{"id":1151,"date":"2014-05-01T16:50:25","date_gmt":"2014-05-01T16:50:25","guid":{"rendered":"http:\/\/phosdev.com\/todaysveterinarypractice\/?p=1151"},"modified":"2022-02-16T15:59:04","modified_gmt":"2022-02-16T15:59:04","slug":"parasite-protocols-canine-pulmonary-helminths-2","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/","title":{"rendered":"Canine Pulmonary Helminths: Recommendations from the Companion Animal Parasite Council"},"content":{"rendered":"<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2016\/06\/T1405C06.pdf\"><img decoding=\"async\" class=\"alignnone size-full wp-image-9886\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2011\/07\/pdf_button.png\" alt=\"pdf_button\" width=\"110\" height=\"27\" \/><\/a><\/p>\n<hr \/>\n<p><em>Dwight D. Bowman, MS, PhD, Diplomate ACVM (Parasitology, Hon), <\/em><br \/>\n<em>Cornell University<\/em><\/p>\n<p><em>Susan E. Little, DVM, PhD, Diplomate ACVM (Parasitology), <\/em><br \/>\n<em>Oklahoma State University<\/em><\/p>\n<p>Pulmonary helminths can cause severe, life-threatening respiratory disease in dogs. Distribution, life cycle, diagnosis, and treatment of common species are discussed.<\/p>\n<hr \/>\n<div class=\"orange-box\">\n<p>The mission of the <strong>Companion Animal Parasite Council (CAPC)<\/strong> is to foster animal and human health, while preserving the human\u2013animal bond, through recommendations for the diagnosis, treatment, prevention, and control of parasitic infections. For more information, including detailed parasite control recommendations, please visit <a href=\"http:\/\/capcvet.org\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>capcvet.org<\/strong><\/a>.<\/p>\n<\/div>\n<p class=\"drop-cap\"><span class=\"x01-garamond-9-5\">Helminth parasites are regularly diagnosed in dogs in the U.S. Those in dogs typically fall into 1 of 2 categories:\u00a0<\/span><span class=\"garamond-bold\">intestinal helminths<\/span><span class=\"x01-garamond-9-5\">\u00a0or\u00a0<\/span><span class=\"garamond-bold\">pulmonary helminths<\/span><span class=\"x01-garamond-9-5\">. Canine intestinal helminths were discussed in this column in the January\/February 2014 issue, available at tvpjournal.com; this article will address canine pulmonary helminths.\u00a0<\/span><\/p>\n<h2 class=\"left-justified\"><span class=\"greenheader\">PULMONARY HELMINTHS<\/span><\/h2>\n<p class=\"left-justified\"><span class=\"x01-garamond-9-5\">A surprisingly wide variety of helminths damage the pulmonary system of dogs and, at times, can cause severe, life-threatening respiratory disease (<\/span><strong><span class=\"garamond-bold\">Table 1<\/span><\/strong><span class=\"x01-garamond-9-5\">).\u00a0<\/span><\/p>\n<p class=\"left-justified\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Screen-Shot-2015-06-18-at-10.10.54-AM.png\"><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-full wp-image-4680\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Screen-Shot-2015-06-18-at-10.10.54-AM.png\" alt=\"Screen Shot 2015-06-18 at 10.10.54 AM\" width=\"566\" height=\"391\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Screen-Shot-2015-06-18-at-10.10.54-AM.png 566w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Screen-Shot-2015-06-18-at-10.10.54-AM-300x207.png 300w\" sizes=\"(max-width: 566px) 100vw, 566px\" \/><\/a><\/p>\n<ul>\n<li><span class=\"x01-garamond-9-5\"><em>Dirofilaria immitis<\/em> (heartworm) is by far the most important parasite of the canine pulmonary system, inducing severe morbidity and, in some cases, mortality.<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\"><em>Toxocara canis<\/em> and <em>Ancylostoma caninum<\/em> are intestinal nematodes that migrate through the lungs as larvae.\u00a0<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\"><em>Paragonimus kellicotti<\/em> is a trematode that develops in cysts in the lung parenchyma.<sup>1<\/sup><\/span><\/li>\n<li><span class=\"x01-garamond-9-5\"><em>Angiostrongylus vasorum<\/em>, the French heartworm, and the lungworms <em>Crenosoma vulpis<\/em>, <em>Eucoleus aerophilus<\/em>, and <em>Filaroides<\/em> species also create pathology in canine lungs.<\/span><\/li>\n<\/ul>\n<p class=\"indent-125\"><span class=\"x01-garamond-9-5\">While less familiar than heartworm, infection with these other pulmonary helminths can be very important in some canine patients. This article outlines how dogs become infected and describes appropriate treatment courses to manage the infections.<\/span><\/p>\n<h3 class=\"left-justified\"><span class=\"Gold\"><em>Angiostrongylus vasorum<\/em><\/span><\/h3>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Distribution<\/strong>.<\/span><span class=\"x01-garamond-9-5\">\u00a0Once considered exotic to North America,\u00a0<\/span><em><span class=\"garamon-italics\">A vasorum<\/span><\/em><span class=\"x01-garamond-9-5\">, commonly known as the French heartworm, has in recent years been found in foxes and dogs in the Atlantic provinces of Canada as well as in the U.S.<sup>2<\/sup><\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Life Cycle<\/strong>.<\/span><span class=\"x01-garamond-9-5\">\u00a0Dogs acquire infection when they eat infected gastropod intermediate hosts (snails or slugs) or frog paratenic hosts. Upon ingestion, larvae first develop in abdominal lymph nodes before entering the portal circulation and moving to the pulmonary arteries and right ventricle. Once in the lungs, the nematodes mature to adults (<\/span><strong><span class=\"garamond-bold\">Figure 1<\/span><\/strong><span class=\"x01-garamond-9-5\">), mate, and produce eggs that lodge and develop in pulmonary capillaries. Larvae that hatch from the eggs move into an airspace; then are coughed up, swallowed, and passed in the feces. Snails and slugs feeding on the feces ingest the larvae and perpetuate the life cycle.<sup>3<\/sup><\/span><\/p>\n<div id=\"attachment_4681\" style=\"width: 283px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-1.jpg\"><img decoding=\"async\" aria-describedby=\"caption-attachment-4681\" class=\"wp-image-4681\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-1.jpg\" alt=\"Figure 1\" width=\"273\" height=\"273\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-1.jpg 750w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-1-300x300.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-1-150x150.jpg 150w\" sizes=\"(max-width: 273px) 100vw, 273px\" \/><\/a><p id=\"caption-attachment-4681\" class=\"wp-caption-text\">Figure 1. Three adult female <em>Angiostrongylus vasorum<\/em>, showing the \u201cbarber pole\u201d appearance caused by the reproductive tract wrapping around the intestinal tract of the worm.<\/p><\/div>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Clinical Signs<\/strong>.\u00a0<\/span><span class=\"x01-garamond-9-5\">Infection with\u00a0<\/span><em><span class=\"garamon-italics\">A vasorum<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>produces disease similar to that caused by\u00a0<\/span><em><span class=\"garamon-italics\">D immitis<\/span><\/em><span class=\"x01-garamond-9-5\">: chronic cough, dyspnea, exercise intolerance, and anorexia.\u00a0<\/span><\/p>\n<ul>\n<li><span class=\"x01-garamond-9-5\">Gagging and weight loss are the most common clinical signs reported.\u00a0<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Pulmonary hemorrhage can occur as larvae migrate into airspaces.\u00a0<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Granulomas develop in response to eggs and larvae, and pulmonary fibrosis occurs.<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Pulmonary vascular lesions include thromboarteritis and intimal proliferation; pulmonary hypertension can lead to congestive right heart failure.<sup>4<\/sup><\/span><\/li>\n<\/ul>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Diagnosis<\/strong>.\u00a0<\/span><span class=\"x01-garamond-9-5\">Larvae can be detected in feces using the Baermann technique or fecal flotation, and are identified by the characteristic kink at the tip of the tail (<\/span><strong><span class=\"garamond-bold\">Figure 2<\/span><\/strong><span class=\"x01-garamond-9-5\">). Radiographic changes associated with\u00a0<\/span><em><span class=\"garamon-italics\">A vasorum<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>infection include:<\/span><\/p>\n<ul>\n<li class=\"left-justified\"><span class=\"x01-garamond-9-5\">Diffuse peribronchial, interstitial, and alveolar densities<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Enlargement of the right heart and pulmonary artery.<\/span><\/li>\n<\/ul>\n<div id=\"attachment_4682\" style=\"width: 351px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-2.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4682\" class=\"wp-image-4682\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-2.jpg\" alt=\"Figure 2\" width=\"341\" height=\"180\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-2.jpg 750w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-2-300x158.jpg 300w\" sizes=\"(max-width: 341px) 100vw, 341px\" \/><\/a><p id=\"caption-attachment-4682\" class=\"wp-caption-text\">Figure 2. Posterior end of tail of first-stage <em>Angiostrongylus vasorum<\/em> larva in feces, demonstrating the tail kink just posterior to the tip.<\/p><\/div>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Treatment<\/strong>\u00a0(<strong>Table 2<\/strong>).\u00a0<\/span><span class=\"x01-garamond-9-5\">Infections have been treated with several different types of anthelmintics:<\/span><\/p>\n<ul>\n<li><span class=\"x01-garamond-9-5\">Albendazole or fenbendazole<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Ivermectin\u00a0<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Levamisole<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Moxidectin.<\/span><\/li>\n<\/ul>\n<p class=\"indent-125\"><span class=\"x01-garamond-9-5\">Severe dyspnea and ascites may be seen after treatment; bronchodilators, expectorants, and diuretics may be required to manage these post-treatment reactions.<\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Prevention<\/strong>.\u00a0<\/span><span class=\"x01-garamond-9-5\">Routine administration of topical moxidectin has been shown to protect dogs from infection with this parasite.<sup>5<\/sup>\u00a0Dogs can also be protected by minimizing opportunities to consume snails, slugs, and frogs.<\/span><\/p>\n<p class=\"left-justified\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Screen-Shot-2015-06-18-at-10.12.50-AM.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-4679\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Screen-Shot-2015-06-18-at-10.12.50-AM.png\" alt=\"Screen Shot 2015-06-18 at 10.12.50 AM\" width=\"564\" height=\"593\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Screen-Shot-2015-06-18-at-10.12.50-AM.png 564w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Screen-Shot-2015-06-18-at-10.12.50-AM-285x300.png 285w\" sizes=\"(max-width: 564px) 100vw, 564px\" \/><\/a><\/p>\n<h3 class=\"left-justified\"><span class=\"Gold\"><em>Crenosoma vulpis<\/em><\/span><\/h3>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Distribution<\/strong>.<\/span><span class=\"x01-garamond-9-5\">\u00a0This lungworm of foxes and other wild canidae is most common in the northeastern U.S. and the eastern part of Canada.<sup>6<\/sup><\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Life Cycle<\/strong>.\u00a0<\/span><span class=\"x01-garamond-9-5\">Dogs become infected when, like foxes, they ingest the snail or slug intermediate host. The nematodes migrate to the lungs and develop into adults, moving from the smaller bronchioles to the larger bronchi as they mature.<\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Clinical Signs<\/strong>.<\/span><span class=\"x01-garamond-9-5\">\u00a0Infections may be asymptomatic or can induce bronchitis and bronchiolitis, resulting in chronic cough.<sup>7<\/sup><\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Diagnosis<\/strong>.\u00a0<\/span><span class=\"x01-garamond-9-5\">Infection with\u00a0<\/span><em><span class=\"garamon-italics\">C vulpis<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>is confirmed by identifying characteristic larvae with a conical head and conical, tapering tail (<\/span><strong><span class=\"garamond-bold\">Figure 3<\/span><\/strong><span class=\"x01-garamond-9-5\">) in the feces, or finding the worms in the bronchi at necropsy.<\/span><\/p>\n<div id=\"attachment_4683\" style=\"width: 425px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-3.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4683\" class=\"wp-image-4683\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-3.jpg\" alt=\"Figure 3\" width=\"415\" height=\"243\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-3.jpg 750w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-3-300x176.jpg 300w\" sizes=\"(max-width: 415px) 100vw, 415px\" \/><\/a><p id=\"caption-attachment-4683\" class=\"wp-caption-text\">Figure 3. Posterior end of tail of first-stage <em>Crenosoma vulpis<\/em> larva in feces, demonstrating the conical, tapering tail.<\/p><\/div>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Treatment<\/strong>\u00a0(<strong>Table 2<\/strong>).\u00a0<\/span><span class=\"x01-garamond-9-5\">Successful treatments described in the literature include fenbendazole, ivermectin, and febantel. More recently, excellent results have been obtained using:<\/span><\/p>\n<ul>\n<li><span class=\"x01-garamond-9-5\">Milbemycin oxime at 0.5 mg\/kg PO single dose\u00a0<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Topical application of 10% moxidectin, single dose.<sup>8,9<\/sup><\/span><\/li>\n<\/ul>\n<p class=\"left-justified\"><span class=\"garamond-bold\">Prevention.<\/span><span class=\"x01-garamond-9-5\">\u00a0Routine use of monthly parasite control products containing milbemycin oxime or moxidectin are expected to prevent establishment of future infections.<\/span><\/p>\n<h3 class=\"left-justified\"><span class=\"Gold\"><em>Eucoleus aerophilus<\/em><\/span><\/h3>\n<p class=\"indent-125\"><span class=\"garamond-bold\"><strong>Distribution<\/strong>.\u00a0<\/span><span class=\"x01-garamond-9-5\">Infection with\u00a0<\/span><em><span class=\"garamon-italics\">E aerophilus<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>is seen wherever dogs and cats are found, although foxes are considered an important reservoir host.<sup>10<\/sup><\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Life Cycle<\/strong>.<\/span><span class=\"x01-garamond-9-5\">\u00a0Eggs are shed in the sputum or feces, and embryonate in 30 to 50 days. Larvae are released when eggs or earthworm paratenic hosts are ingested and migrate by the bloodstream to the lungs. The larvae then penetrate the alveoli and migrate up the air passages as they develop. They reach maturity in the epithelium of the bronchioles, bronchi, and trachea, threading their thin bodies through the epithelial surface.<sup>1<\/sup><\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Clinical Signs<\/strong>.\u00a0<\/span><span class=\"x01-garamond-9-5\">Most infections with\u00a0<\/span><em><span class=\"garamon-italics\">E aerophilus<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>are clinically inapparent. If large numbers of nematodes are present, dogs may develop tracheitis, bronchitis and, sometimes, pneumonia,<sup>11<\/sup>\u00a0which can cause:\u00a0<\/span><\/p>\n<ul>\n<li><span class=\"x01-garamond-9-5\">Anorexia<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Cough<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Debilitation<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Dyspnea<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Nasal discharge.\u00a0<\/span><\/li>\n<\/ul>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Diagnosis<\/strong>.<\/span><span class=\"x01-garamond-9-5\">\u00a0The eggs passed in sputum or feces are characteristic, with polar plugs that are slightly askew of the central axis (<\/span><strong><span class=\"garamond-bold\">Figure 4<\/span><\/strong><span class=\"x01-garamond-9-5\">) and a granular shell. The eggs in the feces of dogs must be differentiated from those of\u00a0<\/span><em><span class=\"garamon-italics\">Trichuris vulpis<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>(larger),\u00a0<\/span><em><span class=\"garamon-italics\">Eucoleus boehmi<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>(contain a partially developed embryo when passed), and\u00a0<\/span><em><span class=\"garamon-italics\">Pearsonema plica<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>(present in feces contaminated with urine).<sup>1<\/sup><\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Treatment<\/strong>\u00a0(<strong>Table 2<\/strong>) <strong>&amp; Prevention.<\/strong><\/span><span class=\"x01-garamond-9-5\">\u00a0Extended courses of ivermectin or fenbendazole have been reportedly successful at eliminating infection, but anecdotal evidence suggests that routine preventives may not be protective against this nematode.<\/span><\/p>\n<div id=\"attachment_8687\" style=\"width: 310px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/pp-fig-4.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-8687\" class=\"wp-image-8687 size-medium\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/pp-fig-4-300x215.png\" alt=\"pp fig 4\" width=\"300\" height=\"215\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/pp-fig-4-300x215.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/pp-fig-4.png 416w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-8687\" class=\"wp-caption-text\">Figure 4. Egg of <em>Eucoleus aerophilus<\/em> in feces, with typical polar plugs that are slightly askew of vertical between each end.<\/p><\/div>\n<h3 class=\"left-justified\"><span class=\"Gold\"><em>Filaroides <\/em>species<\/span><\/h3>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Distribution<\/strong>.\u00a0<\/span><span class=\"x01-garamond-9-5\">Infection with\u00a0<\/span><em><span class=\"garamon-italics\">Filaroides<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>species occurs sporadically, and periodically appears in some kennels or in individual dogs.<sup>12<\/sup><\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Life Cycle<\/strong>.<\/span><span class=\"x01-garamond-9-5\">\u00a0Larvae shed in the feces or in the respiratory secretions of infected dogs are immediately infective and may be transmitted to other dogs by ingestion; this direct life cycle facilitates rapid spread between co-housed dogs. Ingested larvae migrate to the trachea and develop into adults in nodules (<\/span><em><span class=\"garamon-italics\">F osleri<\/span><\/em><span class=\"x01-garamond-9-5\">) or the lung parenchyma (<\/span><em><span class=\"garamon-italics\">F hirthi<\/span><\/em><span class=\"x01-garamond-9-5\">).<\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Clinical Signs<\/strong>.<\/span>\u00a0<span class=\"garamond-bold\">Infection with<em> F osleri\u00a0<\/em><\/span><span class=\"x01-garamond-9-5\">can cause a hard, dry cough triggered by exercise or exposure to cold air.<sup>12<\/sup>\u00a0Young dogs are most acutely affected and sometimes develop respiratory distress, anorexia, and emaciation.<\/span><\/p>\n<p class=\"indent-125\"><span class=\"garamond-bold\">Infection with <em>F hirthi<\/em><\/span><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>is usually asymptomatic, but fatal cases of hyperinfection have developed in severely stressed and immunodeficient animals.<sup>13<\/sup><\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Diagnosis<\/strong>.<\/span><span class=\"x01-garamond-9-5\">\u00a0Infection with\u00a0<\/span><em><span class=\"garamon-italics\">Filaroides<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>species is diagnosed by finding larva with fecal flotation using zinc-sulfate centrifugation. Larva of:\u00a0<sup>14<\/sup><\/span><\/p>\n<ul>\n<li><span class=\"x01-garamond-9-5\"><em>F osleri<\/em>\u00a0have a constriction and a kink just posterior to the end of the tail (<\/span><strong><span class=\"garamond-bold\">Figure 5<\/span><\/strong><span class=\"x01-garamond-9-5\">).<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\"><em>F hirthi<\/em>\u00a0come to a simple point at the tip of the tail (<\/span><strong><span class=\"garamond-bold\">Figure 6<\/span><\/strong><span class=\"x01-garamond-9-5\">).<\/span><\/li>\n<\/ul>\n<p class=\"indent-125\"><span class=\"x01-garamond-9-5\">Infection with\u00a0<\/span><em><span class=\"garamon-italics\">F osleri<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>may also be diagnosed at bronchoscopy by identifying the pathognomonic transparent submucosal nodules containing nematodes.<\/span><\/p>\n<div id=\"attachment_4685\" style=\"width: 406px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-5.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4685\" class=\"wp-image-4685\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-5.jpg\" alt=\"Figure 5\" width=\"396\" height=\"307\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-5.jpg 750w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-5-300x233.jpg 300w\" sizes=\"(max-width: 396px) 100vw, 396px\" \/><\/a><p id=\"caption-attachment-4685\" class=\"wp-caption-text\">Figure 5. Posterior end of tail of first-stage <em>Filaroides osleri<\/em> larva in feces, demonstrating the dorsal kink just terminal to the end of the tail.<\/p><\/div>\n<div id=\"attachment_4686\" style=\"width: 503px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-6.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4686\" class=\"wp-image-4686\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-6.jpg\" alt=\"Figure 6\" width=\"493\" height=\"224\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-6.jpg 750w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-6-300x136.jpg 300w\" sizes=\"(max-width: 493px) 100vw, 493px\" \/><\/a><p id=\"caption-attachment-4686\" class=\"wp-caption-text\">Figure 6. Posterior end of tail of first-stage <em>Filaroides hirthi<\/em> larva in feces, demonstrating the tapering conical tail.<\/p><\/div>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Treatment<\/strong>\u00a0(<strong>Table 2<\/strong>). The<\/span>\u00a0<span class=\"garamond-bold\">treatment of choice for<em> F osleri<\/em><\/span><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>seems to be injectable doramectin; some veterinarians also remove as many nodules as possible with the aid of the bronchoscope. Dogs with\u00a0<\/span><span class=\"garamond-bold\">both <em>F osleri<\/em> and <em>F hirthi<\/em> have also been successfully treated<\/span><span class=\"x01-garamond-9-5\">\u00a0with several days of fenbendazole or ivermectin.<\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Prevention<\/strong>.<\/span><span class=\"x01-garamond-9-5\">\u00a0Because larvae of\u00a0<\/span><em><span class=\"garamon-italics\">Filaroides<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>species are immediately infective when shed in the feces, control can be difficult, particularly if other canine members of the household are infected.<sup>15<\/sup><\/span><\/p>\n<h3 class=\"left-justified\"><span class=\"Gold\"><em>Paragonimus kellicotti<\/em><\/span><\/h3>\n<p class=\"indent-125\"><span class=\"garamond-bold\"><strong>Distribution<\/strong>.\u00a0<\/span><span class=\"x01-garamond-9-5\">Infection with<em>\u00a0<\/em><\/span><em><span class=\"garamon-italics\">P kellicotti<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>occurs along the Mississippi, Missouri, Ohio, and St. Lawrence rivers and in areas of the southeastern U.S.<sup>16<\/sup><\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Life Cycle<\/strong>.<\/span><span class=\"x01-garamond-9-5\">\u00a0Eggs passed in the feces hatch to release a miracidium, which penetrates a snail. Cercariae are produced that leave the snail host and enter a crayfish to encyst as metacercariae. When the crayfish is eaten by a dog, cat, other wild carnivore, or a human, adult trematodes develop within cysts in the lung parenchyma. Paratenic hosts that ingest infected crayfish may also harbor infective metacercariae.<sup>1<\/sup><\/span><\/p>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Clinical Signs<\/strong>.\u00a0<\/span><span class=\"x01-garamond-9-5\">Dogs infected with <em>P kellicotti<\/em> may be asymptomatic or can present with a variety of respiratory signs, including:<\/span><\/p>\n<ul>\n<li><span class=\"x01-garamond-9-5\">Coughing<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Dyspnea<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Bronchiectasis<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Hemoptysis.<\/span><\/li>\n<\/ul>\n<p class=\"indent-125\"><span class=\"x01-garamond-9-5\">Dogs may tolerate a low number of intact cysts, but in heavy infections, or when cysts rupture, severe disease may result due to:<sup>17<\/sup><\/span><\/p>\n<ul>\n<li><span class=\"x01-garamond-9-5\">Pulmonary hemorrhage<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Pneumothorax<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Granulomatous pneumonia.<\/span><\/li>\n<\/ul>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Diagnosis<\/strong>.\u00a0<\/span><span class=\"x01-garamond-9-5\">Eggs of\u00a0<\/span><em><span class=\"garamon-italics\">P kellicotti<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>can be recovered by sugar flotation, sedimentation of feces, or transtracheal wash, and are characterized by their size, seated operculum, and abopercular bump or flange on the end opposite the operculum (<\/span><strong><span class=\"garamond-bold\">Figure 7<\/span><\/strong><span class=\"x01-garamond-9-5\">). Pulmonary cysts may be evident on thoracic radiographs.<\/span><\/p>\n<div id=\"attachment_4687\" style=\"width: 352px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-7.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4687\" class=\"wp-image-4687\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-7.jpg\" alt=\"Figure 7\" width=\"342\" height=\"171\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-7.jpg 1500w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-7-300x150.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-7-1024x512.jpg 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Figure-7-768x384.jpg 768w\" sizes=\"(max-width: 342px) 100vw, 342px\" \/><\/a><p id=\"caption-attachment-4687\" class=\"wp-caption-text\">Figure 7. <em>Paragonimus kellicotti<\/em> egg in feces collected via sedimentation, demonstrating the seated operculum and the abopercular flange or bump.<\/p><\/div>\n<p class=\"left-justified\"><span class=\"garamond-bold\"><strong>Treatment<\/strong>\u00a0(<strong>Table 2<\/strong>).<\/span><span class=\"x01-garamond-9-5\">\u00a0Infections may be treated with repeated courses of any of the following:<sup>18<\/sup><\/span><\/p>\n<ul>\n<li><span class=\"x01-garamond-9-5\">Albendazole<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Fenbendazole<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Praziquantel.<\/span><\/li>\n<\/ul>\n<h2 class=\"left-justified\"><span class=\"greenheader\">RISK FOR ZOONOTIC INFECTION<\/span><\/h2>\n<p class=\"left-justified\"><span class=\"x01-garamond-9-5\">Several of the common canine pulmonary helminths are zoonotic, although infections are acquired from the environment or a vector, rather than direct contact with infected dogs.\u00a0<\/span><\/p>\n<ul>\n<li><span class=\"x01-garamond-9-5\">Toxocariasis upon ingestion of infective eggs of\u00a0<\/span><em><span class=\"garamon-italics\">T canis<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>from contaminated soil is well documented; as many as 1 in 7 adults in the U.S. harbor antibodies to\u00a0<\/span><em><span class=\"garamon-italics\">Toxocara<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>species.<sup>19<\/sup><\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Human infection with\u00a0<\/span><em><span class=\"garamon-italics\">D immitis<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>via mosquitoes also occurs, resulting in development of pulmonary granulomata.<sup>20<\/sup><\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Human infection with\u00a0<\/span><em><span class=\"garamon-italics\">P kellicotti<\/span><\/em><span class=\"x01-garamond-9-5\"><em>\u00a0<\/em>following ingestion of raw crayfish has also been reported in young men and is associated with alcohol consumption.<sup>16<\/sup><\/span><\/li>\n<\/ul>\n<p class=\"indent-125\"><span class=\"x01-garamond-9-5\">Protecting dogs from infection with pulmonary helminths limits environmental contamination, reducing risk of both canine and human disease.<\/span><\/p>\n<h2 class=\"left-justified\"><span class=\"greenheader\">GENERAL CONSIDERATIONS &amp; CAPC RECOMMENDATIONS<\/span><\/h2>\n<ul>\n<li><span class=\"x01-garamond-9-5\">Administer broad-spectrum parasite control products that provide internal parasite control and prevent heartworm infection to all pet dogs year-round.<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Routinely deworm puppies beginning at 2 weeks of age, with deworming repeated every 2 weeks.<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Begin administering a monthly control product with efficacy against intestinal helminths when puppies reach 4 to 8 weeks of age.\u00a0<\/span><\/li>\n<\/ul>\n<p class=\"indent-125\"><span class=\"x01-garamond-9-5\">Other preventive measures that owners can implement include:<\/span><\/p>\n<ul>\n<li><span class=\"x01-garamond-9-5\">Keeping dogs on a leash or in a fenced yard to prevent predation and scavenging activities; this limits the opportunity for dogs to acquire infection via ingestion of vertebrate hosts (ascarids) or from a feces-contaminated environment\u00a0<\/span><\/li>\n<li><span class=\"x01-garamond-9-5\">Promptly removing feces from the yard to prevent eggs from decomposing with fecal material or dispersing into the environment.<\/span><\/li>\n<\/ul>\n<div class=\"orange-box\">\n<p>Inform clients that routine parasite control typically results in negative fecal examinations, confirming the efficacy of routine parasite prevention. In the case of pulmonary helminths, even though those other than heartworm are not mentioned on product labels, it is very likely that administration of these drugs minimizes the ability of lungworms to develop if the dog is receiving monthly preventive therapy.<\/p>\n<\/div>\n<h3><span style=\"line-height: 1.5\">References<\/span><\/h3>\n<ol>\n<li><span class=\"references\">Bowman DD. <em>Georgis\u2019 Parasitology for Veterinarians<\/em>, 10th ed. St. Louis: Elsevier Saunders, 2014, pp 477.<\/span><\/li>\n<li><span class=\"references\">Kistler WM, Brown JD, Allison AB, et al. First report of <em>Angiostrongylus vasorum<\/em> and <em>Hepatozoon<\/em> from a red fox (<em>Vulpes vulpes<\/em>) from West Virginia, U.S.A. <em>Vet Parasitol<\/em> 2013; 200:216-220.<\/span><\/li>\n<li><span class=\"references\">Bolt G, Monrad J, Koch J, Jensen AL. Canine angiostrongylosis: A review. <em>Vet Rec<\/em> 1994; 135(19):447-452.<\/span><\/li>\n<li><span class=\"references\">Koch J, Willesen JL. Canine pulmonary angiostrongylosis: An update. <em>Vet J<\/em> 2009; 179(3):348-359.<\/span><\/li>\n<li><span class=\"references\">Schnyder M, Fahrion A, Ossent P, et al. Larvicidal effect of imidacloprid\/moxidectin spot-on solution in dogs experimentally inoculated with <em>Angiostrongylus vasorum<\/em>. <em>Vet Parasitol<\/em> 2009; 166:326-332.<\/span><\/li>\n<li><span class=\"references\">Conboy G. Natural infections of <em>Crenosoma vulpis<\/em> and <em>Angiostrongylus vasorum<\/em> in dogs in Atlantic Canada and their treatment with milbemycin oxime. <em>Vet Rec<\/em> 2004; 155:16-18.<\/span><\/li>\n<li><span class=\"references\">Unterer S, Deplazes P, Arnold P, et al. Spontaneous <em>Crenosoma vulpis<\/em> infection in 10 dogs: Laboratory, radiographic and endoscopic findings. <em>Schweiz Arch Tierheilkd<\/em> 2002; 144(4):174-179.\u00a0<\/span><\/li>\n<li><span class=\"references\">Conboy G, Hare J, Charles S, et al. Efficacy of a single topical application of Advantage Multi (=Advocate) topical solution (10% imidocloprid + 2.5% moxidectin) in the treatment of dogs experimentally infected with <em>Crenosoma vulpis<\/em>. <em>Parasitol Res<\/em> 2009; 105(S1):S49-S54.<\/span><\/li>\n<li><span class=\"references\">Conboy G, Bourque A, Miller L, et al. Efficacy of Milbemax (milbemycin oxime + praziquantel) in the treatment of dogs experimentally infected with <em>Crenosoma vulpis<\/em>. <em>Vet Parasitol<\/em> 2013; 198:319-324.<\/span><\/li>\n<li><span class=\"references\">Traversa D, Di Cesare A, Milillo P, et al. Infection by <em>Eucoleus aerophilus<\/em> in dogs and cats: Is another extra-intestinal parasitic nematode of pets emerging in Italy? <em>Res Vet Sci<\/em> 2009; 87(2):270-272.<\/span><\/li>\n<li><span class=\"references\">Burgess H, Ruotsalo K, Peregrine AS, et al. <em>Eucoleus aerophilus<\/em> respiratory infection in a dog with Addison\u2019s disease. <em>Can Vet J<\/em> 2008; 49(2):389-392.<\/span><\/li>\n<li><span class=\"references\">Yao CQ, O\u2019Toole D, Driscoll M, et al. <em>Filaroides osleri<\/em> (<em>Oslerus osleri<\/em>): Two case reports and a review of canid infections in North America. <em>Vet Parasitol<\/em> 2011; 179:123-129.<\/span><\/li>\n<li><span class=\"references\">Carrasco L, Herv\u00e1s J, G\u00f3mez-Villamandos JC, et al. Massive <em>Filaroides hirthi<\/em> infestation associated with canine distemper in a puppy. <em>Vet Rec<\/em> 1997; 140(3):72-73.<\/span><\/li>\n<li><span class=\"references\">McGarry JW, Morgan ER. Identification of first-stage larvae of metastrongyles from dogs. <em>Vet Rec<\/em> 2009; 165(9):258-261.<\/span><\/li>\n<li><span class=\"references\">Georgi JR, Georgi ME, Fahnestock GR, Theodorides VJ. Transmission and control of <em>Filaroides hirthi<\/em> lungworm infection in dogs. <em>Am J Vet Res<\/em> 1979; 40(6):829-831.<\/span><\/li>\n<li><span class=\"references\">Lane MA, Marcos LA, Onen NF, et al. <em>Paragonimus kellicotti<\/em> fluke infections in Missouri, USA. <em>Emerg Infect Dis<\/em> 2012; 18(8):1263-1267.<\/span><\/li>\n<li><span class=\"references\">Harrus S, Nyska A, Colorni A, Markovics A. Sudden death due to <em>Paragonimus kellicotti<\/em> infection in a dog. <em>Vet Parasitol<\/em> 1997; 71(1):59-63.<\/span><\/li>\n<li><span class=\"references\">Conboy G. Helminth parasites of the canine and feline respiratory tract. <em>Vet Clin North Am Small Anim Pract<\/em> 2009; 39(6):1109-1126.<\/span><\/li>\n<li><span class=\"references\">Won KY, Kruszon-Moran D, Schantz PM, Jones JL. National seroprevalence and risk factors for zoonotic <em>Toxocara<\/em> spp. infection. <em>Am J Trop Med Hyg<\/em> 2008; 79(4):552-557.<\/span><\/li>\n<li><span class=\"references\">Theis JH. Public health aspects of dirofilariasis in the United States. <em>Vet Parasitol<\/em> 2005; 133:157-180.<\/span><\/li>\n<\/ol>\n<p><span class=\"author-bio\" style=\"line-height: 1.5\"><strong><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Dwight-D.-Bowman.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-8689\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/05\/Dwight-D.-Bowman-150x150.png\" alt=\"Dwight D. Bowman\" width=\"100\" height=\"110\" \/><\/a>Dwight D. Bowman<\/strong>, MS, PhD, Diplomate ACVM (Parasitology, Hon) is professor of parasitology at Cornell University College of Veterinary Medicine. He received his MS and PhD in parasitology from Tulane University.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><span class=\"author-bio\" style=\"line-height: 1.5\"><strong><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/C_CPAC_Little.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-7065\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2013\/09\/C_CPAC_Little.png\" alt=\"C_CPAC_Little\" width=\"100\" height=\"122\" \/><\/a>Susan E. Little<\/strong>, DVM, PhD, Diplomate ACVM (Parasitology), is the director of the National Center for Veterinary Parasitology at Oklahoma State University&#8217;s Center for Veterinary Health Sciences. She received her DVM from Virginia Tech.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dwight D.<\/p>\n","protected":false},"author":1,"featured_media":3045,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":1009,"footnotes":""},"categories":[366],"tags":[],"class_list":["post-1151","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-may-june-2014","column-parasitology","clinical_topics-parasitology"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Canine Pulmonary Helminths: Recommendations from the Companion Animal Parasite Council | Today&#039;s Veterinary Practice<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Canine Pulmonary Helminths: Recommendations from the Companion Animal Parasite Council\" \/>\n<meta property=\"og:description\" content=\"Dwight D.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/\" \/>\n<meta property=\"og:site_name\" content=\"Today&#039;s Veterinary Practice\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/todaysveterinarypractice\" \/>\n<meta property=\"article:published_time\" content=\"2014-05-01T16:50:25+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-02-16T15:59:04+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/03\/Figure-1_header.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"800\" \/>\n\t<meta property=\"og:image:height\" content=\"540\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"12 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/\"},\"author\":{\"name\":\"\",\"@id\":\"\"},\"headline\":\"Canine Pulmonary Helminths: Recommendations from the Companion Animal Parasite Council\",\"datePublished\":\"2014-05-01T16:50:25+00:00\",\"dateModified\":\"2022-02-16T15:59:04+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/\"},\"wordCount\":2472,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2014\\\/03\\\/Figure-1_header.jpg\",\"articleSection\":[\"May\\\/June 2014\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/#respond\"]}]},{\"@type\":[\"WebPage\",\"MedicalWebPage\"],\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/\",\"url\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/\",\"name\":\"Canine Pulmonary Helminths: Recommendations from the Companion Animal Parasite Council | Today&#039;s Veterinary Practice\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2014\\\/03\\\/Figure-1_header.jpg\",\"datePublished\":\"2014-05-01T16:50:25+00:00\",\"dateModified\":\"2022-02-16T15:59:04+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/#primaryimage\",\"url\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2014\\\/03\\\/Figure-1_header.jpg\",\"contentUrl\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2014\\\/03\\\/Figure-1_header.jpg\",\"width\":800,\"height\":540},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/parasitology\\\/parasite-protocols-canine-pulmonary-helminths-2\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Canine Pulmonary Helminths: Recommendations from the Companion Animal Parasite Council\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#website\",\"url\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/\",\"name\":\"Today's Veterinary Practice\",\"description\":\"Peer-Reviewed Veterinary Journal\",\"publisher\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#organization\",\"name\":\"Today's Veterinary Practice\",\"url\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2022\\\/01\\\/tvp-logo.png\",\"contentUrl\":\"https:\\\/\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2022\\\/01\\\/tvp-logo.png\",\"width\":179,\"height\":89,\"caption\":\"Today's Veterinary Practice\"},\"image\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/todaysveterinarypractice\",\"https:\\\/\\\/www.youtube.com\\\/thenavc\"],\"email\":\"info@navc.com\"},{\"@type\":\"Person\",\"@id\":\"\",\"url\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/author\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Canine Pulmonary Helminths: Recommendations from the Companion Animal Parasite Council | Today&#039;s Veterinary Practice","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Canine Pulmonary Helminths: Recommendations from the Companion Animal Parasite Council","og_description":"Dwight D.","og_url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/","og_site_name":"Today&#039;s Veterinary Practice","article_publisher":"https:\/\/www.facebook.com\/todaysveterinarypractice","article_published_time":"2014-05-01T16:50:25+00:00","article_modified_time":"2022-02-16T15:59:04+00:00","og_image":[{"width":800,"height":540,"url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/03\/Figure-1_header.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Written by":"","Est. reading time":"12 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/#article","isPartOf":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/"},"author":{"name":"","@id":""},"headline":"Canine Pulmonary Helminths: Recommendations from the Companion Animal Parasite Council","datePublished":"2014-05-01T16:50:25+00:00","dateModified":"2022-02-16T15:59:04+00:00","mainEntityOfPage":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/"},"wordCount":2472,"commentCount":0,"publisher":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#organization"},"image":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/#primaryimage"},"thumbnailUrl":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/03\/Figure-1_header.jpg","articleSection":["May\/June 2014"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/#respond"]}]},{"@type":["WebPage","MedicalWebPage"],"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/","url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/","name":"Canine Pulmonary Helminths: Recommendations from the Companion Animal Parasite Council | Today&#039;s Veterinary Practice","isPartOf":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/#primaryimage"},"image":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/#primaryimage"},"thumbnailUrl":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/03\/Figure-1_header.jpg","datePublished":"2014-05-01T16:50:25+00:00","dateModified":"2022-02-16T15:59:04+00:00","breadcrumb":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/#primaryimage","url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/03\/Figure-1_header.jpg","contentUrl":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/03\/Figure-1_header.jpg","width":800,"height":540},{"@type":"BreadcrumbList","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/parasite-protocols-canine-pulmonary-helminths-2\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/"},{"@type":"ListItem","position":2,"name":"Canine Pulmonary Helminths: Recommendations from the Companion Animal Parasite Council"}]},{"@type":"WebSite","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#website","url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/","name":"Today's Veterinary Practice","description":"Peer-Reviewed Veterinary Journal","publisher":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#organization","name":"Today's Veterinary Practice","url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#\/schema\/logo\/image\/","url":"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/01\/tvp-logo.png","contentUrl":"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/01\/tvp-logo.png","width":179,"height":89,"caption":"Today's Veterinary Practice"},"image":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/todaysveterinarypractice","https:\/\/www.youtube.com\/thenavc"],"email":"info@navc.com"},{"@type":"Person","@id":"","url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/author\/"}]}},"_links":{"self":[{"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/posts\/1151","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/comments?post=1151"}],"version-history":[{"count":1,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/posts\/1151\/revisions"}],"predecessor-version":[{"id":28075,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/posts\/1151\/revisions\/28075"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/media\/3045"}],"wp:attachment":[{"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/media?parent=1151"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/categories?post=1151"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/tags?post=1151"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}