REGIONALLY BASED LUNG ULTRASOUND EXAMINATION IN DOGS NATURALLY INFECTED WITH ANGIOSTRONGYLUS VASORUM: A PRELIMINARY STUDY

Angiostrongylus vasorum (Nematoda, Metastrongyloidea) is a molluscan-borne parasitic nematode that has been recognized as a cause of cardiopulmonary disease and coagulopathies in dogs. Early and accurate diagnosis is fundamental but difficult because clinical, laboratory and diagnostic imaging findings are not specific [1]. Lung ultrasound (LUS) has shown potential as an important screening test and monitoring tool for the diagnosis and management of respiratory distress or with respiratory disease [2]. The purpose of this study was to establish the usefulness of regionally based LUS examination to describe the artifacts representing different states of pulmonary interstitial-alveolar infiltration or consolidation in dogs infected by A. vasorum. Between January and March 2018 four dogs with the diagnosis of A. vasorum infection (Baermann’s test) were evaluated. For each dog clinical signs (i.e. coughing, tachypnea, and dyspnea), hematology, biochemistry and coagulation profiles, radiographic, and echocardiographic findings were recorded. LUS was performed before (T0), and 30 days after (T30) the treatment with imidacloprid 10%/moxidectin 2.5% (Advocate®, Bayer Animal Health), based on the Veterinary bedside lung ultrasound examination (VetBlue) protocol described by Lisciandro et al. (2014). LUS severity score: normal (0), mild (1), moderate (2), severe (3), was assigned by the evaluation of LUS artifacts (B-lines, Nodules [Nds], consolidation with aeration [Shs], consolidation with no aeration [Ts]) and their prevalence in VetBlue regions. One author-sonographer (GA) performed LUS examinations in all dogs using the same 10 C microconvex 4-10 MHZ ultrasound probe (Logiq S8 Vet GE). At T0 1/4 dogs showed severe clinical signs (coughing, and dyspnea) associated with severe radiologic changes (peripheral alveolar pattern, nodular pattern and lung consolidation affecting areas in all lung lobes). LUS score value was 3, with the prevalence of Shs and Nds findings in all regions of VetBlue examination. Three of 4 dogs showed coughing, and radiologic changes including nodular interstitial and peripheral alveolar patterns (3/3 dogs), and single areas of lung consolidation (2/3 dogs). LUS score values were 2 (2/3 dogs), and 1 (1/ 3 dogs). B-lines, Nds, and Shs were the prevalent LUS findings, with multiple regional distributions. No clinical signs were observed in all 4 dogs at T30, and Baermann test resulted negative. Radiographic features were substantially improved in all dogs. LUS score values were 0 (2/4 dogs), and 1 (2/4 dogs). B- lines, Nds, were the main LUS findings observed in a single location of the Vetblue examination. Based on the results of this study, regionally based Lung Ultrasound examination could represent a noninvasive diagnostic tool complementary to thoracic radiography for the evaluation, and monitoring of lung interstitial-alveolar infiltration and lung consolidation in dogs with A. vasorum infection.