Clinical study on twelve naturally Angiostrongylus vasorum infected dogs under treatment.

angiostrongylosis is an emerging potentially fatal disease in Europe. Aim of the study- clinical monitoring of twelve naturally Angiostrongylus vasorum naturally infected dogs under treatment. Materials and methods- twelve dogs referred to the Clinical Unit of the Veterinary Faculty of Bari (Italy) were enrolled in the study. Diagnosis was made by means of larval morphological identification on faecal samples analysed by Baermann test and/or direct microscopic observation. A blood sample was collected for haematology, biochemical analysis, serum protein electrophoresis and coagulation profile. Thoracic radiographs and echocardiography was performed. Specific therapy was administered choosing fenbendazole (Panacur Ò, Intervet, Animal Health) and/or Im/Mox (AdvocateÒ spot-on, Bayer) based on the severity of symptoms. The study monitoring was stopped at normalization of clinico-pathological alterations and/or at the end of treatment. During monitoring clinical examination was performed once a week in symptomatic dogs, while laboratory and radiographic controls were performed according to owner availability. Results-the owner complaint was heterogeneous: dyspnea, polypnea and hemoptysis, gradual distension of the abdomen, epistaxis and acute unilateral hyphema, severe coughing. Five cases were presented for routine control visit and one case for ocular specialistic examination. Thoracic auscultation was normal in seven cases, while in the other animals rales, wheezing, muffling of heart sounds and loud bronchovescicular sounds were registered. Thoracic radiographs showed pathological findings in all dogs except for one. Circular areas of radiopacity were observed in four cases. The complete blood count showed anemia from mild to moderate in five cases, leucocytosis in four cases and eosinophilia in six cases. The biochemical examination showed non-specific and non-uniform alterations. Primary hemostasis disorders characterized by thrombocytopenia were detected in three cases, associated or not to alterations of clotting profile. Serum protein electrophoresis showed a variable increase in β globulin fraction in all animals except for two asymptomatic dogs. In general clinical pictures significantly improved in all symptomatic dogs after 1-2 weeks from treatment starting. The reverse to normal of clinico-pathological findings and radiographic abnormalities were variable. Fenbendazole was given in monotherapy in five cases for 21 days. The Im/Mox was administered in monotherapy in five cases and in combination with fenbendazole in two other cases. Conclusions - The reported cases show different clinical presentations associated with the presence of A. vasorum in dogs suggesting that angiostrongylosis should be considered as a possible etiological cause of several clinical conditions. Moreover the occasional detectionof L1 in the feces of five dogs referred for a routine control visit suggest that fecal samples (direct or Baermann test) can reveal asymptomatic subjects (Koch et al., 2009). The detection of L1 in a dog of 12 years reveals the receptivity to infection also in old dogs, although a greater risk of infection is reported in young subjects (Chapman et al., 2004; Barutzki and Schaper, 2009). Thoracic radiographic findings are described in the course of angiostrongylosis with the possibility of abnormalities also in asymptomatic dogs (Boag et al., 2004) as it was in the cases described herein.. The particular aspect of the circular/serpiginous radiopacity described in four cases have not been previously reported; these lesions could be attributed to fistulas created during larval migration from the pulmonary capillaries into the alveoli or to bronchoectasiae. A. vasorum infection can be fatal, thus an early diagnosis and appropriate treatment is auspicable. Although none of clinico-pathological findings are specific, a combination of these findings should increase the index of suspicion also in asymptomatic dogs.