Heartworm Infection In Cats Research Articles

Feline heartworm (Dirofilaria immitis) infection: first case report of serological diagnosis in Brazil, confirmed by molecular assay

The clinical importance of heartworm infection in cats has indeed increased in recent years. Dirofilaria immitis infection has been reported worldwide in cats and continues to be regularly diagnosed in endemic areas. The diagnosis can be overlooked easily, especially in Brazil, where there is not a specific feline immunodiagnostic test, forcing the veterinarians to use a test made for the canine host. In 2015, a 10-year-old female neutered cat was diagnosed with D. immitis using an antigen serological test, based on imunocromatography and designed for dogs. The modified Knott test was negative. As the disease progressed, the cat showed clinical signals of respiratory distress, such as dyspnoea and polypnea in addition to prostration and emaciation, and died a few weeks after the diagnosis. During necropsy, one adult nematode was found in the pulmonary artery. D. immitis infection was confirmed by molecular amplification, performed in the worm fragment. This is the first report of serological diagnosis of feline dirofilariasis in Brazil. A chemoprophylaxis routine in cats should be done, as is done in dogs from endemic areas.

Prevalence of heartworm in dogs and cats of Madrid, Spain

BackgroundDirofilaria immitis causes heartworm disease, a chronic and potentially fatal cardiopulmonary disease which mainly affects dogs and cats. It is present in most of Spain, due to favourable climatic factors. Madrid, located in the centre of the Iberian Peninsula, is the most highly populated city in the country. There is a lack of current data on canine heartworm and there are no published epidemiological data regarding feline heartworm in this region, therefore the aim of this study was to assess the prevalence and current distribution of canine and feline dirofilariosis in the province of Madrid.MethodsSerum samples from 1716 dogs and 531 cats, from animals living in the metropolitan area of Madrid and adjacent areas, were studied. All the samples, either from cats and dogs, were tested for circulating D. immitis antigens using a commercial immunochromatographic test kit. Furthermore, to establish the seroprevalence of heartworm infection in cats, serological techniques for anti-D. immitis and anti-Wolbachia antibody detection were used.ResultsPrevalence of D. immitis in the canine population of Madrid was 3%, showing an increase in comparison to previous data. The presence of heartworm in the city centre could be influenced by the presence of Urban Heat Islands, while the positive dogs from metropolitan and adjacent areas were mainly located under the influence of rivers. Regarding cats, 0.2% were positive to the antigens test and 7.3% were seropositive to both anti-D. immitis and Wolbachia surface protein antibodies, which demonstrate the presence of feline heartworm in Madrid. Seropositive cats were present in the same areas where positive dogs were found. Indoor/outdoor cats showed the highest seroprevalence whereas the lowest corresponded to indoor cats, demonstrating that prophylactic treatments should be carried out regardless of lifestyle. Infection was found in 2.2% of dogs and 6.7% of the cats < 1 year-old, which indicates that early preventive campaigns in puppies and kittens should be implemented.ConclusionsThe results point to the need for adequate prophylactic measures through the administration of macrocyclic lactones in animals living in Madrid. Veterinarians should be aware of the presence of this disease and include heartworm in the differential diagnosis when a pet presents with symptoms compatible with D. immitis.

First epidemiological report of feline heartworm infection in the Barcelona metropolitan area (Spain).

BackgroundThe metropolitan area of Barcelona is the most densely populated metropolitan area on the Mediterranean coast. Several studies have reported the presence of canine heartworm disease in this region; however, there are no published epidemiological data regarding feline heartworm in this region and the prevalence in this species remains unknown.MethodsSerum samples from 758 cats living in the metropolitan area of Barcelona (Spain) were collected between 2012 and 2013. To establish the seroprevalence of heartworm infection in cats, serological techniques for anti-D.immitis and anti-Wolbachia antibody detection were used while a commercial ELISA test kit was used to detect circulating D.immitis antigens.ResultsOf these samples, 11.47% were positive to D.immitis and Wolbachia surface protein antibodies and 0.26% were positive to D.immitis antigens. The higher antibody seroprevalences were found in the areas that follow the courses of the rivers Llobregat and Anoia (Baix Llobregat 11.5%, Vallés Occidental 13.2%; Barcelonés 11.7%) where humidity and vegetation favour the development of the mosquito vectors. High antibody seroprevalences were also found in the urban areas (Barcelona city 13.1%; Sabadell 15.5%), which demonstrates that city cats are also at risk from D.immitis infection.ConclusionsGenerally, in Spain cats do not receive prophylactic treatment and therefore the risk of infection is higher in this species than in dogs. Adequate prophylactic plans should be implemented in the feline population. This is the first epidemiologic study on feline heartworm infection to be carried out in continental Spain.

Efficacy of a single dose of a novel topical combination product containing eprinomectin to prevent heartworm infection in cats

Cats may be infected by heartworm, Dirofilaria immitis, through mosquito bites. They can develop severe heartworm disease when infective D. immitis larvae migrate and develop into adults in the pulmonary vasculature or other tissues. As there is no curative treatment for feline heartworm infection, the monthly administration of preventative treatment is recommended in endemic areas. Three controlled, blinded laboratory studies were conducted to evaluate the preventative efficacy of BROADLINE®, a novel combination of fipronil, (S)-methoprene, eprinomectin, and praziquantel against D. immitis in cats. In each study, 28 cats were inoculated with approximately 100 (studies 1 and 2) or 40 (study 3) infective third stage D. immitis larvae by subcutaneous injection, thirty days prior to treatment. The larvae were from recent field isolates from naturally infected dogs from three distinct geographic areas (two in the USA and one in Europe). In each study, the cats were allocated randomly to two study groups of 14 cats each. The control group remained untreated. On Day 0, each cat in the treated group received one topical application of the novel topical formulation, delivering the minimum intended dose of 0.5mg of eprinomectin per kilogram of body weight. At 6 months after infection, all cats were humanely euthanized and examined for adult D. immitis. Across all three studies, 28 (68%) of the 41 untreated cats harbored one or more heartworms, while 100% of the 42 treated cats remained free of heartworm infection, demonstrating the 100% preventive efficacy of BROADLINE® against D. immitis in cats. The treatment was well tolerated and no health abnormality was observed in any treated cat.

First epidemiological report of feline heartworm infection in the Barcelona metropolitan area (Spain)

BackgroundThe metropolitan area of Barcelona is the most densely populated metropolitan area on the Mediterranean coast. Several studies have reported the presence of canine heartworm disease in this region; however, there are no published epidemiological data regarding feline heartworm in this region and the prevalence in this species remains unknown.MethodsSerum samples from 758 cats living in the metropolitan area of Barcelona (Spain) were collected between 2012 and 2013. To establish the seroprevalence of heartworm infection in cats, serological techniques for anti-D.immitis and anti-Wolbachia antibody detection were used while a commercial ELISA test kit was used to detect circulating D.immitis antigens.ResultsOf these samples, 11.47% were positive to D.immitis and Wolbachia surface protein antibodies and 0.26% were positive to D.immitis antigens. The higher antibody seroprevalences were found in the areas that follow the courses of the rivers Llobregat and Anoia (Baix Llobregat 11.5%, Vallés Occidental 13.2%; Barcelonés 11.7%) where humidity and vegetation favour the development of the mosquito vectors. High antibody seroprevalences were also found in the urban areas (Barcelona city 13.1%; Sabadell 15.5%), which demonstrates that city cats are also at risk from D.immitis infection.ConclusionsGenerally, in Spain cats do not receive prophylactic treatment and therefore the risk of infection is higher in this species than in dogs. Adequate prophylactic plans should be implemented in the feline population. This is the first epidemiologic study on feline heartworm infection to be carried out in continental Spain.

Can heartworm prevalence in dogs be used as provisional data for assessing the prevalence of the infection in cats?

Cats are considered a susceptible host for Dirofilaria immitis; however, increased host resistance is reflected by relatively low adult worm burdens in natural and experimental infections; the prolonged prepatent period (8 months); the low level and short duration of microfilaremia; and the short life span of adult worms (2–3 years). From April to September 2006, 212 cats and 608 dogs, all exposed for at least one transmission season, were screened for D. immitis infection in a multi-center study in the Po River Valley in northern Italy. Cats were initially evaluated by antibody testing; positive subjects were followed up by antigen testing and echocardiography (and necropsy if death occurred). The prevalence in dogs was 29% by a modified Knott test and antigen testing compared with a prevalence of 4.7% in cats by an antibody test; six of these infections (2.8%) were confirmed by the follow-up evaluations. This field study demonstrated that the prevalence of heartworm infection in cats in this area is within the expected limits of 9–18% of the prevalence in dogs. Antibody testing likely underestimates the real prevalence of D. immitis infection in cats. These results also emphasize the importance of preventive treatment in cats.

Feline heartworm disease: a clinical review.

Feline heartworm disease is caused by the filarial nematode Dirofilaria immitis, and is transmitted by mosquitoes in heartworm-endemic areas worldwide. While dogs are the definitive hosts for this parasite, cats can also be infected, and the overall prevalence in cats is between 5% and 10% of that in dogs in any given area. The spectrum of feline presentations varies from asymptomatic infections to chronic respiratory signs, sometimes accompanied by chronic vomiting to acute death with no premonitory signs. Ante-mortem diagnosis can be challenging and relies on a combination of tests, including antigen and antibody serology, thoracic radiography and echocardiography. As treatment with heartworm adulticidal drugs can be life-threatening and heartworm infection in cats is often self-limiting, infected cats are frequently managed with supportive treatment (corticosteroids, bronchodilators, and anti-emetics). Surgical removal of filariae using extraction devices may be considered in some acute cases where immediate curative treatment is necessary, but filarial breakage during the procedure may result in an acute fatal shock-like reaction. Necropsy findings are mainly pulmonary and include muscular hypertrophy of the pulmonary arteries and arterioles on histopathology. A number of safe and effective macrocytic lactone drugs are available for prophylaxis in cats. These drugs can kill a range of larval and adult life-cycle stage heartworms, which may be advantageous in cases of owner compliance failure or when heartworm infection status is undetermined at the time prophylaxis is commenced. An index of suspicion for feline heartworm disease is warranted in unprotected cats with respiratory signs, and perhaps chronic vomiting, in areas where canine heartworm disease is endemic. Many cats, once diagnosed and with appropriate supportive care and monitoring, will resolve their infection and be free of clinical signs.

Reassessing the definition of heartworm infection in cats

JAVMA, Vol 231, No. 9, November 1, 2007 R studies by Browne et al and Dillon et al have corroborated earlier findings of Selcer et al, who reported radiographic evidence of pulmonary disease in cats experimentally exposed to heartworm infective larvae, but which did not develop mature heartworm infection (dirofilariasis). Importantly, the two more recent aforementioned studies identified histologic lesions in the pulmonary arteries or in airways and pulmonary parenchyma, as well as pulmonary arteries in cats with natural or experimental infections, respectfully. While it remains to be proven that naturally infected cats (with presumably lesser L 3 exposure) develop pulmonary parenchymal and airway lesions, it seems clear that naturally exposed cats that resist mature infection develop, at the very least, pulmonary vascular disease. These three landmark works broaden our understanding of the pathophysiology of the respiratory tract signs associated with exposure to various stages of Dirofilaria immitis. Their findings also raise questions as to appropriately descriptive terminology, particularly regarding the use of the word exposure. In 2005, I was an investigator on a study of heartworm risk in nondomestic cats in the southeastern United States. In that article, we defined antibodypositive cats as those exposed to, but negative for, heartworm infection if they were heartworm antigen negative and if no heartworms were found on necropsy. During the peer review process, one reviewer challenged this definition conceptually, arguing that antibody-positive cats indeed were infected. While acknowledging that exposed cats might well have pulmonary lesions, we argued that a cat without mature (L 5 ) heartworms did not meet the requirements for a diagnosis of heartworm infection. Our arguments were convincing enough that the manuscript was published with this distinction intact. Perhaps, in light of recent work, this point should be reconsidered. Conceptually, this represents a thorny problem. In an ideal world, cats would either have heartworm infection or not, but there is now a recognized gray zone in which cats that have successfully rejected an infection (probably at the young L 5 stage) may develop lesions (ie, disease) induced by D immitis. New terminology is Reassessing the definition of heartworm infection in cats

Comparison of serological tests for the detection of natural heartworm infection in cats.

Serological tests were performed on 380 cats with necropsy-confirmed heartworm disease to compare the performance of currently available commercial laboratory and point-of-care heart-worm serological tests in a heartworm-endemic area. Overall, antigen tests detected 79.3% to 86.2% of heartworm infections and were highly specific. Most cats with false-negative antigen tests had a single male worm. Antibody tests detected 62.1% to 72.4% of heartworm infections and had a wider range of false-positive results (1.4% to 19.1%) than antigen tests (0.3% to 2.0%). Serological tests for feline heartworm infection varied in diagnostic performance. Combining results from antigen and antibody tests achieved greater sensitivity than using either test alone.

Prevalence and risk factors for heartworm infection in cats from northern Florida.

Necropsies were performed on 630 adult cats in northern Florida to determine the prevalence and risk factors for heartworm infection in cats of this region. Heartworms were identified in 4.9% of cats, and serological evidence of heartworm exposure was present in 17% of cats. Not all cats from which heartworms were recovered were seropositive for heartworm antigen or antibody. There was no association between heartworm infection and co-infection with feline leukemia virus (FeLV) or feline immunodeficiency virus (FIV). Male cats were at higher risk of infection with heartworm, FeLV, or FIV than were females. Because even a single heartworm can cause clinical disease or death in cats, the authors conclude that cats in this region should receive heartworm prophylaxis to prevent heartworm infection.

Prevalence of heartworm infection in healthy cats in the lower peninsula of Michigan.

To determine prevalence of heartworm infection among healthy, client-owned cats in the lower peninsula of Michigan. Cross-sectional prevalence study. 1,348 healthy cats examined at private veterinary practices throughout the lower peninsula of Michigan. Sera were tested by use of an ELISA-based antigen test kit to determine infection and 2 commercially available antibody detection kits to determine exposure. A questionnaire was used to collect data to assess risk factors associated with infection. 25 cats had positive results for heartworm antigen, yielding an observed prevalence of 1.9%. Neither antibody test was reliable or provided reproducible results, and neither yielded positive results for more than 20% of the antigen-positive heartworm-infected cats. Multivariate regression indicated that cats from southeastern Michigan and cats > or = 2 years old had a higher risk of infection. Results indicated that most (80%) heartworm-infected cats in the lower peninsula of Michigan were from the southeastern part of the state, a pattern that closely paralleled the prevalence of heartworm infection in dogs. Therefore, knowledge of the regional prevalence of heartworm infection in dogs may be useful in assessing the risk of infection in cats. Results also suggested that currently available in-clinic heartworm antibody detection kits have limited utility in the diagnosis of heartworm infection in cats.

Heartworm infection in cats: 50 cases (1985-1997).

To characterize risk factors, clinical findings, usefulness of diagnostic tests, and prognosis in cats with naturally occurring heartworm infection (HWI). Retrospective study. 50 cats with Dirofilaria immitis infection. Medical records, thoracic radiographs, and echocardiograms were reviewed and findings compared with appropriate reference populations. Findings suggested that male cats were not predisposed to HWI, domestic shorthair cats were at increased risk, and indoor housing was only partially protective. Fewer cases of HWI were identified in the final quarter of the year, compared with other periods, and prevalence is not apparently increasing. Signs of respiratory tract disease were most common, followed by vomiting. Infection was diagnosed incidentally in > 25% of cats; conversely, 10% of infected cats died suddenly without other clinical signs. Serologic tests were most useful for diagnosis, followed by radiography and echocardiography. Eosinophilia supported the diagnosis. Overall median survival time was 1.5 years but exceeded 4 years in cats surviving beyond the day of diagnosis. Sex does not appear to be a risk factor for HWI in cats, and indoor housing provides only incomplete protection. Signs of respiratory tract disease (dyspnea and cough) are the strongest indicators of HWI in cats, and some radiographic evidence of infection is detected in most cases. Antibody screening for HWI in cats is efficacious, and antigen testing and echocardiography are most useful for making a definitive antemortem diagnosis.

Prevalence of heartworm infection in cats with signs of cardiorespiratory abnormalities

Objective To determine prevalence of heartworm infection in a population of pet cats with cardiorespiratory abnormalities and to determine relative usefulness of clinical signs and tests in diagnosis of heartworm disease. Design Prospective case series. Animals 100 client-owned cats with clinical signs of cardiorespiratory abnormalities. Procedure Cats were evaluated using CBC, modified Knott test, ELISA for serologic detection of heartworm antigen and antibodies to heartworms, thoracic radiography, and echocardiography. Cats were considered infected if they had circulating microfilaria, heartworm antigens in serum, or if heartworms were detected by echocardiography or on necropsy. Cats were considered suspicious for infection if they had 2 of the following: serum antibodies to heartworms, eosinophilia or basophilia, or indicative radiographic findings. Results 9 cats were infected with heartworms, resulting in a prevalence of 9%; 26 cats had evidence of heartworm exposure (ie, serum antibodies to heartworms). Twenty cats were considered suspicious for heartworm infection. Some outdoor exposure was reported twice as often in heartworm-infected cats, compared with noninfected and suspicious cats. However, a third of infected cats were reportedly housed totally indoors. Cough and dyspnea were strong indicators of heartworm disease. Eight of 9 infected cats had serum antibodies to heartworms and heartworm antigen in serum. Thoracic radiography and echocardiography indicated heartworm infection in 6 and 7 of the 9 cats, respectively. Clinical Implications Cough or dyspnea may indicate heartworm disease in cats; serologic tests, echocardiography, and radiography are most useful diagnostic procedures. Although living indoors is protective, it may not preclude heartworm infection in cats. (J Am Vet Med Assoc 1998; 212:517-520)

Expression of an Onchocerca volvulus Ov33 homolog in Dirofilaria immitis: potential in immunodiagnosis of heartworm infection.

In this study, the expression of an Onchocerca volvulus Ov33 homolog was demonstrated in Dirofilaria immitis. Rabbit antiserum raised against a recombinant fusion protein of O. volvulus, MBP/OvD 5B (Ov33), was found to react with a 31-33 kDa glycoprotein (DiT33) of adult worms of D. immitis. An antibody response to MBP/OvD 5B was observed in dogs, as early as 11 weeks post infection with infective larvae of D. immitis, and in dogs with occult infection. Cats both experimentally and naturally infected with D. immitis also reacted strongly with the recombinant antigen. In contrast, sera from dogs receiving chemically-abbreviated infection or from animals harbouring a variety of other helminths failed to react. These data suggest that antibody responses generated by DiT33 may have potential in immunodiagnosis of heartworm infection in cats and dogs.