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Twenty two cases of canine neural angiostronglyosis in eastern Australia (2002-2005) and a review of the literature.

Lunn JA, Lee R, Smaller J, MacKay BM, King T, Hunt GB, Martin P, Krockenberger MB, Spielman D, Malik R - Parasit Vectors (2012)

Bottom Line: Signs were attributed to larval migration through peripheral nerves, nerve roots, spinal cord and brain associated with an ascending eosinophilic meningo-encephomyelitis.Most NA cases in the contemporary series (19/22) and many pups (16/38) in the retrospective cohort were managed successfully using high doses of prednisolone and opioids.Supportive measures included bladder care and physiotherapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia. jlunn@vss.net.au

ABSTRACT
Cases of canine neural angiostrongylosis (NA) with cerebrospinal fluid (CSF) evaluations in the peer-reviewed literature were tabulated. All cases were from Australia. A retrospective cohort of 59 dogs was contrasted with a series of 22 new cases where NA was diagnosed by the presence of both eosinophilic pleocytosis and anti-Angiostrongylus cantonensis immunloglobulins (IgG) in CSF, determined by ELISA or Western blot. Both cohorts were drawn from south east Queensland and Sydney. The retrospective cohort comprised mostly pups presented for hind limb weakness with hyperaesthesia, a mixture of upper motor neurone (UMN) and lower motor neurone (LMN) signs in the hind limbs and urinary incontinence. Signs were attributed to larval migration through peripheral nerves, nerve roots, spinal cord and brain associated with an ascending eosinophilic meningo-encephomyelitis. The contemporary cohort consisted of a mixture of pups, young adult and mature dogs, with a wider range of signs including (i) paraparesis/proprioceptive ataxia (ii) lumbar and tail base hyperaesthesia, (iii) multi-focal central nervous system dysfunction, or (iv) focal disease with neck pain, cranial neuropathy and altered mentation. Cases were seen throughout the year, most between April and July (inclusive). There was a preponderance of large breeds. Often littermates, or multiple animals from the same kennel, were affected simultaneously or sequentially. A presumptive diagnosis was based on consistent signs, proximity to rats, ingestion/chewing of slugs or snails and eosinophilic pleocytosis. NA was diagnosed by demonstrating anti-A. cantonensis IgG in CSF. Detecting anti-A. cantonensis IgG in serum was unhelpful because many normal dogs (20/21 pound dogs; 8/22 of a hospital population) had such antibodies, often at substantial titres. Most NA cases in the contemporary series (19/22) and many pups (16/38) in the retrospective cohort were managed successfully using high doses of prednisolone and opioids. Treatment often included antibiotics administered in case protozoan encephalomyelitis or translocated bacterial meningitis was present. Supportive measures included bladder care and physiotherapy. Several dogs were left with permanent neural deficits. Dogs are an important sentinel species for NA. Human cases and numerous cases in tawny frogmouths were reported from the same regions as affected dogs over the study period.

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Antibody titres in serum and CSF samples from the retrospective/prospective study cohort. The vertical axis represents the reciprocal titre of antibodies against A. cantonensis. Serum titres are shown in blue, whereas CSF titres are shown in red. Cases 21 and 22 had no titre detected using ELISA, but were positive using Western blot analysis for the 31 kDa antigen.
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Figure 5: Antibody titres in serum and CSF samples from the retrospective/prospective study cohort. The vertical axis represents the reciprocal titre of antibodies against A. cantonensis. Serum titres are shown in blue, whereas CSF titres are shown in red. Cases 21 and 22 had no titre detected using ELISA, but were positive using Western blot analysis for the 31 kDa antigen.

Mentions: Of cases where CSF was available for testing, 19/21 (90%) were positive for anti-A. cantonensis IgG using the ELISA. Of these 19 cases, serum was available for 16, of which 12 were positive also using the ELISA. Thus, four cases with negative serum titres had positive IgG titres in CSF. In eight patients, the titre in CSF exceeded that in serum, whereas in two cases the opposite was true, while in one further patient the titres in serum and CSF were equal. Two patients (Cases 1 and 3) had serum samples tested one year after the initial sample (Figure 2). Both were positive, with titres of 1:100 and 1:200, compared to 1:100 and 1:800 at first admission. Both cases that were negative for CSF antibodies using ELISA were also negative for serum antibodies. These results are summarised in Table 3 and Figure 5.


Twenty two cases of canine neural angiostronglyosis in eastern Australia (2002-2005) and a review of the literature.

Lunn JA, Lee R, Smaller J, MacKay BM, King T, Hunt GB, Martin P, Krockenberger MB, Spielman D, Malik R - Parasit Vectors (2012)

Antibody titres in serum and CSF samples from the retrospective/prospective study cohort. The vertical axis represents the reciprocal titre of antibodies against A. cantonensis. Serum titres are shown in blue, whereas CSF titres are shown in red. Cases 21 and 22 had no titre detected using ELISA, but were positive using Western blot analysis for the 31 kDa antigen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3361490&req=5

Figure 5: Antibody titres in serum and CSF samples from the retrospective/prospective study cohort. The vertical axis represents the reciprocal titre of antibodies against A. cantonensis. Serum titres are shown in blue, whereas CSF titres are shown in red. Cases 21 and 22 had no titre detected using ELISA, but were positive using Western blot analysis for the 31 kDa antigen.
Mentions: Of cases where CSF was available for testing, 19/21 (90%) were positive for anti-A. cantonensis IgG using the ELISA. Of these 19 cases, serum was available for 16, of which 12 were positive also using the ELISA. Thus, four cases with negative serum titres had positive IgG titres in CSF. In eight patients, the titre in CSF exceeded that in serum, whereas in two cases the opposite was true, while in one further patient the titres in serum and CSF were equal. Two patients (Cases 1 and 3) had serum samples tested one year after the initial sample (Figure 2). Both were positive, with titres of 1:100 and 1:200, compared to 1:100 and 1:800 at first admission. Both cases that were negative for CSF antibodies using ELISA were also negative for serum antibodies. These results are summarised in Table 3 and Figure 5.

Bottom Line: Signs were attributed to larval migration through peripheral nerves, nerve roots, spinal cord and brain associated with an ascending eosinophilic meningo-encephomyelitis.Most NA cases in the contemporary series (19/22) and many pups (16/38) in the retrospective cohort were managed successfully using high doses of prednisolone and opioids.Supportive measures included bladder care and physiotherapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia. jlunn@vss.net.au

ABSTRACT
Cases of canine neural angiostrongylosis (NA) with cerebrospinal fluid (CSF) evaluations in the peer-reviewed literature were tabulated. All cases were from Australia. A retrospective cohort of 59 dogs was contrasted with a series of 22 new cases where NA was diagnosed by the presence of both eosinophilic pleocytosis and anti-Angiostrongylus cantonensis immunloglobulins (IgG) in CSF, determined by ELISA or Western blot. Both cohorts were drawn from south east Queensland and Sydney. The retrospective cohort comprised mostly pups presented for hind limb weakness with hyperaesthesia, a mixture of upper motor neurone (UMN) and lower motor neurone (LMN) signs in the hind limbs and urinary incontinence. Signs were attributed to larval migration through peripheral nerves, nerve roots, spinal cord and brain associated with an ascending eosinophilic meningo-encephomyelitis. The contemporary cohort consisted of a mixture of pups, young adult and mature dogs, with a wider range of signs including (i) paraparesis/proprioceptive ataxia (ii) lumbar and tail base hyperaesthesia, (iii) multi-focal central nervous system dysfunction, or (iv) focal disease with neck pain, cranial neuropathy and altered mentation. Cases were seen throughout the year, most between April and July (inclusive). There was a preponderance of large breeds. Often littermates, or multiple animals from the same kennel, were affected simultaneously or sequentially. A presumptive diagnosis was based on consistent signs, proximity to rats, ingestion/chewing of slugs or snails and eosinophilic pleocytosis. NA was diagnosed by demonstrating anti-A. cantonensis IgG in CSF. Detecting anti-A. cantonensis IgG in serum was unhelpful because many normal dogs (20/21 pound dogs; 8/22 of a hospital population) had such antibodies, often at substantial titres. Most NA cases in the contemporary series (19/22) and many pups (16/38) in the retrospective cohort were managed successfully using high doses of prednisolone and opioids. Treatment often included antibiotics administered in case protozoan encephalomyelitis or translocated bacterial meningitis was present. Supportive measures included bladder care and physiotherapy. Several dogs were left with permanent neural deficits. Dogs are an important sentinel species for NA. Human cases and numerous cases in tawny frogmouths were reported from the same regions as affected dogs over the study period.

Show MeSH
Related in: MedlinePlus