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The Straight Poop on Toxoplasmosis

Apr26

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Hi Amy,

What is your take on the whole pregnant + cat = toxoplasmosis thing?

I’m newly pregnant (just 6 weeks) and just tested negative for toxoplasmosis, which means I haven’t been exposed to the parasite and do not have the antibodies to protect me and my fetus from future infection.

I have two cats and my husband has been feeding and cleaning their box for the last week as we’ve waited for the test results. This whole time I’ve just been enjoying the break because I was so sure that I would test positive. And why wouldn’t I? I had outdoor cats from birth until I left for college. I slept with my face buried in their fuzzy bellies every night. I kissed them, hugged them and was a lazy handwasher as a kid. By all rights I should have tested positive for the antibodies, but I didn’t.

So now I am trying to figure out how I am going to handle it and how closely I am going to listen to my doctor who, in my opinion, has an overly simplistic and unrealistic line of advice on this one: No cat contact. No touching. At all. Period.

I don’t even see how I can avoid all cat contact. The cats live with us. I work at home 50%. My husband is often away for days on business trips. I don’t want to send my cats away for 8 months!

I’m looking for a less hysterical approach that will still allow me to sleep at night. From what I can deduce, as long as we keep the catbox clean, the chances for indoor cats to pass on toxoplasmosis are very very low. Right?

What did you do, or what would you do in my shoes?

Thanks,
Megan

Oh my goodness, far be it from me to say a trained medical professional is being ridiculous, but your doctor is being RIDICULOUS.

Toxoplasmosis — a mostly symptomless parasitic infection — is indeed a risky thing to contract right before or during pregnancy, since it can get passed to your placenta and fetus. But it’s really rare, and really easy to prevent. And prevention does NOT have to include giving your cat away or living in terror for eight months that it will do something horrific like JUMP IN YOUR LAP or SLEEP IN YOUR BED.

I have a cat. An indoor cat. As soon as I found out I was pregnant, the litter box became Jason’s responsibility. And…that’s it. That’s all I did. I continued to pet and nuzzle and generally love on my cat as much as I ever have.

Here are the standard tips for pregnant women and toxoplasmosis:
1) Don’t clean the litter box yourself.
2) Have your partner clean the litter box on a regular basis.
3) If you must clean the litter box yourself, wear rubber gloves and a breathing mask.
4) Don’t adopt any new cats during your pregnancy or pet any strays.
5) Feed your cats commercially-manufactured food or well-cooked table scraps — no raw meat.
6) Keep your cats indoors so they aren’t hunting (and eating) birds or other small animals.

And that’s it. Other than the litter box thing, I’m guessing your indoor cats are not in the high-risk feline population, regularly lunching on raw chicken carcasses and live rodents. I’m guessing you don’t operate a cat rescue shelter out of your home or routinely offer to change the litter at your friends’ homes. I’m guessing this will probably not be the last minor pregnancy concern that your doctor takes an unreasonable all-or-nothing approach to.

Even if a pregnant woman DOES contract the parasite, it’s not even a sure thing that she’ll pass it on to her baby. If she does, yes, it’s a big deal– I don’t want to sound like I’m pooh-poohing it altogether, though it can be quickly treated with antibiotics. BUT if you contract the infection in your first trimester, you have about a 15 percent chance of passing it along. That percentage jumps to 30 percent in the second trimester and 60 percent in the third. But there’s more good news — the severity of the infection and risk to your baby is highest in the first trimester, when your transmission odds are the lowest.

But…seriously. Just don’t change the litter box. Don’t touch their poop. Or their butts. You’ll be fine. It’s really unlikely that full-time indoor cats who are fed well-cooked or commercial cat food will ever contract the parasite. And the parasite lives in their intestines — not their FUR.

The parasite also lives in the tissue of other animals. Animals you may eat, particularly pork, lamb and game. (But I bet your doctor probably didn’t order you to avoid pork chops for eight months, right?) But just like the cat thing, prevention is relatively easy: heat. A little heat and proper food cooking and handling techniques will put your risk of getting infected at very, very low. At home, freeze meat before cooking it. Use a meat thermometer. Wash your hands and counters thoroughly and regularly. Don’t touch raw chicken and like, stick your fingers in your mouth. You know, the stuff you PROBABLY DO ALREADY. Avoid raw or smoked-only meat preparations at restaurants and make sure your food is cooked properly before digging in. (Though I ate beef tartare and lots of raw seafood in the days right before finding out I was pregnant both times. Awesome. Tested negative for toxoplasmosis both times. Awesomer.)

About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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27 Responses to “The Straight Poop on Toxoplasmosis”

  1. Anonymous Apr 26 at 11:43 am Reply Reply

    The doctor is nuts. As a side note, my kids are in their twenties, and the cat box is still my husband’s responsibility!

  2. Megan Apr 26 at 12:46 pm Reply Reply

    Thanks Amy, you’re awesome and timely in responding to this. I’m an expat living in Germany and although normally pretty cool, the doctors over here have a whole other line of crazy they seem to like to peddle on certain topics. Maybe it’s connected to the crazy German clean freak syndrome, I dunno.
    I really needed this voice of reason today. :-)

  3. Anonymous Apr 26 at 12:56 pm Reply Reply

    My doctor said “Oh, you have cats? Make your husband clean the litter.” And that was it.

  4. Amy J Apr 26 at 12:56 pm Reply Reply

    My doctor said “Oh, you have cats? Make your husband clean the litter.” And that was it.

  5. Julie Apr 26 at 1:09 pm Reply Reply

    Oh, and toxoplasmosis can be contacted from digging in infected soil, so if you’re a gardener, you should wear work gloves. Bet your dr didn’t mention that either?
    My tip if you’re changing the litterbox while you’re husband is gone – you can get a box of the disposable medical style gloves at the pharmacy for much cheaper than the kitchen style rubber gloves, and that way you can throw them away after each use and don’t have to worry about reusing the gloves without touching contaminated surfaces.
    Oh, and wash your hands throughly after changing the litterbox, digging in the soil, etc. Cause the parasite has to actually get into your digestive system, so as long as you don’t rub your mouth or eat with soil or cat poop encrusted hands, you’re fine.
    Why is it that cats always get such a bad rep during pregnancy?

    • Kate May 14 at 10:18 pm Reply Reply

      “Why is it that cats always get such a bad rep during pregnancy?”

      Because cats are disease carrying animals.

  6. Susan Apr 26 at 1:12 pm Reply Reply

    I second what Amy said — that doctor is way overreacting. We have two indoor cats, and I was really concerned when I got pregnant the first time. I was never tested for the antibodies, but we did have the cats tested to see if they had the bacteria. It was an expensive test — about $100-$150 per cat if I recall right, but it was worth it for the peace of mind I got. Both of them were negative and since they are 100% indoor animals, I stopped worrying. Follow the tips Amy gave and stop worrying about this one.
    Good luck and congratulations.

  7. Blanche Apr 26 at 1:40 pm Reply Reply

    No touching, really? What a nut. Why not just tell you to move out of your house since you can’t control where the cats have been or will go?
    We have two cats also and my husband was away off and on for the better portion of my first trimester, so I asked a neighbor if she would be willing to take care of the box while he was away – best $ I’ve spent in a long time. Bonus: I got to know our neighbor a little bit better, and it never hurts to have someone you can turn to close by!

  8. Beth Apr 26 at 2:34 pm Reply Reply

    This is actually really good timing. I’m not pregnant, but I was wondering about this recently–my bf and I have talked about kids later on once we get married–and I have a cat whom I adore beyond reason.
    Also, there are self-cleaning cat boxes aren’t there? That might help husband not feel so put upon. I know it would help in my case if I became pregnant because the cat is mine, not my bf’s and we’re in the process of moving in together, but not quite there yet. He has almost zero relationship with kitty.

  9. Kate Apr 26 at 2:58 pm Reply Reply

    Your doctor is absolutely nuts. I got tested before I got pregnant because I was sure I had the antibodies and wanted to continue being able to work with a student who had been exposed in-vitro. Shockingly I tested negative even after 20+ years of cat ownership and working with a cat rescue where I changed the litter boxes used by a rotating group of over a dozen cats. My conclusion from this was that it’s a heck of a lot harder to catch than they act like it is (although I did resign from the rescue and turn over litter box duty at home to my husband for the duration).
    The idea that you have to basically give away your cats is extremely outdated and seems to be one of those culturally specific things we tell pregnant women. For example, in Italy their big toxoplasmosis thing is that pregnant women aren’t supposed to eat raw vegetables.

  10. Anonymous Apr 26 at 3:02 pm Reply Reply

    Yep. Your doctor is nuts. I work in a University where a lab does research on toxo. Cats can only be infected with it once (because then they develop their own antibodies against it) and at that point shed the spores in their feces – so if your cats have been inside for a long time, even if they once were outdoor cats, they are most likely not shedding spores anymore. Plus, the spores only become airborne and infectious after sitting in the feces for a couple days. So, assuming you scoop their box everyday (as you should!) it’s really a non-issue. Of course, my husband scooped (and still is scooping), because I wasn’t going to be stupid about it, JUST IN CASE.
    And – you’re WAY more likely to get toxo from meat YOU eat. The population of France is estimated to be about 50% positive because of their cuisine.
    So there. Keep the kitties!!! :)

  11. Erin W Apr 26 at 3:49 pm Reply Reply

    Your doctor sounds a little alarmist, if you ask me. If it makes you feel any better, when I was pregnant with my son I got tired of nagging my husband to clean out the litter box so I just started doing it myself. I wore rubber gloves and a mask when I could find one. If we didn’t have one, I just took a deep breath, went in there and got it done. And I was fine, my son was fine and the cats were fine. My husband was especially fine because he got to skate on litter duty.

  12. Bee Apr 26 at 3:52 pm Reply Reply

    I have 2 indoor cats and am 23 weeis pregnant. My doctor asked if I had cats and when I told him I did, he said, the litter box is officially your husband’s job. That’s it. Nothing else.
    Whole heartedly agree with Amy’s advice on this one!

  13. Anonymous Apr 26 at 4:46 pm Reply Reply

    I don’t have a cat, and have never had one so am by no means an expert on the subject… Would it not be possible to get the cats tested for the parasite, and if positive, treat them. It seems that as indoor cats it would be unlikely that they would get infected again anytime soon if they were only fed the right type of food… And just to be on the safe side, let your husband take care of the litter box!

  14. danielle Apr 26 at 5:27 pm Reply Reply

    Yes, I was under the impression that there is a much greater risk of contracting toxoplasmosis from unwashed fruits & veggies and undercooked meats than from cat litter. That being said, the day after I tested positive on an hpt, I woke up to the boy happily scooping the poop. I’m not complaining =)

  15. Suzy Q Apr 26 at 5:42 pm Reply Reply

    You know what? I’m going to side with your doctor. Not for the advice, but for what apppears to be a CYA move on his/her part. You just never know what kind of craziness he/she has had to put up with from former patients. People are very eager to blame doctors for every. little. thing. that goes wrong, even if all preventative measures were taken.

  16. Shelley Apr 26 at 6:00 pm Reply Reply

    I once knew one woman that had an issue with toxoplasmosis, and they’re not even sure it was that. She had a daughter with severe disabilities (who is doing GREAT by the way), but they think what happened is that she spent too much time with the stray cats on a trip to Rome. So, unless you’re going to be surrounded by dirty, stray, Italian cats, I wouldn’t worry.
    I have two furbabies, that WILL NOT STAY OFF OF ME while I’m pregnant. In fact (I’m also 6 weeks preggo), it was how I knew this time around. My hubby has litter box duty, and I’m really getting strict about washing my hands after gardening, even though I wear gloves. And I’ve started ignoring the neighbor’s outdoor cat who likes to keep me company while I garden. Poor Oreo.

  17. Anonymous Apr 26 at 7:18 pm Reply Reply

    Definitely an overreaction…but I agree with the person who said he/she is probably just practicing CYA! I have a 6 week old…we have 2 cats and HI I’M A VETERINARIAN! Who worked all through pregnancy. On cats and dogs. 5 days a week. (And FYI I shockingly tested negative as well…) Cat exposure not an option! So use common sense…wash your hands a lot, wear gloves if you must empty the litter box, and don’t stress. :)
    ___________________
    Editor: Ms. Veterinarian, thank you so much for chiming in!

  18. Mouse Apr 26 at 11:33 pm Reply Reply

    I guess I’m the odd one out who tested positive. But I worked in an animal shelter for a couple years–and they were cited at one point for the way some things were stored (don’t remember what exactly, but I do know one of the results was a second fridge for staff lunches). But if you’ve already been exposed before pregnancy, being positive is not a danger to your baby. For my most recent pregnancy, they didn’t test me–very brief exchange that I already knew I was positive and dropped from there.

  19. sls Apr 27 at 3:37 am Reply Reply

    I think there is a higher risk of eating unwashed veggies and lettuce that come from farms where cats can roam in the fields (or home gardens) and poop in the soil. Those cats are probably eating field mice.
    I didn’t change the litter, didn’t pet stray cats, and made sure to re-wash any salad or veggies that I bought (even the bagged ones can have E coli). I also didn’t eat salami/lunch meats/deli meats unless I heated them to steaming, and I cooked all my meat until well done. I figured that was pretty much the bases covered.
    Congats on the pregnancy and don’t live in fear! :-)

  20. Cheryl S. Apr 27 at 10:11 am Reply Reply

    Your doctor is WAY over reacting. I also tested negative despite having cats all my life. I have 3 indoor cats. My doc just told me to have DH clean the litter box. Guess what? Half the time, I cleaned it anyway. I just washed my hands well afterward (which I did before I got pregnant too, BTW!)
    Pet your cats!! Those furballs are going to need lots of reassuring once the baby comes! (Don’t worry about their reactions, either. My cats could have cared less about the baby once she was born! They looked at her like “It makes a lot of noise and it stinks, why would we want to go over there?”)
    Enjoy your pregnancy, your kitty cats and the fact that your husband has to scoop the box!

  21. wallydraigle Apr 27 at 10:48 am Reply Reply

    I asked my doctor about this when I first got pregnant. In more technical, doctory-sounding words, he basically said, “Pffft. Ain’t no thang.”

  22. Ms. K Apr 27 at 3:00 pm Reply Reply

    @anonymous
    I absolutely love that you refer to toxoplasmosis as “toxo”. My DH got into the habit of yelling “stay away from the litter box, you might get TOXO!!!!!” while I was pregnant. He also began referring to the cat’s rear end as a “toxo-cannon”. Still does. Makes me crack up.

  23. Kathleen Apr 27 at 4:55 pm Reply Reply

    My doc assumed I was positive, never tested, and made my husband take over the litter (think I changed it once while he was gone, with gloves).
    But per Beth’s comment “That might help husband not feel so put upon.” IF this is your concern, he needs to learn to take over some tasks. Now. I couldn’t get laundry up our two flights of stairs for the last month, and I wasn’t so worried about him feeling put upon when I made him do it. The number of tasks needing to be done is just going to increase! I now have a husband who shares the household tasks in far better equality than ever before, and I see that as a very good thing. (getting off the soapbox, sorry)

  24. lindswing Apr 27 at 10:56 pm Reply Reply

    Wow, I knew about the cat litter box (even though I don’t have a cat), but I’ve never heard the veggies thing. I definitely gardened with bare hands and picked at the berries I had just bought at the farmer’s market while I was pregnant. Whoops!

  25. CrazyPrego Apr 29 at 8:28 pm Reply Reply

    We have seen adult, neighborhood cats laying in our flowerbeds before, although we have never seen cat feces in the flowerbeds ever. I am 5 months pregnant and was pulling weeds with no gloves on. I didn’t think anything of it since I didn’t ever see feces. I did put gloves on when digging holes for flowers and other plants but I’m sure I put my hand/glove to my face to wipe the sweat, move my hair from my forehead, or scratch my nose. So now I am freaking out that I could have toxoplasmosis. I did wash my hands multiple times after I was finished. Any insight on the chances me being infected? Am I overreacting? I thought I was being careful but now I don’t know. The nurse practioner I see didn’t seem to think it was a huge deal. Thoughts?

  26. Amanda Oct 10 at 8:31 pm Reply Reply

    I found this while researching toxo myself and now I’m worried. Because while my husband has been cleaning the box (although I did it once while he was gone with gloves, but no mask) I have a kitty who is reacting badly to the fact I’m pregnant and has been stress diahreeahing on the carpet once a week, so I have been cleaning that up, with gloves of course. Now I’m freaking out I mnay have gotten it, even though both my cats have been indoors all their lives, don’t eat raw meat, I don’t garden and don’t touch starnge cats, raw meat or eat unashed veggies. I really hope I’m okay.

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