safest and most effective treatment and prevention plan, and when to do follow-up stool tests. Most veterinarians will recommend rechecking a cat’s stool sample within 2-4 weeks after treatment for Tritrich. If you have other cats in the household, they should be tested as well since Tritrich in one cat can often lead to Tritrich in others.

It’s important to know that some cats will continue to test positive for Tritrichomonas for an unknown period of time after treatment. This is most likely because the cat remains in an environment where re-infection keeps occurring, but not always. Other considerations for treatment failure are poor immune response and drug resistance.[2,4]

ClueJay Cat Stool Test Levels 1, 2, and 3 include a reference lab stool O&P (fecal ova (eggs) and parasites) which screens for roundworms, hookworms, tapeworms, whipworms, and some types of coccidia. While Tritrichomonas may rarely be found in this type of stool preparation, this is not a reliable method because it looks like two other common protozoa: Giardia and Pentatrichomonis hominis. Giardia can cause similar symptoms as Tritrich, but each are treated differently. P. hominis are not considered harmful so don’t need to be treated. Therefore, microbe testing by PCR is used to reliably test for the presence of Tritrichomonas.  If this parasite was reported from a fecal O&P, it’s best to consider this a “tentative finding of Tritrichomonas” or “finding suspicious of Tritrichomonas”. When this happens (Tritrich suspected from stool O&P), it’s best to double-check with a Tritrichomonas PCR test through a veterinarian or using ClueJay Cat Stool Test Level 3. Summary: the stool O&P is a great test to find worms and some coccidia, but not Tritrichomonas.

My Cat Tested Negative for Tritrichomonas?

ClueJay Cat Stool Test Level 3 includes PCR assay tests for disease-causing bacteria, viruses, and protozoa found in cat intestines. One of those protozoa is Tritrichomonas. A negative test means Tritrichomonas DNA was not detected in the stool, which is good news. No one wants their cat or kitten shedding Tritrich and maybe putting other cats at risk of infection.

Depending on their lifestyle, cats can remain at risk of Tritrich exposure so a negative test result today doesn’t mean it couldn’t be positive later. Since cats may shed Tritrichomonas intermittently, it’s possible to test a stool sample from an infected cat without any of this parasite’s DNA. This is called a “false negative” when the test result is negative but the cat is infected. 

If Tritrich infection was suspected and there are other cats in the household, consider testing them as well since Tritrich in one cat can often lead to Tritrich in others. Cats negative on Tritrichomonas by PCR but still with Tritrichomonas-like symptoms such as abnormal stools, likely have a different explanation for their symptoms. You should consult with a veterinarian if this is the situation with your cat.

Sources

  1. PetMD, Tritrichomonas in Cats
  2. Companion Animal Parasite Council (CAPC), Tritrichomonas blagburni (formerly foetus)
  3. Texas A&M University, Fecal PCR Testing for Tritrichomonas
  4. UC Davis Koret Shelter Medicine; Tritrichomonas foetus
  5. Centers For Disease Control and Prevention; Zalonis CA, Pillay A, Secor W, et al. Rare Case of Trichomonal Peritonitis. Emerging Infectious Diseases. 2011;17(7):1312-1313. doi:10.3201/eid1707.100892.

Compare Stool Tests

Dog Stool Tests

3 Levels To Choose From

Top Seller: Level 2

Cat Stool Tests

3 Levels To Choose From

Top Seller: Level 2