An unexpected cause of dysuria in a cat in Poland.

BACKGROUND: Urinary tract infestation by Capillaria spp. in domestic cats is rather rare, but can cause clinical symptoms and affect behaviour. To our knowledge, this report is the first to describe a case of urinary capillariosis in a cat in Poland. CASE PRESENTATION: A female formerly stray cat aged about 1.5 years showing dysuria, stranguria, periuria and lethargy was presented at the veterinary clinic. Urinalysis revealed the presence of Capillaria plica eggs in the sediment. The cat was treated successfully with three topical doses of Broadline (Merial, Toulouse, France). CONCLUSIONS: C. plica is a nematode whose definitive hosts are carnivores, which are infected by eating earthworms (the intermediate hosts). Thus, C. plica infestation is more frequent in wild carnivores and dogs, and rare in cats. Symptomatic bladder capillariosis in cats is very rarely diagnosed and described.

High Prevalence of Intestinal Capillariasis in Chronic Diarrhea Patients in Thailand: Serological Screening Using a Rapid Lateral-Flow Immunochromatographic Assay.

Intestinal capillariasis is an emerging fish-borne helminthic disease caused by the round worm Capillaria philippinensis. Chronic infection may lead to death if the disease is misdiagnosed and inappropriate treatment is given. We used a rapid lateral-flow immunochromatographic test for screening of intestinal capillariasis in patients with chronic diarrhea. We screened 292 chronic diarrhea patients who had visited hospitals in Thailand. Sixty-six (22.6%) cases were positive according to the kit. All positive patients received mebendazole at 200 mg twice per day for 30 consecutive days or albendazole at 200 mg twice per day for 10 consecutive days. Later, stool concentration techniques, used to examine stool samples from all serologically positive individuals on three consecutive days, revealed C. philippinensis eggs, larvae, and/or adults. The kit is useful for screening and rapid diagnosis of intestinal capillariasis in chronic diarrhea patients in an endemic area for prevention of serious disease and facilitates treatment.

Efficacy of milbemycin oxime/afoxolaner chewable tablets (NEXGARD SPECTRA®) against Capillaria aerophila and Capillaria boehmi in naturally infected dogs.

BACKGROUND: Capillaria aerophila and Capillaria boehmi parasitize the respiratory system of wild and domestic carnivores. Capillaria aerophila inhabits the trachea and bronchi of dogs and cats, while C. boehmi affects the nasal cavities and sinuses of dogs. In dogs the infection may be subclinical or characterized by varying respiratory distress. METHODS: The present study evaluated the efficacy of an oral formulation containing milbemycin oxime and afoxolaner (NEXGARD SPECTRA®) in dogs naturally infected with C. aerophila and/or C. boehmi from three enzootic areas of Italy. Dogs were enrolled pending fecal examination and molecular confirmation of respiratory capillarioses. Dogs were allocated in two groups: Group 1 (G1, 25 dogs), treated with a negative control product with no anthelmintic activity (afoxolaner, NEXGARD®), and Group 2 (G2, 26 dogs), treated with NEXGARD SPECTRA®. At the day of treatment administration (Day 0), all dogs were clinically examined. Dogs were again subjected to clinical and fecal examinations at Days 28 (± 4) and 56 (± 2). The primary criterion for treatment efficacy was the reduction of fecal Capillaria egg counts in G2 compared with G1. The regression of/recovery from baseline clinical signs was considered as a further efficacy criterion. RESULTS: Percentage reduction of fecal Capillaria egg counts in the NEXGARD SPECTRA® group compared to the control group was > 97% on Day 28 and 100% on Day 56, respectively (p < 0.05 for both time points). Twelve of the 13 dogs in the NEXGARD SPECTRA® group with respiratory signs prior to treatment were free of clinical signs at the end of the study. Conversely, the six control group dogs with respiratory signs prior to treatment remained symptomatic. CONCLUSIONS: Results of the present study showed that NEXGARD SPECTRA® was safe and highly efficacious in the reduction of C. aerophila and C. boehmi eggs after one treatment with a complete reduction of the egg output after the second administration associated with a recovery from respiratory signs.

Urinary capillariosis in a cat from Rio de Janeiro, Brazil - Clinical, morphological and phylogenetic characterization.

Capillaria spp. infections of the urinary tract of domestic carnivores are uncommon worldwide. Infections are rarely diagnosed and are typically asymptomatic. This study aimed to evaluate a case of capillariosis in a cat from the state of Rio de Janeiro, Brazil. A seven-year-old female cat with apathy and reduced appetite was presented. Urine analysis revealed C. plica eggs in urine sediment, and cystitis was evidenced by the presence of bacteria, pyuria, proteinuria and hematuria. The subject was treated with 50 mg/kg fenbendazole for five days. Urine samples were frozen for molecular analysis and species confirmation. Polymerase chain reaction for amplification of the 18S rRNA gene followed by sequencing confirmed the occurrence of Capillaria sp. There has been limited phylogenetic study of Capillaria spp. in cats, so further studies are needed to identify the species present in different locations and associated with feline pathogenesis.

Capillaria boehmi (syn. Eucoleus boehmi): Challenging treatment of a rarely diagnosed nasal nematode in dogs and high prevalence in Swiss foxes.

Despite morphological differences of eggs and adults, Capillaria boehmi infections have been occasionally misdiagnosed as C. aerophila infections in the past. Capillaria boehmi is found in the nasal and paranasal sinuses of wild canids and dogs, which may suffer from nasal discharge, sneezing, epistaxis and, importantly, their scent can be impaired. In this study we present three challenging cases of nasal capillariosis in dogs, report and review the variable success of anthelmintic treatments and investigate C. boehmi prevalence in Swiss red foxes, considered as potential wild life reservoir. Out of two females and one male dog (all scent hounds, aged 3-9 years and weighing 19-31 kg), two dogs were previously coproscopically misdiagnosed with Trichuris infections. Two dogs showed clinical signs such as sneezing, coughing and impaired scent. From one dog adult living C. boehmi were obtained by nasal lavage. The identity of worms and eggs of all three dogs were genetically confirmed (18S rRNA, 100 % identity in 578 base pairs). Dogs 1-3 were followed-up for overall 54, 8, and 67 months, respectively. All dogs repeatedly excreted C. boehmi eggs in faecal samples despite treatments with the following compounds, in various dosage and retreatment protocols: fenbendazole, milbemycin oxime (orally), moxidectin/imidacloprid/ (spot-on) and levamisole (intramuscularly). The different anthelmintic compounds showed variable success regarding their effect on clinical outcome and on stopping egg excretion. Reinfections due to a contaminated environment could not be fully excluded. In winter 2016 and 2017, 218 foxes from the canton of Zurich, Switzerland, were examined. Tissues of nasal and paranasal sinuses were investigated for adult Capillaria specimens and eggs. We describe for the first time C. boehmi infections in Switzerland, observing a high prevalence (190/218, 87.2 %). Overall, 107 of 126 adults (84.9 %, 95 % Confidence Interval, CI: 77.5-90.7 %) and 83 of 92 youngsters (90.2 %, CI: 82.2-95.4 %) were infected. The presence of C. boehmi did not correlate with age (P = 0.209), but correlated significantly with sex: male foxes (102 of 107, 95.3 %, CI: 89.4-98.5 %) were significantly (P = 0.001) more often infected than females (88 of 111, 79.3 %, CI: 70.5-86.4 %). Worm burden ranged from 1 to 72 adult specimens (geometric mean: 5.7). In conclusion, C. boehmi infections can be mis- and/or underdiagnosed in dogs. Appropriate anthelmintic treatments, preventing coprophagia and egg contamination of the surroundings and performing coproscopic controls after treatments are fundamental aspects. Potentially, nasal washing may represent an auxiliary alternative. However, the successful elimination of C. boehmi infections in dogs remains challenging.

Further evaluation of the efficacy of emamectin benzoate for treating Pseudocapillaria tomentosa (Dujardin 1843) in zebrafish Danio rerio (Hamilton 1822).

Pseudocapillaria tomentosa is a pathogenic nematode parasite, causing emaciation and severe inflammatory lesions in the intestines in zebrafish Danio rerio (Hamilton 1822). Emamectin benzoate is commercially available analogue of ivermectin used for treating salmon for sea lice, under the brand name SLICE® , and we have used this for treating zebrafish with the P. tomentosa. Here, SLICE® , 0.2 per cent active emamectin benzoate, was used for oral treatments at 0.35 mg emamectin benzoate/kg fish/day for 14 days starting at 7 days post-exposure (dpe). Another experiment entailed initiating treatment during clinical disease (starting at 28 dpe). Early treatment was very effective, but delaying treatment was less so, presumably due to inappetence in clinically affected fish. We evaluated emamectin benzoate delivered in water, using Lice-Solve™ (mectinsol; 1.4% active emamectin benzoate) in two experiments. Application of four 24-hr treatments, space over 7 days was initiated at 28 dpe at either 0.168 or 0.56 mg emamectin benzoate/L/bath, and both treatments completely eradicated infections. This was 3 or 10 times manufacture's recommended dose, but was not associated with clinical or histological side effects.

Clinical and laboratory characterizations of hepatic capillariasis.

Hepatic capillariasis is a rare and neglected parasitic disease caused by infection with Capillaria hepatica in human liver. The disease is not well described and the information for the disease's clinical manifestation, laboratory findings and disease management strategy is not well reported. The limited information for this neglected infection often results in the delay of diagnosis or misdiagnosed to other diseases, therefore the real prevalence or severity of the infection may be underestimated. More case report with systemic analysis and features summary of this disease is needed to better understand the serious zoonotic disease. This study included systemic analysis of 16 patients infected with hepatic capillariasis in China between 2011-2017, including clinical manifestations, laboratory/radiative image findings and treatment results. Clinical manifestation included sustained fever (56.25%), respiratory disorder (37.5%), abdominal pain (37.5%), diarrhea (25%), leukocytosis (93.75%) and eosinophilia (100%). No egg was detected in feces of all patients. Over 60% patients showed elevated level of hepatic enzymes and proteins related to liver fibrosis in sera. Ultrasound and MRI examinations displayed scattered parasitic granuloma leisure in affected liver. Liver biopsy revealed parasite eggs, necrotized parasitic granulomas and septal fibrosis. Treatment with albendazole combined with corticoids for several treatment courses cured all patients with capillariasis. The difficulty of diagnosis, apparent damage of liver functions and potential fibrosis make the disease's prevalence and severity underestimated.

Hepatic Capillariasis- Drug Targets.

Zoonotic infections are increasingly becoming public health menaces and are usually transmitted to humans due to unsuitable environmental conditions. One of them is hepatic capillariasis, caused by the parasite Capillaria hepatica, primarily a disease of rodents, with hepatic manifestations in humans. Although its prevalence is very low, it can cause significant morbidity and mortality, with cases reported from all over the world. The main infective form for humans is the embryonated egg of the parasite, which hatches in the intestine and ultimately colonize the liver. The larvae mature and reproduce, and eventually form embryonated eggs, which cause chronic focal inflammation and septal hepatic fibrosis. Clinical presentation mainly consists of fever, abdominal pain, hepatomegaly and eosinophilia. Spurious infection with unembryonated eggs cause gastrointestinal symptoms. Diagnostic modalities include liver biopsy, ultrasonography, CT scan, immunological tests like ELISA and IIFT. The infection can be treated mainly with a combination of benzimidazoles like thiabendazole, mebendazole and albendazole; with corticosteroids. The study emphasizes the need for hepatic capillariasis to be considered as a differential diagnosis in cases of suspected hepatitis, leptospirosis, abdominal lymphadenopathy or other hepatic or parasitic infections prevalent in the region concerned; and meticulously assess the cases to facilitate early diagnosis and prompt treatment, thus reducing the distress faced by patients.

Serratospiculosis in Captive Peregrine Falcons (Falco peregrinus) in Switzerland.

Infection with Serratospiculum species was identified in a captive peregrine falcon (Falco peregrinus) in Switzerland. Pathologic and parasitologic examination results revealed generalized severe granulomatous airsacculitis, with intralesional adults, larvae, and eggs of Serratospiculum species. Subsequently, an individual coprological analysis of the remaining 15 falcons (peregrine falcons and gyrfalcons [Falco rusticolus]) from the same owner was performed. Eggs of Serratospiculum species (4 birds) and Capillaria species (11 birds), and oocysts of Caryospora species (1 bird) were detected. Treatment with ivermection (2 mg/kg SC) was effective, as none of the falcons excreted Serratospiculum species eggs 10 days after one dose. To our knowledge, this is the first report of infection with Serratospiculum species in captive falcons in Europe.

Diagnosis and therapy of Capillaria plica infection: report and literature review.

Worldwide, data on Capillaria (Pearsonema) plica infections of the urinary tract in domestic carnivores are limited. Nevertheless, cystitis with hematuria, dysuria or pollakiuria may suggest a C. plica infection. A three-year old dog from Poland showing pollakiuria and hematuria was presented. At urine analysis, C. plica eggs were found in the urine sediment. The dog was unsuccessfully treated with a daily oral dose of fenbendazole 50 mg/kg BW for 5 days, while a single subcutaneous administration of ivermectin 0.2 mg/kg BW once effectively eliminated C. plica infection.

Experimental Assessment of the Efficacy of Five Veterinary Broad-Spectrum Anthelmintics to Control the Intestinal Capillariasis in Zebrafish (Danio rerio).

Zebrafish in research facilities are frequently infected with capillarids. Since the health status (as a nonprotocol source of variation) of zebrafish can affect the validity of experiments, it is important to develop therapies for common zebrafish diseases. Regarding the likelihood of (1) the development of drug resistance and (2) the loss of the efficacy of a drug for laboratory zebrafish, the availability of alternatives for treatment is of direct importance. The efficacy of five dewormers from the same or different therapeutic groups was assessed in the current study. The exposure to each drug was repeated in triplicate (i.e., 3×100 fish in each treatment). The (1) elimination of parasite eggs, larvae, or adults from fresh fecal droppings (as the first main criterion) and (2) dissection of one-third of treated fish (i.e., 100 fish per drug) and examination of their gut contents (as the second major criterion) were considered to verify the efficacy of the drugs to eradicate the infection. Mebendazole (meb), praziquantel (pra; after the first round of treatment, i.e., six-fold administration, twice a day, for 3 days), fenbendazole (fen; after the second round of treatment), and ivermectin (ive; just after two administrations: twice during a day, i.e., a successful treatment with the smallest therapeutic effort) eradicated the infection, while albendazol (alb) was ineffective, although alb in a combined therapy with fen was successful. No age-, sex-, or disease severity-dependent responses to drugs were observed. The meb, pra, and ive were eliminating parasite eggs effectively in contrast with fen (that just was effective on adults). The drugs produced no observable side effects in zebrafish.

Efficacy of Broadline against Capillaria aerophila lungworm infection in cats.

Capillaria aerophila is a globally distributed parasite of the respiratory system of carnivores and can be considered the second most common lungworm after Aelurostrongylus abstrusus in domestic cats in the northern hemisphere. To evaluate the efficacy of Broadline (Merial), a combination of fipronil 8.3% w/v, (S)-methoprene 10% w/v, eprinomectin 0.4% w/v and praziquantel 8.3% w/v against C. aerophila, a controlled study with 20 naturally infected cats was conducted. Following blocking by body weight, cats were allocated randomly to two groups of ten animals each: control (untreated) or treated once with Broadline according to the label instructions. For evaluation of efficacy, faeces were examined for capillarid egg shedding prior to and weekly for 3 weeks after treatment, when the cats were necropsied for C. aerophila recovery. Following single topical administration of Broadline, faecal capillarid egg counts were significantly reduced by 93.5 to 99.1% (p < 0.01) compared to the controls. Cats treated harboured significantly fewer C. aerophila lungworms compared to the untreated controls (efficacy 82.4%, p = 0.016). Results of this study demonstrate that Capillaria lungworm burdens can be markedly reduced and that faecal egg shedding can be substantially lowered or eliminated following a single treatment with Broadline.

Intestinal capillariasis in the 21st century: clinical presentations and role of endoscopy and imaging.

BACKGROUND: Intestinal capillariasis is one of the common causes of malabsorption in the East. Reports emphasizing the roles of clinical, endoscopic and radiologic findings of intestinal capillariasis are limited. METHODS: Retrospective review of medical records of 26 patients diagnosed with intestinal capillariasis at Siriraj Hospital, Bangkok, Thailand between 2001- 2013. RESULTS: Clinical manifestations were chronic watery diarrhea (93%), chronic abdominal pain (70%), significant weight loss (92%), hypoalbuminemia (100%; 85% lower than 2.0 g/dL), and anemia (50%). The median duration of symptoms was 5.5 months (1-60 months). Parasites were found in stool in 15 patients (57%). In patients whose stool tests were initially negative, parasites were discovered in tissue biopsy from endoscopy in 1 from 10 esophagogastroduodenoscopies (EGD), 0 from 7 colonoscopies, 3 from 5 push enteroscopies, and 3 from 5 balloon-assisted enteroscopies (BAE). Endoscopic findings included scalloping appearance, mucosal cracking, and redness of mucosa. These endoscopic findings affected mostly at jejunum and proximal ileum. They were similar to celiac disease except duodenal involvement which is uncommon in capillariasis. Three patients underwent video capsule endoscopy (VCE) and typical abnormal findings were observed in all patients. Small bowel barium study showed fold thickening, fold effacement, and increased luminal fluid in 80% of patients, mainly seen at distal jejunum and ileum. CT findings were long segment wall thickening, enhanced wall, and fold effacement. Treatment with either albendazole or ivermectin cured all patients with most responding within 2 months. CONCLUSIONS: In endemic area, intestinal capillariasis should be considered if patients develop chronic watery diarrhea accompanied by significant weight loss and severe hypoalbuminemia. Stool examination had quite low sensitivities in making diagnosis in our study. Deep enteroscopy with biopsy guided by imaging or VCE may improve diagnostic yield. Empirical therapy may also be justifiable due to the very good response rate and less side effects.

Tolerance and efficacy of emamectin benzoate and ivermectin for the treatment of Pseudocapillaria tomentosa in laboratory zebrafish (Danio rerio).

Tolerance of adult zebrafish and efficacy of emamectin benzoate and ivermectin in eliminating Pseudocapillaria tomentosa infection were evaluated. In the tolerance study, behavioral changes, fecundity, histopathology, and mortality were evaluated for in-feed administration of emamectin (0.05, 0.10, and 0.25 mg/kg) and ivermectin (0.05 and 0.10 mg/kg). All doses of emamectin were well tolerated. Ivermectin 0.05 mg/kg administration resulted in mild behavioral changes and a transient decrease in fecundity. Ivermectin 0.10 mg/kg administration resulted in severe behavioral changes and some mortality. In the efficacy study, emamectin (0.05 and 0.25 mg/kg) and ivermectin (0.05 mg/kg) were evaluated for their efficacy in eliminating P. tomentosa infection. Emamectin reduced parasite burden in infected zebrafish, and ivermectin eliminated intestinal nematode infections. Despite a small margin of safety, ivermectin 0.05 mg/kg was effective at eliminating P. tomentosa infection in adult zebrafish. Higher doses or a longer course of treatment may be needed for complete elimination of P. tomentosa infection using emamectin. In this study, we propose two possible treatments for intestinal nematode infections in zebrafish.

Efficacy of a novel topical combination of fipronil, (S)-methoprene, eprinomectin and praziquantel against feline urinary bladder worm (Capillaria plica) infection.

Infection with urinary capillarid bladder worms has been observed in cats worldwide. Although considered as generally causing no or little harm, infection with urinary capillarids may be associated with clinical disease which requires an appropriate treatment including the use of anthelmintics. Therefore, the efficacy of a novel topical combination formulation of fipronil 8.3% (w/v), (S)-methoprene 10% (w/v), eprinomectin 0.4% (w/v), and praziquantel 8.3% (w/v) (BROADLINE(®), Merial) was evaluated against urinary capillarids in naturally infected cats. Sixteen European Short Hair cats (5 male, 11 female) with capillarid eggs in their urine pre-treatment were included in the study. At the time of treatment, the cats were approximately ten months to eight years old and weighed 1.6-3.6 kg. Cats were ranked based on decreasing bodyweight and then randomly allocated within replicates of two animals to one of the treatment groups. Each cat in the treated group received one topical application of the combination product at the minimum therapeutic dose of 0.12 mL/kg body weight delivering 10mg fipronil+12 mg (S)-methoprene+0.5mg eprinomectin+10mg praziquantel per kilogram of body weight while the cats allocated to the control group remained untreated. For parasite recovery, identification and count, cats were euthanized humanely 14 days after treatment. All untreated cats harboured Capillaria plica in their urinary bladders (range 4-12), while no capillarids were recovered from the eight treated cats. Thus, the efficacy of the novel topical combination against C. plica was 100%. All cats accepted the treatment well based on post-treatment observations and daily observations thereafter. No adverse events or other health problems were observed during the study.

A pilot trial evaluating the efficacy of a 10% imidacloprid/2.5% moxidectin spot-on formulation in the treatment of natural nasal capillariosis in dogs.

The efficacy and safety of a spot-on formulation containing 10% imidacloprid and 2.5% moxidectin (Advocate(®), Bayer Animal Health GmbH, Leverkusen, Germany) were evaluated in a pilot trial for the treatment of canine nasal capillariosis caused by Capillaria boehmi (syn. Eucoleus boehmi). Sixteen dogs copromicroscopically positive for C. boehmi eggs were confirmed, either by rhinoscopy or species-specific PCR-coupled sequencing assays, as being affected by nasal capillariosis. The animals were randomly allocated to two different study groups, i.e. one (Group T) treated with Advocate(®) and one (Group C) left untreated, in a ratio of 1:1. The animals underwent clinical examination and quantitative copromicroscopy for C. boehmi eggs on Days -6 and -2 (baseline) and Day 28 ± 2 (post-baseline). Animals in Group T received Advocate(®) on Day 0. On Day 28 ± 2 the efficacy of the treatment (Group T) or the persistence of the infection (Group C) was confirmed by rhinoscopy or, alternatively, by molecular procedures. Seven of the eight dogs in Group T were negative on Day 28 ± 2 (reduction of baseline faecal egg counts by 99.14%), while for one dog a second treatment on Day 28 ± 2 was necessary to clear the infection, as demonstrated on Day 56 ± 2 (reduction of baseline faecal egg counts by 100% in Group T). Seven animals in Group C received a rescue dose of Advocate(®) on Day 28 ± 2 and scored microscopically and molecularly negative for the parasite on Day 56 ± 2, thus increasing the reduction of post-baseline egg counts to 99.57% after a single administration. These promising results show that Advocate(®) spot-on is an effective formulation for the treatment of canine nasal capillariosis under field conditions.

A simple and efficient protocol for the treatment of zebrafish colonies infected with parasitic nematodes.

Abstract Our zebrafish colony experienced a period of increased mortality rate of 6.5 times more deaths per month in a colony of over 13,000 zebrafish (Danio rerio), which developed over 3 months. We observed that before death, affected fish appeared emaciated, often with an abdominal bulge. We performed dissection on 18 fish that had this appearance and found in 15 that their gut was infected with a nematode that closely resembled Pseudocapillaria tomentosa. We devised a treatment protocol for this nematode infection, which involved addition of fenbendazole, a drug used to treat nematode infections in cattle and sheep, to the fish feed. Fenbendazole produced no severe side effects in the fish and several treatments have effectively eradicated the parasite from our colony. The mortality rate of our fish has decreased to a value of 0.7%/month (p<0.001, equal to that before the infection). We propose this protocol as an inexpensive alternative to having to rederive an entire colony from bleached eggs, and as a prophylactic measure used in quarantine facilities on a regular basis.

Treatment of E. boehmi infection in a mixed-breed dog using milbemycin oxime.

Numerous bipolar plugged capillarid eggs were detected on a routine centrifugal fecal flotation examination of a 2 yr old castrated male boxer-Chinese shar pei mixed-breed. The eggs were identified as Eucoleus boehmi (E. boehmi), the nasal capillarid, based on size and shell wall surface morphology. The dog had a history of chronic sneezing (> 5 times/day) and intermittent postexercise nasal discharge. Currently, there are no anthelmintics approved for use in dogs for the treatment of E. boehmi. Treatment of the dog with 0.5-1 mg/kg milbemycin oxime was ineffective, but treatment with 2 mg/kg milbemycin oxime resulted in negative fecal examinations 7-28 days and 5 mo posttreatment. The dog's postexertion nasal discharge greatly lessened, and the sneezing behavior improved (it was only noted 2-3 times/wk), but neither the discharge nor sneezing completely resolved following the anthelmintic treatments. Use of milbemycin oxime at an increased dose (2 mg/kg) appeared to be an effective treatment against E. boehmi infection in this dog based on clinical response and the cessation of fecal egg shedding.