This information sheet shows how to use Ponazuril/Toltrazuril most effectively for treatment of coccidia in kittens and puppies.
The articles referenced below describe the use of toltrazuril and/or diclazuril for treatment of coccidia in kittens and puppies. Lloyd, et al found Toltrazuril at 30 mg/kg once or 15 mg/kg repeated daily for three days, then repeated again 10 days later was effective in clearing coccidial infection in experimentally infected kittens. A single dose of Diclazuril at 25 mg/kg did not clear infection in all treated puppies or kittens, but a repeated treatment was not tried in this study. Recontamination of the environment can be a problem and lead to reinfection. Daugschies, et al found that 10, 20 or 30 mg/kg of Toltrazuril suspension given to 4 week old puppies three days post infection successfully prevented shedding or development of signs in puppies. 4/6 untreated controls developed severe hemorrhagic diarrhea and died. The authors recommend prophylactic treatment of puppies at 3-4 weeks of age.
Ponazuril is a metabolite of Toltrazuril, and is available in the United States as Marquis Paste, produced by Merial. Anecdotally, this drug has been used off-label successfully for treatment of coccidia at a dose of 15-30 mg/kg. A recent study by Lister, et al found the use of oral ponazuril at 50 mg/kg once daily for 3 consecutive days for the treatment of coccidiosis in dogs and cats to be effective. A follow-up fecal flotation performed immediately after treatment is recommended, especially if the initial oocyst count is heavy.
Marquis paste is marketed for treatment equine protozoal myeloencephalitis (EPM) and administration to small animals is easiest when the paste is diluted. One tube of paste contains 127 grams (4.5 oz.) at 150 mg/gm (19,050 mgs total per tube) which is a 15% solution.
Although a single tube can be quite expensive, the ‘per animal’ cost is reasonable once diluted. Ponazuril is reportedly stable in suspension and can be mixed with water and VAL syrup or other suspensions to improve palatability. The solution should be stored in a light proof container and thoroughly shaken before administration. You may not want to make the whole tube up at once, in case of spills.
50 mls Marquis paste + 12.5 mls water + 12.5 mls syrup for flavor = 75 mls of 100 mg/ml solution
Or for a smaller amount at one time:
20 mls Marquis paste + 5 mls water + 5 mls syrup for flavor = 30 mls of 100 mg/ml solution
Dose at 25 mg/lb (~55 mg/kg) once at intake for all animals under 6 months of age and repeat again in 10-14 days
For animals testing positive for coccidia - dose at 25 mg/lb (~55 mg/kg) once daily for 3-5 days depending on severity of clinical signs
Single tubes are available from various sources, e.g. Agri-med.com