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Order Strongylida Superfamilies: Trichostrongyloidea Strongyloidea Metastrongyloidea Ancylostomatoidea (hookworms) CVM-NCSU

VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

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Page 1: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Order Strongylida

Superfamilies: Trichostrongyloidea Strongyloidea Metastrongyloidea Ancylostomatoidea (hookworms)

CVM-NCSU

Page 2: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

ORDER STRONGYLIDA ‐ Bursate worms Superfamily ‐ Ancylostomatoidea

HOOKWORMS*dorsally flexed anterior* adult: small intestine

(10‐16 mm)

Lumen of small intestine, note blood

adult worm

Page 3: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

1. Ancylostoma 2. Uncinaria

TEETH CUTTING PLATES

•Strongyle-type eggs in dog or cat feces = “HOOKWORM” eggs

Page 4: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

• Ancylostoma species of importanceA. caninum ‐ DOGSA. tubaeformae ‐ CATSA. braziliense ‐ DOGS & CATS

A. duodenale ‐ HUMANS

Page 5: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Ancylostoma caninum

• SOUTH‐EASTERN STATES, most prevalent helminth in dogs ~20‐40% in shelter dogs

Page 6: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Blood-feeding parasites

Morbidity and potential mortality!

Page 7: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

A. caninum adult

…taking a ‘bloody’ bite of mucosa!

Page 8: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Egg‐‐‐L1‐‐‐L2‐‐‐L3

Infective L3 larva5-7 days

Page 9: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Infection from the environment by: Ingestion of L3 Skin penetration by L3 (Ingestion of paratenic host)

Page 10: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Two choices for an L3 larva:

1.  NORMAL DEVELOPMENTL3 L4 Adult

OR

2.   ARRESTED DEVELOPMENT ( ‘hang out’ as L3 in muscle, organs)

Page 11: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

REACTIVATION of tissue-arrested L3s

SELF-REPOPULATION TRANSMAMMARY

L3 to adult stage TRANSMISSION

in small intestine L3 in milkto pups but not

kittens

When do arrested L3 larvae reactivate?STRESS DEWORMING PREGNANCY

Page 12: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Transmammary transmission

• Migration to mammary glands• Transmission in milk to nursing pups during lactation 

• Experimental observation:  – 1 infection of dam can contribute to transmission of infection to at least 3 subsequent litters!

Page 13: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Getting rid of arrested larvae?

• metabolically quiescent• relatively resistant to host defense mechanisms and to drugs

• negative fecal analysis ?

Page 14: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

What are the different ways by which dogs and cats can acquire Ancylostoma infections?

Ancylostoma caninum• Primary route is lactogenic• Ingestion from environment• Skin penetration from 

environment

Ancylostomum tubaeformae• No lactogenic transmission 

in cats• Primary is ingestion from 

environment

Page 15: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Pathogenesis & Clinical signs

Adult worms are blood‐feeders  ‐‐need oxygen/nutrients

Consequences to the host:– ANEMIA– BLOODY DIARRHEA 

Page 16: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Pathogenesis

• Hemorrhage (Why does blood not clot?)

• Some damage to intestinal mucosa• Larval migrations may cause some pathology (e.g. respiratory signs but this is not common)

Page 17: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Clinical Disease• Acute anemia in nursing puppies

* PCV down to 10+% from  35‐57% (normal)* Blood loss from 50‐100 adults ~3 ml/day* Mortality between 8 and 24 days of age

• Chronic disease: weight loss, poor body condition, especially in older or immunocompromised animals

• Clinical disease very common in dogs but not in cats

Page 18: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Host resistance ‐ Adult dog

• acquired immunity (not complete)– prone to re‐infection

• premunition (inhibition of further infection due to residual population)

• ability to compensate for blood loss

Page 19: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Treatment & Control• Warm, moist conditions favor L3 survival, do not tolerate 

desiccation• Newly emerging multi‐drug resistant Ancylostoma caninum. 

Seen in mature dogs. Originally rescue Greyhounds.• Newborns:  

TREAT with anthelmintic at first sign of disease    (Improvement = Diagnosis)+/‐BLOOD TRANSFUSION+/‐ Iron supplementation, vitamins, protein

Page 20: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

• Puppies: deworm every 2‐3 weeks, until starting monthly heartworm preventative 

• Keep runs clean and dry;  bleach washes

Page 21: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Treating pregnant dogs to prevent infections in puppies

• Fenbendazole ‐ every day from day 40 of gestation to day 14 of lactation (~ 40 days!)

• Selemectin and possibly other monthly avermectin prophylactic drugs timed to coincide with whelping. Much easier than above

Page 22: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Zoonosis #1Infective L3s can penetrate human skin and…..1. Cutaneous larva migrans

* erythematous pruritis*A. braziliense; A. caninum

Page 23: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Zoonosis #2 (FYI not on test)Uncommon eosinophilic gastro‐enteritis

*A. caninumInfective L3s penetrate human skin and find their   way to the intestine

‐typically 1 or 2 adult worms only‐not patent ‐tummy ache!

Page 24: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Uncinara sp. 

• less common hookworm of dogs • relatively non‐pathogenic• no transmammary transmission, only infected by ingestion of L3

Page 25: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Order OXYURIDA

• Pinworms of the large intestine• Adult worms have long tapering tail• Worm most often seen by horse owner• Host‐specific

– Enterobius is a human pinworm– Cats and dogs do NOT have pinworms– Horses:  Oxyuris equi

Page 26: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Long tapering posterior

Page 27: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Oxyuris equis

• HORSES• large, white, thick‐bodied adults

Page 28: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Life‐cycle of Oxyuris equi:• Adult female in large intestine, migrates to the anus and deposits eggs in a sticky fluid on perianal area

• Fluid dries and flakes off with eggs 

• Infective L3 mature within the egg shell in 4‐5 days; ingested by the horse

Page 29: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Life‐cycle of Oxyuris equi:• L3s in large intestine mature to adulthood• Prepatent period ~ 5 months• EGGS: single operculum

operculum

embryo

Page 30: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Pathogenesis/Clinical signs:1.large numbers of adults/larvae colitis2. eggs/sticky fluid perianal itching

bare ‘tailhead’

Page 31: VMP 930 lecture - Nc State University1. NORMAL DEVELOPMENT L3 L4 Adult OR 2. ARRESTED DEVELOPMENT ... Microsoft PowerPoint - VMP 930 lecture Author: jflowers Created Date: 10/7/2019

Diagnosis and Treatment

Diagnosis:‘scotch‐tape’ pressed around perianal area;examine for operculated eggs

Treatment: ivermectin or daily pyrantel