Surgical treatment of coenurosis (gid) in sheep

Treatment and management of coenurosis by Taenia multiceps: field data from outbreaks in endemic regions and literature review

BACKGROUND

Taenia multiceps coenurosis is endemic in sheep from various regions worldwide. Dogs, the key hosts, shed T. multiceps eggs in their feces contaminating the pasture, and lambs are mostly infected during their first turnout into pastures. The disease is manifested in two forms: acute (due to the migrating oncospheres in the CNS) or chronic (due to the developing coenuri in the brain or spinal cord). Both forms are frequently accompanied by neurological symptoms.

METHODS

Field trials conducted in an endemic region (Sardinia, Italy) to treat replacement lambs in six sheep flocks infected with acute coenurosis are summarized in this article. The article also reviews earlier reports on various approaches developed to treat and immunize sheep against coenurosis.

RESULTS

Accurate detection of the time in which lambs become infected is crucial in deciding which treatment approach should be used. Acute disease can be successfully treated via chemotherapy. Results of field trials conducted in Sardinia revealed the efficacy of three (1-week apart) oxfendazole doses (14.15 mg/kg) in protecting apparently healthy lambs in the infected flocks from developing neurological symptoms. A single praziquantel dose (18.75 mg/kg) worked well for the same purpose and was also found significant in treating 5 of 16 clinically ill lambs in one flock. Earlier reports documented high rates of recovery (up to 100%) in clinically diseased lambs that received much higher doses (50-100 mg/kg) of praziquantel. However, chemotherapy is not preferred in chronic coenurosis since it can lead to rupture of the coenuri, giving rise to serious inflammation in the CNS. Surgical intervention is highly recommended in this case, and the pooled success rates for surgery in chronic-infected cases was estimated at 82.1% (95% CI 73.1-91.0%). However, various trials have been conducted to immunize sheep against T. multiceps coenurosis, and the 18k (Tm18) family of oncosphere antigens was found promising as a vaccine candidate.

CONCLUSIONS

In acute coenurosis, selection of the proper anthelmintic should be done after consulting the owner for several reasons: (1) costs of the used anthelmintic: treating a small flock of 100 sheep costs around 1170 and 660 € for praziquantel and oxfendazole, respectively; (2) withdrawal time of the used anthelmintic: No time is required before consuming meat and milk from praziquantel-treated sheep, whereas meat and milk from oxfendazole-treated sheep should not be consumed for 44 and 9 days, respectively, causing additional costs for the farmers. Since no commercial vaccines have yet been developed against T. multiceps coenurosis in sheep, preventive measures remain the cornerstone of controlling this serious disease.

Taenia multiceps coenurosis: a review

Taenia multiceps is a taeniid cestode that inhabits the small intestines of both wild and domestic carnivores. The larval stage, Coenurus cerebralis, is typically found in the central nervous system (CNS) of a wide range of livestock and, to a lesser extent, in the extra-cerebral tissues of sheep and goats. This review covers all aspects of the life cycle of T. multiceps and its epidemiology, molecular characterization, pathogenesis, diagnosis, therapy, control and zoonotic potential. Coenurosis caused by the larval stage of T. multiceps has a worldwide distribution and is often fatal in intermediate hosts, which can result in substantial economic losses in livestock farming. Molecular characterization using the mitochondrial genes cytochrome c oxidase subunit 1 and nicotinamide adenine dinucleotide dehydrogenase subunit 1 of different T. multiceps populations has revealed significant genetic variation and the presence of three major haplotypes. The disease mostly affects young sheep and is referred to as either acute or chronic coenurosis. Acute coenurosis occurs as a result of oncospheres migrating through the CNS, while chronic coenurosis occurs as a consequence of the coenurus maturing, which causes displacement and pressure atrophy of brain tissue. Non-cerebral coenurosis has been most commonly reported in goats. The best diagnostic method for cerebral coenurosis involves the interpretation of clinical signs with accurate localization of the cyst using diagnostic imaging techniques. A vaccine based on recombinant oncosphere antigens has proved to be an effective tool against T. multiceps infection in sheep. Additionally, use of anthelmintics during the parasite's migration stages reduces the development of cysts in the sheep brain. Surgery is considered the most effective method for the treatment of cerebral coenurosis in small ruminants, but is often not carried out because of the limited finances of many sheep and goat breeders. However, coenurosis can also be controlled effectively through preventative measures, such as anthelmintic treatment of dogs and the proper disposal of intermediate host carcasses. The parasite is also zoonotic, and cases of coenurosis have been reported in humans with coenuri located in the brain, spinal cord and eyes.

First Report on Molecular Characterization of Taenia multiceps Isolates From Sheep and Goats in Faisalabad, Pakistan

Coenurus cerebralis is the larval stage of Taenia multiceps commonly found in the brain (cerebral form), intramuscular and subcutaneous tissues (non-cerebral form) of ungulates. Globally, few reports exist on the molecular characterization and genetic diversity of C. cerebralis with none available for Pakistan. The current study molecularly characterized 12 C. cerebralis isolates surgically recovered from sheep (n = 4) and goats (n = 8) from a total of 3,040 small ruminants using a portion of the cytochrome c oxidase subunit 1 (cox1) mitochondrial (mt) gene. NCBI BLAST search confirmed the identity of each isolate. A high haplotype and a low nucleotide diversity with three haplotypes from the 12 isolates were observed. The findings suggest the existence of unique haplotypes of C. cerebralis in Pakistan. The negative value of Tajima's D and the positive value of Fu's Fs were inconsistent with population expansion, however, the sample size was small. Bayesian phylogeny revealed that all Pakistani isolates alongside the Chinese sequences (obtained from GenBank) constituted a cluster while sequences from other regions constituted another cluster. This is the first molecular study to determine the genetic diversity of C. cerebralis in Pakistan and serves as a foundation for prospective studies on the prevalence and population structure of C. cerebralis in the country. Furthermore, in this study, we amplified only a partial segment of the cox1 gene from a limited sample size. This could have implications on the interpretation of the actual population structure in reality. Thus, we recommend future studies to consider a larger sample size in a massive epidemiological survey for further insights.

Total intravenous anaesthesia in a goat undergoing craniectomy

BACKGROUND

Cerebral coenurosis is a disease of the central nervous system in sheep and goats, and is usually fatal unless surgical relief is provided. Information regarding neuroanaesthesia in veterinary medicine in goats is scant.

CASE PRESENTATION

We describe anaesthetic management of an intact female goat (2 years; 16 kg) presented for craniectomy. The goat was sedated with xylazine (0.05 mg kg-1, i.m.) and morphine (0.05 mg kg-1, i.m.). General anaesthesia was induced 20 min later with propofol and maintained with a constant rate infusion of propofol (0.2 mg kg-1 min-1). A cuffed endotracheal tube was placed and connected to a rebreathing (circle) system and mechanical ventilation with 100% oxygen was initiated. A bolus of lidocaine (1 mg kg-1), midazolam (0.25 mg kg-1) and fentanyl 2.5 μg kg-1 was delivered via the intravenous route followed immediately by a constant rate infusion of lidocaine (50 μg kg-1 min-1), midazolam (0.15 mg kg-1 h-1) and fentanyl (6 μg kg-1 h-1) administered via the intravenous route throughout surgery. Craniectomy was undertaken and the goat recovered uneventfully.

CONCLUSION

Total intravenous anaesthesia with propofol, lidocaine, fentanyl and midazolam could be an acceptable option for anaesthesia during intracranial surgery in goats.

Genetic characterisation of Taenia multiceps cysts from ruminants in Greece

This study was designed to genetically characterise the larval stage (coenurus) of Taenia multiceps from ruminants in Greece, utilising DNA regions within the cytochrome c oxidase subunit 1 (partial cox1) and NADH dehydrogenase 1 (pnad1) mitochondrial (mt) genes, respectively. A molecular-phylogenetic approach was used to analyse the pcox1 and pnad1 amplicons derived from genomic DNA samples from individual cysts (n=105) from cattle (n=3), goats (n=5) and sheep (n=97). Results revealed five and six distinct electrophoretic profiles for pcox1 and pnad1, respectively, using single-strand conformation polymorphism. Direct sequencing of selected amplicons representing each of these profiles defined five haplotypes each for pcox1 and pnad1, among all 105 isolates. Phylogenetic analysis of individual sequence data for each locus, including a range of well-defined reference sequences, inferred that all isolates of T. multiceps cysts from ruminants in Greece clustered with previously published sequences from different continents. The present study provides a foundation for future large-scale studies on the epidemiology of T. multiceps in ruminants as well as dogs in Greece.

Efficacy of albendazole against Taenia multiceps larvae in experimentally infected goats

A controlled trial was conducted to evaluate the efficacy of three therapeutics regimes of albendazole (ABZ) against Taenia multiceps larvae in experimental infected goats. Forty-nine goats experimentally infected with 3000 T. multiceps eggs were selected and randomly divided into treatment or control groups. Treatment with 10mg/kg for 3 days for group 1 (G1), 10mg/kg for group 2 (G2) and 20mg/kg/day for group 3 (G3) was applied 2 months after infection; group 4 (G4) served as a control group. A treatment with doses of 10mg/kg/day for 3 days on group 5 (G5) and group 6 (G6) was used as control, 5 months after the infection. The efficacy of ABZ was assessed as percentage of non-viable cysts which were determined by morphologic characteristics, movement and methyl blue staining technique. The efficacy of ABZ against 2 months old cysts was significantly different from the control and were 90.3% (28/31), 72.7% (8/11) and 73.9% (14/19) for G1, G2 and G3, respectively. No differences were observed in cyst viability between treated and control groups for 5-month old cysts. The results in this study indicate that ABZ is effective in goats against 2-month-old cysts of T. multiceps larva located in tissues outside the brain.

Taenia multiceps brain cyst removal in two wild Nubian ibex (Capra nubianas)

Two wild adult Nubian ibex (Capra nubiana) were captured and admitted to the Hebrew University Veterinary Teaching Hospital with various neurologic signs, including alerted mentation, head tilt, and pathologic nystagmus. The lesion in the central nervous system was localized to the forebrain in one ibex and to the cerebellum of the other. Both ibex's were diagnosed with brain cyst using computed tomography (CT). Craniectomy was performed to remove the cysts, and both animals returned to their natural environment after a rehabilitation period. Parasitologic examination revealed cysts of Taenia multiceps coenurus. This is the first report to describe the neurologic signs, CT findings, surgical procedure, and follow-up postsurgery information in wild Capra nubiana.

Clinical and morphopathological characteristics of an enzootic occurrence of acute coenurosis (Coenurus cerebralis) in a sheep herd

In this study, 30 sheep from a flock suddenly showed acute neurological symptoms associated with more than 30 % mortality. At necropsy, thickening associated with congestion and turbidity of meningeal membranes particularly on cerebellum, focal to multifocal necrotic areas and whitish spots measuring 1 to 3 cm in diameter were observed in the cortex of cerebrum and cerebellum. Grossly, numerous white tracts were also observed in the myocardium. Histopathologically, the cross sections of coenurus larvae associated with necrotic suppurative meningoencephalitis were observed. Multiple necrotic areas were also observed in the gray matter of cerebellum due to migration of the larvae with an extensive infiltration of eosinophils and neutrophils. In the heart, multifocal granulomatous myocarditis was diagnosed. No growth was seen in bacterial cultures of the brain and heart. Also, no bacteria were seen in these tissues stained with Ziehl-Neelsen and Brown-Brenn Gram stain. On basis of gross and histopathologic lesions, acute coenurosis was diagnosed. Unlike chronic coenurosis, acute form of the disease rarely reported in sheep.

Magnetic resonance imaging of the brain and skull of sheep with cerebral coenurosis

OBJECTIVE

To determine MRI characteristics of the skulls and brains of sheep with chronic cerebral coenurosis (CC) caused by naturally acquired Taenia multiceps infection.

ANIMALS

33 sheep with CC and 10 healthy control sheep.

PROCEDURES

Sheep underwent MRI of the head. Volumes of the cranial cavity and rostral and caudal fossas of the cranial cavity were determined. For CC-affected sheep, the number, location, and volume of T multiceps cysts were determined and the percentage volumes of cysts in the cranial cavity and rostral and caudal fossas of the cranial cavity were calculated. Focal and diffuse abnormalities of cranial bones in CC-affected sheep were identified. Brain edema and hemorrhage and signs of increased cranial pressure (ICP) in MRI images were determined.

RESULTS

Volumes of the cranial cavity and rostral and caudal fossas of the cranial cavity were significantly larger for CC-affected sheep versus healthy control sheep. Total volumes of cysts ranged from 4.40% to 46.93% in cranial cavities of sheep, 4.12% to 51.53% in rostral fossas of cranial cavities of sheep, and 15.24% to 68.30% in caudal fossas of cranial cavities of sheep. Moderate to severe diffuse cranial bone abnormalities and signs of increased ICP in MRI images were detected in 21 and 24 sheep, respectively, and were positively correlated with cyst volumes.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that cranial cavity volume and morphological abnormalities can be detected in sheep with CC. These changes may reflect abnormalities in ossification of the cranial bones secondary to chronically increased ICP caused by development of T multiceps cysts.

Acute coenurosis of dairy sheep from 11 flocks in Greece

CASE HISTORY

A syndrome of acute neurological dysfunction with increased mortality was observed in lambs of 10 dairy sheep flocks and adult animals in one flock in Central and Northern Greece. Each farmer completed a questionnaire regarding the management and feeding of their flocks. In seven of the 11 flocks the affected animals were grazing pasture, while in the remaining four flocks (5, 8, 9, 10) the animals were fed alfalfa hay (Medicago sativa) and concentrates indoors. A follow-up study of the affected flocks was conducted during the next 12 months.

CLINICAL FINDINGS

Of 42 sheep with acute coenurosis that were examined, the most prominent neurological abnormalities were ataxia, depression, blindness, scoliosis, coma and dysmetria. Except for the four sheep that were comatose, all other animals had normal body temperatures and their appetites remained normal or were slightly decreased. Haematological findings of 15 examined sheep were within normal limits. The affected sheep were subject to euthanasia. A histopathological examination was performed in 13 cases. Faecal samples from dogs associated with these flocks were negative for taeniid infections. During the following 12 months cases of chronic coenurosis in these flocks were observed.

PATHOLOGICAL FINDINGS

In the 42 animals that were necropsied, the main gross findings were cystic formations between 0.5-1 cm in diameter with translucent walls that were seen lying free on the leptomeninges or partly penetrating the brain tissue, sterile microabscecess and brain necrosis. Histopathological evaluation of tissue sections of 13 brains showed multifocal purulent or pyogranulomatous meningoencephalitis, accompanied by eosinophilic infiltrations. No bacteria were isolated following bacterial culture of brain tissue Parasitological examination of the cysts from five cases revealed whitish specks on the transparent cyst wall and germination membrane representing the scolices.

DIAGNOSIS

Acute coenurosis was diagnosed in all cases studied.

CLINICAL RELEVANCE

Acute coenurosis can be one of the causes of acute encephalopathy mainly in lambs, but also in adult sheep. This condition is incurable, but can be controlled by changing the feeding regime. Cases of chronic coenurosis may be seen a few months later in the same flock.