Carretón E, Morchón R, Simón F, Juste M C, González-Miguel J, Montoya-Alonso J A
Faculty of Veterinary Medicine, University of Las Palmas de Gran Canaria, Las Palmas, Spain.
Laboratory of Parasitology, Faculty of Pharmacy and Institute of Biomedical Research of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain.
Vet Parasitol. 2014 Nov 15;206(1-2):55-9. doi: 10.1016/j.vetpar.2014.08.015. Epub 2014 Aug 30.
Adulticide treatment of dogs with canine heartworm disease causes the death of the adult Dirofilaria immitis lodged in the vascular system of the host. During the death of the worms, pulmonary thromboembolisms (PTE), pulmonary inflammation, congestive heart failure, or renal disease are possible consequences. The aim of this study was to evaluate cardiopulmonary biomarkers and renal parameters during adulticide treatment of canine heartworm to compare the classic two-injection treatment protocol versus the American Heartworm Society (AHS) recommended protocol. Fourteen heartworm-infected dogs with high parasite burdens were divided in three groups and allocated to adulticide protocols as follows: Group A (n=5) was treated with the classic two-injection protocol; group B (n=5) was treated using the AHS recommended protocol, and group C (n=4) was treated as for group B but received diminishing anti-inflammatory doses of prednisone. To assess cardiorespiratory status, cardiac troponin I (cTnI), myoglobin, and D-dimer were measured. Renal function was evaluated by measuring urea, creatinine, and urine protein:creatinine (UP:C). Serum and urine samples were collected day 0 (day of diagnosis), 7 and 14 days after the first dose of adulticide, and 1 month after the last adulticide injection. Dogs that received classic treatment presented pathologic concentrations of D-dimer more frequently and showed higher average D-dimer levels, which may indicate the presence of more severe PTE. Group C showed the highest levels of D-dimer during treatment, which may be due to an exacerbation of PTE caused by the administration of prednisone. CTnI and myoglobin values remained above reference values in all groups during the study but reached the lowest values 1 month after the last injection. Levels of urea and creatinine were within normal ranges in all groups, and 28.5% of the dogs were proteinuric on day 0, progressing to better UP:C values at the end of the treatment, except in group A. The results of this study justify the treatment of canine heartworm disease using the AHS recommended adulticide guidelines and recommends re-evaluation of the role of glucocorticosteroids in the prevention and treatment of PTE.
用杀成虫剂治疗患有犬心丝虫病的犬会导致寄生于宿主体内血管系统的成年犬恶丝虫死亡。在虫体死亡过程中，可能会出现肺血栓栓塞（PTE）、肺部炎症、充血性心力衰竭或肾病。本研究的目的是评估犬心丝虫病杀成虫剂治疗期间的心肺生物标志物和肾脏参数，以比较经典的两针治疗方案与美国心丝虫协会（AHS）推荐的方案。将14只寄生虫负荷高的感染心丝虫的犬分为三组，并分配到如下杀成虫剂治疗方案中：A组（n = 5）采用经典的两针治疗方案；B组（n = 5）采用AHS推荐的方案治疗，C组（n = 4）的治疗方式与B组相同，但接受递减抗炎剂量的泼尼松。为评估心肺状态，检测了心肌肌钙蛋白I（cTnI）、肌红蛋白和D-二聚体。通过测量尿素、肌酐和尿蛋白：肌酐（UP:C）来评估肾功能。在第0天（诊断日）、首次给予杀成虫剂后第7天和第14天以及最后一次注射杀成虫剂后1个月采集血清和尿液样本。接受经典治疗的犬更频繁地出现D-二聚体的病理浓度，且平均D-二聚体水平更高，这可能表明存在更严重的PTE。C组在治疗期间D-二聚体水平最高，这可能是由于泼尼松的给药导致PTE加重。在研究期间，所有组的cTnI和肌红蛋白值均高于参考值，但在最后一次注射后1个月达到最低值。所有组的尿素和肌酐水平均在正常范围内，28.5%的犬在第0天出现蛋白尿，治疗结束时UP:C值有所改善，但A组除外。本研究结果证明使用AHS推荐的杀成虫剂指南治疗犬心丝虫病是合理的，并建议重新评估糖皮质激素在预防和治疗PTE中的作用。
