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Lungworms

Advocate®: Effective Against Lungworms

Canine angiostrongylosis is an emerging disease with increasing numbers of diagnosed cases in dogs and other canids. It is caused by Angiostrongylus vasorum which belongs to the family of Angiostrongylidae. First discovered in France, it is also called French heartworm. Since its discovery A. vasorum has been found in many countries all over Europe, Africa and the Americas. Advocate® is newly registered in Europe for the treatment of Angiostrongylus vasorum in dogs.

Life Cycle and Development Stages of Angiostrongylus Vasorum

  1. Various snails act as an intermediate host. Infective larvae develop here (L3).
  2. The fox is a natural host of Angiostrongylus vasorum, but dogs can be infected too.
  3. Larvae (L3–L4–L5) migrate via the alimentary tract, abdominal lymph nodes, liver, venous system and right heart into the pulmonary artery.
  4. Mature Angiostrongylus vasorum in the pulmo na ry artery (top female, bottom male).
  5. Mature worms lay eggs which enter the lung via the bloodstream.
  6. Tissue nodules a consisting of cellular infiltrate filled with larvae and eggs develop in the lung. Bronchiole b Arteriole c
  7. Larvae (L1) develop inside the eggs in the capillaries d, hatch e and move into the alveolus f. They are transported up the airway to the larynx and then swallowed.
  8. Larvae (L1) enter the ground through faeces.

Clinical Cases of Angiostrongylosis become more prevalent

Canine angiostrongylosis is an emerging disease with increasing numbers of diagnosed cases in dogs and other canids.
It is caused by Angiostrongylus vasorum which belongs to the family of Angiostrongylidae. First discovered in France, it is also called French heartworm. Since its discovery A. vasorum has been found in many countries all over Europe, Africa and the Americas.

This endoparasite has been recognized in endemic pockets in many countries with temperate climates. Recently the parasite has appeared in several new geographical areas and is becoming increasingly important in clinical practice.
A. vasorum is a metastrongylid nematode living in the pulmonary artery, mainly causing pulmonary and cardiac diseases – in rare cases even sudden death. Infections tend to be chronic (months to years).

Dogs of any age can be infected. Clinical diseases are most common in younger dogs of less than 2 years of age. Advocate is newly registered in Europe for the treatment of Angiostrongylus vasorum in dogs.


Fig. 1: Angiostrongylus vasorum male, posterior end

Fig. 2: Angiostrongylus vasorum anterior end

Angiostrongylosis: Difficult diagnosis, easy treatment

Angiostrongylosis is a crucial differential diagnosis in any dog with respiratory, bleeding, neurological or syncopal signs of unknown etiology.
Coughing, dyspnoea, coagulopathy, weight loss, vomiting, abdominal pain, lumbar pain, heart failure, bleeding diathesis can be symptoms of angiostrongylosis. A precise diagnosis is difficult (Baermann technique) and often not performed. Due to these drawbacks the prevalence of Angiostrongylus seems to be underestimated.

Advocate was recently registered for treatment of Angiostrongylus vasorum in dogs in Europe. A recently published efficacy study showed an efficacy of 85.2% for Advocate and 91.3% for fenbendazole, with no statistically significant difference between them. All dogs still positive on Baermann testing which then received a further dose of Advocate were subsequently found to be Baermann negative, thus the efficacy in dogs receiving a second dose of Advocate was 100%1 and larval shedding was reduced in the remaining patients.

The above mentioned study demonstrated that Advocate® is safe and yields an excellent prognosis for recovering from the infection. The application of Advocate® also leads to a significant improvement of the clinical signs.

References

  1. Willesen JL, Kristensen AT, Jensen AL, Heine J, Koch J. Efficacy and safety of imidacloprid/ moxidectin spot-on solution and fenbendazole in the treatment of dogs naturally infected with Angiostrongylus vasorum. Veterinary Parasitology 147 (2007): S. 258–264. Coagulopathy, a common complication associated with Angiostrongylus vasorum infection
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Last changed: 19.11.2008