(2003) 9:13036. Received: 29 October 2018; Accepted: 07 February 2019; Published: 26 February 2019. Toxoplasmosis is caused by the globally distributed intracellular protozoan parasite Toxoplasma gondii (phylum Apicomplexa, family Sarcocystidae). A positive IgM-IFA titer along with a negative IgG-IFA titer is diagnostic of an active infection. Isolation of Toxoplasma gondii from the brain of a dog in Australia and its biological and molecular characterization. 23. Such disease may be acute (rapid onset) or more chronic, with periods of illness interspersed with periods of some recovery. Never feed your cat raw meat because it can be a source of the. Once they reach specific tissues (central nervous system, muscle, and viscera), they convert into bradyzoites which remain latent in a cyst form leading to a life-long chronic infection until a DH ingests the tissue. Gluten is an incredibly abundant part of the food supply, but its Menopause is the permanent end of menstruation and fertility, defined as occurring Endometriosis is one of the most common health issues experienced among women Hemorrhoids are a very common anorectal condition that affects millions of people Toxoplasmosis Signs & Symptoms (in Humans & Cats), 8 Natural Treatments for Toxoplasmosis Symptoms, 4 Parasites That Want To Invade Your Brain. Prevent hunting activity by cats (e.g., keep cats indoors). Symptoms of toxoplasmosis in cats can include:(8), However, like with humans, it wont always be apparent that your cat is carrying the parasite. 96. While these drugs do help, an infected dogs immune system must be supported to fully eliminate the infection. (1991) 99:4736. The main cause of toxoplasmosis is ingestion of oocysts, or Toxoplasma eggs. Conventionaltoxoplasmosis treatment typically includes two drugs: pyrimethamine (Daraprim) andSulfadiazine. Brennan A, Donahoe SL, Beatty JA, Belov K, Lindsay S, Briscoe KA, et al. Because infected dogs shed oocysts intermittently, a fecal sample may be negative despite serious infection. An article published in the monthly, peer-reviewed medical journal JAMA Psychiatry also reveals that in two clinical studies, mothers with a toxoplasmosis infection appeared to have an increased risk of self-directed violence such as suicide or suicide attempts.
Clinical Toxoplasmosis in Dogs and Cats: An Update - PubMed According to the FDA,approximately50 percent of toxoplasmosis infections in the U.S. yearly are acquired from food. This is a microscopic single-cell protozoal organism related to coccidia. Sexual stages develop only in the intestine of felid definitive hosts (wild and domestic). Due to toxoplasmosis infection, kittens can be stillborn or die before they are weaned. Cats can get toxoplasmosis by ingesting other cat feces, from infected soil or from any other way they come in contact with theT gondii parasite. Vet Pathol. doi: 10.1016/j.vetpar.2018.02.011, 93. Vet Parasitol.
In Dogs Therefore, high IgG-IFA antibody titers do not definitively diagnose an active infection. Our team includes licensed nutritionists and dietitians, certified health education specialists, as well as certified strength and conditioning specialists, personal trainers and corrective exercise specialists. (2013) 197:6236. However, there are certain people that are much more at risk for having toxoplasmosis cause them symptoms and dangerous health issues. Cohen TM, Blois S, Vince AR. (2010) 26:1906. doi: 10.1111/j.1365-3164.2004.00371.x, 68. Eliminate cat feces on a daily basis; T. gondii oocysts require 1-5 days after being passed in the feces to become infectious. Because the parasite that causes toxoplasmosis is commonly spread by ingestion of raw meat and unwashed produce, the best way to prevent your dog from acquiring this parasite is to refrain from feeding your dog raw meat and always wash produce before giving it to them. UP38, 1257. doi: 10.1590/S1984-29612011000300004, Keywords: Toxoplasma gondii, dogs, cats, clinical disease, symptoms, genotype, differential diagnosis, Citation: Calero-Bernal R and Gennari SM (2019) Clinical Toxoplasmosis in Dogs and Cats: An Update. Other tests that may aid in the diagnosis of toxoplasmosis include: Because the results of some diagnostic tests (i.e. Pulmonary sarcocystosis in a puppy with canine distemper in Costa Rica. Bradyzoites may be reactivated and transform to rapidly dividing tachyzoites upon host immunosuppression. Prevention is often a more effective way of dealing with toxoplasmosis. This is only a risk if the woman acquires the infection during pregnancy. If the results come back positive for the parasite, treatment may be necessary. doi: 10.1590/S0036-46652006000600012, 48. Plugge NF, Ferreira FM, Richartz RR, de Siqueira A, Dittrich RL. (25), A 2015 blind, controlled, randomized study using animal subjects showed that a homeopathic remedy made from the cysts of the T. gondii parasites effectively reduced the number of cysts inside of the animals bodies due to toxoplasmosis, which is promising for humans.
Toxocariasis: Symptoms & Causes - Cleveland Clinic Finally, further studies aiming the isolation of T. gondii from clinical cases is of major interest to establish a possible association of strains causing specific clinical diseases and outcomes. So how do you gettoxoplasmosis? These eggs most often come fromthe feces of cats so you can get toxoplasmosis from unknowingly consuming these eggsthrough direct contact with or from handling a cats litter box. Congenital infection with T. gondiican cause neurologic disease, birth defects, stillbirth, and ocular disease in humans and some other animals, particularly sheep and goats. Park CH, Ikadai H, Yoshida E, Isomura H, Inukai H, Oyamada T. Cutaneous toxoplasmosis in a female Japanese cat. (26), Another food I recommend adding to your diet is radicchio, which is abitter and purpleleafy vegetable that has many health benefits one of which is anti-parasitic abilities. This review could be of special interest to clinicians and researchers. Why is my dog crying in the middle of the night? This is a microscopic single-cell organism related to coccidia. They can also result infected vertically, by congenital infection. If vomiting and diarrhea occur during the administration of an antibiotic, contact your veterinarian as soon as possible. Detection and isolation of Toxoplasma gondii from fresh semen of naturally infected dogs in Southern Brazil. (1993) 203:15469. McConnell JF, Sparkes AH, Blunden AS, Neath PJ, Sansom J. Eosinophilic fibrosing gastritis and toxoplasmosis in a cat. Moreover, if your dog's immune system is already compromised, avoid walks in these high-risk areas. Sato K, Iwamoto L, Yoshiki K. Experimental toxoplasmosis in pregnant cats. The Toxoplasmosis prognosis is usually good with proper treatment. Swinger RL, Schmidt KA Jr, Dubielzig RR. doi: 10.1016/j.vetpar.2017.04.003, 58. 21. doi: 10.5326/15473317-37-3-251, 26. (13), It is also possible for T. gondiito beliving in someones body in the dormant form. This concept is still under study. 12. Most of infections in dogs and cats occur horizontally, but infectivity by the oral route depends on the parasite stage ingested, this issue has been revised thoroughly elsewhere (1). Wondering if your kitten or cat has toxoplasmosis? Immunoglobulin G (IgG) and Immunoglobulin M (IgM) antibody testing with the Immunoflourescence Assay (IFA) is the most common method of diagnosing toxoplasmosis. (2014) 34:22931. When toxoplasmosis is suspected in a cat, it is usually treated with a course of antibiotics. Organ transplantation has been identified as a cause of acute toxoplasmosis; three cats and one dog developed signs 36 weeks after renal transplantation (13).
Clinical Toxoplasmosis in Dogs and Cats Is Toxoplasmosis in dogs curable? Infection through milk ingestion in cats is supported by results, such as the detection of T. gondii by bioassay and PCR in milk of nursing queens after experimental infection (58). (2011) 25:14852. Vet Pathol. This is why it is rare, yet possible, that toxoplasmosis can be transmitted by an organ transplant or blood transfusion. Fecal flotation is not recommended as a clinical means of evaluating the infection status of an individual cat. Do all cat owners have toxoplasmosis? Do not feed uncooked meat, entrails or bones as these tissues may contain toxoplasma cysts. (2016) 49:4750. Sign up and make sure you are always on top of the most important info for you and your pets. To help ease any worries, this article provides everything pet parents need to know about toxoplasmosis in dogs. (2006) 84:305. There are acute and chronic forms of toxoplasmosis, in which the acute form is more symptomatic than the chronic form, which is usually a substandard disease devoid of any clinical signs. Moreover, topical anti-inflammatory therapy required to control keratoconjunctivitis sicca in a dog triggered a necrotizing conjunctivitis by T. gondii (11). Experimental infection of pregnant queens with two major Brazilian clonal lineages of Toxoplasma gondii. are clickable links to these studies. Experimental infection of queens in the middle third of pregnancy, using two different Brazilian isolates (BrI, BrIII), showed almost no difference in abortion and premature stillbirth rates (56). Keep feral cats out of your yard, and if you have a cat, keep the litter box in an area where your dog cannot access it. (86), N. caninum (85), and lungworms (87); hepatitis in dogs by Sarcocystis spp. doi: 10.1111/j.1748-5827.2007.00421.x, 36. Sarcocystid organisms found in bile from a dog with acute hepatitis: a case report and review of intestinal and hepatobiliary sarcocystidae infections in dogs and cats. Cerebrospinal fluid analysis (CSF analysis), Analysis of pleural (chest) or peritoneal (abdominal) fluid, Antibiotics such as clindamycin, trimethoprim-sulfonamide, or sulfonamides combined with pyrimethamine, Intravenous (IV) fluids for debilitated animals. You are pregnant.The FDA website cites thataround85 percent of pregnant women in the United are at risk of being infected with toxoplasmosis. Wash all cutting boards and knives thoroughly with hot soapy water after each use. Toxoplasmosis is a serious infection caused by the parasite Toxoplasma gondii. Alternatively, you can use tea tree oil, oregano oil, or colloidal silver. Serological survey of Toxoplasma gondii, feline immunodeficiency virus and feline leukaemia virus in urban stray cats in Belgium. Comes in a convenient powder, which means it can be easily mixed into your dog's usual meals Side effects are rare Check Price Benefits and Uses of Panacur for Dogs Canine distemper virus is very difficult to diagnose and would be differentiated from toxoplasmosis on the basis of the pets age, medical history and toxoplasmosis titers. With strict editorial sourcing guidelines, we only link to academic research institutions, reputable media sites and, when research is available, medically peer-reviewed studies. Molecular assessment of the transplacental transmission of Toxoplasma gondii, Neospora caninum, Brucella canis and Ehrlichia canis in dogs. J Am Vet Med Assoc. Vet Parasitol. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The disease may be rapidly fatal in cats with severe respiratory or neurological signs (18). Heres what you should know about the symptoms, causes, and treatments for toxoplasmosis in dogs. The most common viruses causing these symptoms are parvovirus and coronavirus. J Vet Diagn Invest. Exp Parasitol. WebSelect basic ads. T. gondii DNA was detected in fresh semen from five out of eleven seropositive naturally infected healthy dogs in Brazil, and in vitro isolation of the parasite was achieved (50). Transplacental or transmammary transfer of tachyzoites from dam to offspring also occurs, albeit rarely, in pets.
doi: 10.1016/j.vetpar.2015.02.004, 76. Acute respiratory distress syndrome and septic shock in a cat with disseminated toxoplasmosis. Serum was tested for N. caninum, T. gondii, Leishmania infantum chagasi, and Leishmania amazonensis IgG antibodies, and only T. gondii antibodies were detected (IFAT titer = 65,536). Pot dogs transfer toxoplasmosis to humans Is on that point a disease that (2005) 7:2038. Although humans may become infected through exposure to oocysts in the environment, a more common source of infection appears to be infected meat. doi: 10.1177/104063870301500314, 87. Dubey JP, Calero-Bernal R, Rosenthal BM, Speer CA, Fayer R. Sarcocystosis of Animals and Humans. (20), Wormwood is definitely one of my top suggestions when it comes to fighting off any type of parasitic infection. While ARN is usually fatal, there is currently no cure for this condition. Resolves within weeks with treatment, may be a The parasite that causes toxoplasmosis is found all over the world and it is possible for everyone and anyoneto be infected with toxoplasmosis. Clinical Sarcocystis neurona, Sarcocystis canis, Toxoplasma gondii, and Neospora caninum infections in dogs. While there is no surefire way to know whether or not your dog has toxoplasmosis, taking these simple steps can help increase your chances of avoiding the illness. How do I know if my dog has toxoplasmosis? I am a dog lover who helps others by writing blog posts about dog-related topics. Most healthy adult dogs show no symptoms of toxoplasmosis, though some do. If your dog has seizures, anticonvulsant medication may be prescribed to control them. Toxoplasma gondii has been found all over planet Earth. Oocysts represent a hardy form of the organism that can survive in the external environment for many months or even years. PCR is the typical test to diagnose toxoplasmosis and determine if the infection is acute or chronic. Itsactually the source ofthe key ingredient inthe herbal drug artemisinin, which is the most powerful antimalarial on the market proven to even be effective against drug-resistant strains. Intracranial Toxoplasma gondii granuloma in a cat.
doi: 10.1292/jvms.55.1005, 62. 63% ; 9 months Toxoplasma gondii: a study of oocyst re-shedding in domestic cats. (2007) 9:826. Boca Raton, FL: CRC Press (2016). During experimental infections, challenge with FIV triggered the disease and predisposed cats to acute generalized toxoplasmosis (64), but later studies on the general population did not identify the same association (65). WebHome Remedies For Toxoplasmosis In Dogs. Mari L, Shelton GD, De Risio L. Distal polyneuropathy in an adult birman cat with toxoplasmosis. It can be fatal in dogs and cats if not treated promptly. N Z Vet J. Al-Qassab S, Reichel MP, Su C, Jenkins D, Hall C, Windsor PA, et al. Outdoor dogs living in endemic regions are at higher risk. Occurrence of Leishmania infantum in the central nervous system of naturally infected dogs: parasite load, viability, co-infections and histological alterations. Can my dog get toxoplasmosis from eating cat feces? If you think you may have been infected and do not feel well, please see your doctor for further evaluation.
Dogs Boca Raton, FL: CRC Press (2017). A wide range of histologic lesions included: proliferative interstitial pneumonia, necrotizing hepatitis, myocarditis, skeletal and glossal myositis, non-suppurative encephalitis affecting the cerebrum, brain stem, and spinal cord, uveitis, necrotizing adrenal adenitis, and interstitial nephritis. If youre pregnant, your doctor may also perform an ultrasound to look for the parasite in your babys brain or other organs. 22. The oocysts of. In another case, disseminated toxoplasmosis involving acute respiratory distress syndrome and septic shock occurred in a cat (26) after the use of cyclosporine for eosinophilic dermatitis treatment. An atypical Toxoplasma gondii genotype in a rural Brazilian dog co-infected with Leishmania (Viannia) braziliensis.
Frontiers | Clinical Toxoplasmosis in Dogs and Cats: An Update But it can only reproduce in the conditions provided by a feline gut. doi: 10.1645/GE-3257.1, 29. The cost of testing for toxoplasmosis varies and can range from $300-$1,500. Dubey JP, Prowell M. Ante-mortem diagnosis, diarrhea, oocyst shedding, treatment, isolation, and genetic typing of Toxoplasma gondii associated with clinical toxoplasmosis in a naturally infected cat. (2009) 39:100934. doi: 10.1111/j.1939-165X.2005.tb00030.x, 84. Keep sandboxes covered when not in use to avoid fecal contamination by roaming cats. The topic of pregnancy and cats is a reason why you may already be somewhat familiar with Toxoplasma gondiiand toxoplasmosis. A sample for analysis is obtained by removing fluid from the pets chest or abdomen by sterile centesis. doi: 10.1016/j.vetpar.2016.06.008. (10). Powell CC, Lappin MR. Clinical ocular toxoplasmosis in neonatal kittens. While hospitalized, dogs will typically receive intravenous fluid treatment for hydration and intravenous antibiotics to eliminate the infection through an IV catheter placed in their arm. A woman previously exposed to the organism carries no risk of transmission to her fetus if she subsequently becomes pregnant. J Vet Diagn Invest. Even though Toxoplasma gondii is a common parasite, the good news is that most dogs do not get sick from it, and there are ways to minimize your dogs exposure. Avoid microbial Hotspots are overgrown bushes, foliage-filled areas, wooded areas, hunting areas, and camps. Only a Fewer percentage of the affected dogs relapse after treatment is finished. If testing reveals that your unborn baby is infected with toxplasmosis, a conventional doctor may recommend the prior mentioned drugs (pyrimethamine and sulfadiazine), but only in the 17th week of pregnancy and beyond in extreme situations since these are very risky drugs for pregnant women and their unborn. Bresciani KD, Costa AJ, Toniollo GH, Sabatini GA, Moraes FR, Paulillo AC, et al. However, if the cat is immunocompromised and its immune system is not working properly,Toxoplasmamay continue to replicate, spread, and cause damage to tissues. Sarcocystis caninum and Sarcocystis svanai n. spp. 35% ; 8 months ago; HD 09:30.
How Do They Test For Toxoplasmosis In Dogs? Best Dog Answers Some dogs will eat cat feces directly, but others can be exposed when cat feces comes into contact with food, such as raw vegetables in a garden, for example. 2008. doi: 10.1645/15-821, 99. doi: 10.1111/jeu.12182, 90. Cats and other felids are the only species that develop patent infections withT. gondii, shedding oocysts 3-10 days following ingestion of bradyzoites in raw meat and 19-48 days following ingestion of oocysts. Federal University of Bahia (UFBA), Brazil, Department of Infectious Diseases, First Affiliated Hospital of Jilin University, China. 63. Vet Ophthalmol. T. gondii is a parasite that can infect nearly all mammals including humans, though it can only grow to maturity and reproduce in domestic and wild cats. Furthermore, pyogranulomatous cystitis was observed in a cat 6 weeks after the same surgery (29). Luckilyfor most people with a normally functioning, healthy immune system,Toxoplasmathankfully doesnt cause any unwanted symptoms. In dogs, T. gondii was isolated from pups from a seropositive bitch in Australia; however, no clinical signs were seen in any of the animals (45) (Table 1). Pregnant dogs infected by the parasite will pass it on to unborn puppies. It is important to keep in mind that these tests are only preliminary and should only be used as a screening tool. There is no vaccine available to prevent toxoplasmosis, so people who are infected need to take precautions to avoid getting it. It has been reported in the literature that skin nodules worsened after treatment with corticosteroids in two cats (41, 66), and three cases of generalized toxoplasmosis with pneumonia in cats were observed after cyclosporine (5, 67) and prednisolone (68) treatments. Evans NA, Walker JM, Manchester AC, Bach JF. doi: 10.1177/1040638712461787, 39. Falzone C, Baroni M, De Lorenzi D, Mandara MT. Dogs usually contract the disease by the following means: The signs of toxoplasmosis in pets are nonspecific, and most dogs show no signs of infection. Vet Clin Pathol. Can Vet J. Not surprisingly, disseminated infection also has a high mortality rate. However, Toxoplasma gondii has been found in the bladder, kidneys, and intestines ofinfected humans. Malmasi A, Mosallanejad B, Mohebali M, Sharifian Fard M, Taheri M. Prevention of shedding and re-shedding of Toxoplasma gondii oocysts in experimentally infected cats treated with oral clindamycin: a preliminary study. In fact, this is a common way to contract the disease in cats. Most healthy humans wont show any symptoms of toxoplasmosis even when they have it. doi: 10.1016/j.vetpar.2014.09.008, 7. When humans do show symptoms they are similar to flu symptoms and can include: For people with weakened immune systems, signs of toxoplasmosis are likely to be more intense and may also include: Even if a mother doesnt show any signs of infection, she maycontract toxoplasmosis during her pregnancy or right before and can have a child with congenital toxoplasmosis. There are several reasons for this: Following a few sensible environmental and meat hygiene measures can significantly reduce the risk of human infection: Already have a myVCA account? (1993) 143:148697. J Vet Diagn Invest. Protothecosis causes loss of appetite, weight loss, diarrhea, depression, incoordination, paralysis, and ocular lesions. Vet Rec. Dubey JP, Mattixa ME, Lipscomb TP. Some cases may also require sedatives to calm them down, as the initial disorientation can be distressing. (2018) 249:1720. doi: 10.1080/00480169.1997.36035, 9. 19. Wolfer J, Grahn B. Can toxoplasmosis really make people more prone to self-directed violence? Powell CC, Brewer M, Lappin MR. Bolckmans A, Gielen I, Van Soens I, Bhatti S, Poncelet L, Chiers K, et al. Cook all meat thoroughlyat least 160-180F (70-82C) throughout. Therefore, ocular fundic examination should be a routine part of the examination in febrile cats (1). (12), It has yet to be proven if contaminated human urine or fecescould be a means of transmitting the parasitic infection. Koch MO, Weiss RR, Cruz AA, Soccol VT, Gonalves KA, Bertol M, et al. Feed cats only commercially prepared diets. Pyrimethamine (0.25 to 0.5 mg/kg) plus a sulfonamide (30 mg/kg twice daily for 2 to 4 weeks) also can be used to treat disseminated toxoplasmosis and to reduce oocyst shedding. Adopt mature, healthy cats as new pets rather than young kittens. -Weight loss or gain, because people with toxoplasmosis often feel tired and have reduced energy levels. Independence America Holdings Corp. All Rights Reserved. However, some of the most commonly used methods are:-A positive urine test for toxoplasmosis, -A change in bowel habits (such as diarrhea or constipation). Simpson KE, Devine BC, Gunn-Moore D. Suspected Toxoplasma-associated myocarditis in a cat. Vet Parasitol. Zoonoses Public Health (2009) 56:1024. Toxoplasma gondii, Dirofilaria immitis, feline immunodeficiency virus (FIV), and feline leukemia virus (FeLV) infections in stray and pet cats (Felis catus) in northwest China: co-infections and risk factors. doi: 10.1016/j.jfms.2010.05.002, 32. There are three stages in the protozoan's life cycle that explain its biological success. doi: 10.4102/jsava.v84i1.299, 40. Aust Vet J. doi: 10.1111/j.1863-2378.2008.01174.x, 71. A high IgM-ELISA titer (>1:256) with a negative or low IgG-IFA titer indicates an active infection. Can my dog get toxoplasmosis from eating cat feces? 15 Fermented Foods for a Healthy Gut and Overall Health, Frankincense Essential Oil Uses and Benefits for Healing, Oregano Oil Benefits for Infections, Fungus & Even the Common Cold, Secret Detox Drink Recipe (A Natural Detox Drink Recipe), Chia Seeds Benefits: The Omega-3, Protein-Packed Superfood, Apple Cider Vinegar Benefits for Weight Loss, Skin Health, Cholesterol & More, Symptoms of Candida Overgrowth & How to Get Rid of It, Gluten Intolerance Symptoms & Treatment Methods, Best Menopause Supplements & Diet to Relieve Symptoms, Endometriosis Symptoms? Zulpo DL, Sammi AS, Dos Santos JR, Sasse JP, Martins TA, Minutti AF, et al. Vet Parasitol. Diagnosis of naturally occurring toxoplasmosis by bronchoalveolar lavage in a cat. Also, non-infectious neurological diseases showing a wide range of signs are frequent in cats (30, 93) and dogs (94, 95). At any point in time, approximately 1% of cats have intestinal infection and will be shedding oocysts. Join thousands of pet parents and get vet-approved guidance, product reviews, exclusive deals, and more! doi: 10.1016/j.jcpa.2015.10.179, PubMed Abstract | CrossRef Full Text | Google Scholar, 3. J Parasitol. 60. Thus, a negative fecal sample does not rule out toxoplasmosis. In combination with an antimicrobial with Gram-negative coverage, empiric treatment of sepsis or bacteremia. Avoid drinking untreated water, particularly when traveling in less developed countries. This parasite usually affects cats and passes to other species through their fecal matter, though cats are not the only source of Toxoplasmosis. Vet Parasitol. Toxoplasma gondiiin humans and animals in the United States. Eastern equine encephalitis in puppies in Michigan and New York states. Detection and molecular analysis of Toxoplasma gondii and Neospora caninum from dogs with neurological disorders. These latent symptoms can include serious eye infections, mental disability and hearing loss. Domestic cats and other felids are the definitive hosts (DHs). J Clin Microbiol. Toxoplasmosis of Animals and Humans. Teixeira WFP, Tozato MEG, Pierucci JC, Vital GP, Cruz AC, Lopes WDZ, et al. De Tommasi AS, Morini M, Turba ME, Otranto D, Bettini G. Hyperplastic cholangitis in a naturally Toxoplasma gondii-infected cat. Toxoplasmosis is an infectious disease caused by a single-celled organism called Toxoplasma gondii, or T. gondii for short. Venereal transmission in cats does not appear to occur; T. gondii was not detected in the semen, testicles, or epididymis tissues of primo-infected cats, after challenging with T. gondii tissue cysts and tachyzoites (57). Additional precautions for these higher risk individuals include: Allow only immunocompetent, nonpregnant persons to perform daily litter box cleaning.