Lungworm

[oscarsdad]

Quick question...does anyone have any experience of lungworm infection in their dog?

 

My border terrier was at the vet last night as he has had a bit of a cough and phlegm in his throat for a couple of weeks now. He was examined, chest all sounds fine, heart fine and temp fine. He was put on a course of antibiotics.

 

I mentioned to the vet that last week after my girlfriend had walked him (which involves him chasing his ball like something possessed) he had difficulty supporting himself on his back legs for about 10min - she called me in tears and I rushed home from work to find that by the time I got there he was absolutely fine.

 

As I went to line the vet's pocket at reception the vet runs out and decides my dog could have lung worm because he has a cough and has fitted (which I would not describe as a fit at all). she has asked for stool samples.

 

Now the problem I have here is twofold...I have looked up the symptoms of lungworm and my dog does not have the majority of them (I have been to medical school so understand most of the vetinary speak). Also, I have very little confidence in this vet as I have argued with her before when she wanted to operate on my border for a blocked tear duct when he was a small puppy and I resisted (I diagnosed the blocked tear duct myself, she had no idea what the problem was) as I thought it would clear up as he grew (which it did).

 

So, my question is, has anyone experienced a case of lungworm and did it start with a mild cough or any episodes of unsteadiness when standing?

 

Also, before it is suggested, I am changing vets instead of seeing the one I have no confidence in!

 

Thanks ,

 

Anthony

Edited January 27, 2011 by oscarsdad

[pavman]

Hope you little dog gets sorted mate, sounds like nasty business

 

 

 

 

 

 

 

I once went out with a girl at school who had worms, not very plesant when i found out but being an Angler I stayed with her till it cleared up cause the cost of maggots had just went up

[new to the flock]

Treatment/Control

 

There are no anthelmintics approved for use in the treatment of angiostrongylosis in dogs. Levamisole,fenbendazole and ivermectin have been used successfully to treat dogs infected with A. vasorum [7, 21, 23].The use of levamisole in dogs for the treatment of angiostrongylosis should be discontinued due to a lowtherapeutic index, potential side-effects and a presumed increased risk of post-treatment reactions due to itsrapid killing rate of the worms. Release of worm antigen causing an anaphylactic reaction was thought to bethe cause of hypovolemic shock in one A. vasorum infected dog after levamisole treatment [36]. Two doses ofivermectin (0.2 mg/kg) given subcutaneously one week apart has been reported to be effective for treatment ofA. vasorum. Fenbendazole has been used at a dosage regimen of 20 mg/kg, per os, given 1-2 times daily for2-3 weeks. Severe dyspnea and ascites may occur as post-treatment complications. Broncho-dilators,expectorants and diuretics may need to be administered due to these post-treatment reactions [4].Currently, premise application of molluscicides or fencing designed to exclude wild canids are not available aspractical control options. It is unknown whether any of the preventative anthelmintics designed for theprevention of Dirofilaria immitis infection in dogs would also offer protection against A. vasorum. Sanitationto limit exposure of gastropods to feces of infected animals may prevent the spread of infection within akennel or multi-dog household. However, wild canids probably represent an infection reservoir beyond theeffects of human control measures.

 

 

 

 

We use an Ivermec wormer once a month to repell Canine Heartworm here. So unless you are on a monthly program of say "Heart Guard" .....one of the approved monthly wormers here.......then you are not preventing this problem.

 

LB, here are the Clinical Signs.

 

Clinical signs can be variable. Infections are usually characterized by a gradual onset of progressivelyworsening signs of respiratory and/or cardiac disease. Chronic cough, dyspnea, exercise intolerance, anorexia,gagging and weight loss are the most common clinical signs of infection. Subcutaneous swellings (hematomas), ascites, syncope, vomiting and signs of central nervous system disease may also occur. In rarecases, usually in younger dogs, an acute onset of illness followed by sudden death can occur. Occlusion of thepulmonary artery, acute onset of right-sided congestive heart failure and rupture of the femoral artery havebeen cited as the cause of death in these animals [21, 30, 32, 33].DiagnosisDiagnosis is based on history, clinical signs and the detection of first-stage larvae in fecal or transtrachealwash samples. Larvae are detected in feces using the Baermann technique or fecal flotation. Larvae are lessreliably detected on fecal flotation and may be difficult to identify due to osmotic damage from exposure tothe high specific gravity of the flotation media. The larvae are 310-399 x 14-16 microns in size. They have ananterior cephalic button and the tail terminates in a sinus wave curve ("severe kink") with a dorsal spine (Fig.3, Fig. 4). Immobilizing larvae with mild heat or the addition of a drop of iodine allows the diagnostician toperform a detailed morphological evaluation and obtain accurate size measurements. Multiple fecal samplesmay need to be examined to detect larvae due to intermittent shedding.Radiographs and hematological changes are nonspecific but may be supportive of a diagnosis ofangiostrongylosis in cases where fecal examinations are inconclusive. Radiographic changes include a diffuseincrease in peribronchial, interstitial and alveolar densities. Multiple nodular like densities may occur in theperipheral regions of the caudal lung lobes. Right-heart and pulmonary artery enlargement may also be visible[7, 21, 23, 34-35]. Hematological changes are inconsistent but may indicate anemia and monocytosis

 

 

 

NTTF

[oscarsdad]

Treatment/Control

 

There are no anthelmintics approved for use in the treatment of angiostrongylosis in dogs. Levamisole,fenbendazole and ivermectin have been used successfully to treat dogs infected with A. vasorum [7, 21, 23].The use of levamisole in dogs for the treatment of angiostrongylosis should be discontinued due to a lowtherapeutic index, potential side-effects and a presumed increased risk of post-treatment reactions due to itsrapid killing rate of the worms. Release of worm antigen causing an anaphylactic reaction was thought to bethe cause of hypovolemic shock in one A. vasorum infected dog after levamisole treatment [36]. Two doses ofivermectin (0.2 mg/kg) given subcutaneously one week apart has been reported to be effective for treatment ofA. vasorum. Fenbendazole has been used at a dosage regimen of 20 mg/kg, per os, given 1-2 times daily for2-3 weeks. Severe dyspnea and ascites may occur as post-treatment complications. Broncho-dilators,expectorants and diuretics may need to be administered due to these post-treatment reactions [4].Currently, premise application of molluscicides or fencing designed to exclude wild canids are not available aspractical control options. It is unknown whether any of the preventative anthelmintics designed for theprevention of Dirofilaria immitis infection in dogs would also offer protection against A. vasorum. Sanitationto limit exposure of gastropods to feces of infected animals may prevent the spread of infection within akennel or multi-dog household. However, wild canids probably represent an infection reservoir beyond theeffects of human control measures.

 

 

 

 

We use an Ivermec wormer once a month to repell Canine Heartworm here. So unless you are on a monthly program of say "Heart Guard" .....one of the approved monthly wormers here.......then you are not preventing this problem.

 

LB, here are the Clinical Signs.

 

Clinical signs can be variable. Infections are usually characterized by a gradual onset of progressivelyworsening signs of respiratory and/or cardiac disease. Chronic cough, dyspnea, exercise intolerance, anorexia,gagging and weight loss are the most common clinical signs of infection. Subcutaneous swellings (hematomas), ascites, syncope, vomiting and signs of central nervous system disease may also occur. In rarecases, usually in younger dogs, an acute onset of illness followed by sudden death can occur. Occlusion of thepulmonary artery, acute onset of right-sided congestive heart failure and rupture of the femoral artery havebeen cited as the cause of death in these animals [21, 30, 32, 33].DiagnosisDiagnosis is based on history, clinical signs and the detection of first-stage larvae in fecal or transtrachealwash samples. Larvae are detected in feces using the Baermann technique or fecal flotation. Larvae are lessreliably detected on fecal flotation and may be difficult to identify due to osmotic damage from exposure tothe high specific gravity of the flotation media. The larvae are 310-399 x 14-16 microns in size. They have ananterior cephalic button and the tail terminates in a sinus wave curve ("severe kink") with a dorsal spine (Fig.3, Fig. 4). Immobilizing larvae with mild heat or the addition of a drop of iodine allows the diagnostician toperform a detailed morphological evaluation and obtain accurate size measurements. Multiple fecal samplesmay need to be examined to detect larvae due to intermittent shedding.Radiographs and hematological changes are nonspecific but may be supportive of a diagnosis ofangiostrongylosis in cases where fecal examinations are inconclusive. Radiographic changes include a diffuseincrease in peribronchial, interstitial and alveolar densities. Multiple nodular like densities may occur in theperipheral regions of the caudal lung lobes. Right-heart and pulmonary artery enlargement may also be visible[7, 21, 23, 34-35]. Hematological changes are inconsistent but may indicate anemia and monocytosis

 

 

 

NTTF

 

 

Thanks for that - that reinforces my view that he does not have lung worm and that the vet is wrong (again).

 

Of the clinical signs you have listed, the only one present is cough. I wouldnt say it is worsening either, in fact, he is a lot better this morning. He certainly does not have an intolerance to exercise as it is nigh on impossible to wear him out and he still has a great appetite and wolfs his food down. He has not had any weight loss and has exhibited no gagging at all - just a slight cough.

 

hopefully the antibiotics will give him a boost to shake off whatever it is, assumuning it is not viral and he will be back to 100% soon.

 

As you have pointed out, the vet has asked for stool samples which you have said are unreliable, so really she should have done transtracheal wash to get a diagnosis - further reinforcing my desire to change vets!

 

Thanks,

 

Anthony

[new to the flock]

If you want some really good first hand info contact Tiercel by PM or email from his profile, as he has been through it with his one dog.

 

NTTF

[CharlieT]

Have a read of this......http://www.lungworm.co.uk/scripts/pages/en/home.php

 

Treatment is simple so if in doubt go for the stool test just to put your mind at ease.

[apache]

Some of the copy and paste links are just wrong.

 

There are licensed and effective treatments for lungworm in dogs, Panacur and Advocate are two off the top of my head.

 

The faecal test is not perfect but it's cheap and non-invasive. If in doubt [due to intermittent shedding] faeces can be pooled for 48 hours before submitting to the lab. A tracheal wash would require an anaesthetic and a tube placing down into the lungs. More expense and more risk. Faeces is a more than adequate screening test.

 

If in doubt treat it to rule it out. If you have lungworm in your area you should be treating for it monthly anyway.