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In both dogs and cats, routine haematology, biochemistry and urinalysis should be performed. Most parameters are usually within normal limits, but an anaemia can often be seen. Eosinophilia and basophilia are also common, and when seen together suggests occult dirofilariasis or allergic lung disease <sup>1, 3</sup>. Eosinophilia peaks as L5 enter the pulmonary arteries and subsequently varies. An inflammatory leukogram is also possible<sup>3</sup>. Hyperglobulinemia due to antigenic stimulation is an inconsistent finding<sup>1, 3</sup>. Right-sided heart failure or immune-complex glomerulonephritis can lead to hypoalbuminaemia and, very occasionally, nephrotic syndrome<sup>1</sup>. Because of this, it is possible for urinalysis to reveal proteiunuria<sup>1, 3</sup>. Haemoglobinaemia and haemoglobinuria are associated with caval syndrome<sup>3</sup>.  
 
In both dogs and cats, routine haematology, biochemistry and urinalysis should be performed. Most parameters are usually within normal limits, but an anaemia can often be seen. Eosinophilia and basophilia are also common, and when seen together suggests occult dirofilariasis or allergic lung disease <sup>1, 3</sup>. Eosinophilia peaks as L5 enter the pulmonary arteries and subsequently varies. An inflammatory leukogram is also possible<sup>3</sup>. Hyperglobulinemia due to antigenic stimulation is an inconsistent finding<sup>1, 3</sup>. Right-sided heart failure or immune-complex glomerulonephritis can lead to hypoalbuminaemia and, very occasionally, nephrotic syndrome<sup>1</sup>. Because of this, it is possible for urinalysis to reveal proteiunuria<sup>1, 3</sup>. Haemoglobinaemia and haemoglobinuria are associated with caval syndrome<sup>3</sup>.  
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Direct microscopic examination
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There are several methods for the specific demonstration of ''Dirofilaria immitis'' in the animal. Firstly, direct microscopic examination allows rapid identification microfilariae in a drop of fresh blood as their movements can vigorously displace the surrounding red blood cells<sup>2</sup>. Despite being quick, simple and inexpensive, this test is not sufficiently sensitive to provide a definitive diagnosis, particularly when there is a low concentration of microfilariae in the bloodstream. Filtration methods therefore exist to facilitate the microscopic demonstration of microfilariae. These include the modified Knott's test, which involves haemolysis, centrifugation and staining with methylene blue before direct examination. Tests such as this are more
If present, microfilariae can be easily identified on direct
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sensitive than merely examining a drop of blood, and the morphology of microfilariae can be clearly seen. However, cats frequently lack circulating microfilariae, and so direct micrscopic examination is of little use in this species.
microscopic examination of a drop of fresh blood
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because they can vigorously move the surrounding red
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blood cells. However, although this method offers an
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easy and inexpensive diagnosis, it is not sufficiently sensitive,
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especially when there is a low concentration of
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microfilariae in the bloodstream. Filtration methods (eg,
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Difil-test; EVSCO Pharmaceuticals, Buena, New Jersey,USA) and the modified Knott's test (haemolysis, centrifugation
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and staining with methylene blue) are more
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sensitive and allow morphological examination of the
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microfilariae. In cats, given the absence or short-term
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presence of circulating microfilariae, these tests have
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little practical value.
   
Antigen tests
 
Antigen tests
 
ELISA antigen tests detect specific circulating proteins
 
ELISA antigen tests detect specific circulating proteins
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results because of the low antigen levels in the circulating
 
results because of the low antigen levels in the circulating
 
blood.
 
blood.
Antibody tests
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Antibody tests are currently available for routine screening
 
Antibody tests are currently available for routine screening
 
of feline heartworm infection, either as in-house or
 
of feline heartworm infection, either as in-house or
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in unconventional hosts. However, at present, these tests
 
in unconventional hosts. However, at present, these tests
 
are not widely available.
 
are not widely available.
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he antigen detection test is the preferred diagnostic method for asymptomatic dogs or when seeking verification of a suspected HW infection. This is the most sensitive diagnostic method available to veterinary practitioners. Even in areas where the prevalence of HW infection is high, ~20% of infected dogs may not be microfilaremic. Also, monthly macrolide prophylaxis induces embryo stasis in female dirofilariae.
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Available antigen detection tests are very sensitive and specific. To determine when testing might become useful, it is advisable to add a predetection period to the approximate date on which infection may have been possible. A reasonable interval is 7 mo. There is generally no need to test a dog for antigen or microfilariae prior to ~7 mo of age. The level of antigenemia is directly related to the number of mature female worms present. At least 90% of dogs harboring ≥3 adult females will test positive. In general, strong-quick positive reactions correlate with relatively high worm burdens. For low-burden suspects, commercial laboratory-based microwell titer tests are the most sensitive.
      
===Pathology===
 
===Pathology===
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