Lungworm: A roundtable discussion
Abstract
Lungworm (Angiostrongylus vasorum) is increasingly recognised as a cause of illness, particularly cardiorespiratory signs and haemorrhage, in dogs. It is now distributed across the UK, although prevalence varies widely and there are local foci of higher infection. Presentation of clinical cases varies considerably, and lungworm should be on many differential diagnosis lists. Diagnostic tests now include direct faecal smear, Baermann's, bronchoalveolar lavage, antibody and antigen ELISAs and PCR. Appropriate testing depends on the clinical situation, and no test is 100% sensitive and 100% specific. Treatment involves moxidectin or milbemycin oxime, plus supportive care. Tranexamic acid and plasma transfusions may both be useful in dogs showing coagulopathies. Dogs may be at risk from accidental ingestion of intermediate host slugs with grass, or larvae in puddles, as well as from deliberately eating slugs, so prevention relies heavily on monthly appropriate anthelmintics, and compliance is an issue in this. Other lungworm species also occur and should not be forgotten. In cats, the lungworm Aelurostrongylus abstrusus can cause severe, even fatal, infection and this is probably under-diagnosed. Monthly preventative treatment with a licensed product is recommended in cats that go outside.
This roundtable, held 16 January 2020, was sponsored by Bayer. The aim was to inform and guide discussions with pet owners regarding Angiostrongylus vasorum and other lungworms, and enable veterinary practices to provide appropriate preventative and treatment advice and care.
Angiostrongylus vasorum has been found with increasing frequency in the UK and across Europe, posing a growing threat to domestic dogs.
Previously, A. vasorum was regarded as confined to small pockets in West Cornwall (Truro area) and South Wales (Swansea area). However, by 2000 reports suggested that it had become established in south-east England. It has since been recorded in dogs in the Midlands and as far north as Glasgow, so that now it is perceived as a potential threat to domestic dogs throughout the UK mainland. But has this rapid spread been a real change, or is it an artefact caused by increased awareness of the parasite's biology, together with the availability of new tests?
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