Reason #362: Cats and toxoplasmosis

I love cats.

Until 1996 I lived with three cats. Perhaps I got toxoplasmosis from their food, changing their litter or burying my nose in the warm fur of their underbelly. I will never know."Do not allow the cats on work surfaces or in bedrooms." is the advice proferred by vets (1) but we always disregarded it.

Meet my cats

The bigger one was the more refined one , the intellectual; " I will use this cat litter," he seemed to be saying, "but this is so beneath me. Oh dear! There, I shall now scratch to cover my doodies with litter. Please do clean this tray after me."

The girl, second in age but not in rank, was aggressive and unpredictable. "Rhaaaaa, I want to get out, let me out!" she'd blurt out all of sudden while you petted her. All nails out and into you or the nearest sofa/rug/wallpaper, her attitude showed insecurity and a need to dominate you until you gave her more food.

The last one in age and in rank, a cuddly black cat was the more subdued, huggable type. A difficult childhood -what with being abandoned as a kitten in a public car park- had left him with bad kidneys and a constant craving for love and caresses. He too was suspected of being gay.

Meet toxo, our parasite

Ten to twenty percent of the population of North America are infected by the parasite toxoplasma gondi and most experience no signs at all. Neither my three cats, until their old-age related death three years ago or I ever complained of symptoms. Even my mother, who had been tested for it, shared this toxo with us and did not suffer in any way from it.

If it was not for scientific research I wouldn't even know that  "Toxoplasmosis associated with HIV infection is typically caused by reactivation of a chronic infection and manifests primarily as toxoplasmic encephalitis. This disease is an important cause of focal brain lesions in HIV-infected patients." (Carlos S. Subauste, MD, Toxoplasmosis and HIV)

Give a dog a bone, give a doctor a toxoplasmosis... and they will fetch the sunset. 

Somehow this quiet parasite who lives in all of us became a dangerous criminal to the average uneducated doctor. Sadly a lot of my doctors seem to defy statistics by being average and uneducated; they seem to think that having found the parasite is the same as having diagnosed the disease.

In my opinion, which happens to be borrowed from the Royal Adelaide Hospital of Australia, the  presumptive diagnosis of toxoplasmosis of the brain is based on observation of:

  • recent onset of a focal neurological abnormality consistent with intracranial disease or a reduced level of consciousness; and
  • evidence by brain imaging (computed tomography or magnetic resonance imaging) of a lesion having a mass effect or the radiographical appearance of which is enhanced by injection of contrast medium;
  • serum antibody to Toxoplasma or successful response to therapy for toxoplasmosis.

In other words, you have a toxo of the brain if: (1) something weird's going on;  (2) a scan of your brain shows something unusual and (3) a test shows you have said toxo parasite in the first place.

Toxo causes toxo encephalitis

Presumably toxo causes toxo-of-the-brain. Although this may be a simplistic view and we could argue that a soft, edible brain causes toxo parasite to eat away the brain. Or something similar. If you are brain scientist, don't be outraged, send me a better image to illustrate the point. Note also that you could have encephalitis and no toxo-parasite around at all, so it is not a toxo-encephalitis at all. Or imagine if you developed some sort of encephalitis and then like, two weeks later, your cat licked your face with a bit of toxo-infested raw meat as you were changing his litter tray, then you would have a non-toxo encephalitis, a toxo-parasite and bang! you will be diagnosed with toxo-encephalitis by mistake.

I know. I'm splitting hairs with this example, but hey, just imagine. It's all a metaphor and a simile. Just like toxo, hiv causes aids only if an aids-definig illness is around.

Toxoplasmosis causes aids

The shortcut is obvious to the average doctor (of which I always get a larger proportion than statistical laws allow (but then again I played with six dice and my nephew recently and statistically we could have have had each of the numbers 1 to 6 every time we rolled the dice, it never happened)). Said average doctors infers:

Toxoplasmosis means patient has a toxoplasmosis encephalitis; toxoplasmosis encephalitis means AIDS (if signs of hiv too); therefore toxoplasmosis means AIDS patient.

I quit hiv because I love cats and I quit toxoplasmosis because it is also a mere parasite coexisting in my body without doing any harm. Next time I see a doctor writing down in their medical report something about the toxoplasmosis I will challenge them to explain why this is significant in the absence of encephalitis, of neurological troubles.


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