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− | Also known as: '''heartworm disease
| + | [[Image:Dirofilaria immitus.jpg|thumb|right|250px|''Dirofilaria immitis'' - Courtesy of the Laboratory of Parasitology, University of Pennsylvania School of Veterinary Medicine]] |
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− | Do not confuse with: ''[[Angiostrongylus vasorum]]'', [[angiostrongylosis]].
| + | Also known as: '''Heartworm Disease — Dirofilariasis |
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| + | Beware confusing with: ''[[Angiostrongylus vasorum]]'', [[angiostrongylosis]]. |
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| ==Introduction== | | ==Introduction== |
− | [[Image:Dirofilaria immitus.jpg|thumb|right|200px|''Dirofilaria immitus'' - Courtesy of the Laboratory of Parasitology, University of Pennsylvania School of Veterinary Medicine]]
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| ''Dirofilaria immitis'' is a nematode parasite that causes heartworm disease in dogs, cats and ferrets. Heartworm disease is transmitted by [[Culicidae|mosquito]] bites and there are more than 70 species of mosquito that are able to transmit infection; ''Aedes, Anopheles'' and ''Culex'' are the most common vector species. Heartworm disease has been reported in many countries with temperate climate and is particularly prevalent in the USA, Canada, and southern Europe. The introduction of the PETS travel scheme has increased the concern over Dirofilariasis in the UK. | | ''Dirofilaria immitis'' is a nematode parasite that causes heartworm disease in dogs, cats and ferrets. Heartworm disease is transmitted by [[Culicidae|mosquito]] bites and there are more than 70 species of mosquito that are able to transmit infection; ''Aedes, Anopheles'' and ''Culex'' are the most common vector species. Heartworm disease has been reported in many countries with temperate climate and is particularly prevalent in the USA, Canada, and southern Europe. The introduction of the PETS travel scheme has increased the concern over Dirofilariasis in the UK. |
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| ==Pathogenesis== | | ==Pathogenesis== |
− | Heartworm disease primarily affects the cardiopulmonary system and the severity and extent of lesions depends on several factors. These include the number and location of adult worms<sup>1, 2</sup>, the duration of infection, and the level of activity of the host<sup>1</sup>. Parasites in the pulmonary arteries cause mechanical irritation, leading to endothelial damage, proliferation of the intima and perivascular cuffing with inflammatory cells. This results in narrowing and occlusion of the vessels which in turn causes pulmonary hypertension. A combination of pulmonary hypertension and inflammatory mediators can lead to in an increase in the permeability of pulmonary vessels, giving periarterial oedema and intersitial and alveolar infiltrates. Eventually, irreversible interstitial fibrosis arises. | + | Heartworm disease primarily affects the cardiopulmonary system and the severity and extent of lesions depends on several factors. These include the number and location of adult worms<sup>1, 2</sup>, the duration of infection, and the level of activity of the host<sup>1</sup>. Parasites in the pulmonary arteries cause mechanical irritation, leading to endothelial damage, proliferation of the intima and perivascular cuffing with inflammatory cells. This results in narrowing and occlusion of the vessels which in turn causes pulmonary hypertension. A combination of pulmonary hypertension and inflammatory mediators can lead to an increase in the permeability of pulmonary vessels, giving periarterial oedema and intersitial and alveolar infiltrates. Eventually, irreversible interstitial fibrosis arises. |
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| Sequelae to heartworm infection include pulmonary thromboembolism, which can either occur due to the death and metastasis of adult worms, or due to platelet aggregation induced by the parasite. In severe cases, live nematodes can migrate to the right ventricle, right atrium and caudal vena cava. The resulting incompetence of the tricuspid valve, augmented by concurrent pulmonary hypertension, leads to signs of right-sided heart failure. Flow of erythrocytes through the mass of parasites formed can also cause haemolysis and thus haemoglobinaemia. This combination of acute right-sided heart failure and intravascular haemolysis is referred to as "caval syndrome", which in severe cases can also be characterised by thromboembolic events and [[Disseminated Intravascular Coagulation|disseminated intravascular coagulation]]. Due to the smaller numbers of adult worms, caval syndrome is less common in cats<sup>2</sup>. | | Sequelae to heartworm infection include pulmonary thromboembolism, which can either occur due to the death and metastasis of adult worms, or due to platelet aggregation induced by the parasite. In severe cases, live nematodes can migrate to the right ventricle, right atrium and caudal vena cava. The resulting incompetence of the tricuspid valve, augmented by concurrent pulmonary hypertension, leads to signs of right-sided heart failure. Flow of erythrocytes through the mass of parasites formed can also cause haemolysis and thus haemoglobinaemia. This combination of acute right-sided heart failure and intravascular haemolysis is referred to as "caval syndrome", which in severe cases can also be characterised by thromboembolic events and [[Disseminated Intravascular Coagulation|disseminated intravascular coagulation]]. Due to the smaller numbers of adult worms, caval syndrome is less common in cats<sup>2</sup>. |
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− | '''Caval syndrome''' is a very severe form of heartworm disease that can occur in dogs and cats. It is characterised by respiratory distress, signs of right-sided heart failuer, intravascular haemolysis and haemoglobinuria. Disseminated intravascular coagulation frequently occurs, and the syndrome is often fatal. | + | '''Caval syndrome''' is a very severe form of heartworm disease that can occur in dogs and cats. It is characterised by respiratory distress, signs of right-sided heart failure, intravascular haemolysis and haemoglobinuria. Disseminated intravascular coagulation frequently occurs, and the syndrome is often fatal. |
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| In cats, most infections are asymptomatic. However, sudden death can occasionally occur. This may be preceded by an acute respiratory crisis, thought to be due to parasitic thromboembolism and obstruction of a major pulmonary artery<sup>1, 2</sup>. When clinical signs are less acute, they are vague and may include anorexia, weight loss and lethargy. Intermittent coughing and dyspnoea can appear similar to feline asthma. Syncope may also occur, and cats may vomit. The cause of this vomiting is undetermined<sup>3</sup>. | | In cats, most infections are asymptomatic. However, sudden death can occasionally occur. This may be preceded by an acute respiratory crisis, thought to be due to parasitic thromboembolism and obstruction of a major pulmonary artery<sup>1, 2</sup>. When clinical signs are less acute, they are vague and may include anorexia, weight loss and lethargy. Intermittent coughing and dyspnoea can appear similar to feline asthma. Syncope may also occur, and cats may vomit. The cause of this vomiting is undetermined<sup>3</sup>. |
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| In mildly symptomatic or asymptomatic animals, the course of dirofilariasis is usually uneventful following treatment and the prognosis is excellent<sup>3</sup>. Animals with severe infection carry a guarded prognosis with a higher risk of complications. | | In mildly symptomatic or asymptomatic animals, the course of dirofilariasis is usually uneventful following treatment and the prognosis is excellent<sup>3</sup>. Animals with severe infection carry a guarded prognosis with a higher risk of complications. |
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− | ==Literature Search== | + | {{Learning |
− | [[File:CABI logo.jpg|left|90px]] | + | |literature search = [http://www.cabdirect.org/search.html?rowId=1&options1=AND&q1=%22Dirofilaria+immitis%22&occuring1=title&rowId=2&options2=AND&q2=&occuring2=freetext&rowId=3&options3=AND&q3=&occuring3=freetext&x=21&y=6&publishedstart=2000&publishedend=yyyy&calendarInput=yyyy-mm-dd&la=any&it=any&show=all Dirofilaria immitis publications since 2000] |
| + | |full text = [http://www.cabi.org/cabdirect/FullTextPDF/2010/20103181752.pdf '''A review of American heartworm society guidelines for the management of heartworm infections in cats.''' Guerrero, J.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Orlando, Florida, USA, 16-20 January 2010, 2010, pp 1173-1176, 1 ref.] |
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| + | [http://www.cabi.org/cabdirect/FullTextPDF/2008/20083097550.pdf '''Epidemiology and prevention of ''Dirofilaria'' infections in dogs and cats.''' Genchi, C.; Guerrero, J.; McCall, J. W.; Venco, L.; Veterinary Parasitology and Parasitic Diseases, Naples, Italy, Mappe Parassitologiche, 2007, 8, pp 145-161, many ref.] |
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| + | [http://www.cabi.org/cabdirect/FullTextPDF/2006/20063226177.pdf ''' Heartworm of dog - its aetiopathogenesis, diagnosis, treatment and prevention.''' Kundu, P.; Intas Pharmaceuticals Ltd, Ahmedabad, India, Intas Polivet, 2006, 7, 1, pp 106-110, 16 ref.] |
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| + | [http://www.cabi.org/cabdirect/FullTextPDF/2005/20053201370.pdf ''' The utility of echocardiography in the diagnosis of feline heartworm disease: a review of published reports.''' Defrancesco, T. C.; Atkins, C. E.; Seward, R. L.; Knight, D. H.; American Heartworm Society, Batavia, USA, Recent advances in heartworm disease: Symposium '98, Tampa, Florida, USA, 1-3 May, 1998, 1998, pp 103-106, 20 ref.] |
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| + | |Vetstream = [https://www.vetstream.com/canis/search?s=nematode Nematodes] |
| + | }} |
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− | Use these links to find recent scientific publications via CAB Abstracts (log in required unless accessing from a subscribing organisation).
| + | {{Chapter}} |
− | <br><br><br>
| + | {{Mansonchapter |
− | [http://www.cabdirect.org/search.html?rowId=1&options1=AND&q1=%22Dirofilaria+immitis%22&occuring1=title&rowId=2&options2=AND&q2=&occuring2=freetext&rowId=3&options3=AND&q3=&occuring3=freetext&x=21&y=6&publishedstart=2000&publishedend=yyyy&calendarInput=yyyy-mm-dd&la=any&it=any&show=all Dirofilaria immitis publications since 2000]
| + | |chapterlink = http://www.mansonpublishing.co.uk/book-images/9781840760576_sample.pdf |
| + | |chaptername = Cardiopulmonary Dirofilariasis |
| + | |book = Arthropod-borne Infectious Diseases of the Dog and Cat |
| + | |author = Susan E. Shaw, Michael J. Day |
| + | |isbn = 9781840760576 |
| + | }} |
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| ==Links== | | ==Links== |
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| #Venco, L (2007) Heartworm (Dirofilaria immitis) disease in cats. ''Dirofilaria immitis and D. repens in dog and cat and human infections'', 126-132. | | #Venco, L (2007) Heartworm (Dirofilaria immitis) disease in cats. ''Dirofilaria immitis and D. repens in dog and cat and human infections'', 126-132. |
| #Ridyard, A (2005) Heartworm and lungworm in dogs and cats in the UK, ''In Practice'', '''27(3)''', 147-153. | | #Ridyard, A (2005) Heartworm and lungworm in dogs and cats in the UK, ''In Practice'', '''27(3)''', 147-153. |
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| + | {{review}} |
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| + | ==Webinars== |
| + | <rss max="10" highlight="none">https://www.thewebinarvet.com/parasitology/webinars/feed</rss> |
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| [[Category:Filarioidea]] | | [[Category:Filarioidea]] |
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| [[Category:Cat_Nematodes]] | | [[Category:Cat_Nematodes]] |
| [[Category:Zoonoses]] | | [[Category:Zoonoses]] |
| + | [[Category:Cardiovascular Diseases - Dog]] |
| + | [[Category:Cardiovascular Diseases - Cat]] |
| + | [[Category:Respiratory Parasitic Infections]] |
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− | [[Category:Respiratory Parasitic Infections]] | + | [[Category:Expert_Review]] |
− | [[Category:To_Do_-_Lizzie]] | + | [[Category:Cardiology Section]] |
− | [[Category:To_Do_-_Review]]
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