Canis ISSN: 2398-2942

Angiostrongylosis

Synonym(s): angiostrongylus vasorum, French heartworm

Contributor(s): Rory Bell, Kyle Braund, Simon Platt

Introduction

  • First described in the United Kingdom in 1975 in a survey of greyhound fecal sample.
  • CauseAngiostrongylus vasorum.
  • Signs:
    • May be subclinical.
    • Non-specific:
      • Lethargy, weight loss, vomiting.
    • Cardiorespiratory:
      • Cough, severe dyspnea, reduced exercise intolerance, hemoptysis, congestive heart failure.
    • Hemorrhage:
      • Scleral, conjunctival, sublingual, subcutaneous, hematuria.
    • CNS signs:
      • Obtundation, loss of central vision, seizures, weakness, neck pain, paralysis.
  • Diagnosis: larval presence in dog feces. Blood test for A. vasorum antigen.
  • Treatment: address coagulopathy if present; fenbendazole, moxidectin/imidacloprid, milbymycin.
  • Prevention: avoidance of slug/snail/frog ingestion, avoidance of foxes, moxidectin/imidacloprid or milbemycin monthly.
  • Prognosis: guarded to favorable.
    Print off the factsheet Lungworms in dogs (Angiostrongylus) Lungworms in dogs (Angiostrongylus) to give to your client.
Clinical tip:
Question: How sensitive is the antigen test for A. vasorum?
Answer: 95%

Pathogenesis

Etiology

Predisposing factors

General

  • Dogs living in close contact with other dogs, eg in kennels, packs of hunting dogs or a group of Greyhounds.
  • Dogs in close contact with foxes (reservoir host).
  • Dogs that habitually ingest snails, slugs or frogs.

Specific

  • Regions of hyper-endemicity scattered throughout the UK.

Pathophysiology

  • The 2-5 cm worm resides in the pulmonary artery and right ventricle of dogs. The larvae are coughed up, swallowed and passed in feces. Molluscs serve as obligatory intermediate hosts, ie snails, slugs. Frogs can serve as intermediate or paratenic hosts. Foxes are the most important reservoir host. The final host is infected by eating an intermediate host containing third-stage larvae Lifecycle Angiostrongylus vasorum - diagram.
  • Pulmonary artery obstruction, endarteritis and thrombosis occur, as well as parenchymal damage to various organs due to larval migration.
  • Fibrosis and induration of lungs and occlusion of the pulmonary arteries can cause pulmonary hypertension and right-sided cardiac failure resulting in hydrothorax, hydropericardium, liver congestion and ascites.
  • Disseminated intravascular coagulation Disseminated intravascular coagulation can occur. Immune-mediated thromboctopenia Immune-mediated thrombocytopenia , and/or factor deficiency are less commonly described following infection, all of which result in a predisposition to, or spontaneously occurring, hemorrhage.
  • Embolic larvae to other organs, especially kidney and brain resulting in granulomatous hemorrhagic or infarcted foci.

Diagnosis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Elsheika H A, Holmes S A, Wright I & Morgan E R (2014) Recent advances in the epidemiology, clinical and diagnostic features, and control of canine cardio-pulmonary angiostrongylosis. Vet Res 45 (1), 92-97 PubMed.
  • Morgan E R, Tomlinson A, Hunter S, Nichols T, Roberts E, Fox M T & Taylor M A (2008) Angiostrongylus vasorum and Eucoleus aerophilus in foxes (Vulpes vulpes) in Great Britain. Vet Parasitol 154, 48-57 PubMed.
  • Willesen J L, Kristensen A T, Jensen A L, Heine J & Koch J (2007) Efficacy and safety of imidacloprid/moxidectin spot-on solution and fenbendazole in the treament of dogs naturally infected with Angiostrongylus vasorum (Baillet, 1866). Vet Parasitol 147, 258-264 PubMed.
  • Wessmann A, Lu D, Lamb C R, Smyth B, Mantis P, Chandler K, Boag A, Cherubini G B & Cappello R (2006) Brain and spinal cord hemorrhages associated with Angiostrongylus vasorum infection in four dogs. Vet Rec 158, 858-863 PubMed.
  • Boag A K, Murphy K F & Connolly D J (2005) Hypercalcaemia associated with Angiostrongylus vasorum in three dogs. JSAP 46, 79-84 PubMed.
  • Garosi L S, Platt S R, McConnell J F, Wray J D & Smith K C (2005) Intracranial haemorrhage associated with Angiostrongylus vasorum infection in three dogs. JSAP 46, 93-99 PubMed.
  • Whitley N T, Corzo-Menendez N, Carmichael N G & McGarry J W (2005) Cerebral and conjunctival haemorhages associated with von Willebrand factor deficiency and canine angiostrongylosis. JSAP 46, 75-78 PubMed.
  • Chapman P S, Boag A K, Guitian J & Boswood A (2004) Angiostrongylus vasorum infections in 23 dogs (1999-2002). JSAP 45, 435-440 PubMed.
  • Conboy G (2004) Natural infections of Crenosoma vulpis and Angiostrongylus vasorum in dogs in Atlantic Canada and their treatment with milbemycin oxime. Vet Rec 155, 16-18 PubMed.
  • Barcante T A, Barcante J M, Dias S R & Lima Wdos S (2003) Angiostrongylus vasorum (Baillet, 1866) Kamensky, 1905: emergence of third-stage larvae from infected Biomphalaria glabrata snails. Parasitol Res 91, 471-475 PubMed.
  • Søland J & Bolt G (1996) Hypovolemic shock after anthelmintic treatment of canine angiostrongylosis. JSAP 37 (12), 594-596 PubMed.
  • Bolt G et al (1994) Canine angiostrongylosis - a review. Vet Rec 135 (19), 447-452 PubMed.
  • Reifinger M & Greszl J (1994) Pulmonary angiostrongylosis with systemic distribution and central nervous system symptoms in a dog. J Vet Med (Series B) 41 (6), 391-398 VetMedResource.
  • Jacobs D E & Prole J H (1975) Angiostrongylus vasorum and other nematodes in British greyhounds. Vet Rec 96 (8), 180 PubMed.
  • Roche M M & Kelliher D J (1968) Angiostrongylus vasorum infestation in the dog: A case report. Irish Vet J 22, 108-113 VetMedResource.

Other sources of information

  • Brennan S (2008) Canine angiostrongylus vasorum infection. Veterinary Review September, pp 25-26.
  • Hawking E C (2000) Pulmonary parenchymal diseases. In: Textbook of Veterinary Internal Medicine. 5th edn. Ettinger S J & Feldman E C (eds). W B Saunders, Philadelphia. pp 1061-1091.


ADDED