RESUMEN
BACKGROUND: This retrospective study evaluated modified three-dose melarsomine treatment protocols in a shelter setting and compared them to the American Heartworm Society (AHS)-recommended protocol. METHODS: As compared with the AHS protocol, the shelter protocols utilized doxycycline 10 mg/kg once daily (SID) or twice daily (BID), and varied the time from initiation of doxycycline (day 1) to the first melarsomine injection (M1). Dogs were retrospectively grouped based on the shelter's current protocol (M1 on day 14; Group A) and the AHS protocol (M1 on day 60; Group C), allowing a week on either side of the target M1 day. Treatments that fell outside these ranges formed two additional treatment groups (Groups B and D). Respiratory complications were defined as respiratory signs requiring additional treatment, and were statistically compared for Groups A and C. New respiratory signs and gastrointestinal (GI) signs were compared between dogs receiving SID or BID doxycycline. RESULTS: One hundred fifty-seven dogs with asymptomatic or mild heartworm disease at presentation were included. All dogs survived to discharge. There was no statistically significant difference between Groups A (n = 79) and C (n = 27) for new respiratory signs post-melarsomine (P = 0.73). The time to M1 for 14 dogs that developed new respiratory signs was a median of 19 days, compared with 22 days for 143 dogs without new respiratory signs (P = 0.2). Respiratory complications post-melarsomine were uncommon. New respiratory signs post-melarsomine occurred in 10/109 (9.2%) dogs receiving SID doxycycline and 4/48 (8.3%) dogs receiving BID doxycycline (P > 0.999). GI signs prior to M1 were recorded for 40/109 (36.7%) dogs receiving SID doxycycline and 25/48 (52.1%) receiving BID doxycycline (P = 0.08). Forty-four follow-up antigen test results were available; all tests performed > 3 months after the third melarsomine injection were negative. CONCLUSIONS: This study provided support for initiating melarsomine after 14 days of doxycycline and for a lower doxycycline dose. Shorter and less expensive treatment protocols can increase lifesaving capacity and improve quality of life for shelter dogs by reducing the duration of exercise restriction and length of stay.
Asunto(s)
Dirofilaria immitis , Dirofilariasis , Enfermedades de los Perros , Filaricidas , Perros , Animales , Doxiciclina/uso terapéutico , Estudios Retrospectivos , Calidad de Vida , Enfermedades de los Perros/tratamiento farmacológico , Filaricidas/efectos adversos , Dirofilariasis/tratamiento farmacológicoRESUMEN
This study reports heartworm (Dirofilaria immitis) prevalence in dogs tested by an animal shelter located in a low-prevalence region of Ontario, Canada. From 2015-2018, 4567 unique dogs were tested. The prevalence of heartworm was 3.9 %, with sub-prevalence of 0.3 % (2/662) for dogs surrendered within the Greater Toronto Area (both dogs were originally imported from the US); 6.6 % (130/1,981) for dogs relocated from beyond the Greater Toronto Area; 0% (0/1,668) for dogs tested at the shelter's public veterinary services clinic and 18.4 % (47/256) for owned dogs tested at outreach clinics at a First Nations community in south-eastern Ontario. More than half (54.7 %) of the heartworm-positive dogs originated from Canada. Most heartworm-positive dogs from the US (72/80; 90 %) were transferred from Texas and Georgia. Ninety-three heartworm-positive Canadian dogs were from Ontario, 4 from Manitoba and 1 from Quebec. Most (83/98, 84.7 %) were from four First Nations communities. The prevalence in homeless dogs from one First Nations community in south-western Ontario was 36.5 % (31/85). For 140 shelter dogs with at least one positive test result, there was 91 % concordance between shelter and reference laboratory antigen tests and poor agreement between antigen tests and microfilarial tests (approximately 50 %). Results of historical tests and post-relocation antigen tests were discordant in 28.2 % (shelter point-of-care tests) and 36.2 % (reference laboratory tests) of cases. This was most commonly due to negative historical results followed by positive results after relocation. Microfilarial filtration tests were positive for 77.1 % antigen-positive dogs from First Nations communities, compared with 37.1 % of dogs from other sources. Microfilarial counts were significantly higher for dogs from First Nations communities. This study demonstrated endemic and hyperendemic foci of heartworm within Canada, which were presumed to be associated with limited access to veterinary care. The results support recommendations to retest previously negative animals after relocation.