Life-threatening strongyloidosis in a puppy

INTRODUCTION. Strongyloides stercoralis is a worldwide-distributed intestinal nematode infecting humans, dogs and other animals including non-human primates and wild canids. Reports on S. stercoralis infections in dogs from Europe are limited (Basso et al., 2018 Parasitol. Res. 118:255-66). Dogs acquire strongyloidosis through active penetration or ingestion of infective larvae, or via lactation (Shoop et al., 2002 J Parasitol. 88:536-39). Auto-infections are frequently described, leading to long-lasting and to potentially life-threatening hyper-infection syndrome. Infected dogs show subclinical pictures to severe signs. Gastrointestinal and respiratory signs, along with anemia, lethargy, reduced growth and sudden death, are described in young dogs (Thamsborg et al., 2017 Parasitol. 144:274-84). This report describes a severe clinical case of S. stercoralis hyper-infection in a puppy. MATERIAL AND METHODS. A 3-months-old miniature Pomeranian Spitz was brought to a veterinary practice for a sudden onset of cough and diarrhea. Blood count, chest radiographs and SNAPGiardia® were performed and the puppy was empirically treated using amoxicillin/clavulanic acid. Nevertheless, cough and general clinical conditions worsened in two days, and the dog was referred to veterinary clinic with lateral decubitus, drooling, hypoglycemia (38 mg/dL), anorexia, vomit and diarrhea with hematochezia. Thereafter the puppy was subjected to hemogasanalysis, SNAP Parvo®, fresh fecal smear, faecal floatation and Baermann’s test. RESULTS AND CONCLUSIONS. The puppy scored positive to the SNAP Giardia® and negative to the SNAP Parvo®. Floatation was negative, while rabdithoid larvae were detected at the fecal smear and in Baermann sediment. Larvae were microscopically identified as S. stercoralis (Inês et al., 2011 Acta Trop. 120:206-10). After clinical stabilization, the puppy was treated with maropitant, metoclopramide, probiotics and fenbendazole (50 mg/kg q12 for 7 days) (Paradies et al., 2017 Rev. Veterinary Clin. 51:55-9). The Baermann tests performed 5 days and 5 weeks post treatment (p.t.) were negative. The clinical condition of the dog rapidly improved until complete resolution of clinical signs. From the second day p.t. vomit and diarrhea ceased, while the cough disappeared 3 weeks p.t.. This case report shows the importance of routine Baermann examinations in puppies with respiratory and gastrointestinal signs, as strongyloidosisis often overlooked due to the low awareness on this potentially fatal parasitosis.