Angiostrongylus lungworm in northern England in 2018
After a break of a couple of years we’ve seen two cases of angiostrongylosis in the last few weeks. As ever, it continues to manifest in a variety of presentations.
The first case, a dog with a cough of a couple of weeks duration, was seen after seizuring. Within 12 hours she had suffered catastrophic neurological deterioration and died.
Interestingly, although her lung changes were typically severe -a wide scatter of consolidated subpleural hypoechoic patches on ultrasound:
Echocardiographically, there was no appreciable evidence of pulmonary hypertension:
The earlier dog initially presented with lethargy and then bruised markedly on venepuncture although platelet count and coagulation tests were within normal limits. Echocardiography was much more typical with marked right ventricular dilation, paradoxical septal motion and accelerated tricuspid regurgitation velocity consistent with pulmonary hypertension:
left apical view optimised for trans-tricuspid flow. regurgitation at 4m/s implies a systolic RV and pulmonary artery pressure >80mmHg in a patient with overt right-sided congestive failure (i.e. RA pressure @15mmHg) where normal is <35mmHg.
This second dog, especially, had large number of larvae on faecal wet smears:
