Detection of Angiostrongylus vasorum by quantitative PCR in bronchoalveolar lavage fluid in Belgian dogs

Is the Angiostrongylus vasorum infection in domestic dogs underestimated or misdiagnosed? A comprehensive presentation of four lethal cases

Introduction

Angiostrongylus vasorum (A. vasorum) is a widely distributed gastropod-borne nematode, causing severe cardio-pulmonary disorders in dogs. In Romania, A. vasorum was detected in foxes and serologically confirmed in domestic dogs, but no clinical cases are currently diagnosed.

Methods

Four dogs with clinical history of respiratory distress, originating from different geographical regions of Romania, were included in the study. One dog (case 1) was clinically evaluated using thoracic radiology and cardiac ultrasound; examination of feces and PCR were also performed for the etiologic diagnosis. The postmortem exam was performed in the other three cases, followed by parasitological and molecular analyses.

Results

In the first case, parasitic pneumonia was suspected based on the radiographic examination of the thorax and the infection with A. vasorum was confirmed by L1 morphological identification and PCR. The main postmortem changes included large, coalescing, dark red areas of pulmonary consolidation (n = 3) and numerous adult nematodes in the pulmonary arteries (n = 2). The histopathological examination of the lungs showed necrotizing and granulomatous pneumonia with severe hemorrhages and chronic pulmonary arterial changes. Intralesional nematodes were seen in all necropsied cases. Additional inflammatory changes related to A. vasorum infection were identified in the brain and tracheobronchial and mediastinal lymph nodes (n = 2). Identification of larvae, histopathology and PCR confirmed the infection with A. vasorum.

Conclusions

This study describes the first cases of canine cardiopulmonary angiostrongylosis in domestic dogs in Romania, and focuses on clinical presentation, pathological findings and molecular analysis. Angiostrongylosis should be included on the list of differential diagnoses of canine cardiopulmonary distress and/or haemorrhagic diathesis in Romania and awareness should be raised among clinicians to avoid post-mortem diagnosis in the future.

Detection of a characteristic beta-2 peak in serum by capillary zone electrophoresis in dogs with Angiostrongylus vasorum

BACKGROUND

Angiostrongylosis is an emerging canine parasitic disease that often causes polyclonal hyperglobulinemia. In the authors' experience, we have seen what could be a typical serum protein electrophoretic pattern characterized by a large, symmetrical beta-2 peak in dogs with angiostrongylosis.

OBJECTIVES

The purpose of this study was to evaluate the frequency of this pattern in dogs infected with Angiostrongylus vasorum compared with a randomly selected canine population.

METHODS

Serum protein capillary zone electrophoreses (CZEs) from dogs with angiostrongylosis were assigned to Group 1. The CZE pattern was classified as normal, nonspecific polyclonal, or polyclonal with a typical beta-2 peak. The frequency of this latter pattern in Group 1 was compared with the frequency of similar findings in a randomly selected canine sera group (Group 2).

RESULTS

Groups 1 and 2 included 22 and 3687 cases, respectively. Thirteen of 22 (59.1%) dogs in Group 1 had this peak in the beta-2 region. A similar CZE pattern was observed in 43 dogs in Group 2 (1.2%). The remaining dogs in Group 1 had a nonspecific polyclonal hyperglobulinemia (six cases), a normal tracing (one case), or an ambiguous tracing (two cases).

CONCLUSIONS

Dogs with angiostrongylosis commonly have polyclonal hyperglobulinemia, frequently characterized by a large and symmetrical beta-2 peak on CZE, which is uncommon in the canine population. Additional studies are needed to identify the protein composition of this peculiar beta fraction.

Abnormal platelet activity in dogs and cats - impact and measurement

Abnormal platelet activity can either lead to bleeding tendencies or inappropriate thrombus formation and can occur secondarily to a wide variety of disease processes, with a range of clinical consequences and severity. This article will discuss the pathophysiology of platelet function abnormalities and consider a logical diagnostic approach applicable to veterinary practice. Recent advances in platelet function testing will then be discussed, with regards to detection of platelet dysfunction and tailoring of pharmacological manipulation. Although many of these tests are still confined to research or academic institutions, techniques for indirectly assessing platelet function are starting to become more widely available. Although we still require further research to develop guidelines for the use of these tests in clinical decision-making, the recent advances in this field are an exciting step forward in being able to detect and manage platelet dysfunction in both primary care and referral practice.

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (Dirofilaria and Angiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH‐specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously.

Angiostrongylosis in dogs with negative fecal and in-clinic rapid serological tests: 7 Cases (2013-2017)

BACKGROUND

Angiostrongylosis is considered as emerging disease in dogs in Belgium. Detection of first-stage larvae in feces using the Baermann method has an imperfect sensitivity.

OBJECTIVES

Investigation of efficacy of noninvasive blood and fecal diagnostic tests in comparison with PCR on bronchoalveolar lavage (BAL) material in a small series of coughing or dyspnoeic dogs naturally infected with Angiostrongylus vasorum.

ANIMALS

Seven dogs with angiostrongylosis.

METHODS

Retrospective study. Dogs with cough, exercise intolerance and dyspnea of 2- to 8-week duration. Diagnostic methods used included Baermann analysis, AngioDetect rapid assay, ELISAs for detection of circulating antigen and specific antibodies and qPCR on BAL material.

RESULTS

Baermann analysis, AngioDetect rapid assay, antigen ELISA, antibody ELISA, and qPCR on BAL material were positive in 3/7, 2/7, 3/6, 6/6, and 7/7 dogs, respectively. ELISA for antibodies or qPCR on BAL material were essential for definitive diagnosis in 3 dogs. Relative sensitivities of AngioDetect rapid assay, Baermann analysis, and ELISA for antigen detection were lower than 50% compared with ELISA for antibodies or qPCR on BAL material.

CONCLUSION AND CLINICAL IMPORTANCE

In this small clinical series, Baermann analysis and AngioDetect rapid assay failed to confirm the diagnosis in some dogs. Therefore, ELISA for antibody detection and qPCR on BAL material should strongly be considered in clinically suspected dogs when antigen detection methods (AngioDetect or ELISA) and Baermann analysis are negative.

GIS-supported epidemiological analysis on canine Angiostrongylus vasorum and Crenosoma vulpis infections in Germany

BACKGROUND

Angiostrongylus vasorum infections are the cause of severe cardiopulmonary diseases in dogs. In the past, canine angiostrongylosis has largely been neglected in Europe, although some recent studies indicated an expansion of historically known endemic areas, a phenomenon that might also apply to Crenosoma vulpis. The aim of the present study was to analyse temporal and spatial trends of canine A. vasorum and C. vulpis infections and to perform GIS-supported risk factor analysis to evaluate the role of landscape, age and seasonality in the life-cycle of these nematodes.

METHODS

A total of 12,682 faecal samples from German dogs (collected in 2003-2015) with clinical suspicion for lungworm infection were examined for the presence of A. vasorum and C. vulpis larvae by the Baermann funnel technique and respective epidemiological data (location and age of the sampled dogs, date of sampling) were subjected to GIS-supported risk factor analysis.

RESULTS

Overall, A. vasorum and C. vulpis larvae were detected in 288 (2.3%) and 285 (2.2%) faecal samples, respectively. In general, both lungworm infections were found to be widely spread in Germany. GIS-supported analyses demonstrate spatial differences in the occurrence of canine A. vasorum and C. vulpis infections in Germany. also, risk factor analyses revealed an overlap but also diverging risk and protective factors for A. vasorum and C. vulpis infections. The current data also indicate a significant increase of A. vasorum and C. vulpis prevalences from 2003 to 2015 and from 2008 until 2015, respectively, and a potential spread of A. vasorum endemic areas to the northeastern part of Germany.

CONCLUSIONS

The results of the present study show an insight into the epidemiological situation of lungworm infections (A. vasorum and C. vulpis) of the past 13 years in Germany. The data clearly demonstrate an increase of diagnosed A. vasorum prevalence in the tested dog population between 2003 and 2015 as well as spatial differences in the occurrence of diagnosed A. vasorum and C. vulpis infections of dogs in Germany. Risk factor analyses suggest possible differences in the biology of these parasites, presumably at the intermediate host level.

Prevalence of Angiostrongylus vasorum in southern Belgium, a coprological and serological survey

Background

Canine angiostrongylosis, a gastropod-borne helminthic infection, is increasingly being described in North America and is now reported in many European countries. In dogs, Angiostrongylus vasorum may cause a wide spectrum of clinical signs. Respiratory distress such as coughing and dyspnoea are the most frequently described manifestations. The aim of the present study was to gain additional information on the distribution, prevalence and risk factors associated with A. vasorum infection in dog from southern Belgium through the combined used of a commercially available in-clinic assay for detection of circulating antigen (Angio Detect™, IDEXX, Westbrook, USA) and coprology in two different canine populations: dogs with clinical signs compatible with angiostrongylosis and asymptomatic dogs or dogs presented for unrelated conditions (control).

Results

A total of 979 dogs were enrolled in the study from November 2014 until February 2016. Seven hundred fifty-seven dogs were included in the control group, whereas 222 dogs had clinical signs compatible with angiostrongylosis. Forty-six dogs out of 979 (4.7 %) had A. vasorum circulating antigen. There was a highly significant difference between the two populations (3.6 % (27/747) and 8.6 % (19/222) in control and symptomatic dogs, respectively) (P = 0.00379). First stage larvae (L1) of A. vasorum were found in seven out of 24 serologically positive control dogs and in six out of 17 serologically positive symptomatic dogs. Interestingly, L1 of Crenosoma vulpis were detected by Baermann technique in one control and nine symptomatic dogs, respectively. Out of 17 Angio Detect™ (IDEXX, Westbrook, USA) positive dogs with negative (14) or not performed Baermann test (three), one dog was positive in both in-house ELISAs (Ag and Ab) and one dog was positive for Ag. Statistical analysis was unable to detect any risk factors associated with the direct and/or indirect detection of A. vasorum.

Conclusions

This seroepidemiological study demonstrated for the first time a high seroprevalence in Southern Belgium for A. vasorum. The Angio Detect™ was found to be suitable in this context as the collection, preservation and examination of stools were difficult. Nevertheless, discrepancies were observed between the different available tests. Additional research is clearly needed. Also, coproscopy remains a very useful tool in dogs infected for less than nine weeks and for the identification of other canine lung nematodes such as C. vulpis. This study also demonstrates that asymptomatic dogs may shed A. vasorum L1 in their faeces and therefore contribute to the maintenance of A. vasorum life-cycle.