Τreatment and prevention of canine heartworm disease (dirofilariosis): what is new?

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Published: Dec 18, 2017
DOI: https://doi.org/10.12681/jhvms.15477
Keywords:
dirofilariosis dog heartworm disease prevention treatment Wolbachia pipientis
T. N. SINANIS (Θ.Ν. ΣΙNΑΝΗΣ)
Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki
C. K. KOUTINAS (Χ.Κ. ΚΟΥΤΙΝΑΣ)
Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki
Abstract

Canine heartworm disease (dirofilariosis) is a frequent parasitic disease in Greece and other para-Mediterranean countries. Immediate adulticide therapy, followed by administration of microfilaricidals, has been the mainstay of heartworm treatment. However, a more recent approach has included the requirement to killing microfilariae and Wolbachia pipientis prior to adulticide treatment. Administration of prophylactic doses of milbemycin, moxidectin, ivermectin or selamectin for 2 to 3 months, as well as of doxycycline (10 mg kg-1 bw, per os, twice daily) for a month, seems to negate the ‘susceptibility gap’ and to decrease the possibility of pulmonary thromboembolism. Moreover, an alternative protocol of adulticide therapy (2.5 mg kg-1 bw of melarsomine, intramuscularly, followed by two further injections, 24-hours apart, a month later) is considered superior to the classical one, regardless of the clinical stage of the disease.

Treatment of potential complications (right heart failure or vena cava syndrome) includes administration of heart failure medication and surgical removal of adult worms. Strict exercise restriction seems to play the most important role in reducing the possibility of pulmonary thromboembolism. Alternative protocol melarsomine administration, after treatment with macrocyclic lactones and doxycycline, increases the therapeutic effect and improves prognosis in earlier stages of the disease. Continuous (or at least during the warm period of the year) preventive administration of microfilaricidals coupled with annual serological testing of animals is important for effective disease control.

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References
Abraham D (1988) Biology of Dirofilaria immitis. In: (eds.: Boreham PFL, Atwell RB) Dirofilariasis, CRC Press, Boca Raton, Florida, pp. 29-46.
American Heartworm Society (2012) Current Canine Guidelines for the Diagnosis, Prevention, and Management of Heartworm (Dirofilaria immitis) Infection in Dogs. www.heartwormsociety.org
Anderson RC (2000) Dirofilaria Immitis. In: (eds.: Anderson RC) Nematode Parasites of Vertebrates, Their Development and Transmission, 2nd edn. CABI Publishing, Wallingford, pp. 650-668.
Atkins C (2010) Canine Heartworm disease. In: (eds.: Ettinger SJ, Feldman EC) Textbook of Veterinary Internal Medicine, 7th edn. W.B. Saunders, Philadelphia, pp. 1353-1380.
Atkins C, Miller MW (2003). Is there a better way to administer heartworm adulticidal therapy? Vet Med 98:310–317.
Atwell, R., Sutton, R., Carlisle, C., 1983. The reduction of pulmonary thromboembolic disease (D. immitis) in the dog associated with aspirin therapy. Proceedings of the Heartworm Symposium (Orlando, Florida), p. 115-118.
Bandi C, McCall JW, Genchi C, Corona S, Venco L, Sacchi L (1999). Effects of tetracycline on the filarial worms Brugia pahangi and Dirofilaria immitis and their bacterial endosymbiont Wolbachia, Int J Parasitol 29:357-364.
Bazzocchi C, Mortarino M, Grandi G, Kramer LH, Genchi C, Bandi C, Genchi M, Sacchi L, McCall JW (2008). Combined ivermectin and doxycycline treatment has microfilaricidal and adulticidal activity against Dirofilaria immitis in experimentally infected dogs. Int J Parasitol 38:1401-1410.
Blagburn, B., Hendrix, C., Lindsay, D., 1992. Post-adulticide milbemycin oxime microfilaricidal activity in dogs naturally infected with Dirofilaria immitis. Proceedings of the Heartworm Symposium (Batavia , USA), p. 159-164.
Boudreaux MK, Dillon AR, Ravis WR, Sartin EA, Spano JS (1991). Effects of treatment with aspirin or aspirin/dipyridamole combination in heartworm-negative, heartworm-infected, and embolized heartworm-infected dogs. Am J Vet Res 52:1992- 1999.
Bourguinat C, Keller K, Prichard RK, Geary TG (2011). Genetic polymorphism in Dirofilaria immitis. Vet Parasitol 176:368-373.
Bowman DD, Atkins CE (2009). Heartworm Biology, Treatment, and Control. Vet Clin North Am Small Anim Pract 39:1127-1158.
Bowman, D., Johnson, R., Ulrich, M., 1992. Effects of long-term administration of ivermectin and milbemycin oxime on circulating microfilariae and parasite antigenemia in dogs with patent heartworm infections. Proceedings of the Heartworm Symposium (Austin, Texas), p. 151-158.
Bowman DD, Mannella C (2011). Macrocyclic Lactones and Dirofilaria immitis Microfilariae. Top Companion Anim Med 26:160-172.
Calvert CA, Losonsky JM (1985). Occult heartworm disease associated allergic pneumonitis. J Am Vet Med Assoc 186:1096-1098.
Calvert CA, Rawlings CA (1985). Pulmonary manifestations of heartworm disease. Vet Clin North Am Small Anim Pract 15:991-1009.
Calvert CA, Rawlings CA, McCall JW (1999) Canine heartworm disease. In: (eds.: Fox PR, Sisson D, Moise SN) Textbook of canine and feline cardiology, 2nd edn. W.B. Saunders, Philadelphia, pp. 702-726.
Calvert CΑ, Ridge L (2006) Heartworm disease. In: (eds.: Birchard SJ, Sherding RG) Saunders manual of small animal practice, 3rd edn. W.B. Saunders, St. Louis Missouri, pp. 1561-1573.
Dingman P, Levy JK, Kramer LH, Johnson CM, Lappin MR, Greiner EC, Courtney CH, Tucker SJ, Morchon R (2010). Association of Wolbachia with heartworm disease in cats and dogs. Vet Parasitol 170:50-60.
Dzimianski, M., McCall, J., Steffens, W., 2001. The safety of selamectin in heartworm infected dogs and its effect on adult worms and microfilariae. Proceedings of the Heartworm Symposium (San Antonio, Texas), p. 135-140.
Genchi C, Rossi L, Cardini G, Kramer LH, Venco L, Casiraghi M, Genchi M, Agostini A (2002). Full season efficacy of moxidectin microsphere sustained-release formulation for the prevention of heartworm (Dirofilaria immitis) infection in dogs. Vet Parasitol 110:85-91.
Grauer GF, Culham CA, Cooley AJ, Poff BC, Oberley TD, Brownfield MS, Grieve RB (1987). Clinicopathologic and histologic evaluation of Dirofilaria immitis-induced nephropathy in dogs. Am J Trop Med Hyg 37:588-596.
Holm-Martin M, Atwell R (2004). Evaluation of a single injection of moxidectin for prevention of experimental heartworm infection after 12 months in dogs. Am J Vet Res 65:1596-1599.
Hopper K, Aldrich J, Haskins SC (2002). Ivermectin toxicity in 17 collies. J Vet Intern Med 16:89-94.
Jackson RF, Seymour WG, Growney PJ, Otto GF (1977). Surgical treatment of the caval syndrome of canine heartworm disease. J Am Vet Med Assoc 171:1065-1069.
Kitoh K, Watoh K, Kitagawa H, Sasaki YKitoh K (1994). Blood coagulopathy in dogs with shock induced by injection of
heartworm extract. Am J Vet Res 55:1542-1547.
Kramer L, Grandi G, Leoni M, Passeri B, McCall J, Genchi C, Mortarino M, Bazzocchi C (2008). Wolbachia and its influence on the pathology and immunology of Dirofilaria immitis infection. Vet Parasitol 158:191-195.
Kramer L, Grandi G, Passeri B, Gianelli P, Genchi M, Dzimianski MT, Supakorndej P, Mansour AM, Supakorndej N, McCall SD, McCall JW (2011). Evaluation of lung pathology in Dirofilaria immitis-experimentally infected dogs treated with doxycycline or a combination of doxycycline and ivermectin before administration of melarsomine dihydrochloride. Vet Parasitol 176:357-360.
Lee SG, Moon HS, Hyun C (2008). Percutaneous heartworm removal from dogs with severe heartworm (Dirofilaria immitis) infestation. J Vet Sci 9:197-202.
McCall JW, Genchi C, Kramer L, Guerrero J, Dzimianski MT, Supakorndej P, Mansour AM, McCall SD, Supakorndej N, Grandi G, Carson B (2008). Heartworm and Wolbachia: therapeutic implications. Vet Parasitol 158:204-214.
McCall, J., Guerrero, J., Roberts, R., 2001. Further evidence of clinical prophylactic, retroactive (reach-back) and adulticidal activity of monthly administrations of ivermectin in dogs experimentally infected with heartworms. Proceedings of the Heartworm Symposium (San Antonio, Texas), p. 189-200.
McCall JW, Kramer L, Genchi C, Guerrero J, Dzimianski MT, Supakorndej P, Mansour A, McCall SD, Supakorndej N, Grandi G, Carson B (2011). Effects of doxycycline on early infections of Dirofilaria immitis in dogs. Vet Parasitol 176:361-367.
McCall, J., Ryan, W., Roberts, R., 1998. Heartworm adulticidal activity of prophylactic doses of ivermectin (6 mg/kg) plus pyrantel administered monthly to dogs. Proceedings of the Heartworm Symposium (Tampa, Florida), p. 209-215.
McTier, T., McCall, J., Dzimianski, M., 1992. Epidemiology of heartworm infection in Beagles naturally exposed to infection in three southeastern states. Proceedings of the Heartworm Symposium (Austin, Texas), p. 47-57.
Miller, M., Keister, D., Tanner, P., 1995. Clinical efficacy of melarsomine dihydrochloride (RM340) and thiacetarsemide in dogs with moderate (class 2) heartworm disease. Proceedings of the Heartworm Symposium (Auburn, Alabama), p. 123-128.
Morini, S., Venco, L., Fagioli, P., 1998. Surgical removal of heartworms versus melarsomine treatment of naturally infected dogs with risk of thromboembolism. Proceedings of the Heartworm Symposium (Tampa, Florida), p. 235-240.
Prichard RK (2005). Is anthelmintic resistance a concern for heartworm control? What can we learn from the human filariasis control programs? Vet Parasitol 133:243-253.
Rawlings CA, Losonsky JM, Lewis RE, McCall JW (1981). Development and resolution of radiographic lesions in canine heartworm disease. J Am Vet Med Assoc 178:1172-1177.
Sasaki, Y., Kitagawa, H., Ishihara, K., 1989. Clinical and pathological effects of heartworm removal from the pulmonary arteries using flexible alligator forceps. Proceedings of the Heartworm Symposium (Charleston, South Carolina), p. 45-51.
Simón F, Morchón R, González-Miguel J, Marcos-Atxutegi C, Siles-Lucas M (2009). What is new about animal and human dirofilariosis? Trends Parasitol 25:404-409.
Sinanis TN, Koutinas CK, Diakou A, Papadopoulou P. (2012). Canine heartworm disease (dirofilariosis): pathogenesis and diagnosis of a multidimensional disease. J Hellenic Vet Med Soc 63:291-300.
Thomas CA (1999). Revolution: A unique endectocide providing comprehensive, convenient protection. Compend Contin Educ Pract Vet 21:26-31.
Ware WA (2007) Heartworm disease. In: (eds.: Ware WA) Cardiovascular Disease in Small Animal Medicine, Manson Publishing, London, pp. 351-368.
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