S8 E1: The Worms Crawl In: The Story of Whipworm (feat Sweet Pea)

WEBVTT

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Hi guys. I'm Courtney and I'm
Lisa, and we are the hosts of

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the Book of the Dead, a
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where we tell you about the most
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of. So join us in the
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Every week, I take you on
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over to the dark Side. We're
really nice people once you get past the

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true crime and scary science. Hello, and welcome to Cause of Death.

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One hundred seconds to midnight. I'm
your host, Jackie Morante. This episode

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begins a new season of the podcast. The topic for this season is parasites.

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I call it Creepy Crawley's. There
may not be a whole lot of

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history in this season, but there
will be plenty of diseases that you don't

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really want. Today, we're going
to talk about whipworm. I chose this

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particular parasite because my dog's sweet pea
was diagnosed with it a few weeks ago,

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despite having worm meds every month.
We'll begin this story as usual with

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ediology and pathology. Worm infections are
often referred to as helminth infections, and

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I'll use both references. Whipworm is
a parasitic roundworm. Its scientific name is

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Tricurus tricuria. Its phylum is Nematoda. It's in the class of Anoplia.

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Its domain is Eukaryota. It's in
the family Tricyidae, genus Tricurus and kingdom

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Animalia. The body of the worm
is shaped like a whip, with a

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long, thick handle like structure at
one end, the anus that tapers off

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to a thin whip like structure at
the other end. It's this end that

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attaches to the sekum, but we'll
get to that. The disease that it

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causes in people is tricuriasis. The
size of these worms varies between three to

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five centimeters, and the female is
usually larger than the male. The female

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lays anywhere from two thousand to ten
thousand eggs per day. Think about that

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for a minute. These eggs are
generally left behind after an infected human defecates

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in the soil. If you've ever
wondered why I tell you to wash your

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fruits and vegetables before you eat them, well soon you will have your answer.

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The eggs mature in about fourteen to
twenty one days. This is when

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they enter the effective stage. If
someone ingests the ambryonated eggs, the eggs

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will hatch in the small intestine,
where they'll use the intestinal microflora and the

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nutrients in the digestive tract to mature
and grow. The majority of the larvae

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will move to the secum, where
they penetrate the mucosa and mature to adulthood.

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If a large worm burden is present, parts of the large intestine could

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become involved. Most of the disease
burden is found in tropical climates. Asia

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has the highest burden, and less
often it is seen in Africa and South

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America. It's also found in the
rural southeastern United States. Worldwide, between

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four hundred and fifty million and one
billion people were recently diagnosed with whipworm infections.

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Most of these cases affect children,
with boys at higher risk than girls.

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It's possible that a partial immunity to
the worm develops with age tricuriates.

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This is one of three well documented
soil transmitted helminth infections. It's considered to

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be a neglected tropical disease by the
World Health Organization and the CDC. The

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most common cause of whipworm disease is
the ingestion of infected eggs that live in

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the soil. Most often, this
is due to poor sanitary conditions, including

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areas where people defecate on the ground
and the use of human feces as fertilizer.

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Wash everything before you eat it,
everything you don't know where it's been.

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Once ingested, the larvae hatch and
the small intestine, then they migrate

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to the large intestine, where they
attach to the mucosal membrane. In severe

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infections, the infestation may include the
entire rectum and colon. This leads to

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cell destruction and the activation of the
host immune system through lymphocytes, eosinophils,

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and plasma cells. Unembryonated eggs will
be dispelled through the feces, where they

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become embrionated in two to four weeks, and this makes them infective. The

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worm lives between one and four years
in patients who go untreated. Infections usually

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occur in people who visit areas where
whipworm infections are common. Patients may experience

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abdominal pain, rectal bleeding, painful
passage of stools, abdominal discomfort, and

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mucous discharge. Diarrhea and constipation may
also present. Nocturnal passage of stools is

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a common complaint among patients with whipworm
infections. Many patients remain asymptomatic if the

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worm burden is light. Rectal prolapse
is common in those with heavy worm burdens.

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Children with whipworm may develop anemia,
growth deficiency, and impaired cognitive development

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due to an iron deficiency and malnutrition, since the worms are taking up all

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the nutrients that the children are eating. The diagnosis depends on stool samples taken

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from the patient. Microscopic examination should
reveal the presence of eggs. It may

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then be possible to determine the number
of eggs in the sample, thus determining

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the worm burden. This diagnostic tool
has one pitfall, however, between the

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time that the eggs are ingested to
the development of the mature worm. There

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is a lag of about three months. During this period, there may be

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no signs of an infestation and the
stools may not show evidence of eggs or

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shedding. Red blood cells and white
blood cells, specifically eosinophils may be present

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in the stool samples, and a
blood test could confirm anemia. Treatment includes

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mebendazol, albendazol or ivermectin, Yes, the very same ivermeictin that people claim

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will Ward off COVID nineteen. It
doesn't. That thought is totally ridiculous.

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I talked about covid and ivermectin in
Season one. Go back and listen.

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While all these drugs are suggested for
treatment of whipworm, neither albendizol nor ivermectin

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have been approved by the FDA for
the treatment of whipworm. Treatment with a

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prescribed antiparasitic normally lasts three days.
As with any helmeth infection, It's important

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to note that there may be more
than one parasite involved, so combinations of

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antiparasitics may be required. Whipworms tend
to be more resistant to treatment than other

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worms. Some studies list the curates
as low as twenty eight to thirty six

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percent. While whipworms can still be
present after treatment, the low warm count

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may not lead to a significant disease
burden. Tricariasis is not a fatal disease,

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but it can cause anemia and nocturnal
stooling. Many patients develop colitis and

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malabsorption. Deficiencies of fat soluble vitamins
are not uncommon. Children may develop poor

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growth and rectal prolabs. In areas
of the world where the disease is endemic,

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mass drug administration may occur. Mass
drug administration will include entire risk groups,

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with health care providers going door to
door to offer preventive treatment. The

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drugs used are relatively safe and are
either very inexpensive or donated. This practice

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is normally performed annually in these higher
risk areas. We'll be talking more about

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mass drug administration in a few future
season on Neglected Tropical Diseases. The whole

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reason that I chose whipworm as the
first episode in this season is because my

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dog, sweet Pea, was diagnosed
with whipworm a few weeks ago. My

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dog gets a heartguard wormer every month
like clockwork, so I didn't understand how

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she could get whipworm. It turns
out that heartguard doesn't prevent or treat whipworm

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or tapeworm. I need to talk
to my vet again about changing her wormer

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to something that controls allworms. I
have a special guest in the studio today.

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I'm going to let Sweet Pea tell
you about her experience with whipworm.

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Then I'll come back to talk about
how the disease affects dogs. Hi.

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Everyone, I really didn't want to
talk about this because it's super embarrassing.

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It's a lot about poop and some
of my bad habits. I'd much rather

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talk about my birthday party at doggie
daycare. You can talk about your birthday

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party on TikTok. Right now you
need to talk about worms. Gross,

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Okay, I guess it's better to
begin at the beginning. Daycare isn't always

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good for dogs. We learn bad
habits there and we get away with everything.

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Some daycares are better than others,
but most of the time there are

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way too many dogs hanging out and
playing to give much attention to everyone.

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I picked up some bad habits too. One of them was eating poop.

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I don't know why I do it. It doesn't taste very good, but

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my friends sometimes do it, so
I do it too. I'm a follower.

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I won't go anywhere near another dog's
poop when I'm out with Jackie,

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but all the dogs eat poop at
daycare, so I don't want to be

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different. It's kind of a big
deal. Anyway, Enough about peer pressure.

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Jackie feeds me two pieces of pineapple
and two sprigs of curly parsley three

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times a week to make me stop
eating poop, and that seems to work.

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I haven't done it in quite a
while. I really like pineapple,

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but parsley is like garnish, isn't
it. I don't like it so much.

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Anyway, One day, Jackie noticed
that I was straining to poop.

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I had to go, but nothing
was coming out, and when it did

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come out, it was really hard. On the way back from our walk,

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I had to poop again, but
this time it was really runny and

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it had a little blood in it. I went to day and all day

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I had really renny poops and there
was a lot of mucus and some blood

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in them. I didn't play very
much that day either, I just wanted

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to sleep. My tummy hurt,
and I wasn't feeling like being social.

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When we got home that night,
I wouldn't eat. I'm a voracious eater.

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If I don't eat, there's something
definitely wrong. So Jackie called the

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vet and made an appointment for me
to go in the next day. She

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was hoping to be one of the
last appointments that night, but they were

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just getting ready to close, so
we had to wait. I went to

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bed, but I got up twice
during the night to poop. Both times

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it was pretty runny, and it
was really stinky too, Not like poop

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doesn't stink anyway, but this was
really stinky. The next morning, Jackie

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took me to the vet along with
a stool sample. After a lot of

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uncomfortable examination, he found out that
I had whipworm. Jackie was pretty upset

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when the VET told her that heartguard
doesn't control whipworm, but the VET said

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that Heartguard is the best wormer out
there. She's still kind of mad about

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the whole thing. Anyway. The
VAT put me on three days of panker,

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and when I was all done with
the medication, my worms were gone

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and I felt much better. Okay, is that enough of my poopskapads?

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Can I talk about my birthday party? Now? You can talk about your

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birthday party in a little bit.
I need to get this episode out.

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When I drop it, we'll work
on your TikTok video. Okay, but

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everyone needs to know about my birthday
party. They will. Let's just get

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this done first, Okay. Tell
everyone goodbye and you'll talk to them a

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little later. Bye. Everyone,
Thank you for listening to Cause of Death

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00:16:04.759 --> 00:16:10.480
one hundred seconds to midnight. Watch
out for my video where I talk about

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00:16:10.519 --> 00:16:15.399
my birthday party. There was no
poop involved, well some, but it

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00:16:15.440 --> 00:16:18.440
didn't have anything to do with my
birthday party. We're all dogs, we

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00:16:18.600 --> 00:16:22.759
poop. Okay, sweet pee,
we get it. Go play so I

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00:16:22.799 --> 00:16:30.360
can finish this. Bye. Everyone. I was pretty worried about my dog.

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She's got a genetic disorder called double
murle gene trait, so I thought

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that possibly something was really wrong with
her gut and it was a much bigger

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deal. I was also worried that
she ate something like a ball or a

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toy that got stuck in her intestinal
system. Surgery wasn't in my budget,

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even with pet insurance. I tend
to overthink everything and land right on the

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worst case scenario, though, so
I freak out over all lot of things.

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I'm still mad that the vet prescribed
heartguard when he could have prescribed an

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allwormer. The whole situation was rather
maddening. Really, Okay, we're going

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to take a break to hear from
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Leaf Market has added a new tool
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a pro. It's the seed Finder
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me choose the best varieties of plants
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experience, and the characteristics of the
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had chosen several varieties of melons,
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I'm still building my order, so
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I'll be back in a few days
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need. Check out as simple and
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your grow on with true Leaf Market
anyway. Now you have the background on

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sweetpeas experience with whipworm, and you
know the topic of her next TikTok,

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So let's get back to how the
worm affects dogs. These infections are difficult

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to detect in dogs. Clinical signs
vary from nothing to intermittent large bowel diarrhea.

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Severe infections present as critical and life
threatening. Whipworm infection is often misdiagnosed

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as hookworms, roundworms, giardia,
or the ever popular garbage enteritis. Garbage

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enteritis was my go to when sweet
Peas started showing signs of infection. She's

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always eating something that she shouldn't be
eating, and she and I both pay

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for it when she goes out to
poop. Whipworm wasn't even on my radar.

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According to MRK Animal Health, this
is common among dog owners and veterinary

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professionals. We discount whipworm because the
dogs are getting warmer on a regular schedule.

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But Merk also says that there are
three characteristics of whipworm that should keep

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them on the list of things to
look out for. Whipworms are patient,

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sneaky, and persistent. Canine whipworm
is known as Tricurus vulpus. These worms

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also look like whips and can grow
from four to seven centimeters long. The

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adult worms live primarily in the secum, while the thick portion of the worm

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will remain in the intestinal lumin and
the thinner end will penetrate the secual mucosa.

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Adult whipworms live off the dog's mucosal, epithelium, blood, and tissue

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fluids. The female worm may lay
up to two thousand eggs in a day,

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but she's patient. She doesn't produce
eggs daily. Shedding episodes may occur

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days or weeks apart, so there
won't always be worms in a stool sample.

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When the female finally does lay eggs, dogs shed them in the environment

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Tricurus eggs generally embryonate between nine and
twenty one days, but they're also patient.

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They can remain effective in the environment
for years before being ingested by the

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unsuspecting dog who just happens to pick
up the ball that rolled in the dirt

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patch at the dog park, or
the dog who eats poop. After ingestion,

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the larvae hatch and develop in the
mucosa lining of the small intestine for

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up to ten days. Then the
cycle begins, and anywhere from seventy four

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to ninety days later, the female
will begin shedding more eggs. The usual

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down and dirty way to detect worms
is the float test. Basically, a

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stool sample is put into a container
of water or saline and the eggs float

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to the top. Whipworm eggs,
however, are very dense. They have

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a specific gravity of one point one
point five, so rather than using saline,

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a sugar solution with a specific gravity
of one point two five must be

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used so that the eggs will float. Often, whipworm is diagnosed by ruling

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other bacterial and parasite infections out rather
than finding the worms. This happened in

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sweet peas case. The worms couldn't
be found, but the vet suspected whipworms

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since she didn't have anything else.
Whipworm eggs are thick and they're tough.

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They can survive desiccation, extreme temperatures, and even UV radiation. The human

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whipworm can survive temperatures from one hundred
and twenty six degrees fahrenheit down to negative

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00:25:59.480 --> 00:26:07.319
sixty degrees fahrenheit and still ambryonate.
The resilience of these worms makes it highly

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likely that they're everywhere in the dog's
environment. Murk cited a recent study of

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parasite prevalence in two hundred and eighty
eight dog parks in thirty metropolitan cities.

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They found Tricuris vulpus in eighteen percent
of those parks. This means that nearly

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one in five dog parks are infested
with whipworms. Now let's get this part

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straight. Am I telling you to
keep your dogs away from dog parks and

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daycares? Not at all. What
I am telling you is that you need

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to talk to your vet and get
them on a good all around worm prevention.

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Whipworms are persistent in more ways than
one. The common treatment for whipworms

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00:26:56.359 --> 00:27:00.319
and dogs is panker, but it
may not get all the eggs that are

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circulating in the dog's digestive system.
This means that the infection may not completely

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clear after the first treatment. Having
a good preventive wormer will ensure that your

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dog doesn't get them in the first
place, so you don't have to worry

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00:27:15.920 --> 00:27:25.039
about treating the same infection over and
over again. So that's whipworm, no

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00:27:25.240 --> 00:27:29.559
history at all, but it's a
good cautionary tale for those with dogs that

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go out and socialize in dog parks, parks, doggy daycares, and just

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00:27:33.599 --> 00:27:38.240
about anywhere else that dogs poop.
Are we still talking about poop? I

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00:27:38.319 --> 00:27:44.799
want to talk about my birthday,
for Heaven's sakes, let me finish.

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00:27:44.880 --> 00:27:51.400
Then you could talk about your birthday. Thank you all for listening to Cause

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00:27:51.400 --> 00:27:55.839
of Death one hundred seconds to midnight. If you would like to support the

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show, there are several ways you
can do so. The easiest way is

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to listen and share these episodes with
everyone you know. I would also love

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00:28:06.240 --> 00:28:11.160
it if you would stop by Apple
Podcasts or Spotify and leave a five star

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review. These two things help the
show grow and move the podcast up the

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charts so that others can find it
too. Another way to support the show

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is to sign up on either Patreon
or Apple subscriptions. I have some truly

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00:28:27.799 --> 00:28:33.279
amazing sponsors, and stopping by their
online stores and using the promo codes that

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00:28:33.319 --> 00:28:38.559
I give you can also help the
show grow and expand. Honestly, I

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00:28:38.559 --> 00:28:45.200
wouldn't be talking about these sponsors if
I didn't believe in their products. If

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00:28:45.200 --> 00:28:48.960
you'd like to contact me, please
feel free to email me at Jackie at

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00:28:49.039 --> 00:28:55.119
cause of Death one hundred scs dot
net, or you can leave a message

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00:28:55.160 --> 00:29:00.000
on the website at www. Cause
of Death one hundred second dot net.

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00:29:02.920 --> 00:29:07.160
The show notes are a great place
to find my Patreon page, my website,

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00:29:07.440 --> 00:29:11.839
my sponsors, and the research that
I used for this episode. I

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00:29:11.920 --> 00:29:17.440
want to thank my amazing dog,
Sweetpea, for sharing her poop story with

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00:29:17.599 --> 00:29:25.240
us. I promise the birthday story
is much easier to swallow. Stop talking

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00:29:25.319 --> 00:29:30.960
about poop. I'll see you in
two weeks when I'll be talking about brain

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00:29:32.079 --> 00:29:37.880
eating amba and why they're so dangerous. Until then, don't lick the dog

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00:29:38.000 --> 00:30:07.680
park. Stop stop, stand still, stand