Lungworms - A case study

This article is not intended to diagnose or treat your dog, nor to replace the advice of a qualified vet. If in doubt, consult your vet.

Lungworm are parasites that infect dogs. They can be fatal.
Their presence in the UK, until recently, was thought to be fairly rare and largely confined to certain geographical regions - the south west of England and south west Wales are commonly mentioned on various websites.
But evidence is gathering which suggests that they are spreading throughout the UK.

Dogs catch them from infected slugs and snails. Evidence strongly suggests that ingestion of the mollusc itself is not necessary - and that the parasite can infect through contact with the "slime trails".

Vets and drug manufacturers are now warning that eating grass, drinking from puddles or water bowls left outside, or even playing with toys which are left outside is a sufficient means by which infection can occur.

The word lungworm can be thought of as something as a misnomer - the parasite's actions are not restricted entirely to the lung. The infection is generally present in the heart and major arteries within the dog's body, as well as the lungs.

The parasite is officially termed angiostrongylus vasorum, and can cause all sorts of problems in your dog. Apportioning symptoms to this specific parasite is difficult, and anecdotal evidence strongly suggests that misdiagnosis is common. Your dog may be infected but general testing at the vets may not reveal the cause, leaving the dog's illness to further develop and the owner baffled.

One of the board's members has recently gone through such an ordeal and has agreed to provide a timeline of symptoms. However, it is generally accepted that the symptoms of lungworm infection are diverse and often different in individual cases - it depends on where the lungworm migrate to within the body and the degree of infection. So, this timeline might not reflect the symptoms in other dogs.

Indeed, as you will see, there has been no firm diagnosis of lungworm in this dog - he has been treated for the illness on the balance of probability, and is responding well.



December 2011:
Dog visited south west Wales for around 10 days.


January 2012:
Coughing began.
When we mention coughing, we often think of sustained coughing.
In this case, it was more of a short, hacking single cough, as though the dog was coughing up something specific. He could then be seen to swallow whatever it was he'd coughed.

Sneezing began.

It was suggested the dog had a cold.


February 2012:

Coughing and sneezing continued. Occasional vomiting of a thin yellowish substance began.

This cold was going on for a long time.



March 2012:

The dog became "stiff" after walks and didn't want to, or couldn't, jump up onto the sofa after exertion.

Exercise intolerance began - while he wasn't panting heavily, he was very tired after short walks and showed little enthusiasm for going out.

Vomiting continued.



April 2012:

The dog presented with sudden and unexplained aggression, shaking and tremors. He became very vacant - staring into space for long periods of time, facing cupboards or corners, etc.

His legs began to slide out from underneath him, as though drunk, and his front legs would often give out, causing him to fall.

A vet suggested elbow or shoulder dysplasia but was unable to find symptoms of such maladies through routine examination.

All routine blood tests are normal and the dog is further tested for Cushing's Disease (negative) and UTIs (negative).

A different vet noticed the dog's neck had become stiff. X-rays showed some damage to the neck vertebrae. This, as it turns out, was correct - but it was a long-standing injury from his earlier days.


May 2012:

The dog is actively avoiding all forms of company and is sleeping up to 22 hours a day. His stiffness is pronounced. He is short-tempered but not as aggressive.

Coughing and sneezing have mostly stopped.

The dog begins to lose weight at a far faster rate than his diet suggests he should.

He begins to fall over regularly.

Fitting begins - small seizures where the dog is shaking from head to toe, and drool (excess saliva) presents. These exclusively follow times where the dog is asleep.

Vets suggest a brain tumour since this is apparently the most common cause of seizure in older dogs (dog is almost eight years old). However, signs of neurological deficit are absent (for example, lifting a dog's paw while he's standing, and seeing whether he puts his paw back down pad-first, or whether he puts the front side down first).

Pupil response is normal.

Breathing becomes strange - shallow, double breaths, approx 25 breaths per minute at rest.

Towards the end of May, the dog is essentially unable to walk more than a couple of 100 metres.



June 2012:

Fits continue, and increase in regularity. Muscular spasms throughout the body while awake are in evidence. The dog falls over with regularity.

Another vet asks if he could have been poisoned.

Dog's voice goes very hoarse and raspy. His bark is very weak and "strangulated".

His right nostril begins to discharge a heavy, clear liquid which dries white.

Eyes are bloodshot for days on end.

Vet says his lungs and heart sound ok.


July 2012:

Dog begins to experience long post-ictal (post-seizure) periods, where excessive pacing, temporary blindness, getting stuck in corners of the room, and bumping into things becomes very frequent.

Seizures come at the rate of one or two per day.

The dog's blood appears to be thinning - he nicks himself on splinters on the decking while "scooting" and it doesn't clot.

An hour later at the vets, the fresh blood is still there.

Further bloods are taken and analysed but are normal - nothing is out of reference range.

The dog is put onto anti-seizure medication which is supposed to sedate him. It has entirely the opposite effect - he paces for eight to 12 hours at a time, before briefly collapsing into sleep, then waking to resume this pacing. He gets stuck in every corner, in every gap, cannot find his water bowl, can't eat from his food bowl (licks thin air above it).

Waving a hand in front of his eyes shows that he can see nothing, yet pupil response to bright light is normal.

The vet warns that this is surely a brain tumour but a test for lungworm is conducted where stool samples collected over three consecutive days are tested for the presence of larvae. It comes back negative.

The family talk about putting the dog to sleep - he's suffering immensely and has lost so much weight.

Another vet is contacted, who listens to the timeline of events, then suggests that lungworm is very much a possibility. He says that the stool test often does not return a positive result as the larvae are not shed continuously.

The dog is started on lungworm treatment.

He has a seizure that night.

The next day, he appears to be less "confused" - while he's still looking at cupboards and corners, he's not standing in them, stuck.

Day two post-treatment brings further results - the dog's mental confusion has stopped, as have his seizures. He is beginning to engage with his owner but is still lethargic and stiff.

Day three and he's up and about, albeit slowly. He seems very nervous, and over-reacts to small noises. His limping and stiffness have subsided greatly.

Day four and he's interacting normally within the household, though still resting a lot.

Day five and he's pawing at the cupboard where his lead is. His appetite is huge and he's 10 times more active than yesterday. He's no longer even looking at walls or corners.

Day six and it's out for walkies. His voice sounds more normal, his stamina is dramatically improved and he's wagging his tail and pulling that happy doggy face.

Day seven is today. As I write this, he's rolling around in the sun, wagging his tail, and behaving completely normally.

Caveat: lungworm has still not been confirmed in this case. He has been treated on the balance of probability that this difficult-to-diagnose illness is what's causing his symptoms. He has improved dramatically and continues to improve measurably on a daily basis.

Some symptoms of lungworm as given on various vet and drug manufacturer sites are:

Breathing problems or coughing - tiring more easily.

Poor blood clotting leading to excessive bleeding from minor wounds.

Nose bleeds, bleeding into the eye and anaemia.

Behavioural changes, seizures (fits), spinal pain, weight loss.

Loss of appetite, vomiting and diarrhoea.

Nasal discharge.


I've bolded the ones I've observed in my dog.

This story is much like my dogs story. But she keeps getting ill when we remove the lungworm treatment. She has been ill for more than a year and as I wrote - each time we stop the treatment she gets ill again. She has been through all possible tests for all kind of diseases and they are pretty sure it's lungworm (french heartworm).

I'm writing here because my vet and I really don't know what to do - by dog can't be on the worm treatment forever but we can't remove it ...

So I have a question for 'Working dog': has your dog been well since you wrote this story or ? As you can understand I'm really really interested in knowing how your dog is now. IF he has been well since the treatment could you be so kind to let me know which treatment he got? We've tried: Advocate, Milbemax and Panacur - all of them works as long as we don't stop the treatment.

Unfortunately, Marley was put to sleep soon after this was written. He had a severe turn for the worse and was given rest to prevent further suffering.

Please post an introduction in the following forum & let us know what treatment your dog is receiving & what its symptoms are - you will get more response than on this forum.

https://staffy-bull-terrier.niceboard.com/f7-new-member-introductions

Sorry, but I don't know what do you mean by "Please post an introduction in the following forum" .. do you want me to make a completely new topic and put my story in there or is there already a 'lungworm-topic/thread' I should post it in?

no just say hello to everyone

serri wrote:So I have a question for 'Working dog': has your dog been well since you wrote this story or ? As you can understand I'm really really interested in knowing how your dog is now. IF he has been well since the treatment could you be so kind to let me know which treatment he got? We've tried: Advocate, Milbemax and Panacur - all of them works as long as we don't stop the treatment.

Hi,
So sorry to hear this.
The decision - and one which I agonised over - to put my boy to sleep was taken when he went into a prolonged fitting episode. Rectal diazepam stopped the first fit but I had to watch, quite helpless, as lots more occurred overnight. They were exceptionally severe. I videod his final two to show the vet, as though it woulh somehow provide an answer, and the vet just winced when he saw them, and said he was surprised my boy had even survived them.
I am still numb, a few months on.
Up to that point, there was no way I would give up on him while there was still hope.
Had he not gone into the long fits, my next stop was to have been admission to a teaching practice at a university.
Is this something you can discuss with your vet?
My personal take is never to give up until all hands have been played.

From my own selfish perspective, serri, I would be interested to hear what symptoms your own dog is displaying, and their timeline.
I understand if it's too painful to divulge.