Diagnostic and clinical implications of a nested PCR specific for ribosomal DNA of the feline lungworm Aelurostrongylus abstrusus (Nematoda, Strongylida)

Efficacy of Bravecto® Plus spot-on solution for cats (280 mg/ml fluralaner and 14 mg/ml moxidectin) in the prevention of feline Aelurostrongylus abstrusus infection evaluated in a multi-diagnostic approach

BACKGROUND

Aelurostrongylus abstrusus is one of the most important respiratory nematodes of felines. Infections may lead to respiratory clinical signs with varying severity or even death, emphasizing the need for preventive treatment of cats with outdoor access to circumvent patent infections.

METHODS

Therefore, the preventive efficacy of a spot-on formulation of 280 mg/ml fluralaner and 14 mg/ml moxidectin (Bravecto® Plus spot-on solution for cats, MSD) against A. abstrusus was evaluated in a negative controlled, randomized and partially blinded efficacy study with 28 purpose-bred cats in a non-terminal design. In three different treatment regimes, the minimum recommended dose of 40 mg fluralaner and 2.0 mg moxidectin/kg bodyweight (BW) was administered once at 12, 8 or 4 weeks (study group G1, G2 and G3, respectively) prior to experimental infection with 300 third-stage A. abstrusus larvae, while G4 served as placebo-treated control.

RESULTS

From 30 to 46 days post infection (dpi; SD 114 to 130), faeces were sampled to monitor first-stage larvae (L1) excretion for efficacy determination. Secondary efficacy criteria, including respiratory parameters, serological antibody levels and computed tomography (CT) findings, were assessed once before enrolment (SD -7 to -1) and before infection (SD 75 to 83). After infection, CT evaluation was performed once at 47-50 dpi (SD 131 to 134), and respiratory parameters and antibody levels were regularly assessed twice or once a week, respectively (1 up to 78 dpi, SD 85 up to 162). All animals in the control group excreted L1 by 33-37 dpi and remained positive throughout the study period from 41 to 46 dpi (SD 125 to 130). In the treatment groups, only one animal each of G1 and G2 excreted L1 at two consecutive days, and four cats of G1, two of G2 and three of G3 were positive on single occasions. While the geometric mean (GM) of the maximum number of excreted L1 per 5 g of faeces was 7380.89 in the control group (G4), GMs were significantly lower in the treatment groups with 1.63 in G1, 1.37 in G2 and 0.79 in G3. Thus, based on GMs, the reduction in excreted L1 exceeded 99.9% in all three treatment groups. Based on CT severity scores, all lungs of the animals of the control group showed severe pulmonary changes post infection, whereas lungs of the cats of the treatment groups were either unaltered (4 animals), mildly (11 animals), or moderately altered (5 animals). Moreover, seroconversion was observed in all cats of the control group, but not in those of the treatment groups.

CONCLUSIONS

The combination of diagnostic methods used in this non-terminal study yielded coherent and reliable results. A single administration of Bravecto® Plus spot-on solution for cats was well tolerated and effective in the prevention of aelurostrongylosis for at least 12 weeks.

Comparative analysis of diagnostic methods and risk factors for Aelurostrongylus abstrusus infection in brazilian cats

This study aimed to prospectively evaluate the risk factors of infection by Aelurostrongylus abstrusus in Brazilian cats with cough and/or radiographic changes, using as diagnostic tools the Baermann method (BM), polymerase chain reaction (PCR) of feces, bronchoalveolar lavage fluid (BALF), and cytology. Forty-three cats that were presented with cough or lung radiographic abnormalities compatible with bronchoalveolar disease were included in the study. After clinical evaluation, feces samples were collected to investigate lungworm parasitism through BM and PCR. BALF was performed to provide samples for cytology, bacteriology, and fungal culture. Stool PCR was considered the gold standard for diagnosis tests, and the other methods were evaluated by their agreement. PCR presented 74% (32/43) of positivity for A. abstrusus, while in the BM, 41% (18/43) were positive. BM showed sensitivity of 56.25% and specificity of 100% when compared with PCR. No larva was found in the cytological evaluation of 21 BALF samples. Lungworm is an important cause of bronchopulmonary disease in domestic cats in Brazil and should be included as a differential diagnosis when a cat is presented with cough or radiographic abnormalities. BM is a sensitive, non-invasive, and cheap technique to diagnose the disease, but it is not as sensitive as PCR.

Molecular prevalence, phylogenetic characterization, and epidemiological risk factors of pulmonary nematodes in domestic cats in Türkiye

Aelurostrongylus abstrusus, Oslerus rostratus, and Troglostrongylus brevior are nematodes found in the respiratory system of domestic cats and cause a variety of symptoms. All three parasites use the same hosts and niches, and the morphological measurements of their L1s excreted in faeces overlap with each other. In this study, 300 cats brought to Ondokuz Mayıs University Veterinary Teaching Animal Hospital were screened for lungworms by morphological measurements and molecular analyses. The prevalence of the lungworms was found as 1.33% (4/300) for A. abstrusus, 0.66% (2/300) for O. rostratus, and 0.33% (1/300) for T. brevior. Molecular identification of A. abstrusus, T. brevior, and O. rostratus in domestic cats was carried out for the first time in Türkiye within the present study. This study also reveals the risk factors of lungworm positivity in domestic cats in Türkiye.

The giant African snail Achatina (Lissachatina) fulica Bowdich, 1822 as an intermediate host of Aelurostrongylus abstrusus (Railliet, 1898) in the Rio de Janeiro state, Brazil

Aelurostrongylus abstrusus is a metastrongilid nematode that causes feline aelurostrongylosis. The adult life stage parasitizes the lungs of wild and domestic felids. Terrestrial mollusks act as its intermediate host, and birds, amphibians, and small mammals act as paratenic hosts. Aelurostrongylus abstrusus presents a worldwide distribution, and in Brazil it has been recorded in most states. The present study investigates the occurrence of Aelurostrongylus abstrusus in terrestrial mollusks from urban areas of two out of the six Mesoregions of Rio de Janeiro state: Metropolitana and Centro Fluminense (46 municipalities). Larvae were recovered from the tissue of the mollusks collected during the surveys and identified based on morphology and sequences of the Internal Transcribed Spacer 2 (ITS2). In all, 2791 mollusks, belonging to 14 different species, were collected. Larvae of A. abstrusus were recovered from two species: Achatina fulica in 22 out of 46 municipalities, and from the slug Latipes erinaceus in 1 out of 46 municipalities. Aelurostrongylus abstrusus was recorded in half (50%) of the municipalities of the Metropolitana Mesoregion and in 44% of those of the Centro Fluminense Mesoregion. Results indicate a strong association between A. abstrusus and A. fulica, since 99% of the mollusks infected with A. abstrusus were A. fulica. This study recorded A. abstrusus in the Centro Fluminense Mesoregion and naturally parasitizing L. erinaceus for the first time. Despite the high number of mollusks infected with A. abstrusus and their wide distribution in Rio de Janeiro State, there are still few reports of infection in Brazilian felids, probably given that this is an under-diagnosed parasitosis in this country. Further studies in other regions of the Rio de Janeiro State, and other Brazilian States, focusing on intermediate and definitive hosts, particularly in the urban environments where they coexist, are needed. These studies will enable further understanding of the epidemiology and prevention of aelurostrongylosis.

A Comparison of Copromicroscopic and Molecular Methods for the Diagnosis of Cat Aelurostrongylosis

Simple Summary

Feline aelurostrongylosis is a worldwide distributed parasitic disease of domestic cats caused by the nematode Aelurostrongylus abstrusus. Cats may have a subclinical infection with this parasite or may show signs that overlap with those of many other respiratory conditions of cats, either parasitic or not. The diagnosis of feline aelurostrongylosis currently relies on fecal examinations, though this approach has some limits that can be overcome by innovative molecular techniques. Therefore, the present study has investigated the diagnostic reliability of a PCR assay performed on different samples collected from cats from Italy and Greece. The results of the study confirmed that PCR is highly sensitive and specific for the diagnosis of A. abstrusus infections in domestic cats.

Abstract

The gold standard method for the diagnosis of cat aelurostrongylosis is the detection of Aelurostrongylus abstrusus first stage larvae with the Baermann’s examination. Nevertheless, molecular assays have shown higher diagnostic performances compared to copromicroscopy. This study evaluated the usefulness of an A. abstrusus species-specific PCR on different biological samples collected in clinical settings from 100 privately-owned cats in Italy (n. 60) and Greece (n. 40). A fecal sample was collected from each animal and a pharyngeal swab was also obtained for cats from Italy. All stool samples were subjected to flotation and Baermann’s test. The cats were categorized in three groups based on the results of copromicroscopy, i.e., Group A (n. 50 cats with A. abstrusus infection regardless of positivity for other helminths), Group B (n. 25 cats negative for A. abstrusus but positive for at least one of any other helminth), Group C (n. 25 cats negative for any helminth). DNA was extracted from individual aliquots of feces, flotation supernatant, Baermann’s sediment and the pharyngeal swab and then subjected to a PCR specific for A. abstrusus. At least one fecal aliquot or the pharyngeal swab scored positive by the A. abstrusus-specific PCR for 48/50 (96%) cats enrolled in Group A; in particular, 38/50 (76%), 35/50 (70%), 41/50 (82%) and 21/25 (84%) DNA extracts from feces, flotation supernatant, Baermann’s sediment and pharyngeal swabs were positive by PCR. These results confirm that molecular tools are highly sensitive and specific and indicate that pharyngeal swabs are the most suitable sample for molecular analysis in clinical settings.

Hemorrhagic Meningoencephalomyelitis Due to Ectopic Localization of Aelurostrongylus abstrusus in a Cat: First Case Report

Simple Summary

Aelurostrongylus abstrusus is the most important parasitic nematode affecting cat airways worldwide. The adult nematodes live in the lungs and cause pneumonia with typical respiratory clinical signs such as cough, nasal and ocular discharge, and difficulties in breathing. The localization of adult A. abstrusus in other organs than lungs is not common. This report describes, for the first time, an unusual and fatal localization of A. abstrusus within the central nervous system of a kitten displaying neurological signs.

Abstract

The lungworm Aelurostrongylus abstrusus is one of the main causes of respiratory diseases in cats worldwide. This report describes the unusual case of a kitten infected with A. abstrusus and presented to a veterinary clinic in Brazil with lethargy, dysphagia, non-ambulatory tetraplegia, and pelvic limbs bilateral myoclonus. The clinical picture of the kitten worsened with generalized flaccid tetraplegia and death a few days after hospitalization. At necropsy, hemorrhagic necrosis and subarachnoid hemorrhages were detected in several areas of the central nervous system. Nematode stages were found at post-mortem histological examinations in lungs, cerebellum, subarachnoid space of the brain and spinal cord. Microscopic and molecular (PCRs-coupled-sequencing protocols) examination showed the presence of A. abstrusus in histological samples. This study describes the first neurological aelurostrongylosis due to ectopic localization of adult worms in the central nervous system of a cat, causing acute hemorrhagic multifocal meningoencephalomyelitis. Further studies are necessary to elucidate whether unusual localizations and the migration of A. abstrusus are more frequent than expected.

A Molecular Survey on Neglected Gurltia paralysans and Aelurostrongylus abstrusus Infections in Domestic Cats (Felis catus) from Southern Chile

Gurltia paralysans and Aelurostrongylus abstrusus are neglected metastrongyloid nematode species which infect domestic and wild cats in South American countries and in Chile, but no epidemiological studies on concomitant infections have been conducted in Chile so far. The aim of this study was not only to evaluate the occurrence of concomitant infections, but also to identify epidemiological risk factors associated with of G. paralysans and A. abstrusus infections in urban domestic cats (Felis catus) from Southern Chile. Blood samples from clinically healthy domestic cats from three cities of Southern Chile-Temuco, Valdivia, and Puerto Montt-were analyzed by an experimental semi-nested PCR protocol. A total of 171 apparently healthy domestic cats in Temuco (n = 68), Valdivia (n = 50), and Puerto Montt (n = 53) were sampled and analyzed. A total of 93 domestic cats (54.4%) were positive for G. paralysans, and 34 (19.9%) were positive for A. abstrusus infections. From those animals, 34 (19.9%) were co-infected. Cats positive with G. paralysans were found in all three cities; 47.2% in Puerto Montt, 48% in Valdivia, and 64.7% in Temuco. Levels of infection for A. abstrusus in the population under study were 4% (Valdivia), 10% (Puerto Montt), and 32.4% (Temuco). The present large-scale epidemiological study confirmed the presence of these neglected nematodes in domestic cat populations in Southern Chile, and described the possible risk factors associated with feline gurltiosis and aelurostrongylosis.

Aelurostrongylus abstrusus Antibody Seroprevalence Reveals That Cats Are at Risk of Infection throughout Germany

Cats infected with the metastrongylid nematode Aelurostrongylus abstrusus may show clinical signs ranging from mild to severe respiratory disease or remain unobserved, despite damages present in the lung tissue. This study aimed to determine the seroprevalence and distribution of A. abstrusus in cats by testing serum samples from all over Germany to identify potential risk areas and strengthen disease awareness accordingly. Sera of 2998 cats were screened for the presence of antibodies against A. abstrusus by ELISA, and the data were evaluated by a geographic information system to visualise the regional distribution of the analysed samples. Overall, 12.0% of the samples tested positive (361/2998 cats, 95% confidence interval: 10.9–13.3%). Seropositive cats were identified throughout the country, suggesting that all cats in Germany with outdoor access are at risk of A. abstrusus infection and that the infection is overall underdiagnosed. Increased testing for A. abstrusus infection would allow earlier detection of infected animals, hence improving the life quality and health of cats and preventing potential death under anaesthesia.

Do All Roads Lead to Rome? The Potential of Different Approaches to Diagnose Aelurostrongylus abstrusus Infection in Cats

An infection with the cat lungworm, Aelurostrongylus abstrusus, can be subclinical, but it can also cause severe respiratory clinical signs. Larvae excretion, antibody levels, clinical assessment findings of the respiratory system and diagnostic imaging findings were recorded and compared for six cats with experimental aelurostrongylosis. In five cats, patency started 33-47 days post infection (pi), but two cats excreted larvae only in long intervals and low numbers. Positive ELISA results were observed in four cats with patent aelurostrongylosis, starting between five days before and 85 days after onset of patency. One seropositive cat remained copromicroscopically negative. Mild respiratory signs were observed in all cats examined. A computed tomographic (CT) examination of the lungs displayed distinct alterations, even in absence of evident clinical signs or when larvae excretion was low or negative. The thoracic radiograph evaluation correlated with the CT results, but CT was more distinctive. After anthelmintic treatment in the 25th week post infection, pulmonary imaging findings improved back to normal within 6-24 weeks. This study shows that a multifaceted approach, including diagnostic imaging, can provide a clearer diagnosis and monitoring of disease progression. Furthermore, a CT examination provides an alternative to post mortem examination and worm counts in anthelmintic efficacy studies.

Cat Respiratory Nematodes: Current Knowledge, Novel Data and Warranted Studies on Clinical Features, Treatment and Control

The nematodes Aelurostrongylus abstrusus, Troglostrongylus brevior and Capillaria aerophila are the most important parasites inhabiting the airways of cats. They are receiving growing attention from academia, pharmaceutical companies and veterinarians, and are now considered a primary cause of respiratory diseases in feline clinical practice and parasitology. In the past few years, several studies have been conducted in both natural and experimental settings to increase knowledge, provide new insights and fill gaps on respiratory parasitoses of cats. Awareness and knowledge of clinical scenarios towards appropriate and timely diagnosis and prompt and efficacious treatment options have become a priority to investigate. At the same time, chemopreventative approaches have been evaluated to assess the geographical spreading of these parasites and the rise in the number of clinical cases in cat populations of different countries. Given the intense accumulation of novel data, this review presents and discusses the state of the art and the latest updates on the clinical features, treatment, and control of major respiratory parasitoses of cats. Moreover, food for thought is also provided with the aim of spurring on new studies in the near future.

Evaluation of the Baermann-Wetzel method for detecting lungworm larvae in wild ruminants from faecal samples

Lungworms can exert a negative impact on wild ruminant fitness; for this reason, the diagnosis of the associated diseases is an important prevention measure. The Baerman-Wetzel technique is the most usual method for the diagnosis of bronchopulmonary nematodes and is based on the active migration and movement of their first-stage larvae. Pulmonary tissue samples are frequently used for the post-mortem diagnosis of these parasites, but this kind of sample is not always available and easy to obtain. Faecal samples represent a more accessible choice for parasite monitoring. This work aimed to evaluate the agreement between the results obtained by the Baermann-Wetzel technique when samples of lung parenchyma or faeces from wild ruminants are used. A good level of agreement as well as a similar sensitivity between the two types of sample were observed, validating the use of faecal samples as a less invasive and cost-effective alternative for the monitoring of lungworm in wild ruminant populations.

Angiostrongylosis in northeastern Italy: First report of two autochthonous fatal cases in dogs and first detection in a wild red fox

Canine angiostrongylosis is an emergent cardio-pulmonary gastropod-borne helminthic infection caused by the metastrongyloid nematode Angiostrongylus vasorum. Clinically, it is characterized by a wide spectrum of non-specific signs and the red fox serves as the most important reservoir for dog infections. In Italy, this disease has been well documented both in northwestern and central-southern regions, whereas it is apparently poorly recognized in the northeastern area of the country. This report describes the diagnostic findings of two autochthonous cases of fatal canine angiostrongylosis and of one case in a wild red fox detected in northeastern Italy. Reporting cases is relevant to clinicians in order to increase their awareness for the prompt diagnosis of a potentially life-threatening disease that may go unnoticed or misdiagnosed.

Troglostrongylus brevior is the dominant lungworm infecting feral cats in Jerusalem

Feline lungworms infect the respiratory tract of wild and domestic cats, causing infection often associated with clinical disease. Until recently, Aelurostrongylus abstrusus has been considered the most relevant species of lungworm, while Troglostrongylus brevior was considered of less significance. Fecal samples of feral cats from Jerusalem, Israel, collected over a year, were examined for first stage lungworm larvae (L1) using the Baermann method. Positive samples were morphologically identified, and their species identity was molecularly confirmed. Forty of 400 (10.0%) cats were lungworm-positive, of which 38/40 (95.0%) shed Troglostrongylus brevior and 6/40 (15.0%) shed Aelurostrongylus abstrusus. Four cats (10.0%) had mixed infections with both lungworm species. L1 shedding was associated with clinical respiratory signs in 11 (19.0%) T. brevior shedding cats of a total of 58 cats manifesting respiratory signs, while 23/342 (6.7%) cats without respiratory signs were L1-positive (p = 0.006). Non-respiratory clinical signs were also found to be more prevalent in L1 shedders (p = 0.012). A young kitten ≤ 4 weeks of age shed T. brevior L1 larvae. DNA sequences of both lungworm species using the ribosomal internal transcribed spacer 2 (ITS2) locus were > 99% similar to other sequences deposited in GenBank, suggesting that T. brevior and A. abstrusus ITS2 sequences are both highly conserved. In conclusion, L1 shedding in feral cats from Jerusalem were mostly caused by T. brevior with only a small proportion involving A. abstrusus, different from many studies from other geographical regions.

Molecular Detection of Gurltia paralysans by Semi-Nested PCR in Cerebrospinal Fluid and Serum Samples from Domestic Cats (Felis catus)

Simple Summary

Feline gurltiosis is a parasitic myelopathy caused by Gurltia paralysans. This nematode infects domestic cats without distinction of sex, breed or age, invading the venous system of the spinal leptomeninges and causing vascular congestion that mainly produces paralysis of the pelvic limbs, among other clinical signs of chronic myelopathy. To date, the definitive diagnosis of feline gurltiosis is only possible through post-mortem analysis that shows the location of the parasite in the vasculature of the spinal cord. For this reason, this investigation aimed to detect G. paralysans DNA, via semi-nested PCR, in samples of cerebrospinal fluid and serum from 12 domestic cats from potentially endemic areas in southern Chile, with compatible signs of feline gurltiosis. The presence of G. paralysans-specific DNA was detected in the cerebrospinal fluid of four out of nine cats and the sera of seven out of seven cats. These results allow us to suggest the implementation of a semi-nested PCR technique as a routine diagnostic test for early and timely detection of feline gurltiosis.

Abstract

Gurltia paralysans is an angio-neurotropic metastrongyloid nematode that infects domestic and wild cats, invading the veins of the subarachnoid space of the spinal cord and mainly causing progressive paralysis of the pelvic limbs. The definitive diagnosis of feline gurltiosis can only be achieved by post-mortem examination that reveals the presence of the nematode in the spinal cord vein vasculature. An early diagnosis with conclusive results is required since laboratory and imaging findings are not sufficient. Therefore, the purpose of this study was to detect the presence of G. paralysans, via semi-nested PCR, in samples of cerebrospinal fluid (CSF) and the sera of domestic cats naturally infected with the parasite. A total of 12 cats with a diagnosis suggestive of feline gurltiosis were selected, and they underwent a complete neurological and imaging examination. DNA samples were analysed by semi-nested PCR, with universal (AaGp28Sa1/AaGp28Ss1) and specific (Gp28Sa3/Aa28Ss2) primers, for G. paralysans (G. paralysans 18S rRNA gene, partial sequence; ITS 1, 5.8S rRNA gene, and ITS 2, complete sequence; and 28S rRNA gene, partial sequence) and Aelurostrongylus abstrusus, obtaining amplifications of 356 and 300 bp, which indicated the presence or absence of nematode DNA, respectively. The presence of G. paralysans was detected in the CSF of four out of nine cats, and the sera of seven out of seven cats. In the sera analysis of five out of seven cats, a mixed infection with A. abstrusus was found, despite no alterations of the respiratory tract being observed during the necropsies. It is proposed that serum samples could be more effective than CSF in detecting the parasite by PCR analysis. Sequencing analysis showed high percentages of identity with G. paralysans, which indicated the feasibility of detection and the sensitivity/specificity of the method used, suggesting the implementation of semi-nested PCR as a routine diagnostic test for early and timely detection of feline gurltiosis.

Controlled field study evaluating the clinical efficacy of a topical formulation containing emodepside and praziquantel in the treatment of natural cat aelurostrongylosis

BACKGROUND

Aelurostrongylus abstrusus is the most important nematode affecting the respiratory tract of cats in terms of prevalence and clinical relevance. The aim of this randomised controlled field study was to confirm the efficacy of the spot-on containing emodepside/praziquantel (Profender, Bayer Animal Health) in the treatment of aelurostrongylosis.

METHODS

Seventeen cats with aelurostrongylosis and presenting with clinical and/or radiographic signs were included in the study. Eight cats received two biweekly doses of emodepside/praziquantel, while nine cats were allocated to a control group and received a rescue treatment at the end of the study. Clinical response was the primary outcome, while the secondary end point was the reduction of larval shedding in faeces.

RESULTS

Two weeks after the first application, the cats showed a significant, though partial, recovery of clinical signs with complete clinical and parasitological resolution. The resolution of inflammatory leucogram and a significant reduction of radiographic lesions were observed two weeks after the second treatment. Red blood cells and albumin values significantly increased after eight weeks from the second application, together with the complete regression of radiographic patterns.

CONCLUSION

Two applications of this spot-on solution two weeks apart assured complete cessation of larval shedding and led to a complete clinical, clinicopathological and radiographic recovery.

Evaluation of Bronchoscopy and Bronchoalveolar Lavage Findings in Cats With Aelurostrongylus abstrusus in Comparison to Cats With Feline Bronchial Disease

The cat lungworm Aelurostrongylus abstrusus is a cause of lower respiratory tract disease worldwide. Bronchoscopy and bronchoalveolar lavage (BAL) are important tools for diagnosing respiratory diseases in cats. Therefore, the aim of the study was to investigate the usefulness of bronchoscopy and BAL in the diagnosis of A. abstrusus. Findings from bronchoscopic examination and BAL of 24 naturally infected cats were evaluated and compared with those of 12 cats with idiopathic Feline Bronchial Diseases (FBDs). Data were analyzed using Mann-Whitney or Fisher's exact tests. No significant bronchoscopic differences were detected between cats with aelurostrongylosis and FBDs in bronchial mucus, nodular lesions, and airway collapse. On the other hand, airway hyperemia, epithelial irregularities, and bronchial stenosis were observed more frequently in cats affected by FBDs than aelurostrongylosis, while bronchiectasis was found only in cats infected by A. abstrusus. Neutrophilic, eosinophilic, lymphocytic, and mixed inflammation were recorded in both groups. Bacteria or bacterial DNA was identified regardless of the presence or absence of A. abstrusus with no significant differences between groups. Larvae of A. abstrusus were cytologically detected in 5 of the 24 cats (20.8%) with aelurostrongylosis. These results indicate that, although some findings on bronchoscopic examination (i.e., bronchiectasis) can be described more frequently in cats infected by A. abstrusus, bronchial alterations and cytological findings in aelurostrongylosis are not specific unless larvae are observed and overlap with those of other feline airway diseases.

First molecular identification of Aelurostrongylus abstrusus in a cat presenting severe respiratory disease from Israel

Feline lung worm infection is increasingly reported in recent years, and recognized as a cause for respiratory disease in cats. Aelurostrongylus abstrusus is regarded as the most prevalent cause of such cases. Infective L3 larvae carried in gastropods and paratenic hosts infect felines, developing to adult worms that reside in the lungs' parenchyma and may cause verminous pneumonia. The L1 larvae hatch from eggs deposited in the lung, and are released to the environment by either feces or sputum. While the majority of epidemiological information regarding A. abstrusus originates in European countries, recent studies have shown that it is also found around the Mediterranean basin, as far east as Turkey and Cyprus. A local domestic cat from Israel showing signs of respiratory illness was diagnosed with aelurostrongylosis, confirmed by both morphological and molecular tools. Presence in Israel of this nematode was previously reported in 1949, with no further mentions since. ITS-2 sequence of the isolated larvae was highly similar to that of A. abstrusus from domestic cats from Italy. These findings show that distribution of A. abstrusus stretch to the eastern shores of the Mediterranean, and that this nematode should be considered as a cause for respiratory disease in cats in Israel and the surrounding countries.

Screening nested-PCR primer for 'Candidatus Liberibacter asiaticus' associated with citrus Huanglongbing and application in Hunan, China

Citrus Huanglongbing (HLB) is one of the most devastating citrus diseases worldwide. Sensitive and accurate assays are vital for efficient prevention of the spread of HLB-associated "Candidatus Liberibacter spp". "Candidatus Liberibacter spp" that infect Citrus includes "Candidatus Liberibacter asiaticus" (Las), "Candidatus Liberibacter africanus" (Laf) and "Candidatus Liberibacter americanus" (Lam). Of them, Las is the most widespread species. In this study, a set of nested PCR primer pairs were screened to diagnose Las, and the nested PCR method greatly enhanced the sensitivity to detect Las up to 10 times and 100 times compared to qPCR and conventional PCR, respectively. Totally, 1112 samples from 5 different citrus cultivars in 39 different counties and cities were assayed by nested PCR. The results show that 384 samples were HLB-infected; the highest positive detection rate was 79.7% from the lopsided fruit samples, and the lowest positive detection rate was 16.3% from the apical dieback samples. The results indicate that the designed nested PCR primer pairs can detect Las from different symptomatic tissues, different citrus cultivars and different geographic regions. The set of nested PCR primers designed in the present study will provide a very useful supplementation to the current approaches for Las detection.

Angiostrongylus vasorum and Aelurostrongylus abstrusus: Neglected and underestimated parasites in South America

The gastropod-borne nematodes Angiostrongylus vasorum and Aelurostrongylus abstrusus are global causes of cardio/pulmonary diseases in dogs and cats. In the last decade, the number of reports on canine and feline lungworms has increased in several areas of Europe and North America. The unspecific clinical signs and prolonged course of these diseases often renders diagnosis challenging. Both infections are considered as emerging and underestimated causes of disease in domestic pets. In South America, little information is available on these diseases, apart from occasional reports proving the principle presence of A. vasorum and A. abstrusus. Thus, the purpose of this review is to summarize reports on infections in both domestic and wildlife animals in South America and to increase the awareness on gastropod-borne metastrongyloid parasites, which also include important zoonotic species, such as A. cantonensis and A. costaricensis. This review highlights the usefulness of diagnostic tools, such as the Baermann funnel technique, serology and PCR, and proposes to include these routinely on cases with clinical suspicion for lungworm infections. Future national epidemiological surveys are recommended to be conducted to gain a deeper insight into the actual epidemiological situation of gastropod-borne parasitoses in South America.

Single and mixed feline lungworm infections: clinical, radiographic and therapeutic features of 26 cases (2013-2015)

Objectives The aim of this study was to retrospectively describe clinical, radiographic and therapeutic features of feline lungworm infection. Methods Medical records of cats with lungworm diagnosis, thoracic radiography and without concurrent diseases between 2013 and 2015 were reviewed. Collection of data included physical examination, haematology, serum biochemistry, therapy with a variety of anthelmintics and outcomes. Results Thirty-seven records were recovered and 26 were included in the study. Single infections by Aelurostrongylus abstrusus (n = 15), Troglostrongylus brevior (n = 3) and Capillaria aerophila (n = 1) and coinfections by T brevior/ A abstrusus (n = 6) and T brevior/ C aerophila (n = 1) were diagnosed. The most common respiratory signs were coughing (n = 12), increased vesicular sounds (n = 10), dyspnoea (n = 9), such as laboured breathing, orthopnoea or open-mouth breathing, and tachypnoea (n = 6). Two cats were subclinically infected. The most common laboratory abnormality was anaemia (n = 7). Radiographic patterns recorded were interstitial (n = 24), bronchial (n = 21), alveolar (n = 10) and vascular (n = 2). Twenty-five cats had a complete recovery within 2-6 weeks of therapy. One kitten died 7 days after the diagnosis. Conclusions and relevance Lungworms should always be included in the differential diagnosis in cats living in endemic areas and presenting with respiratory signs and radiographic abnormalities. A copromicroscopic examination should be considered as the first diagnostic step for all cats at risk of lungworm infections. In most cases, timely therapy with a variety of anthelmintics guarantees recovery.

Detection of specific antibodies in cats infected with the lung nematode Aelurostrongylus abstrusus

Feline aelurostrongylosis, caused by the metastrongylid nematode Aelurostrongylus abstrusus, is an underestimated respiratory parasitosis. Its diagnosis currently mainly relies on the isolation of first stage larvae from fresh faecal samples. The aim of our study was to develop a serological test for the detection of specific antibodies against A. abstrusus by ELISA. We used recombinant major sperm protein (MSP) of the bovine lungworm Dictyocaulus viviparus as detection antigen and evaluated two different ELISA plates (Maxisorp and Immobilizer™ Amino-plate, Nunc Roskilde, Denmark) with two different enzyme systems [alkaline phosphatase (AP) and horseradish peroxidase (HRP)]. Sera from cats experimentally (n=54) and naturally (n=17) infected with A. abstrusus and from randomly selected cats with different medical issues (n=160) were used to determine sensitivity and specificity. Furthermore, cross-reactions were evaluated using sera from cats naturally (n=71) and experimentally (n=8) infected with different nematodes. A sensitivity of 100% was obtained with sera from experimentally infected cats at 10 weeks post infection using MSP on the Immobilizer™ Amino-plate with HRP, while it ranged between 90.5 and 95.2% in the other ELISA set-ups. Using sera from naturally infected cats, a sensitivity of 88.2% (95% confidence interval: 63.6-98.5%) was achieved in all four set-ups. The specificity was 85.2-94.4% in sera from uninfected cats prior to experimental infection and 68.1-90% in randomly selected cats depending on the plate and enzyme system. The number of seropositive cats increased over time post infection. Serological follow-up showed a decrease of antibody levels within 30days after anthelmintic treatment. Seropositive reactions were observed with sera from stray cats naturally infected with Toxocara cati, Capillaria sp., hookworms and Taeniidae; however, coproscopic false negative A. abstrusus findings cannot be excluded. The serological detection of specific antibodies against A. abstrusus using ELISA requires a single serum sample and therefore represents a valid alternative for reliable individual diagnosis of A. abstrusus in cats and facilitates mass screening, overcoming the usually difficult collection of cat faeces.

Respiratory distress associated with lungworm infection in a kitten

CASE SUMMARY

A 5-month-old feral kitten developed worsening respiratory signs, including tachypnea, coughing and wheezing after standard anthelmintic treatment with fenbendazole at a local shelter. The kitten was referred to the University of California, Davis, William R Pritchard Veterinary Medicine Teaching Hospital for further evaluation. Thoracic radiographs revealed a severe diffuse bronchointerstitial pattern with bronchial cuffing, ill-defined nodules and lymphadenomegaly. Differentials included infectious etiologies such as toxoplasmosis, feline infectious peritonitis and cryptococcosis. Parasitic infection was considered less likely, owing to previous anthelmintic treatment. Bronchoalveolar lavage revealed marked neutrophilic and eosinophilic inflammation, and parasitic larvae were observed in a swab of trachea mucus. PCR confirmed the larvae as Aelurostrongylus abstrusus. The kitten recovered with two more rounds of anthelmintic treatment.

RELEVANCE AND NOVEL INFORMATION

Parasitic pneumonia should be considered as a cause of respiratory distress in kittens and cats. Lungworm infections have been more commonly reported in free-roaming young and adult cats, but cannot be excluded as a differential diagnosis in cats from varied environments and in kittens. Kittens appear to be especially sensitive to lungworm infections, manifested by the development of more severe clinical signs; thus lungworm infection should always be considered when presented with a kitten in respiratory distress. In the absence of cytologic confirmation of infection via bronchoalveolar lavage or oropharyngeal swab, PCR provides a valuable means for identification of lungworms, such as A abstrusus and Troglostrongylus brevior.

Updates on feline aelurostrongylosis and research priorities for the next decade

Feline aelurostrongylosis, caused by the metastrongyloid nematode Aelurostrongylus abstrusus, is an important gastropod-borne parasitic lung disease in cats. Infection with A. abstrusus is widespread globally, but the increasing awareness of this parasite and the advent of more sensitive diagnostics have contributed to the apparent increase in its prevalence and geographic expansion. Clinical features may range in severity from subclinical to life-threatening respiratory disease. Parasitological standard techniques, such as visualization of the nematode first larval stage in faecal and respiratory (bronchial mucus or pleural fluid) samples, remain the mainstays of diagnosis. However, diagnosis is evolving with recent advances in serological and molecular testing, which can improve the time to initiation of effective anthelmintic therapy. Despite numerous anthelmintics that are now available as treatment options, the role of host immunity and lifestyle factors in selecting cats that may benefit from more targeted anthelmintic prophylaxis or treatment practice remains unclear and is likely to guide therapeutic choices as newer data become available. This review summarizes the biology, epidemiology, pathophysiology, diagnosis and treatment options currently available for feline aelurostrongylosis.

Aelurostrongylus abstrusus in wild felids of South Africa

The increasing interest on respiratory nematodes of domestic cats (Felis silvestris catus) has recently stimulated several studies on their epidemiology and geographic distribution. At the same time, there are still important gaps in our knowledge of the infections caused by respiratory nematodes in wild felids. The present study investigated the occurrence of pulmonary parasites in wild hosts housed in sanctuaries and protected areas of South Africa. Faecal samples collected from seven species of wild felids living in three study sites were copromicroscopically and genetically examined. Of twenty-one samples six, i.e. three from caracals (Caracal caracal), two from lions (Panthera leo) and one from a serval (Leptailurus serval), scored positive for the metastrongyloid Aelurostrongylus abstrusus at copromicroscopic and/or molecular tests. No other lungworms were recorded. The occurrence of the cosmopolitan cat lungworm A. abstrusus in wild hosts has been so far questioned. Importantly, the present findings represent an unequivocal evidence of the capability of A. abstrusus to infect some species of wild felids. Further studies are warranted to understand the epidemiological patterns of lungworms in wild and domestic felids, and to better investigate the impact of these parasitoses on health and welfare of wild animals.

Diagnosis and management of lungworm infections in cats: Cornerstones, dilemmas and new avenues

PRACTICAL RELEVANCE

Respiratory parasites infecting domestic cats are attracting increased attention in feline clinical practice. In addition to the most commonly recognised 'cat lungworm' Aelurostrongylus abstrusus, Troglostrongylus brevior and Capillaria aerophila are now considered important pathogens of the respiratory tract of cats.

GLOBAL IMPORTANCE

These parasites are being increasingly diagnosed in several regions of the world and a continuous update on epidemiological changes and advances in diagnosis and control is of practical importance.

AIMS

This article reviews current knowledge of lungworms affecting cats, with a special focus on recent insights into diagnosis and management of the diseases they cause. The article also explores some potential new avenues for control of feline parasitic respiratory diseases, and highlights some key areas requiring further research.

Felid Lungworms and Heartworms in Italy: More Questions than Answers?

Nematodes infecting the cardiorespiratory system of cats have recently stimulated high scientific interest. Over the past few years, different aspects of these parasites have been clarified and various issues elucidated. This increased knowledge has improved awareness on this topic but, at the same time, some dilemmas have not been solved and new questions have been raised. In this review, we underline and discuss current knowledge of, and new doubts relating to, feline lungworms and heartworms, with the aim of stimulating new studies to fill gaps of basic (i.e., epidemiology and biology) and applied (i.e., clinical aspects) knowledge of the old and new parasites affecting the cardiorespiratory system of cats.

Lungworm disease in cats: ABCD guidelines on prevention and management

OVERVIEW

Cardiopulmonary nematodes are emerging parasites of cats in Europe. A number of helminth parasites may be involved. The most prevalent lungworm in domestic cats is Aelurostrongylus abstrusus. Oslerus rostratus and Troglostrongylus species are found mainly in wild cats. The trichurid Capillaria aerophila has a low host specificity and is not uncommon in cats. Additionally the lung flukes Paragonimus species are reported in many species outside of Europe, including cats.

CLINICAL SIGNS

Lungworm infections may be asymptomatic, or cause mild to severe respiratory signs, dependent on the worm species and burden; mixed infections are observed. Kittens can be vertically infected and may develop a more severe disease. Affected cats show a productive cough, mucopurulent nasal discharge, tachypnoea, dyspnoea and, in severe cases, respiratory failure and death.

MANAGEMENT

Early diagnosis and treatment greatly improves the prognosis. First-stage larvae can be easily detected in fresh faecal samples; the Baermann migration method is the enrichment technique of choice, but takes 24 h. Lungworm larvae can be found in tracheal swabs and bronchoalveolar lavage fluid, but with less sensitivity than in faeces. Molecular methods have been developed that exhibit high specificity and sensitivity, and allow diagnosis in the prepatent phase. Treatment options include fenbendazole paste, milbemycin oxime/praziquantel and various spot-on formulations. Severe cases should receive prompt medical care in an intensive care unit.

PREVENTION

Avoiding predation is at present the only preventive measure for pulmonary worms with indirect life cycles.

ZOONOTIC RISK

C aerophila has zoonotic potential, causing severe pulmonary disease in humans. Some Paragonimus species are also of zoonotic concern.

Novel Molecular Assay for Simultaneous Identification of Neglected Lungworms and Heartworms Affecting Cats

Feline lungworms and heartworms are stimulating the interest of the scientific community due to their clinical impact and apparent geographical expansion. Diagnosis of the infections caused by these nematodes is indeed challenging. This report describes a novel multiplex PCR able to identify simultaneously three species of lungworms (Aelurostrongylus abstrusus and Troglostrongylus brevior) and heartworms (Angiostrongylus chabaudi) affecting felids. Epidemiological and clinical perspectives are discussed.

Comparison of coprological, immunological and molecular methods for the detection of dogs infected with Angiostrongylus vasorum before and after anthelmintic treatment

Timely diagnosis of the nematode Angiostrongylus vasorum in dogs is important in view of severe and permanent lung and cardiovascular lesions that may occur. The performance of the classical Baermann coprological method was compared with ELISAs for the serological detection of circulating antigen and specific antibodies and with Polymerase chain reaction (PCR) performed on EDTA blood, feces and tracheal swabs of serial samples from experimentally inoculated dogs over 13 weeks post inoculation (wpi) (n = 16) and following anthelmintic treatment (n = 6). Patency was observed from 6.7 to 7.6 wpi in all dogs, Baermann results were then mostly positive (116/119, 97%) during the patent period, with wide variations in the numbers of first stage larvae numbers. Blood PCR was tested positive on 1-2 occasions in 11/16 dogs in the pre-patent period, while all tested positive by antibody-detection ELISA by 6 wpi. The proportion of dogs testing positive by fecal PCR and antigen-detection ELISA rose early in the patent period. Tracheal swabs were occasionally DNA-positive in 3/16 dogs starting from 10 wpi. Following treatment, larval excretion stopped within 3 weeks and blood PCR results became negative within 1 week (5/6 dogs), while 4/6 dogs were positive for parasite DNA in tracheal swabs. Parasite antigen and specific antibodies both persisted in the blood for 3-9 weeks after treatment, with average optical densities and the proportion of positive dogs falling gradually, while results using other tests were much more variable. Results indicate that the earliest and most consistent results are obtained by the ELISAs, which can also be used for monitoring dogs after anthelmintic treatment.

Treatment of Troglostrongylus brevior (Metastrongyloidea, Crenosomatidae) in mixed lungworm infections using spot-on emodepside

Feline lungworms have long been known as pathogens of cats. However, an increased incidence of clinical cases in some areas has been the focus of a number of recent epidemiological and clinical studies. While Aelurostrongylus abstrusus causes respiratory signs in cats all over the world, Troglostrongylus brevior has recently been found in domestic cats from Spain and Italy (where it often causes severe clinical signs). Capillaria aerophila, a parasite that infects many wild carnivores, may cause respiratory distress in cats. A variety of treatment options are known for A abstrusus, while almost no information is available on the treatment of troglostrongylosis and capillariosis. This series describes two mixed infections in clinically affected kittens with T brevior, one with concurrent A abstrusus and the other with C aerophila. In both cases, the nematodes were identified and confirmed by copromicroscopic examination and specific DNA-based assays. Kittens showed respiratory signs that resolved after one or two administrations of a spot-on solution containing emodepside. Larval (T brevior and A abstrusus) and egg (C aerophila) shedding was also eliminated 2-4 weeks after treatment. New clinical insights into these parasitoses are discussed.

Verminous pneumonia and enteritis due to hyperinfection with Aelurostrongylus abstrusus in a kitten

Severe infestation with Aelurostrongylus abstrusus was identified in the lungs and small intestine of a 2-month-old kitten that died due to verminous pneumonia and enteritis. On clinical examination, the kitten had dyspnoea, pneumonia, pleural effusion, ascites and diarrhoea. An interstitial pattern was evident radiographically in the lungs. The kitten died before treatment could be instituted. On gross and histopathological examination, there was severe interstitial pneumonia and large numbers of A. abstrusus eggs and larvae were present in alveoli, together with fewer adult nematodes in small bronchioles. The mucosa of the small intestine was invaded by large numbers of A. abstrusus larvae. The findings were consistent with a hyperinfection syndrome due to A. abstrusus.

Clinical, laboratory and pathological findings in cats experimentally infected with Aelurostrongylus abstrusus

Aelurostrongylus abstrusus parasitizes the respiratory tract and can heavily affect the breathing and general condition of cats. Experimental infections of six cats were initiated by intragastric administration with 100 or 800 third-stage larvae (L3) obtained from the terrestrial snail Helix aspersa. First-stage larvae were isolated from faecal samples after 35-41 days post infection (dpi) in five animals and until end of study (84 dpi) in two cats. Cough and respiratory sounds were observed starting from 28 to 41 dpi and dyspnoea and panting starting from 52 dpi. All cats had enlarged lymph nodes and, starting from 56 dpi, reduced body weight, and four cats showed intermittent reduced general condition with apathia and anorexia. Eosinophilia and leucocytosis partially with massive lymphocytosis, and occasional basophilia and monocytosis were observed. Mild anaemia was present in five cats, while alterations in coagulation parameters suggested stimulation of the coagulation cascade with increased consumption of coagulation factors (delayed PT, hypofibrinogenemia). Adult A. abstrusus specimens were isolated from the five patent cats at necropsy and all six cats showed pathological changes in the lungs, including disseminated inflammatory cell infiltrates, often associated with incorporated larvae and eggs. There was some degree of overlap between the severity and the inoculation doses. Infections starting from 100 L3 of A. abstrusus had an impact on the lung tissues and on the health of the cats, despite the presence of only mild haematological abnormalities. Due to the worldwide occurrence of feline lung worms, parasitic infections should be considered in the differential diagnosis of lung diseases regardless of the presence of clinical signs and larval excretion.

Gross and histopathological changes associated with Aelurostrongylus abstrusus and Troglostrongylus brevior in a kitten

Aelurostrongylus abstrusus affects the respiratory system of domestic cats worldwide, causing different clinical signs. Recently, Troglostrongylus brevior, a parasite found only in feral and wild animals until 2010, has been regarded as a cause of potentially severe bronchopneumonia in domestic cats. The life cycle of both nematodes involves the same intermediate (i.e. land mollusks) and paratenic hosts (i.e. lizards, birds and small mammals). Biological and epidemiological drivers may cause the spreading of A. abstrusus along with a possible emergence of T. brevior from marginal areas and limited hosts. Given the merit in increasing knowledge on these potentially emerging nematodes, the present paper describes clinical features and the first post mortem gross and histopathological observations in a case of mixed infection by A. abstrusus and T. brevior in a kitten.

Lungworms of the genus Troglostrongylus (Strongylida: Crenosomatidae): neglected parasites for domestic cats

Feline lungworms belonging to the Troglostrongylus genus have been neglected for a long time. However, recent reports of Troglostrongylus brevior and Troglostrongylus subcrenatus in domestic cats have stimulated the interest of the scientific community on these lungworms. Troglostrongylus spp. have an indirect life cycle, which overlaps that of the better known Aelurostrongylus abstrusus. Nonetheless, adult worms of both genera have a distinct morphology and localization within the respiratory system of definitive hosts and, potentially, a different epidemiology and pathogenicity. As copromicroscopy has a low specificity for metastrongyloids due to the similarities of first-stage larvae, specific morphometrical keys and/or PCR diagnostic tools are advocated. Accordingly, more clinical studies and necropsy data are needed to elucidate the impact of Troglostrongylus spp. on the health of domestic cats. This article reviews current information on Troglostrongylus spp. as well as data on their occurrence in Europe and reports specific key morphological characters for the identification of adults and larvae, which is important to refine their diagnosis and for a better understanding of the feline lungworm infections.

Detecting Aelurostrongylus abstrusus-specific IgG antibody using an immunofluorescence assay

Diagnosis of feline lungworm, Aelurostrongylus abstrusus, is typically achieved by identifying larvae in feces following concentration through flotation or using the Baermann technique. This work presents observations on the usefulness of an indirect immunofluorescence antibody assay for detection of antibodies to this parasite in the sera of infected cats. Using first-stage larvae of A abstrusus and sera from both experimentally and naturally infected cats, it was determined that the test was fairly sensitive and did not cross-react with serum from an Ancylostoma braziliense (hookworm)-infected cat.

Mixed infection by Aelurostrongylus abstrusus and Troglostrongylus brevior in kittens from the same litter in Italy

Parasitic nematodes affecting the respiratory system of felids are spreading in endemic regions and emerging in previously free areas and/or hosts. This is particularly the case of the cat lungworm Aelurostrongylus abstrusus, which can cause respiratory signs in cats all over the world. Additionally, Troglostrongylus brevior has been recently found in domestic cats from Ibiza Island in Spain and Southern Italy. The present paper describes the first mixed infection by these lungworms in kittens belonging to the same litter. Two ∼10-11 weeks old kittens were found infected by A. abstrusus and T. brevior at a copromicroscopical examination. The identity of larvae shed by faeces were confirmed with an already validated PCR specific for A. abstrusus and a novel DNA-based assay specific for T. brevior. One kitten showed severe respiratory signs and died despite an anthelmintic treatment, while the other had a subclinical infection and recovered after a parasiticide administration with milbemycin oxime. New insights into epidemiology, biology, clinical aspects and control of these parasitoses are discussed.

Simultaneous detection of the feline lungworms Troglostrongylus brevior and Aelurostrongylus abstrusus by a newly developed duplex-PCR

In addition to Aelurostrongylus abstrusus (Strongylida: Angiostrongylidae), referred to as the feline lungworm, Troglostrongylus brevior (Strongylida: Crenosomatidae) has recently been identified as an agent of bronco-pulmonary infestations in cats. These two parasites have a similar biology, share ecological niches, potentially co-infesting cats, but are difficult to be differentiated due to the morphological similarities of their first-stage larvae (L1). This paper describes a molecular tool, based on single-step duplex polymerase chain reaction (duplex-PCR) on the ribosomal internal transcribed spacer 2 region (ITS-2) for the simultaneous detection and differentiation of T. brevior and A. abstrusus. L1 of both species were collected from faecal samples, morphologically identified, and single larval specimens isolated. An aliquot of faeces was used as a test sample for a case of mixed natural infestation. The duplex-PCR was performed using species-specific forward primer sets for the ITS-2 region (i.e., A. abstrusus: 220bp; T. brevior: 370bp). The detection limit of the molecular assay was also assessed by serial dilutions of DNA from single larvae of both species (from ≈ 4.0 to 4.0 × 10(-5) μg/μl). The duplex-PCR carried out on individual DNA samples was able to detect as low as 5.2 × 10(-3) μg/μl of DNA for A. abstrusus, 4.9 × 10(-3)μg/μl for T. brevior, and as low as 4.0 × 10(-3) μg/μl for samples containing both species. Species-specific bands of the expected sizes and two bands were simultaneously amplified from the faecal sample containing both species. The phylogenetic analyses of the ITS-2 sequences here examined and those available for other metastrongyloids were concordant in clustering them with those of other Troglostrongylus brevior and A. abstrusus sequences available in GenBank database. This molecular approach proved to be effective and highly sensitive for the simultaneous detection of the two lungworms species and it might be used for molecular epidemiological studies and for monitoring therapeutic protocols.

Intermediate and paratenic hosts in the life cycle of Aelurostrongylus abstrusus in natural environment

The cat lungworm Aelurostrongylus abstrusus affects the domestic cats and other felids all over the world. Feline aelurostrongylosis is of importance in clinical feline medicine. Snails and slugs are the intermediate hosts, but the cat is probably infected by eating paratenic hosts, e.g., rodents, birds, amphibians and reptiles. Herein we present the first finding of A. abstrusus in a naturally infected invasive synantropic slugs Arion lusitanicus (intermediate host) and wild living rodents Apodemus agrarius (paratenic host). The results confirm the usefulness of molecular approaches for investigating the biology, ecology and epidemiology of A. abstrusus, the agent of feline aelurostrongylosis.

Feline lungworms: what a dilemma

Aelurostrongylus abstrusus is regarded as the major lungworm infecting Felis catus, although other, albeit poorly studied, nematodes have been described from the respiratory system of domestic cats. Recent records of these neglected parasites have renewed the attention of the scientific community, but their actual role in respiratory disease in cats is blurred. The epidemiology, pathogenic role, and diagnosis of Troglostrongylus spp., Oslerus rostratus, and Capillaria aerophila in domestic cats are far from being clarified. Indeed, recent studies have provided novel information but have also given rise to relevant doubts. We discuss here the state of current knowledge regarding felid lungworms together with the dilemmas recently roused in the scientific literature.

Larval development of the feline lungworm Aelurostrongylus abstrusus in Helix aspersa

The cat lungworm Aelurostrongylus abstrusus affects the domestic cat and other felids all over the world. Feline aelurostrongylosis is of importance in clinical feline medicine and is gaining more and more attention for the present expansion in the geographical range of A. abstrusus. Global warming and changes in phenology of snail intermediate hosts have been incriminated in this spreading. Helix aspersa, a potential vector of A. abstrusus, is endemic in most regions of the world, where it has become recently a pest outside its native Mediterranean range. The present work evaluated key features of larval development of A. abstrusus in H. aspersa at two different temperature conditions. The results showed that A. abstrusus may reach the infective stage in muscular foot and viscera of H. aspersa and that environmental temperatures may influence the biological cycle of the cat lungworm. In particular, the higher the average temperature, the higher the rate of larval development, i.e., about 50% of larvae of A. abstrusus reached the infective stage between temperatures of 18.8-29.5 °C, while only 17.8% of larvae completed their development at temperatures of 6.7-22 °C. Biological and epidemiological implications are discussed.

Evaluation of the use of pooled fecal samples for the diagnosis of protostrongylid infections in sheep

The Baermann-Wetzel method is the recommended test for the diagnosis of lungworm infections. The objective of this study was to evaluate the use of pooled fecal samples for the diagnosis of protostrongylid infections in sheep flocks and to investigate the sensitivity of the pooled Baermann-Wetzel technique in relation to individual analysis, which is time consuming and expensive. Fecal samples were taken from 10 sheep flocks positive for protostrongylids located in northwestern Spain. Ten pools composed of 6 individual fecal samples, chosen at random from the entire flock sampling, were performed for each flock at the same time as individual analyses. Protostrongylid larvae were detected in 56 pools, with a 56% flock sensitivity. Flock sensitivity was positively associated with the within-flock prevalence (P<0.001), but not with the mean larvae output. A high sensitivity (78.3%) has been observed in flocks with medium or high prevalence, so pooled fecal samples can be used in those flocks that require an effective treatment regimen against these nematodes.

The mitochondrial genome of Aelurostrongylus abstrusus-diagnostic, epidemiological and systematic implications

Aelurostrongylus abstrusus (Railliet, 1898) is a metastrongylid nematode of major clinical relevance in felids, causing aelurostrongylosis. In spite of its clinical importance in cats, the genetics, epidemiology and biology of this parasite are not entirely understood. mt DNA can provide markers for studies of these areas, but genetic data are scant for A. abstrusus and related lungworms. Here, the mt genome was amplified by long-range polymerase chain reaction (long-PCR) from a single male adult of A. abstrusus, sequenced using 454 technology and annotated using an established bioinformatic pipeline. This circular mt genome is 13,913 bp and contains two ribosomal RNA, 12 protein-coding and 22 transfer RNA genes, consistent with most other chromadorean nematodes. This genome should provide a source of markers for future investigations of the epidemiology and ecology of A. abstrusus. Molecular tools, employing such mt markers, are likely to find utility for explorations into the epidemiology, biology and systematics of this parasite, and the diagnosis of feline aelurostrongylosis.

Molecular detection of Capillaria aerophila, an agent of canine and feline pulmonary capillariosis

Capillaria aerophila, a trichuroid nematode causing pulmonary infections in wild and domestic carnivores, is occasionally and potentially poorly recognized in infections of humans due to clinicopathological mimicry and a lack of accurate, robust laboratory diagnostics. The present work evaluated the efficiency of a DNA-based assay amplifying a partial cytochrome c oxidase subunit 1 (cox1) gene of C. aerophila in the diagnosis of lung capillariosis. Fecal samples from 34 dogs and 10 cats positive at parasitological examination for C. aerophila and other endoparasites (i.e., other lungworms, whipworms, roundworms, hookworms, tapeworms, and/or coccidia) and from 44 animals negative for C. aerophila but positive for other endoparasites were molecularly examined. Of the 44 samples positive for C. aerophila at copromicroscopy, 43 scored positive (i.e., 33/34 dogs and 10/10 cats) in seminested PCR, resulting in a sensitivity of 97 to 100%. Samples that were copromicroscopy negative for C. aerophila although positive for other endoparasites never produced a PCR product or nonspecific amplicons. The specific PCR amplification of C. aerophila (i.e., specificity of 100%) was confirmed by a nucleotide sequence analysis of the cox1 amplicons. The potential implications of the molecular diagnosis of lung capillariosis are discussed.

Alteration in blood gases in cats naturally infected with Aelurostrongylus abstrusus

Four cats were presented with respiratory signs and first-stage larvae of Aelurostrongylus abstrusus were found in faecal samples. Anthelmintic treatment was given to the infected cats and venous blood gases were analysed during the treatment period. Blood gas analysis suggested hypoventilation and respiratory acidosis in infected cats. Hypoventilation may be the result of airway obstruction by adults and larvae in respiratory bronchioles and the alveolar canals. The blood gas values had returned close to the physiological range by two months after treatment. Assessment of respiratory acidosis may aid development of additional treatment methods in cats infected with A. abstrusus.

Lower respiratory tract infections in cats: reaching beyond empirical therapy

PRACTICAL RELEVANCE

Lower respiratory tract infections (LRTIs) in cats can be due to bacteria, parasites, fungi and viruses. This review details the practical investigation of these infections and highlights specific therapy where possible. The aim is to avoid the all-too-frequent temptation in practice to treat cats with lower respiratory tract signs empirically for feline bronchial disease (FBD)/asthma. This is potentially hazardous as immunosuppressive therapy for FBD/asthma could exacerbate disease due to a LRTI. Empirical treatment of suspected LRTI is also difficult to recommend given the wide range of potential pathogens.

CLINICAL CHALLENGES

Making a clinical ante-mortem diagnosis of LRTI in a cat can be challenging. Consistent historical, clinical, haematological and radiographic abnormalities are often lacking and findings may be non-specific. Astute clinical acumen, thorough investigation and high quality laboratory analysis are usually required for a diagnosis. Bronchoalveolar lavage, if feasible, and tests for lungworm should be routine in cats with lower respiratory tract signs. Lung fine needle aspiration may be useful in cases of diffuse or nodular pulmonary disease. Histopathology is rarely employed in ante-mortem investigations.

EVIDENCE BASE

The authors have reviewed a substantial body of literature to provide information on many of the reported bacterial, parasitic, fungal and viral pathogens, including some that occur in Asia. Attention has been given to specific therapy for each pathogen, with evidence-based comments when there is a deviation from routine recommendations.

Aelurostrongylus abstrusus larvae in the colon of two cats

A 12-year-old male domestic shorthair cat with a history of depression, aggression, and fever was presented for necropsy, and formalin-fixed tissues from a second male domestic shorthair cat of unknown age were submitted for histopathologic examination to the Athens Veterinary Diagnostic Laboratory. Both cats had granulomatous pneumonia associated with large numbers of parasite eggs and larvae, consistent with Aelurostrongylus abstrusus. Both cats also had larvae within glands in the colon that were identified morphologically as A. abstrusus first-stage larvae.