When Worms Were the Missing Piece: Sanna’s Story

Meet Sanna, a beautiful seven-month-old Romanian rescue. Sweet-natured, very pretty, and incredibly lucky – her new guardians had already worked with us before, and were determined to give her the very best start.

Like so many overseas rescues, Sanna arrived with a lot of fear, particularly around people and she certainly didn’t want to be touched. “But that’s normal for rescues from her background,” her guardians thought. “It will take time for us to help her feel safe, it’s not a health issue.”

Her poo wasn’t great in those first weeks, but surely that was stress? She was a bit itchy, her coat was lacklustre — but she had been in a shelter, it was her first experience in a home so again “That’s to be expected, right?”

Doing everything right

With our guidance her amazing guardians did all the right things:

• A much better diet
• Routine vet care, including deworming as per the vet’s health plan
• The most wonderful, structured support to help her settle and feel safe

And they made some brilliant progress in her first few weeks… but it wasn’t as much as we would expect from the exceptionally careful and dedicated approach. Some things were much harder than they should have been – we were missing something.

Looking deeper into health

In addition to the behaviour challenges, there were some niggly physical symptoms which weren’t settling down – itching, her poo was still a bit inconsistent (but not unexpected just a few weeks after a huge move from a Romanian shelter).

With her vets agreement, we started a strict exclusion diet to rule out food intolerances and help her insides settle down, alongside some targeted gut health support. Her parasite treatment continued per the vet practice guidelines and they also treated her skin where she had scratched herself and used medication to reduce the itching.

She was still not right.

That’s when we helped the client organise parasite testing, even though:

• Sanna had been on the vet’s flea/tick/dewormer plan for two months.
• Her poo was looking great on the new diet!
• Her behaviour was slowly improving, but just not as it should.

Her guardians were understandably a little dubious! “Surely it can’t be worms? She’s already been treated three times!”

The surprise: hookworm

The test result came back positive for hookworm. Yuck. It is particularly unpleasant.

The vets treated her again, but behaviourally and physically, she still wasn’t right.

A repeat test a month later showed the infection had increased tenfold, despite treatment. It was an enormous hookworm burden, which can be extremely serious from a health perspective. No wonder she was struggling.

Turning the corner

A change of treatment, targeted environmental management, and continued gut support finally tipped the balance.

• Sanna became more playful and relaxed.
• Her itching reduced a little and a couple of specific areas of rash disappeared. 
• She began to enjoy some gentle touch from her new guardians.
• Her rate of behaviour progress started to increase.

The next test a few weeks later? Clear. Phew.

And yes, there will be a number of repeat tests over the coming months given the potential risks of reinfection from the environment (although we have hopefully reduced this significantly!)

Still more to uncover

Like many complex cases, Sanna’s story didn’t end there. Continued feedback to the vets of our observations prompted some targeted testing for other health issues (some potentially related to the hookworm, some not) and we’re now gradually navigating these. It can take a lot of persistent detective work to get to the bottom of everything!

Resolving the hookworm has been a significant piece of that puzzle — for Sanna, and for her guardians (although i’m not sure they will walk round their garden in bare feet for quite some time yet, it is a very itch-inducing thought to realise you could be picking them up) 

Take-aways

• Behaviour can improve when worm burdens are resolved.
• Vet-prescribed treatments aren’t a guarantee – or even a guaranteed preventive.
• Decent poo doesn’t mean no worms!
• Parasite management isn’t the sole-solution to behaviour challenges by any stretch of the imagination, but it can be an important part of the picture.
• Even if your dog doesn’t have any behaviour challenges – test regularly – no-one wants to deal with them, but far better to know they are there and get rid of them, than realise later you have unknowingly been coming into contact with them for months!!!!

The bigger message

Professional guidelines (BSAVA, 2021; WSAVA, 2025) all recommend a risk-based, responsible approach to parasites: test, then treat.

That’s why at Canine Thinking, we say: Don’t guess, test. And when the results come in, we’ll help you work with your vet to take the right action – combining targeted treatment with gut support, environmental care, and our holistic House of Harmony approach to your dog’s well-being. To talk to us about your dog, email us at hello@caninethinking.com

References

• BSAVA (2021). Policy position on responsible parasiticide use. British Small Animal Veterinary Association.
• WSAVA (2025). Global Principles of Wellness. World Small Animal Veterinary Association.
• Traversa, D. (2012). ‘Hookworm infection in dogs’. Parasites & Vectors, 5:91.