Department of Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA.
Gulf Coast Veterinary Specialists, Houston, Texas, USA.
J Vet Intern Med. 2021 May;35(3):1361-1367. doi: 10.1111/jvim.16127. Epub 2021 May 2.
The trematode Heterobilharzia americana (HA) causes granulomatous gastrointestinal and hepatic disease in dogs. Before 2008, diagnosis relied on saline fecal sedimentation or histopathology, and earlier reports primarily described dogs with advanced disease or cases diagnosed incidentally at necropsy. The advent of a fecal PCR test has facilitated the diagnosis of HA and provided insights into manifestations and response to treatment.
Describe the clinical findings, response to treatment, and outcome for dogs infected with HA.
Sixty dogs diagnosed with HA between 2010 and 2019.
Retrospective study. Medical records were searched for dogs diagnosed with HA by fecal PCR testing, identification of ova in feces, or histopathology.
Mean age was 7.5 (±4.1) years and weight was 23.2 (±10.18) kg. Clinical signs included diarrhea (55.8%), vomiting (46.2%), and weight loss with or without anorexia (15.4%). Laboratory abnormalities included hyperglobulinemia (42.6%) and increased liver enzyme activities (30%). More than 40% of dogs had an eosinophil count >500/μL. Hypercalcemia attributable to HA was identified in only 4 dogs. Pinpoint hyperechoic foci were noted in intestines, liver, or mesenteric lymph nodes during transabdominal ultrasonography in 64.4% of dogs. Survival data was available for 34 dogs, of which 73.5% (25) were alive 6 months after diagnosis.
Hyperglobulinemia, high eosinophil count, and ultrasonographic evidence of visceral mineralization were suggestive of infection. Hypercalcemia was uncommon. Combination treatment with praziquantel and fenbendazole was variably effective, and 17.6% of treated dogs with known outcome died as a result of HA infection.
美洲双腔吸虫（HA）可引起犬的胃肠道和肝肉芽肿性疾病。在 2008 年之前，诊断依赖于盐水粪便沉淀或组织病理学检查，并且早期的报告主要描述了患有晚期疾病的犬或在尸检时偶然诊断出的病例。粪便 PCR 检测的出现促进了 HA 的诊断，并提供了对其临床表现和治疗反应的深入了解。
描述感染 HA 的犬的临床发现、治疗反应和结果。
2010 年至 2019 年间诊断为 HA 的 60 只犬。
回顾性研究。通过粪便 PCR 检测、粪便中虫卵的鉴定或组织病理学检查诊断为 HA 的犬的病历进行检索。
平均年龄为 7.5（±4.1）岁，体重为 23.2（±10.18）kg。临床症状包括腹泻（55.8%）、呕吐（46.2%）以及伴有或不伴有厌食的体重减轻（15.4%）。实验室异常包括球蛋白血症（42.6%）和肝酶活性升高（30%）。超过 40%的犬的嗜酸性粒细胞计数＞500/μL。仅在 4 只犬中发现了与 HA 相关的高钙血症。在 64.4%的犬中，经腹超声检查可见肠道、肝脏或肠系膜淋巴结有针尖状强回声灶。34 只犬的生存数据可用，其中 73.5%（25 只）在诊断后 6 个月时存活。
球蛋白血症、高嗜酸性粒细胞计数和内脏矿物质化的超声证据提示存在感染。高钙血症并不常见。吡喹酮和芬苯达唑联合治疗的效果各不相同，已知结局的 17.6%的治疗犬因 HA 感染而死亡。
