Aortic thromboembolism associated with Spirocerca lupi infection

doi:10.1016/j.vetpar.2005.03.037

Veterinary Parasitology

Volume 130, Issues 3–4, 30 June 2005, Pages 331-335

https://doi.org/10.1016/j.vetpar.2005.03.037 Get rights and content

Abstract

A 2-year-old male castrated Cavalier King Charles Spaniel was presented with paraplegia, cold caudal extremities and lack of femoral pulses. A 2 cm long thrombus occluding the aortic trifurcation and a 3 cm long abdominal aortic aneurysm with a thrombus were detected by ultrasonographic examination. The clinical and ultrasonographic findings were consistent with aortic thromboembolism. Anti-thrombotic and vasodilative therapy was not helpful and the dog was euthanized 3 days after the onset of paraplegia. A thrombus in the aortic trifurcation, multiple thoracic and abdominal aneurysms and a distal mediastinal esophageal granuloma containing Spirocera lupi worms were found on necropsy. The abdominal aortic aneurysms formed by S. lupi larval migration are believed to be responsible for the formation of the thrombus that occluded the aortic trifurcation. This is the first report of aortic thromboembolism associated with S. lupi infection.

Introduction

Canine aortic and iliac thrombosis is an uncommon condition that usually arises secondarily to a predisposing disease process. These included: cardiac dysfunction, neoplasia, renal disease, gastric dilation and volvulus, atherosclerosis associated with hypothyroidism and hyperadrenocorticism (Carter, 1990, Van-Winkle et al., 1993, Boswood et al., 2000, Santamarina et al., 2003, MacGregor et al., 2004)). Arterial thromboembolism has also been associated with blastomycosis (Ware and Fenner, 1998).

Spirocerca lupi is a cosmopolitan nematode pathogen of canines, distributed mostly in warm climates. Dogs become infected with S. lupi by ingesting coprophagous beetles in which S. lupi larvae have developed after ingestion of the nematode's eggs. Infection may be acquired also by ingesting paratenic hosts such as birds, hedgehogs, lizards, mice and rabbits.

The lesions caused by S. lupi are due mainly to the migration and persistent presence of larvae and adults in the tissues. Esophageal or gastric granulomas, aortic scars and aneurysms are the lesions most frequently seen (Mazaki-Tovi et al., 2002). Spondylitis and spondylosis of the caudal thoracic vertebrae are additional typical lesions. Neoplastic transformation of the granulomas to fibrosarcoma, osteosarcoma and undifferentiated sarcomas may occur in dogs with spirocercosis (Ranen et al., 2004). Hypertrophic osteopathy was reported as a further complication (Lobetti, 2000).

Mazaki-Tovi et al. (2002) found that the most common clinical signs in canine spirocercosis were vomiting or regurgitation (60%), pyrexia (24%), weakness (22%), respiratory abnormalities (20%), anorexia (18%), melena (18%) and paraparesis (14%). Schroeder and Berry (1998) described an underlying association between S. lupi infestation and salivary gland necrosis. Aberrant migration of S. lupi is common and larvae have been found in different organs primarily in the thoracic cavity but also in the skin, and heart (Harrus et al., 1996).

Section snippets

Case history

A 2-year-old male castrated Cavalier King Charles Spaniel was referred to the Hebrew University Veterinary Teaching Hospital (HUVTH) with a chief complaint of paraplegia. The onset of clinical signs was 24 h prior to presentation, with hind legs ataxia, depression, decreased appetite, lethargy and hypothermia (36.6°).

Upon presentation the dog was depressed, the rear legs were swollen, femoral pulses were absent and the caudal extremities were cold. A neurological examination revealed paraplegia,

Discussion

This report presents a potential complication associated with S. lupi infection. Larval migration in the aortic wall and aneurysm formation during the life cycle of S. lupi are well documented. The changes in rheologic properties of the blood as a consequence of blood flow within an aortic aneurysm predispose to the formation of clots. Dislodged aortic blood clots can then occlude blood vessels that branch out of the aorta such as the external iliacs. It is surprising that in Spirocerca endemic

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Aortic and iliac thrombosis in six dogs
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W.O. Carter
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Spirocercosis in dogs
Compend. Contin Educ. Pract. Vet.
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R.F. Fox
CVT update: therapy for feline myocardial diseases
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Contractile effects of 5-hydroxytryptamine in isolated intrapulmonary arteries and veins
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Spirocerca lupi infection in the dog: aberrant migration
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(2000)

There are more references available in the full text version of this article.

Cited by (42)

Miscellaneous Nematode Infections
2022, Greene's Infectious Diseases of the Dog and Cat, Fifth Edition
Physaloptera spp. Infection
- •
  Cause: Physaloptera praeputialis and Physaloptera rara.
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  First Described: Physaloptera praeputialis was first isolated from a domestic cat and described in 1889 (von Linstow). Physaloptera rara was first isolated from a domestic dog in North America and described in 1918 (Hall and Wigdor).
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  Affected Hosts: Domestic and wild dogs and cats.
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  Geographic Distribution: Worldwide (P. praeputialis), North America (P. rara).
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  Route of Transmission: Ingestion of intermediate insect or paratenic hosts.
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  Major Clinical Signs: May cause chronic intermittent vomiting. Infections often are subclinical.
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  Differential Diagnosis: Any GI or systemic cause of chronic vomiting (e.g., idiopathic gastritis, gastric foreign body, gastric neoplasia, food intolerance/allergy, chronic pancreatitis). Eggs must be differentiated from those of Spirocerca lupi. Vomited nematodes must be differentiated from Toxocara canis, Toxocara cati, and Toxascaris leonina.
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  Human Health Significance: Physaloptera spp. of dogs and cats are not considered a zoonosis.
Spirocerca lupi Infection
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  Cause: Spirocerca lupi (esophageal worm), Superfamily Spriuroidea, Order Spirurida.
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  First Described: Karl Asmund Rudolphi (Swedish parasitologist and “father” of helminthology), 1809.
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  Affected Hosts: Domestic dogs, wild canids, and other carnivores; rarely cats.
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  Geographic Distribution: Worldwide but primarily in tropical and subtropical regions with the highest prevalence in the southern United States, Brazil, the Caribbean, South Africa, and the Middle East.
- •
  Route of Transmission: Dogs become infected after ingestion of the intermediate host (coprophagous beetles in the Family Scarabaeidae, Order Coleoptera) or paratenic hosts (e.g., birds, frogs, lizards and other reptiles, rodents) containing a third-stage larva.
- •
  Major Clinical Signs: Vomiting or regurgitation, odynophagia, ptyalism, respiratory difficulty, cough, weight loss, and fever.
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  Differential Diagnoses: Differentials for regurgitation include esophageal foreign bodies, esophageal strictures, esophageal neoplasia or granulomas of other origin, megaesophagus, and so on. Differentials for vomiting include any GI or systemic cause of chronic vomiting (e.g., idiopathic gastritis, gastric foreign body, gastric neoplasia, food intolerance/allergy, chronic pancreatitis). Eggs must be differentiated from Physaloptera spp.
- •
  Human Health Significance: Spirocerca lupi infection is not considered a zoonosis.
Strongyloides spp.
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  Cause: Strongyloides are commonly referred to as threadworms and belong to the Family Strongyloididae in the Order Rhabditida.
- •
  First Described: Larval stages of Strongyloides stercoralis were first isolated from human feces in 1876; the first identification of natural infection in a dog was in 1914. In cats, Strongyloides planiceps was isolated by Leiper from a rusty tiger cat (Felis planiceps) in 1927. Strongyloides felis was first isolated from cats in India in 1925. While Strongyloides tumefaciens was first noted in cats in the USA in 1929, it was not described or named until 1941.
- •
  Affected Hosts: Strongyloides stercoralis occurs in dogs, cats, non-human primates, and people. Strongyloides felis and S. tumefaciens have been described in domestic and wild cats; S. planiceps in domestic and wild cats, dogs, and wild carnivores.
- •
  Geographic Distribution: Worldwide.
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  Route of Transmission: Oral, percutaneous, and, less frequently, transmammary infections occur in dogs. Oral and percutaneous transmission occur in cats.
- •
  Major Clinical Signs: Subclinical infections are common. Cough and other signs of bronchial involvement can occur in the early stage of infection in dogs. Severe enteritis with profuse diarrhea can occur in the later stage of infection. Skin papules are sometimes seen when larvae enter the dog percutaneously. In cats, clinical signs are rare, but diarrhea has been reported in some infections.
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  Differential Diagnoses: The clinical signs are nonspecific and must be differentiated from other causes of diarrhea, for example, dietary, infectious, inflammatory, toxic, or extraintestinal causes of diarrhea. In puppies, S. stercoralis must be differentiated from other parasites that have larval lung migration stages (e.g., Toxocara canis, Ancylostoma caninum), cause diarrhea, and are able to enter the animal percutaneously (e.g., Ancylostoma caninum, [Uncinaria stenocephala]). In cats and dogs, recovered larvae must be distinguished from lungworm and hookworm larvae.
- •
  Human Health Significance: Strongyloides stercoralis can be transmitted from dogs to people and from people to dogs. Zoonosis of cat Strongyloides has not been studied and there have been no reports of Strongyloides being transmitted from cats to people.
Mammomonogamus spp.
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  Cause: Mammomonogamus ierei and Mammomonogamus auris, which occur in cats, are commonly referred to as gapeworms. These nematodes belong to the Family Syngamidae.
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  First Described: Mammomonogamus ierei (synonym Syngamus ierei) was first described by Buckley in 1934, who isolated it from a domestic cat in Trinidad. Mammomonogamus auris (synonym Syngamus auris) was first described by Faust and Tank in 1934, who isolated it from the middle ear of several cats in China.
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  Affected Hosts: Mammomonogamus ierei and M. auris infect domestic cats.
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  Geographic Distribution: The distribution of Mammomonogamus is disparate with M. ierei reported in the Caribbean and M. auris found in Asia.
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  Route of Transmission: Unknown. Given the life cycle of other parasites in this family, it is likely that paratenic hosts are involved.
- •
  Major Clinical Signs: Subclinical infections are common. However, infections can be associated with inflammation of the nasopharynx resulting in a mucoid nasal discharge, coughing, sneezing episodes, and weight loss with M. ierei. Head shaking has been seen in a cat with M. auris infection.
- •
  Differential Diagnoses: Other infections that cause nasal discharge and sneezing (e.g., viral infections, Eucoleus aerophilus, Cuterebra spp.). In the case of M. auris, Otodectes cynotis also can result in head shaking. The dark cerumen associated with O. cynotis infection does not occur with M. auris infection. Eggs of M. ierei and M. auris can be seen in a fecal flotation.
- •
  Human Health Significance: There are no reports of M. ierei and M. auris infecting humans and neither are believed to be zoonotic.
Dioctophyme renale
- •
  Cause: Dioctophyme renale, the giant kidney worm, is the largest parasitic nematode of domestic animals (Family Dioctophymidae and the Order Ascaridida).
- •
  First Described: Dioctophyme renale was first described by the German zoologist Johann Goeze in 1782; earlier reports of giant kidney worms date back to the late 1500s.
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  Affected Hosts: Most cases of D. renale in domestic animals are reported in dogs, with infections occasionally seen in cats and other host species, including humans. Fish-eating vertebrates, especially mink and other mustelids, are the natural definitive host.
- •
  Geographic Distribution: Dioctophyme renale has a sporadic, worldwide distribution although reports of infection are rare in Africa and Asia. The parasite is widespread in the Americas and has been reported from dogs and other hosts from Canada to Brazil.
- •
  Route of Transmission: Eggs are shed in the urine of infected definitive hosts. First-stage larvae develop inside the eggs and hatch following ingestion by aquatic oligochaete annelid intermediate hosts found in the detritus of ponds and streams. Third-stage larvae develop within the tissues of the annelids and may be passed to paratenic hosts, such as fish and frogs, when they ingest the intermediate hosts. Dogs and other final hosts are infected upon ingestion of annelids, or, more commonly, by ingesting third-stage larvae in fish paratenic hosts.
- •
  Major Clinical Signs: Most infections are subclinical. Some dogs have hematuria, renal pain, renal enlargement, abdominal pain, and abdominal effusion. Development of worms in subcutaneous fat has also been reported.
- •
  Differential Diagnoses: Other causes of cystitis; renal neoplasia; or a retroperitoneal, abdominal, or subcutaneous mass. Abdominal D. renale infection in cats can resemble FIP. Eggs of D. renale are not always present in urine sediment and thus diagnosis may sometimes be made by ultrasound or exploratory laparotomy.
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  Human Health Significance: Although rare, zoonotic infections with D. renale have been reported and are associated with ingestion of larvae in undercooked fish or frogs.
Dracunculus insignis
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  Cause: Dracunculus insignis, a subcutaneous worm of raccoons and other carnivores that also infects dogs, is a spirurid nematode closely related to the human Guinea worm, Dracunculus medinensis.
- •
  First Described: Dracunculus spp. have been described since antiquity. Dracunculus medinensis was described by Linnaeus in 1758, and D. insignis by Leidy in 1858.
- •
  Affected Hosts: Most cases of D. insignis infection in domestic animals are reported in dogs, although ferrets are also susceptible; a limited number of cases have been described in cats. Wild carnivores, especially raccoons, are most commonly infected and considered the natural definitive host of this parasite in North America. Although primarily a human parasite, D. medinensis also readily infects dogs in endemic areas.
- •
  Geographic Distribution: Dracunculus insignis has only been reported from Canada and the United States. Due to concerted eradication efforts, D. medinensis is currently limited to three countries in Africa. Other Dracunculus spp. have been reported from mammals, snakes, and turtles in the Western Hemisphere and from snakes in Europe, Africa, Asia, and Australia.
- •
  Route of Transmission: Gravid female Dracunculus spp. migrate to the extremities of the definitive host and form subcutaneous cysts. The presence of the nematode induces the formation of blisters; when immersed in water, the uterus of the nematode ruptures, releasing hundreds of thousands of larvae into the water. The motile larvae are ingested by copepod intermediate hosts. After third-stage larvae develop, copepods are ingested by definitive hosts drinking water; the nematodes then migrate to subcutaneous locations, mature, mate, and eventually form new cysts to continue the life cycle. Alternatively, infected copepods may be ingested by aquatic vertebrates which can then serve as paratenic hosts.
- •
  Major Clinical Signs: Dogs with D. insignis present with fluctuant subcutaneous swellings, usually on a distal extremity or, less commonly, the thorax. Lesions are often pruritic and painful. The skin may appear ulcerated or bear a patent opening; when the affected limb is immersed in water, an adult nematode may emerge.
- •
  Differential Diagnoses: Other, more common causes of subcutaneous masses include lipoma, reactive lymph nodes, neoplasia, or other dermal parasites (e.g., Cuterebra, Dirofilaria repens). However, the distinct location on a distal extremity and, when present, the appearance of a patent ulcer through which a nematode emerges, considerably narrows potential diagnoses. Specimen collection using fine-needle aspiration often leads to recovery of D. insignis larvae. Long female nematodes may be encountered during surgical exploration of the cystic lesion.
- •
  Human Health Significance: Human infection is most commonly by D. medinensis. Recent reports of D. medinensis in domestic dogs have created challenges in the final stages of eradication efforts for the human Guinea worm.
Ocular Nematodes
- •
  Cause: Onchocerca lupi and Thelazia spp. Aberrant migration has also resulted in other species of nematodes reported from the eye, including Dirofilaria spp., Dracunculus spp., and Toxocara spp.
- •
  First Described: Onchocerca lupi was first described in a feral wolf in Russia. Thelazia callipaeda was first described by Ralliet and Henry in 1910 and Thelazia californiensis by Price in 1930.
- •
  Affected Hosts: Onchocerca lupi is primarily a parasite of domestic dogs although feline onchocerciasis has been reported. Thelazia callipaeda and T. californiensis are described from dogs and cats with occasional reports from wildlife definitive hosts. Other Thelazia spp. infect the eyes of large animals.
- •
  Geographic Distribution: Ocular nematodes occur sporadically around the world, with O. lupi reported from northern Asia, southern and central Europe, and the southwestern United States; T. callipaeda from Asia and, more recently, Europe; and T. californiensis from western North America.
- •
  Route of Transmission: The life cycle of O. lupi is not fully understood, but other Onchocerca spp. are transmitted between definitive hosts by arthropod intermediate hosts, including black flies (Simulium spp.) and biting midges (Culicoides spp.). Thelazia spp. are transmitted by muscid flies feeding around the eyes.
- •
  Major Clinical Signs: Ocular lesions due to O. lupi and Thelazia spp. may be mild to severe although many animals appear largely subclinical. In the acute phase of O. lupi infection, general ocular discomfort is seen with excessive lacrimation and photophobia. In chronic infections, nodules develop on the sclera, conjunctiva, and eyelids. Infection with Thelazia spp. may be associated with chronic conjunctivitis but nodules are not present.
- •
  Differential Diagnoses: Many infectious, inflammatory, and traumatic conditions can cause ocular irritation and conjunctivitis. However, once nematodes are visualized coiled in inflammatory tissue on the conjunctiva (O. lupi) or free under the eyelids or nictitating membrane (Thelazia spp.), the diagnostic list of differentials is short. Other nematodes that occasionally migrate aberrantly to the eyes include Angiostrongylus vasorum, Dirofilaria spp., Dracunculs insignis, Toxocara spp., and Trichinella spiralis (eyelid).
- •
  Human Health Significance: Human infection with both O. lupi and Thelazia spp. occasionally occurs resulting in ocular irritation, excessive lacrimation, and the presence of intraocular nematodes.
Insights on Spirocerca lupi, the Carcinogenic Dog Nematode
2020, Trends in Parasitology
Citation Excerpt :
Mineralization of the scarred aortic wall causes increased rigidity with pockets of decreased resistance which form aneurysms [28]. Subsequently, blood clots that form in the aortic aneurysms can be released and lead to aortic iliac thromboembolism [29]. The rupture of aneurysms may cause rapid and fatal bleeding into the chest cavity (hemothorax) [32].
Spirocerca lupi is a nematode transmitted by dung beetles that infects domestic and wild canids in tropical and subtropical regions and is associated with neoplasia. It produces a distinctive pathology with the formation of esophageal nodules classified as inflammatory, preneoplastic, or neoplastic with metastasis to distant organs. Aberrant central nervous system migration of this nematode is also responsible for severe neurological manifestations. Reports of spirocercosis have increased over the last two decades showing spread of this canine helminth in five continents. S. lupi from different geographical locations is genetically distinct with two genotypes, genotype I from Africa, Asia, and Australia, and genotype II from Europe, and recently separated from Spirocerca vulpis, a new species described in red foxes from Europe.
Spirocercosis in dogs in Israel: A retrospective case-control study (2004-2009)
2015, Veterinary Parasitology
Citation Excerpt :
Aberrant spinal cord migration induces myelomalacia, leading to paraparesis or paraplegia (Dvir et al., 2007; Chai et al., 2008). Aortic aneurisms often result in in thromboembolism, and once ruptured hemothorax occurs (Ivoghli, 1977; Gal et al., 2005; Kirberger et al., 2013b). Spirocercosis is diagnosed based on the history, clinical signs, thoracic imaging, conventional and molecular coproscopy, esophagoscopy and necropsy (Brodey et al., 1977; Markovics and Medinski, 1996; Dvir et al., 2001; Traversa et al., 2007, 2008; Dvir et al., 2008; Ranen et al., 2008; Christie et al., 2011; Avner and Hertage, 2013; Kirberger et al., 2013a).
This case-control retrospective study (years 2004–2009) investigated the epidemiological, clinical, and diagnostic test findings of dogs with esophageal spirocercosis (ES) presented to the Hebrew University Veterinary Teaching Hospital (HUVTH) and coproscopy-positive dogs at the Kimron Veterinary Institute (KVI), Israel. It included 133 dogs with ES and 133 negative controls diagnosed at the hospital, and 343 dogs diagnosed at the KVI. The average incidence of ES at the HUVTH was 22.5/year, and the percentage of spirocercosis cases was stable at both institutions (HUVTH, 0.67–1.23%; KVI, 5–8%). Dogs aged >5 years old had 100-fold likelihood to be infected compared to dogs aged ≤1 year of age (P < 0.001). Mean body weight (P = 0.0004), proportion of Retrievers (P =0.002) and sporting breed dogs (P = 0.006) were higher, while proportion of toy breeds (P = 0.004) was lower in the ES group compared to the control group. The proportion of cases from Greater Tel-Aviv decreased (P = 0.002), while that of those from Judea and Jerusalem increased (P = 0.01) compared to the 1990s. Spirocercosis occurred in 22 dogs despite past prophylactic avermectin treatment. Vomiting and regurgitation were the most common clinical signs of ES. Coproscopy was S. lupi-positive in 33/60 dogs (55.0%). The median number of esophageal nodules was two (range 1-8), with a median diameter of 3.5 cm (range 1.0-11.0). Malignant esophageal lesion transformation was confirmed in 29 dogs (22%). Despite preventive attempts, spirocercosis has spread in Israel over time, compared to previous findings, raising questions about the efficacy of the currently accepted prophylactic protocol is incompletely effective.
Serum acute phase protein concentrations in dogs with spirocercosis and their association with esophageal neoplasia - A prospective cohort study
2014, Veterinary Parasitology
Citation Excerpt :
Spirocerca lupi, the dog esophageal worm, has a worldwide distribution, but is mostly endemic in tropical and subtropical areas (Mazaki-Tovi et al., 2002; van der Merwe et al., 2008). Spirocercosis has diverse clinical manifestations resulting from direct mechanical damage, inflammation, larval migration, and presence of adult worms in the esophageal wall (Schroeder and Berry, 1998; Dvir et al., 2001; Mazaki-Tovi et al., 2002; Gal et al., 2005; Mylonakis et al., 2006; van der Merwe et al., 2008). Aberrant nematode migration to various organs is less common, and leads to variable clinical presentations (van der Merwe et al., 2008).
Spirocerca lupi, the dog esophageal worm, typically induces formation of esophageal nodules, which may transform to sarcoma. Ante mortem discrimination between benign and malignant esophageal masses is challenging. Serum acute phase proteins (APPs) are utilized in diagnosis and prognosis of various canine diseases as markers of inflammation. This study characterized serum APPs concentrations in dogs with benign and malignant esophageal spirocercosis and evaluated their accuracy in differentiating benign from malignant lesions. Seventy-eight client-owned dogs with esophageal spirocercosis were included. Serum C-reactive protein (CRP), haptoglobin, serum-amyloid A (SAA) and albumin concentrations were measured upon diagnosis and follow-up visits, and compared with healthy dogs, and between malignant and benign cases. Haptoglobin, CRP and SAA concentrations were higher, and albumin concentration was lower (P < 0.001 for all) in infected dogs compared to healthy controls. Dogs with suspected neoplasia had significantly higher CRP (P = 0.011), haptoglobin (P = 0.008) and SAA (P = 0.05), and lower albumin (P = 0.012) concentrations compared to dogs with benign esophageal nodules. APPs moderately discriminated between suspected malignant and benign esophageal disease. None of the dogs with suspected neoplasia had concurrent normal concentrations of all APPs. The present results indicate that canine spirocercosis is characterized by an acute phase reaction, both at presentation and during treatment. When concentrations of all four APPs are within reference range, esophageal malignancy is highly unlikely. Although concentrations of all positive APPs were significantly higher in suspected neoplastic cases compared to benign ones, moderate discriminatory power limits their clinical use. Neither APP was useful to monitor response to treatment.
Spirocercosis in owned and stray dogs in Grenada
2012, Veterinary Parasitology
The aim of this retrospective study was to estimate the prevalence of Spirocerca lupi and its associated lesions in owned and stray dogs in Grenada. During 2001–2011 necropsies were carried out on 1022 owned and 450 stray dogs at the pathology diagnostic laboratory, School of Veterinary Medicine, St. George's University, Grenada. Lesions due to S. lupi characterized by focal to multifocal granulomatous esophagitis with aneurysms, mineralized plaques and nodules in the adjacent thoracic aorta were found in 90 (8.8%; 95% confidence interval, 7.1–10.5%) of owned dogs and 64 (14.2%; 95% CI, 11.2–17.6%) of stray dogs. Stray dogs were significantly more affected by spirocercosis than owned dogs (p = 0.0022). Of the 90 owned dogs with spirocercosis, 3 dogs had aberrant migration to the thoracic vertebral column with resultant spondylitis; 1 dog each had aberrant migration involving the stomach and the lung. Two dogs had ruptured aorta with hemothorax. Among the 64 stray dogs with spirocercosis, one dog had an esophageal granuloma that transformed into a fibroblastic osteosarcoma; spondylitis due to aberrant migration of S. lupi and hypertrophic osteopathy. We report spirocercosis for the first time in the dogs from a tropical island of Grenada.
Serum acute phase proteins in dogs with symptomatic esophageal spirocercosis
2012, Veterinary Parasitology
Citation Excerpt :
The clinical hallmark of the disease is esophageal dysphagia due to parasite-induced esophageal nodules, manifested usually with regurgitation, repeated attempts to swallow (odynophagia) and hypersalivation (Mazaki-Tovi et al., 2002; Mylonakis et al., 2006). Other conditions including esophageal sarcomas, aortic aneurysms and thromboembolism, thoracic discospondylitis or spondylosis, pyothorax, neurological disease due to aberrant spinal migration, hypertrophic osteopathy and sialadenosis have also been associated with CS (Fox et al., 1988; Gal et al., 2005; Van der Merwe et al., 2007; Ranen et al., 2004; Dvir et al., 2007, 2010; Du Plessis et al., 2007; Klainbart et al., 2007; Mylonakis et al., 2008). The clinical severity of CS and the treatment outcome vary depending on the extent (number and size) and nature (benign or malignant) of esophageal nodules as well as the coexistence of extra-esophageal conditions associated with CS (Van der Merwe et al., 2007).
Canine spirocercosis (CS) is a helminthic infection caused by the nematode Spirocerca lupi. The clinical hallmark of the disease is esophageal dysphagia due to parasite-induced esophageal nodules. Currently, there is limited information on the involvement of serum acute phase proteins (APPs) in the symptomatic CS. The objective of this study was to investigate whether C-reactive protein (CRP), serum amyloid A (SAA), haptoglobin (Hp) and albumin are involved in CS, and if their concentrations measured on admission reflect the severity of benign esophageal lesions. Nineteen dogs with spontaneous symptomatic esophageal spirocercosis and 7 clinically healthy dogs were studied retrospectively. The most consistently increased APP in the symptomatic dogs was Hp (95% of the dogs), followed by CRP (68%). The SAA concentrations were infrequently increased (5% of the dogs), while albumin concentrations were decreased in 58% of the affected dogs. The dogs with spirocercosis had significantly higher median concentrations of Hp (p = 0.0001) and CRP (p = 0.02) compared to healthy dogs. Median albumin concentrations did not differ between the two groups of dogs. The median concentrations of Hp, CRP and albumin did not differ significantly between the dogs having a single or multiple esophageal nodules. The results of this study indicate that in symptomatic CS, Hp and CRP are significantly and consistently increased, while SAA and albumin may be of limited value as diagnostic markers. No association was established between the concentrations of Hp, CRP and albumin measured on admission and the number of esophageal nodules.

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Veterinary Parasitology

Abstract

Introduction

Section snippets

Case history

Discussion

References (17)

Canine spirocercosis: clinical, diagnostic, pathologic, and epidemiologic characteristics

Vet. Parasitol.

Aortic and iliac thrombosis in six dogs

J. Small Anim. Pract.

Aortic thromboembolism as a complication of gastric dilatation/volvulus in a dog

J. Am. Vet. Med. Assoc.

Spirocercosis in dogs

Compend. Contin Educ. Pract. Vet.

CVT update: therapy for feline myocardial diseases

Contractile effects of 5-hydroxytryptamine in isolated intrapulmonary arteries and veins

Can J. Physiol. Pharmacol.

Spirocerca lupi infection in the dog: aberrant migration

J. Am. Anim. Hosp. Assoc.

Survey of the incidence, diagnosis, clinical manifestations and treatment of Spirocerca lupi in South Africa

J. S. Afr. Vet. Assoc.

Cited by (42)

Miscellaneous Nematode Infections

Insights on Spirocerca lupi, the Carcinogenic Dog Nematode

Spirocercosis in dogs in Israel: A retrospective case-control study (2004-2009)

Serum acute phase protein concentrations in dogs with spirocercosis and their association with esophageal neoplasia - A prospective cohort study

Spirocercosis in owned and stray dogs in Grenada

Serum acute phase proteins in dogs with symptomatic esophageal spirocercosis

Short communicationAortic thromboembolism associated with Spirocerca lupi infection

Abstract

Introduction

Section snippets

Case history

Discussion

Vet. Parasitol.

Aortic and iliac thrombosis in six dogs

J. Small Anim. Pract.

Aortic thromboembolism as a complication of gastric dilatation/volvulus in a dog

J. Am. Vet. Med. Assoc.

Spirocercosis in dogs

Compend. Contin Educ. Pract. Vet.

CVT update: therapy for feline myocardial diseases

Contractile effects of 5-hydroxytryptamine in isolated intrapulmonary arteries and veins

Can J. Physiol. Pharmacol.

Spirocerca lupi infection in the dog: aberrant migration

J. Am. Anim. Hosp. Assoc.

Survey of the incidence, diagnosis, clinical manifestations and treatment of Spirocerca lupi in South Africa

J. S. Afr. Vet. Assoc.

Short communication
Aortic thromboembolism associated with Spirocerca lupi infection