Abstract
BackgroundThe parasitic nematode Angiostrongylus vasorum causes severe clinical signs in dogs. The disease is often challenging because infected animals are often presented with clinical signs overlapping those of other diseases.MethodsThe present article describes six angiostrongylosis cases (Cases 1-6) that represent key examples of how canine angiostrongylosis may be extremely confounding. The six animals presented clinical signs compatible with canine angiostrongylosis but they were subjected to clinical examinations for other diseases (e.g. dirofilariosis or immune-mediated disorders) before achieving a correct diagnosis.ResultsIn Case 1 clinical, radiographic and ultrasound examinations' results resembled a lung neoplasia. Case 2 was a dog with a mixed infection caused by A. vasorum and Dirofilaria immitis. Case 3 was a critically ill dog presented in emergency for an acute onset of dyspnoea caused by lungworm infection. The dog died a few hours after presentation despite support and etiologic therapy. Case 4 was a dog presented for chronic hemorrhages and ecchymoses caused by thrombocytopenia of unknown origin, thought to have an inherited, immune-mediated or infective cause. Case 5 was referred for neurological signs due to a suspected discospondylitis. Case 6 was erroneously diagnosed infected only with D. immitis although the dog was infected only with A. vasorum. A timely administration of an anthelmintic (mostly moxidectin) showed to be effective in treating the infection in those dogs (i.e. Cases 1,2, 4 and 5) that did not suffer with severe lung haemorrhages yet.ConclusionsDogs 1-5 were referred in two regions of Italy that are considered non-endemic for A. vasorum. These findings indicate that veterinarians should include angiostrongylosis in the differential diagnosis of cardio-respiratory distress also in non-endemic regions and should perform appropriate diagnostics in the presence of compatible signs even if the clinical picture is atypical.
Highlights
The parasitic nematode Angiostrongylus vasorum causes severe clinical signs in dogs
The clinical signs presented by the here examined dogs were due to the typical pathogenic mechanisms caused by A. vasorum, i.e. inflammation triggered by parasite eggs and larval stages in the lungs, and by damage caused by adult worms in the pulmonary vessels
A. vasorum was not suspected because history and clinical findings were consistent with a diagnosis of cardiopulmonary filariosis
Summary
Case 1 A 2-year-old Dalmatian dog was referred to a private Veterinary Hospital in Pavia municipality (northern Italy, Lombardy region) with a history of respiratory distress and weight loss over the previous month and of unsuccessful therapy with ceftriaxone 50 mg/kg IM once a day for 2 weeks. Forty-five days from the first treatment, the faeces were negative for A. vasorum, coughing and dyspnoea were absent, no nodular lesion could be revealed upon lung sonographic examination (Fig. 1e) and the thoracic radiographs were markedly improved (Fig. 1f ). Radiographic examination of the thorax revealed a generalized unstructured interstitial to alveolar pattern compatible with lung hemorrhage or acute respiratory distress syndrome, Case 5 A 7-month-old female mix breed dog was referred to the same Veterinary Hospital of Case 4, with a history of anxiety, vocalizations, labored breathing in the previous day and an acute onset of paraplegia. Diagnostic imaging findings make the clinician suspicious of A.vasorum infection as the cause of the lung lesion and pulmonary hypertension, a rapid antigenic test (IDEXX Angio DetectTM) for A.vasorum was performed giving a positive result. Case 6 An 8-month old Pinscher dog was referred to a veterinary practice in Rieti municipality
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