Why Hasn’t My Vet Heard of the Modern Treatment for Coccidia?


Hello Dr. Barchas,

I have two 6-month-old kittens with coccidia. My vet prescribed a 10-day course of Albon, which I administered and kept the litter box clean. Within one week, they had the symptoms back — terrible diarrhea, and it is getting progressively worse. I have just started a second round of Albon. Should this not work, is Ponazuril available in the U.S.? I am in San Jose, CA, and my vet has never heard of Ponazuril. I told her it was for horses, but could be compounded into a paste for cats. She said she did not feel comfortable prescribing something she was unfamiliar with. My question is, if the second round of Albon doesn’t work, where can I get a prescription for Ponazuril, and how safe is its use in cats?


Let’s start with a basic primer on coccidia: They are microscopic parasites, which are relatively ubiquitous. There are many different species of coccidia, but the ones that most frequently cause problems in kittens and puppies are called Isospora.

Coccidia parasites infest the intestines and cause diarrhea. They most frequently are simply a nuisance — the diarrhea can be a frustrating problem, which can take weeks to resolve, even when treated with Albon. Some especially weak kittens or puppies can develop diarrhea that is severe enough to be life threatening.

The generally accepted recommendations for coccidia infestations are to treat it and to decontaminate the pet’s habitat, since the organisms are shed in huge numbers in the stool and re-infestation is possible if the environment is not sufficiently clean. In my experience, environmental decontamination is a difficult (and generally superfluous) task, outside of shelter or multi-cat situations.

The true cure for coccidia is immune system competence. I have only treated one or two adult cats for coccidia in my entire career, and it is not common for infested kittens to sicken adult cats in the same house. The overwhelming majority of cats outgrow their susceptibility to coccidia as they mature. (However, this article should not be taken to imply that proper hygiene is not crucial for all pets in all circumstances.) Sadly, the parasite can cause significant frustration for kittens and their owners while they wait for the kitten’s immune system to mature.

There are two commonly used treatments for coccidia. Albon has been around for ages. Its use for the treatment of coccidia is off-label. It has loads of potential side effects. And, in my experience, it is barely effective.
Ponazuril has been used as a coccidia treatment in horses for a long time, and its use (also off-label) in cats and dogs has been documented since at least 2006. In my experience, it wipes coccidia out with just a dose or two. It is readily available in the U.S. through major veterinary compounding pharmacies such as Roadrunner, Wedgewood, or BCP. A profile of the drug is included in the most recent edition of Plumb’s, which is the veterinary drug bible. A quick search on VIN (an online resource for veterinarians) reveals dozens of discussions about and descriptions of the use of ponazuril. Ponazuril has been recommended in at least a half dozen continuing education lectures that I have attended over the last five years.
I am at a loss to explain how any vet could not have heard of Ponazuril by now, but plenty have not.
Amy, if your kittens are still suffering from coccidia symptoms, there is a significant chance that ponazuril will help. Consider talking to your vet again. If she is unwilling to prescribe ponazuril, perhaps she will be amenable to referring you to a colleague who will.

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