Pennisi MG, Tasker S, Hartmann K, Belák S, Addie D, Boucraut-Baralon C, Egberink H, Frymus T, Hofmann-Lehmann R, Hosie M, Lloret A, Marsilio F, Thiry E, Truyen U, Möstl K. Dirofilarioses in cats: European guidelines from the ABCD on prevention and management.
J Feline Med Surg 2020;
22:442-451. [PMID:
32326862 PMCID:
PMC11132531 DOI:
10.1177/1098612x20917601]
[Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OVERVIEW
Dirofilaria immitis and Dirofilaria repens are the most important filarial worms, causing heartworm disease and subcutaneous dirofilariosis, respectively. D repens is currently considered an emerging zoonotic agent in Europe.
LIFE CYCLE AND INFECTION
Filarial worms infect mainly dogs, but also cats, ferrets, wild carnivores and humans. The life cycle involves an intermediate mosquito host. Compared with dogs, cats are imperfect hosts for dirofilarial worms. After inoculation, only a low number of L3 larvae develop to the adult stage in a small percentage of cats. Heartworm disease in cats may be associated with severe pulmonary thromboembolism and an eosinophilic inflammatory response in the lungs, potentially leading to sudden death. Otherwise self-cure occurs in most cases after 18-48 months. Subcutaneous dirofilariosis may present as subcutaneous nodules or dermatitis.
DIAGNOSIS AND TREATMENT
Diagnosis in cats is more difficult compared with dogs and needs a multistep approach (antigen and antibody tests, as well as diagnostic imaging). Cats with acute heartworm disease require stabilisation within an intensive care unit. Cats with respiratory signs or suggestive radiographic changes should receive prednisolone and follow-up with a similar multistep approach. Adulticidal therapy is not safe in cats.
PREVENTION
In endemic areas cats should receive year-round chemoprophylaxis from 2 months of age.
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