ECHOCARDIOGRAPHY IN THIRTY AMERICAN FLAMINGOS (PHOENICOPTERUS RUBER) AND A CASE OF SUSPECTED NEURALLY MEDIATED REFLEX SYNCOPE.

Heart disease in birds contributes to premature death and is usually detected postmortem. Echocardiography is a sensitive and noninvasive diagnostic modality but reported standard values for many species of birds, including American flamingos (Phoenicopterus ruber), are unavailable. Echocardiography was opportunistically performed on 30 unsedated American flamingos during their annual routine health examination. Structural heart disease was not found in any of the examined birds. However, 18 birds showed varying degrees of dynamic intraventricular obstruction. Echocardiographic parameters are reported. Benign neurocardiogenic weakness or syncopal events during handling were suspected in three birds. Stress combined with an intraventricular obstruction is believed to have triggered a cascade of parasympathetic innervation and sympathetic inhibition, similar to neurally mediated reflex syncope in humans.

Evaluation of cardiac troponin I as a predictor of death in critically ill cats.

BACKGROUND: Abnormally high serum cardiac troponin I (cTnI) concentration, reflecting leakage from or necrosis of cardiomyocytes, is a negative prognosticator for death in dogs. OBJECTIVES: To investigate in critically ill cats whether serum cTnI concentration is abnormally high, identify conditions associated with abnormally high cTnI concentrations, and evaluate cTnI as an independent prognosticator for death and a potential coprognosticator to the acute patient physiologic and laboratory evaluation (APPLE) score in cats. ANIMALS: One hundred nineteen cats admitted to intensive care units (ICU) and 13 healthy cats at 2 university teaching hospitals. METHODS: Prospective study. Clinical examinations were performed, APPLE scores calculated, and serum cTnI and serum amyloid A (SAA) measured within 24 hours after admission. Outcome was defined as death/euthanasia or survival to discharge, 28 and 90 days after ICU-admission. Prognostic capacity of cTnI, APPLE scores and models combining cTnI and scores were evaluated by receiver-operator-characteristic analyses. RESULTS: Median (IQR) serum cTnI concentration was higher in ill (0.63 [0.18-2.65] ng/mL) compared to healthy (0.015 [0.005-0.041] ng/mL) cats (P < .001) and higher in subgroups with structural cardiac disease (2.05 [0.54-16.59] ng/mL; P < .001) or SAA >5 mg/L (0.84 [0.23-2.81] ng/mL; P = .009) than in cats without these characteristics (0.45 [0.12-1.70] and 0.35 [0.015-0.96] ng/mL). The in-hospital case fatality rate was 29%. Neither serum cTnI concentration for all critically ill cats (area-under-the-curve 0.567 [95% CI 0.454-0.680], n = 119) or subgroups (0.625 [0.387-0.863], n = 27; 0.506 [0.360-0.652], n = 86), nor APPLE scores (fast 0.568 [0.453-0.682], full 0.585 [0.470-0.699], n = 100), were significant prognosticators for death. CONCLUSIONS AND CLINICAL IMPORTANCE: Abnormally high serum cTnI concentration was common in critically ill cats. Unlike in dogs, cTnI did not confer prognostic information regarding death.

Hemostatic Dysfunction in Dogs Naturally Infected with Angiostrongylus vasorum-A Narrative Review.

This narrative review aims to describe Angiostrongylus vasorum-induced hemostatic dysfunction of dogs with emphasis on clinical and laboratory findings as well as potential therapeutic strategies for the bleeding patient. Canine angiostrongylosis (CA) is a disease with potentially high morbidity and mortality in endemic areas and with fatal outcome often associated with either severe respiratory compromise, pulmonary hypertension and right-sided heart failure, or hemostatic dysfunction with severe bleeding. The most common signs of hemorrhage are hematomas, petecchiation, ecchymoses, oral mucosal membrane bleeding and scleral bleeding, while intracranial and pulmonary hemorrhage are among the most severe. The pathophysiological mechanisms underlying hemostatic dysfunction in these patients are presently researched. While the larval effect on platelets remains unknown, the parasite appears to induce dysregulation of hemostatic proteins, with studies suggesting a mixture of pro-coagulant protein consumption and hyperfibrinolysis. Importantly, not all dogs display the same hemostatic abnormalities. Consequently, characterizing the hemostatic state of the individual patient is necessary, but has proven difficult with traditional coagulation tests. Global viscoelastic testing shows promise, but has limited availability in general practice. Treatment of A. vasorum-infected dogs with hemostatic dysfunction relies on anthelmintic treatment as well as therapy directed at the individual dog's specific hemostatic alterations.

Field safety and efficacy of an orally administered combination of sarolaner, moxidectin and pyrantel (Simparica Trio®) for the prevention of angiostrongylosis in dogs presented as veterinary patients.

BACKGROUND: Infection with the cardiopulmonary nematode Angiostrongylus vasorum may cause severe disease in dogs, therefore prophylactic treatments are necessary to prevent infection in dogs at risk. A clinical field study was conducted to demonstrate the efficacy and safety of an oral combination of sarolaner, moxidectin and pyrantel (Simparica Trio®) for the prevention of A. vasorum infection in dogs (prevention study). A survey study was conducted concurrently to determine the infection pressure in the same areas. METHODS: Prevention and survey studies were both conducted at the same veterinary clinics in endemic hot spots for A. vasorum in Denmark and Italy. The prevention study was a randomized, placebo controlled, double masked study where 622 client-owned dogs were treated and tested at 30 days intervals for 10 months. In the survey study 1628 dogs that were at risk of infection and/or were suspected to be infected were tested by fecal and/or serological methods, and the percent of dogs positive for A. vasorum was calculated. RESULTS: In the prevention study, there were no adverse events related to treatment with Simparica Trio®. Two placebo-treated animals became infected with A. vasorum during the 10-month study period, while none of the dogs in the combination product-treated group became infected. In the survey study, 12.2% of the study dogs were found positive to A. vasorum, indicating high exposure to the parasite during the period of the prevention study. CONCLUSIONS: Monthly oral treatment with the combination of sarolaner, moxidectin and pyrantel (Simparica Trio®) was 100% effective in the prevention of natural infection with A. vasorum in dogs in highly endemic areas. In endemic areas, A. vasorum occurrence in dogs at risk is considerable.

Malnutrition Predisposes to Endotoxin-Induced Edema and Impaired Inflammatory Response in Parenterally Fed Piglets.

BACKGROUND: Poor nutrition status is common among hospitalized children and children in low-income countries and may be associated with increased susceptibility to edema and infections. We hypothesized that poor nutrition status, established with a suboptimal composition of parenteral nutrition (PN), predisposes to endotoxemia-induced edema, oxidative stress, and dysregulated immune responses. METHODS: Using a 2 × 2 factorial design, 3-day-old piglets (n = 40) were given either optimal or suboptimal composition of PN for 7 days and then infused with either saline or lipopolysaccharide (LPS) for 9 hours to induce an acute-phase reaction. Abdominal tissue edema and blood markers of immunity, inflammation, and oxidative stress were assessed. RESULTS: Piglets receiving suboptimal nutrition showed signs of malnutrition with restricted growth, signs of inflammation (elevated C-reactive protein [CRP], interleukin-6, and serum amyloid A levels), oxidative stress (lower erythrocyte glutathione/hemoglobin and α-tocopherol/cholesterol ratios), and liver dysfunction (increased liver weight and blood bilirubin levels). Perirenal edema was more excessive in malnourished LPS-infused animals, relative to healthy LPS-infused control animals (P < .01). Malnutrition reduced the inflammatory response to LPS (lower CRP, tumor necrosis factor-α, haptoglobin, and neutrophil to lymphocyte ratio) but did not influence LPS-induced oxidative stress markers. CONCLUSIONS: We conclude that endotoxemia and malnutrition in combination lead to acute-phase hyporesponsiveness and perirenal edema in piglets. This finding may have implications for pediatric patients that suffer from malnutrition, as their response to bacterial infections may differ substantially from patients of normal nutrition status.

INVESTIGATION INTO CARDIOVASCULAR ASSESSMENT OF CAPTIVE ADULT SCARLET IBIS (EUDOCIMUS RUBER).

Cardiovascular lesions are commonly diagnosed postmortem in scarlet ibis (Eudocimus ruber), but antemortem diagnosis is rare. The aim of this study was to evaluate the cardiovascular health of a zoo population (n = 44) of apparently healthy, adult, scarlet ibis. A cross-sectional study design was employed whereby each animal was manually restrained for physical examination, phlebotomy, and echocardiographic examination performed with a 12-MHz transducer and a ventromedial approach, and observed intervals were calculated for 12 parameters. Seven individuals from the study population had high left-sided mid-ventricular velocities (2.59-5.89 m/sec) compared with values in other species. Follow-up examination suggested that these mid-ventricular obstructive lesions were dynamic and transient in nature rather than caused by fixed lesions within the outflow tract and may therefore be associated with stress. Conscious echocardiography proved to be feasible, although, unsurprisingly, the stress response in nonhabituated birds appeared to increase blood flow velocities. Handling protocols likely have a significant effect on echocardiographic parameters and should be taken into consideration when interpreting findings. Serum cholesterol concentrations were generally high (7.4-13.0 mmol/L), and further work is required to investigate the relationship between circulating cholesterol and the development of atherosclerosis in scarlet ibis. Serum cardiac troponin I concentrations were measured, and four animals were identified with suspected elevated levels, likely indicative of myocardial damage.

Analytical validation of platelet microparticle quantification in cats.

BACKGROUND: Cardiogenic embolism (CE) in cats is a devastating condition primarily associated with hypertrophic cardiomyopathy (HCM). Hypercoagulability may pose a risk for thrombus formation; however, no single test can predict CE development. Platelet microparticles (PMPs) released from platelet membranes are associated with thrombosis in humans. OBJECTIVES: The aims were to validate flow cytometric PMP quantification in cats analytically and, in a pilot study, evaluate the procoagulant annexin V (AnV) positive PMP concentration in healthy cats and cats with asymptomatic HCM. METHODS: With CD61 as a platelet marker, CD61+ AnV+ PMPs (0.3-1.0 µm) were quantified in citrated whole blood (WB) and platelet-poor plasma (PPP) using flow cytometry. Analyses were performed in 6 healthy cats and 5 cats with asymptomatic HCM. The coefficient of variation (CV) for duplicate (intra-assay) and parallel (inter-assay) analyses were calculated. RESULTS: PMP concentrations were quantified with acceptable intra-assay CV for WB (CD61+ /AnV- ; 2.4%, 0.2%-8.4% (median, range), CD61+ /AnV+ ; 3.8%, 0.1%-12.5%) and PPP (CD61+ /AnV- ; 5.0%, 0.7%-12.8%, CD61+ /AnV+ ; 7.4%, 0.5%-15.3%), and acceptable inter-assay CV for WB in 10/11 cats (CD61+ /AnV- ; 6.2%, 1.4%-13.3%, CD61+ /AnV+ ; 6.4%, 0.7%-17.2%), but unacceptable for PPP (CD61+ /AnV- ; 15.6%, 5.8%-42.7%, CD61+ /AnV+ ; 27.8%, 8.4%-77.1%). For WB PMP concentrations, the pilot data demonstrated no differences between healthy cats and cats with asymptomatic HCM (4/5 with left ventricular outflow obstruction) for either the CD61+ /AnV- or the CD61+ /AnV+ PMPs. CONCLUSIONS: Only WB PMP concentrations could be quantified reliably in cats in a clinical setting. PMP concentrations did not differ between healthy and asymptomatic HCM cats in this pilot study.

Occurrence and clinical significance of Aelurostrongylus abstrusus and other endoparasites in Danish cats.

Feline endoparasites are highly prevalent worldwide and may cause a variety of clinical signs in infected cats. Prevalence rates are dynamic and there is limited knowledge of the current prevalence in Denmark and the clinical manifestation and significance of especially the lungworm Aelurostrongylus abstrusus. This study investigated the total and local prevalence of Aelurostrongylus abstrusus and other endoparasites in Danish cats. The clinical significance of feline aelurostrongylosis was also examined through identification of frequency and severity of selected clinical signs. Faecal samples (n=327) and clinical data (n=312) were collected from August to October 2015, primarily from outdoor cats located at shelters distributed across Denmark. A modified Baermann method and a concentration McMaster technique was used to diagnose A. abstrusus first stage larvae and eggs/oocysts of other endoparasites. The total A. abstrusus prevalence was 8.3% [95% CI: 5.6-11.9] but local prevalence rates varied from 0% [95% CI: 0.0-8.8] to 31.4% [95% CI: 16.9-49.3]. A rural habitat appeared to increase the risk of A. abstrusus and this accounted for most of the local variation. Furthermore, the risk of infection was lower in kittens younger than 11 weeks compared to older cats (p=0.002). The cats were also infected with Toxocara cati (44.4% [95% CI: 38.3-50.7]), taeniid species (8.9% [95% CI: 5.7-13.0]), Capillaria aerophila (3.1% [95% CI: 1.3-6.0]), Aonchotheca putorii (3.9% [95% CI: 1.9-7.0]), Cystoisospora felis (3.1% [95% CI: 1.3-6.0]) and Cystoisospora rivolta (2.3% [95% CI: 0.9-5.0]), but there was no difference in local distribution. Co-infection was common, as 66.7% of A. abstrusus infected cats were also infected with one or more other parasites, the most common being T. cati. However, none of these parasites were significantly associated with A. abstrusus. The vast majority of the A. abstrusus infected cats displayed mild to moderate clinical signs. The main symptoms associated with the infection were increased sound on auscultation of the lungs (p=0.002), increased respiratory rate (p=0.02), coughing (p=0.007) and enlarged mandibular lymph nodes (p=0.002). None of these symptoms were associated with T. cati or C. aerophila which may also affect the lungs. This supports that the symptoms may be related to A. abstrusus and that aelurostrongylosis should be considered an important differential diagnosis in any feline respiratory patient.

Performance of the Angio Detect™ in-clinic test kit for detection of Angiostrongylus vasorum infection in dog samples from Europe.

Angiostrongylosis is a crucial differential diagnosis in any dog with respiratory, bleeding, neurological, or syncopal signs of unknown etiology in endemic areas. Many cases of angiostrongylosis have a fatal outcome; subclinical angiostrongylosis also has been reported. The most common method for supporting diagnosis of angiostrongylosis has been identification of Angiostrongylus vasorum first stage larvae in the feces by the Baermann-Wetzel method. Although considered as gold standard, this method has technical and sampling challenges and cannot detect infections during prepatency or in case of intermittent shedding of the larvae. A rapid in-clinic antigen test has been developed for serologic detection of A. vasorum infections using blood samples (Angio Detect™, IDEXX Laboratories Inc., Westbrook, Maine, USA). The study reported here was conducted to determine diagnostic sensitivity and specificity of the Angio Detect test kit by comparing Angio Detect testing results using serum or plasma samples with the results of Baermann-Wetzel testing using matched fecal samples. Samples from 214 dogs [with clinically suspected (N=195) or diagnosed angiostrongylosis (N=19)] were used for this evaluation. Baermann-Wetzel testing was performed independently at commercial reference laboratories or at university hospitals. All serum/plasma samples were blinded and randomized before testing with Angio Detect. The Angio Detect test was positive for 34 of the 35 cases found positive by the Baermann-Wetzel method; sensitivity of the Angio Detect test was 97.1% (95%CI: 85.1%-99.9%). The Angio Detect test was negative for 177 of 179 samples that were negative by the Baermann-Wetzel test; specificity was 98.9% (95%CI: 96.0%-99.9%). In cross-reactivity testing, all 89 samples from dogs confirmed to be infected with other common nematodes (Dirofilaria immitis, D. repens, Crenosoma vulpis, hookworms, ascarids, or whipworms) were all negative for A. vasorum by the Angio Detect antigen test. Angio Detect provides a rapid and reliable method for diagnosis of A. vasorum in clinically suspected dogs at risk for infection. The test requires minimal steps by the operator and provides results in 15min, allowing the clinician to initiate treatment for positive dogs before leaving the clinic.

Occurrence of Aelurostrongylus abstrusus (Railliet, 1898) in Danish cats: A modified lung digestion method for isolating adult worms.

As Aelurostrongylus abstrusus has not previously received any attention in Denmark, the study investigated the occurrence of A. abstrusus amongst outdoor cats from three regions (Zealand, Møn and Falster). Faeces and lungs were collected from a total of 147 feral (n=125) and domesticated cats (n=22) that were euthanized for reasons outside of this project. Using a modified Baermann technique 13.6% of the cats was found to be positive. A new lung digestion technique was developed to isolate eggs, L1 and adult worms from the lungs and this revealed a prevalence of 15.6% although with regional differences. There was no difference between feral and domesticated cats just as sex and age did not appear to influence prevalence and worm burden. Lungs from 87% of the positive cats had the gross appearance compatible with A. abstrusus and the severity of lung damage was proportional to LPG and number of adult worms. Within the current range of worm burdens (0-22) with a mean intensity of 7 per cat, there was a correlation with faecal excretion levels of L1 that ranged from 0-39,000 with a mean of 3586 per cat. The results did not indicate that the infection levels of the naturally infected cats were substantially affected by acquired immunity, but further studies are needed to determine the importance of host immune responses in regulating parasite populations.

Myocardial injury in dogs with snake envenomation and its relation to systemic inflammation.

OBJECTIVE: To investigate the presence of myocardial injury in dogs hospitalized for snake envenomation and to examine its relationship with systemic inflammation. DESIGN: Prospective case-control study. SETTING: University teaching hospital and small animal referral hospital. ANIMALS: Dogs naturally envenomed by the European viper (Vipera berus; n = 24), African puff adder (Bitis arietans; n = 5), or snouted cobra (Naja annulifera; n = 9). INTERVENTIONS: Blood was collected from dogs envenomed by V. berus at admission, 12-24 hours postadmission, and 5-10 days postadmission. Blood was collected from dogs envenomed by B. arietans or N. annulifera at admission, and 12, 24, and 36 hours postadmission. MEASUREMENTS AND MAIN RESULTS: Concentrations of cardiac troponin I (cTnI), a marker of myocardial injury, and C-reactive protein (CRP), a marker of systemic inflammation, were measured in each blood sample. Evidence of myocardial injury was found in 58% of dogs envenomed by V. berus at one or more time points. A significant correlation between cTnI and CRP concentrations was found at all time points. Evidence of myocardial injury was found in 80% of dogs envenomed by B. arietans at one or more time points; however, no correlation was found between cTnI and CRP concentrations. Evidence of myocardial injury was found in 67% of dogs envenomed by N. annulifera at one or more time points. A significant correlation between cTnI and CRP concentrations was found at admission, but not at other time points. CONCLUSIONS: Myocardial injury frequently occurred in dogs with snake envenomation. While the degree of systemic inflammation was significantly correlated with degree of myocardial injury in V. berus envenomation at all time points, this was not the case in dogs envenomed by N. annulifera or B. arietans. This could be due to differences in the toxic substances of the snake venoms or to differences in the cytokines induced by the venom toxins.

A coprological investigation of gastrointestinal and cardiopulmonary parasites in hunting dogs in Denmark.

A coprological survey was conducted to investigate the prevalence of parasites infecting hunting dogs with no history of recent anthelmintic treatments and with no overt clinical manifestations of cardiopulmonary or gastrointestinal illness. The hunting dogs were recruited from four different areas in Denmark, and fecal samples were obtained in October and November, 2007. For detecting gastrointestinal parasites, samples (N=178) were examined by a commercial flotation kit (Fecalyzer(®) EVSCO, USA). For detection of cardiopulmonary parasites, samples (N=181) were collected on three consecutive days and examined using the Baermann method. Parasites were recovered from 22.1% of the hunting dogs: Angiostrongylus vasorum (2.2%), Toxocara canis (12.4%), Uncinaria stenocephala (7.3%), Taenia spp. (1.7%), Toxascaris leonina (0.6%), Coccidia (0.6%) and unidentified trematode eggs (1.1%). Infection with only one species of parasite was more common (89.5%) than infection with two species (10.5%). A multiple logistic regression model showed that prevalence of intestinal parasites was not influenced by age, gender or breed in adult dogs. There was a significantly higher prevalence of intestinal parasites in the densely populated area of the island Zealand compared with the less populated regions of the peninsular Jutland. The present study reports the first case of A. vasorum in a dog from Jutland. The dog had been visiting the endemic area of western Zealand, suggesting that translocation of sub-clinically infected dogs may contribute to introduction of A. vasorum into non-endemic areas.

Clinical implications of infection with a novel metastrongyloid species in the red panda (Ailurus fulgens).

In a recent survey, 30% of the European red panda (Ailurus fulgens) population was found to be infected with a newly discovered metastrongyloid nematode. In a following prospective study, four naturally infected captive-bred red pandas infected with this parasite were examined and compared with two uninfected control animals. On clinical examination, no abnormalities were detected with respect to vital parameters and cardiovascular system in all six examined animals. Similarly, few and nonspecific changes were recorded on serum biochemistry. No changes on pulmonary pattern were noted on thoracic radiographs. Vertebral heart scores were between 7.2 to 8.6, and no difference was noted between infected and control animals. Two animals had slightly prolonged clotting time and reaction time on thromboelastography but not likely to be of clinical relevance. In conclusion, infection with the newly identified metastrongyloid nematode in the red pandas seems to have little or no clinical importance.

Acute neurological signs as the predominant clinical manifestation in four dogs with Angiostrongylus vasorum infections in Denmark.

Four dogs with acute neurological signs caused by haemorrhages in the central nervous system were diagnosed with Angiostrongylus vasorum infection as the underlying aetiology. Two dogs presented with brain lesions, one dog with spinal cord lesions and one with lesions in both the brain and spinal cord. Only one dog presented with concurrent signs of classical pulmonary angiostrongylosis (respiratory distress, cough), and only two dogs displayed overt clinical signs of haemorrhages. Results of coagulation assays were inconsistent. Neurological signs reflected the site of pathology and included seizures, various cranial nerve deficits, vestibular signs, proprioceptive deficits, ataxia and paraplegia. One dog died and three were euthanised due to lack of improvement despite medical treatment. This emphasises canine angiostrongylosis as a potential cause of fatal lesions of the central nervous system and the importance of including A. vasorum as a differential diagnosis in young dogs with acute neurological signs in Denmark.

Diversity and prevalence of metastrongyloid nematodes infecting the red panda (Ailurus fulgens) in European zoos.

Metastrongyloid induced pneumonia has been described sporadically in the red panda (Ailurus fulgens). Early descriptions in pandas recently imported to the USA from China involved parasites morphologically similar to Angiostrongylus spp. and Crenosomatidae. More recently, four cases of severe verminous pneumonia associated with Angiostrongylus vasorum have been reported from European zoos. A coprological survey of the red panda population within European zoos was conducted in 2008. Faecal samples from 115 pandas originating from 54 zoos were collected on 3 consecutive days. Using Baermann technique, 40 animals (35%) from 20 zoos (37%) were found to shed metastrongyloid first stage larvae (L(1)). Based on their morphology and size, the L(1) observed could be divided into three morphologically distinct types: (1) a Crenosoma sp. type (n=5, overall prevalence: 4.3%), (2) an A. vasorum type (n=3, 2.6%), and (3) an unidentified metastrongyloid species, similar to, but morphologically distinct from A. vasorum (n=32, 27.8%). Further confirmation of species identification was provided by PCR amplification and sequencing of the 18S rRNA gene, which confirmed three different species. The novel Crenosoma species was most genetically analogous to Crenosoma mephitidis and the unidentified metastrongyloid species was most similar to Stenurus minor and Torynurus convulutus. Routine and quarantine health care of red pandas in captivity should take account of the risk of Angiostrongylus and Crenosoma infection in endemic areas, but should also be cognisant of the widespread presence of an apparently less pathogenic species of lungworm. The identity of the two potentially novel species is subject to further work.

PCR detection of Angiostrongylus vasorum in faecal samples of dogs and foxes.

The cardiovascular nematode Angiostrongylus vasorum is spreading in the fox and dog populations of northern Europe. A. vasorum can result in severe clinical manifestations in dogs; therefore, specific diagnosis is crucial for assessing its prevalence. In the present study, faecal samples from foxes and domestic dogs were tested by a new polymerase chain reaction (PCR) targeting the second internal transcribed region of the ribosomal DNA (ITS2) of A. vasorum. Initial isolation of faecal larvae by sieving facilitated the processing of larger sample volumes and allowed for the recovery of dead larvae from frozen samples. The sieve-PCR method enabled the identification of a single larva per 2 g of faecal sample and did not amplify DNA of a range of canine helminths, thus presenting a non-invasive tool for wildlife surveillance and for confirmative diagnosis in dogs.

Quantitative computed tomography evaluation of pulmonary disease.

Objective assessment of pulmonary disease from computed tomography (CT) examinations is desirable but difficult. When such assessments can be made, it is important that they are related to some part of the pathophysiologic process present. Herein we propose that automated volume histogram analysis can yield data that allow differentiation of normal from abnormal lung, and that the magnitude of disease will have an association with objective CT indices. Data from pulmonary CT images from 34 foxes (six uninfected controls and 28 infected with Angiostrongylus vasorum, subdivided by age and infective dose) were available. Lung tissue was segmented from surrounding tissue using an automated segmentation method. A volume histogram showing voxel frequency for each CT number in the range -1024 to -250 HU was created from the entire image stack from each fox. Using these data, the inter-quartile range and the CT number at the 95th percentile were determined. The results showed that segmentation could be readily achieved but that areas of severely diseased lung were excluded. Based on two-way analysis of variance for both the inter-quartile range and the CT number at the 95th percentile, both quantities were significantly affected by the infection status of the animal and were related to worm burden (P < 0.001). The study shows that this form of analysis is readily achieved and provides quantitative data that can be used to assess disease severity, progression, and response to treatment.

Haematological and biochemical changes in dogs naturally infected with Angiostrongylus vasorum before and after treatment.

Haematological and biochemical parameters were studied prospectively in 48 dogs naturally infected with Angiostrongylus vasorum in a primary care setting. Samples for analysis were obtained when treatment was started and 42days afterwards. Prior to treatment, 21% of affected dogs exhibited eosinophilia, whereas increased total white blood cell (WBC) counts and neutrophilia were observed in only 4.2%. WBC counts and concentrations of neutrophils, eosinophils and monocytes decreased significantly from days 0 to 42, indicating that, even in dogs without elevated absolute blood values, a low grade inflammatory response may be present in dogs with A. vasorum infection. Biochemical changes (especially an increase in serum globulins and a decrease in serum fructosamine) were in agreement with the findings of other studies. The results show that the diagnosis of canine angiostrongylosis should not be excluded based on unremarkable haematological and blood biochemical parameters. They also support our recent finding that a low serum fructosamine concentration may be associated with infection with A. vasorum.