Heartworm Disease

Ames, Marisa K.

doi:10.1002/9781119028994.ch58

Cited by 1 publication

(6 citation statements)

References 29 publications

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“…The exact mode of action of melarsomine on D. immitis is unknown. Adverse reactions observed after treatment with melarsomine may be directly attributable to the medication or may be secondary to worm death or the underlying heartworm disease process (3). If toxicity secondary to melarsomine is suspected, dimercaprol has been reported as an antidote for arsenic toxicity (16).…”

Section: Discussionmentioning

confidence: 99%

“…It has a long and complex life cycle involving transmission by a mosquito vector and several molts prior to sexual maturity ( 2 ). D. immitis also harbors Wolbachia , a gram-negative bacterium which is required for its reproduction ( 3 ). Mature heartworms mainly reside in the caudal pulmonary arteries and may cause physical obstruction, inflammation, and endothelial dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…Wolbachia appears to contribute to immune polarization during infection as well as inflammatory/immunomodulatory activity via surface protein antigens ( 4 ). Clinical signs (if any) depend on the severity of disease and duration of infection ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…In many, if not most cases of canine heartworm infection, melarsomine is considered a safe and effective adulticide ( 5 ). However, worm death commonly leads to some degree of thromboembolic disease and a number of clinical sequelae have been described ( 3 ). Treated dogs must be carefully monitored for adverse cardiopulmonary effects and intense inflammatory reactions ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…surface protein antigens (4). Clinical signs (if any) depend on the severity of disease and duration of infection (3).…”

mentioning

confidence: 99%

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Case report: Disseminated intravascular coagulation in a dog following treatment with melarsomine for Dirofilaria immitis

Philp

Farrell²,

Li³

2023

Front. Vet. Sci.

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Disseminated intravascular coagulation following melarsomine therapy for Dirofilaria immitis (D. immitis) is reported in a 9-year-old female intact pit bull-type dog. The dog had been diagnosed with D. immitis (antigen and microfilaria positive) and treated with imidacloprid, moxidectin, doxycycline and 3 doses of melarsomine over a 92-day period. Seven days after the third melarsomine injection, the patient was presented to her family veterinarian due to right pelvic limb swelling. Prothrombin and activated partial thromboplastin times were prolonged beyond the detectable range. Treatment included vitamin K1 and fresh frozen plasma (FFP) prior to referral to the authors' institution. At this time the patient remained coagulopathic. Further investigations included thoracic radiographs, abdominal ultrasound and an echocardiogram. The patient was administered multiple units of packed red blood cells and FFP, sildenafil, dexamethasone SP, aminocaproic acid and vitamin K1. Repeat CBC approximately 20 h after admission showed persistent anemia and thrombocytopenia. Despite ongoing administration of FFP, a repeat coagulation panel showed worsening of the coagulopathy with prothrombin time of 84.2s [reference interval (RI) 7.0–9.3s], activated partial thromboplastin time >140s (RI 10.4–12.9s) and fibrinogen <50 mg/dL (RI 109–311 mg/dL). Following discussion with the owners, the patient was euthanized. Necropsy was performed and confirmed heartworm infection with severe pulmonary arterial thrombosis, vascular remodeling, and intraluminal degenerate nematodes. Multifocal subcutaneous and organ hemorrhage was apparent. Although coagulopathy has been described in caval syndrome associated with heartworm disease and is listed as a potential side effect of melarsomine administration, this is the first report of documented disseminated intravascular coagulation following melarsomine treatment for D. immitis. Potential mechanisms for the coagulopathy are discussed and the case report highlights a rare, but serious complication of adulticide therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%