Can IDEXX Angio Detect™ accurately detect canine Angiostrongylosis?

Natashia Weir,Jo Ireland

doi:10.18849/ve.v6i4.515

Abstract

PICO question In dogs, is IDEXX Angio Detect™ as accurate as Baermann coprology when diagnosing Angiostrongylus vasorum infection?  Clinical bottom line Category of research question Diagnosis The number and type of study designs reviewed Eight papers were critically reviewed: three diagnostic accuracy studies, two cross-sectional studies (one of which also included a retrospective case series), one cohort study, one case-control study, and one case series Strength of evidence Weak Outcomes reported Angio Detect™ (IDEXX) was shown to have low-moderate sensitivity and high specificity in comparison to Baermann coprology. Occasionally, false-negative results occurred with Angio Detect™ when compared to Baermann coprology. This was thought to be due to antigen-antibody complex formation. Positive Angio Detect™ assays were obtained in both symptomatic and asymptomatic canine patients. In an experimental setting, Angio Detect™ was shown to obtain a positive result five weeks post-inoculation Conclusion There is weak evidence supporting Angio Detect™ as a highly specific and moderately sensitive diagnostic test when compared to Baermann coprology  How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. 

Highlights

O positive quantitative (q) PCR from bronchoalveolar lavage (BAL) samples and clinical recovery after administration of either 50 mg/kg q24h fenbendazole PO for 3 week treatment duration or 2.5 mg/kg moxidectin repeated after [2,3,4] weeks
A. vasorum infection was suspected based on compatible respiratory signs, radiographic findings, bronchoscopy, and bronchoalveolar lavage (BAL) cytology examination
Angiostrongylosis was confirmed in all seven dogs by: o positive quantitative (q) PCR from BAL samples and clinical recovery after administration of either 50 mg/kg q24h fenbendazole PO for 3 week treatment duration or 2.5 mg/kg moxidectin repeated after [2,3,4] weeks

Summary

Summary of the evidence

One sample per dog was thawed for Angio DetectTM diagnostic testing. The second serum sample underwent A. vasorum antigen and antibody sandwich-ELISAs; both analysed at the Institute of Parasitology, Vetsuisse Faculty, University of Zurich, Switzerland. Faecal samples were obtained from each dog over 3 consecutive days for Baermann coprology. Outcome studied: Objective assessment: Positive or negative results from Angio DetectTM, A. vasorum antigen sandwich-ELISA, A. vasorum antibody sandwich-ELISA and Baermann coprology. O Positive Baermann coprology result was determined by identifying L1 larvae of A. vasorum in the faeces. In one dog, positive on A. vasorum antigen sandwich-ELISA, the Angio DetectTM assay was repeated twice as invalid results were obtained (the control line was not visible). Not all diagnostic test results were available for each dog; all PICO relevant data were available

Limitations:

Methodology Section

Findings

CONFLICT OF INTEREST