Neuro squirrel - possible raccoon roundworm?

[Will's Mom]

We have a red squirrel admitted to our rehab with neuro symptoms, head tilt, falls over when eating, unsteady, possibly vision impaired. Fecal tests show a large strongyloides parasite load, was treated twice with fenbendazole, once with ivomec, and still showing high parasite number. Wondering if he could be infected with raccoon roundworm

[redwuff]

Raccoon roundworm takes them out very quickly.

[redwuff]

We have a red squirrel admitted to our rehab with neuro symptoms, head tilt, falls over when eating, unsteady, possibly vision impaired. Fecal tests show a large strongyloides parasite load, was treated twice with fenbendazole, once with ivomec, and still showing high parasite number. Wondering if he could be infected with raccoon roundworm

How long have you had this squirrel in rehab? What area of the country are you in ?

[HRT4SQRLS]

I would be very careful giving ivermectin to a neuro. It can be fatal.

[Will's Mom]

We've had this squirrel for almost a month and a half, we are on the east coast of Canada.

Thanks for advice re: ivomec, I thought that there was one drug you had to watch when giving to neuro impaired; the vet gave the ivomec after the fenbendazole didn't seem to work.

If the neuro-impairment is caused by raccoon roundworm, do they still shed them in their feces?

[HRT4SQRLS]

We have a red squirrel admitted to our rehab with neuro symptoms, head tilt, falls over when eating, unsteady, possibly vision impaired. Fecal tests show a large strongyloides parasite load, was treated twice with fenbendazole, once with ivomec, and still showing high parasite number. Wondering if he could be infected with raccoon roundworm

Did the vet treat with daily doses for 3-5 days?

According to the Wild Mammal Baby book, fenbendazole should be dosed once a day for 3-5 days.
The treatment should be repeated in 2-3 weeks. It is dosed at 50mg/kg.

With an infestation this heavy, I would give the full dosing per the book. Fenbendazole should also eradicate raccoon roundworm. I would suspect head trauma as a cause of neurological issues before I would think raccoon roundworm.

[Mel1959]

Dr. Emerson’s protocol for treating roundworm in RACCOONS exceeds the normal standard. She recommends Panacur (Safeguard) one time a day for 5 days, repeat in 14 days. She also treats with Pyrantel Pamoate 50mg/mL, one time a week for 4 weeks.

This is for raccoons, so I’m not sure if red squirrels can take a combination of these meds, I’m just sharing her protocol.

If raccoon roundworm will kill an animal quickly, and you’ve had him for a month and a half, I question that the neuro problems are associated with roundworm.

Has he been treated with prednisone for the neuro issues?

[Milo's Mom]

Per my vet, RR symptoms will continue to progress and seem to get more rapid in progression. Neuro will generally show improvement the first few days.

It is always better to treat when in doubt because once the damage is done it cannot be reversed. The worm can be stopped but the damage it's done cannot be reversed. The body will do some healing on it's own with time though. A RR infestation in the brain can only be properly/definitively diagnosed with an MRI.

Following are some notes from the conversation I had with my vet related specifically to identifying and treating RR, just a few weeks ago. I have an NR woodchuck and they are very prone to RR (which is why I discussed it with the vet)

Treatment for a WOODCHUCK is as follows:
Baytril 10mg/kg PO SID 4-8 weeks
Panacur 100mg/kg PO SID 7 days
Metronidazole 25mg/kg PO BID 4-8 weeks

The Baytril and Metro will cross the blood/brain barrier and they are to fight the infection left by the dying RR's. Panacur will kill the RR's.

I then asked how to tell the difference between head trauma and RR symptoms without having an MRI. He said, HT will generally show "marked" change in 3-5 days with proper anti-inflammatory. If the change is not "marked" it is best to treat for RR cause it's only going to get worse. Treat sooner so animal has less damage and the potential to have to relearn less. He also made it very clear to give animal time IF this is RR...they have the ability to relearn.

I am not sure if this treatment would be appropriate for a grey/red/fox squirrel, but a woodchuck is a squirrel, so I think I'd be inclined to act along these lines.