Short communicationAortic thromboembolism associated with Spirocerca 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).
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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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Miscellaneous Nematode Infections
2022, Greene's Infectious Diseases of the Dog and Cat, Fifth EditionInsights on Spirocerca lupi, the Carcinogenic Dog Nematode
2020, Trends in ParasitologyCitation 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].
Spirocercosis in dogs in Israel: A retrospective case-control study (2004-2009)
2015, Veterinary ParasitologyCitation 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).
Serum acute phase protein concentrations in dogs with spirocercosis and their association with esophageal neoplasia - A prospective cohort study
2014, Veterinary ParasitologyCitation 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).
Spirocercosis in owned and stray dogs in Grenada
2012, Veterinary ParasitologySerum acute phase proteins in dogs with symptomatic esophageal spirocercosis
2012, Veterinary ParasitologyCitation 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).