Lungworm: A roundtable discussion

Lungworm (Angiostrongylus vasorum) is increasingly recognised as a cause of illness, particularly cardiorespiratory signs and haemorrhage, in dogs. It is now distributed across the UK, although prevalence varies widely and there are local foci of higher infection. Presentation of clinical cases varies considerably, and lungworm should be on many differential diagnosis lists. Diagnostic tests now include direct faecal smear, Baermann's, bronchoalveolar lavage, antibody and antigen ELISAs and PCR. Appropriate testing depends on the clinical situation, and no test is 100% sensitive and 100% specific. Treatment involves moxidectin or milbemycin oxime, plus supportive care. Tranexamic acid and plasma transfusions may both be useful in dogs showing coagulopathies. Dogs may be at risk from accidental ingestion of intermediate host slugs with grass, or larvae in puddles, as well as from deliberately eating slugs, so prevention relies heavily on monthly appropriate anthelmintics, and compliance is an issue in this. Other lungworm species also occur and should not be forgotten. In cats, the lungworm Aelurostrongylus abstrusus can cause severe, even fatal, infection and this is probably under-diagnosed. Monthly preventative treatment with a licensed product is recommended in cats that go outside.