The fox (Vulpes vulpes) as a reservoir for canine angiostrongylosis in Denmark. Field survey and experimental infections.

Until recently, Angiostrongylus vasorum was not considered to be an endogenous Danish parasite, since demonstration of this worm had been confined to necropsy findings in 2 dogs, both of which had visited France. During the last 2 years, however, clinical cases have been diagnosed among a considerable number of Danish dogs, none of which had ever been outside Denmark. All these cases have occurred north of Copenhagen, where an endemic focus seems to exist. In this field survey A. vasorum was found for the first time in wild Danish red foxes. Furthermore, experimental infections showed that the parasite can be transferred between foxes and dogs. Consequently, the wild fox population must be considered a potential reservoir for transfer of A. vasorum to domestic dogs.     

Canine angiostrongylosis: the French heartworm: an emerging threat in North America

Angiostrongylus vasorum, French heartworm, is a metastrongloid parasite found in the pulmonary arteries and right ventricle of wild and domestic canids and various other animals. The natural definitive hosts are species of foxes. The geographic distribution of the parasite includes various countries of Europe, Africa, South America, and North America. Angiostrongylosis is considered an emerging disease in dogs in Europe. In North America, autochthonous A. vasorum infection occurs only in the Canadian province of Newfoundland-Labrador. Computer modeling suggests there is a high probability that A. vasorum will spread to other parts of North America and will likely become endemic in the eastern half of the continent and in the states and provinces along the western coast. Animals acquire infection by the ingestion of gastropod or frog intermediate hosts that carry the infective 3rd-stage larvae. Frogs can also serve as paratenic hosts. Definitive antemortem diagnosis is by detection of L(1) in feces, sputum, or bronchoalveolar lavage samples. Baermann fecal examination is the most reliable method for fecal detection. However, false negative results can occur due to the typical erratic/sporadic fecal larval shedding pattern of A. vasorum. Recently, promising new methods for A. vasorum infection diagnosis have been reported involving polymerase chain reaction of blood and fecal samples and a sandwich ELISA for detection of circulating worm excretory/secretory antigen. Current treatment options include moxidectin, milbemycin oxime, and fenbendazole.     

Clinical signs,diagnosis and treatment of three dogs with angiostrongylosis in Ireland

: Infection with Angiostrongylus vasorum was diagnosed at necropsy on a dog that died from acute pulmonary haemorrhage, and on recovery of L1 larvae by Baermann examination of faeces from two dogs, one of which had abdominal pain and retroperitoneal haemorrhage, while the other had right-sided heart failure due to cor pulmonale. The presenting signs included syncope (one dog), exercise intolerance (two dogs), cough (two dogs), abdominal pain (one dog) and depression (one dog). One-stage prothrombin time and activated partial thromboplastin time were prolonged in two dogs, buccal mucosal bleeding time was prolonged in one dog and globulin was elevated in all three dogs. Two dogs were treated with fenbendazole and recovered.     

Neural angiostrongylosis in three captive rufous bettongs (Aepyprymnus rufescens)

Neurological disease attributed to migration of the rat lungworm ( Angiostrongylus cantonensis ), is described in three captive rufous bettongs ( Aepyprymnus rufescens ). Clinical signs, including ascending paralysis and multifocal neurological deficits, were similar to those seen in other species. Histologically, the severity of meningoencephalomyelitis ranged from mild to moderate. In one animal cerebrospinal fluid contained a high percentage of eosinophils but peripheral blood cell counts were within normal limits. Treatment with dexamethasone, diazepam and vitamin E was unsuccessful. The prognosis for bettongs with this disease is poor. The susceptibility of this species to this disease has implications for enclosure design.     

An 8‐week Brain MRI Follow‐up Analysis of Rat Eosinophilic Meningitis Caused by Angiostrongylus cantonensis Infection

Early differential diagnosis and timely follow‐up are advantageous in the management of Angiostrongylus cantonensis infection. This study aimed to characterize angiostrongyliasis in the rat brain for an 8‐week period using magnetic resonance imaging (MRI) with contrast‐enhanced T1‐weighted images (T1WI), T2‐weighted imaging (T2WI), fluid attenuation inversion recovery (FLAIR) and R2 mapping sequences. The data were analysed with Mathematica and Matlab software programs for weekly changes in each brain following the infection of 20, 50, 100 and 300 third‐stage larvae (L3), respectively. The results showed that the average subarachnoid space detected by T2WI technique was peaked up to 10% increase of original size on day 35 after 100 or 300 larvae infection, while those infected with 20 or 50 larvae showed less than 4% increase during the entire course of observation. This increase was relevant to the mortality of the infected rats, because those with 100 or 300 larvae infections showed a sharp decrease in survival rate before day 40. After day 40, the average subarachnoid space was decreased, but the average ventricle size was persistently increased, with the highest increase observed in the group infected with 300 larvae on day 56. Furthermore, the R2 mapping mean and R2 mapping size were significantly different between the brains with severe infection (100 and 300 larvae groups together) and those with mild infection (20 and 50 larvae groups together) on day 49, but not on day 35. Our results showed that diagnosis for different quantity of larvae infection using MRI is possible and follow‐up characterization is informative in revealing the effects of angiostrongyliasis on different brain areas. In conclusion, our results support the use of MRI as a non‐invasive diagnostic technique for eosinophilic meningitis caused by A. cantonensis infection.     

Imaging diagnosis: CT findings in a dog with intracranial hemorrhage secondary to angiostrongylosis

A seven-month-old Cocker Spaniel had a cough, acute lethargy, decreased responsiveness, and episodes of hyperexcitability. There were bilateral generalized increased lung sounds, bilateral episcleral hemorrhage, and systemic hypertension. Prolonged buccal mucosal bleeding time and elevated D-dimer concentrations were detected. Radiographically, there was a generalized moderate unstructured interstitial pattern. In thoracic CT images, there was a diffuse moderate hyperattenuating appearance of the bronchial walls and interstitium and diffuse areas of moderate bronchiectasis. The brain CT images were characterized by marked hyperattenuating well-defined masses. In addition, there were smaller hyperattenuating and hypoattenuating masses scattered throughout the cerebral and cerebellar parenchyma. A zinc sulphate flotation test confirmed large numbers of Angiostrongylus vasorum L1 larvae. Despite therapy the dog continued to deteriorate and underwent euthanasia. Postmortem examination confirmed the presence of multiple intracranial and extracranial hemorrhages. Angiostrongylosis should be considered as one of the differential diagnoses in dogs presenting with neurologic signs consistent with acute intracranial haemorrhage.     

Canine pulmonary angiostrongylosis: an update

Canine pulmonary angiostrongylosis is an emerging snail-borne disease causing verminous pneumonia and coagulopathy in dogs. The parasite is found in Europe, North and South America and Africa, covering tropical, subtropical and temperate regions. Its distribution has been characterised by isolated endemic foci, with only sporadic occurrences outside these areas. In the last two decades, the literature has been dominated by several case reports and small case series describing sporadic disease in old or new endemic areas. Case reports and experimental studies with high doses of infective third stage larvae may not reflect what happens under field conditions. There is insufficient understanding of the spread of infection and the dynamic consequences of this parasite in the canine population. This review discusses the biology, epidemiology, clinical aspects and management of canine pulmonary angiostrongylosis.