Management and outcome of intracardiac heartworms in dogs

Abstract Background Intracardiac heartworm (IH) disease is a serious condition that can become life threatening if the patient develops caval syndrome. We aim to describe the management and outcome of IH in dogs evaluated by Medvet’s New Orleans cardiology service from November 2015 to December 2021...

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Main Authors: Jorge Vila, Elisabeth Alost
Format: Article
Language:English
Published: BMC 2023-04-01
Series:Parasites & Vectors
Subjects:
Online Access:https://doi.org/10.1186/s13071-023-05677-5
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author Jorge Vila
Elisabeth Alost
author_facet Jorge Vila
Elisabeth Alost
author_sort Jorge Vila
collection DOAJ
description Abstract Background Intracardiac heartworm (IH) disease is a serious condition that can become life threatening if the patient develops caval syndrome. We aim to describe the management and outcome of IH in dogs evaluated by Medvet’s New Orleans cardiology service from November 2015 to December 2021. Methods Records of 27 dogs with IH were examined retrospectively. Follow-up information was obtained from phone conversations with referring veterinarians and owners. Results Nine of 27 dogs had a previous diagnosis of heartworm disease and were undergoing “slow kill” treatment; 12/27 dogs' heartworm disease was a new diagnosis, and 6/27 had either scheduled or started adulticide therapy. Nine dogs had heartworm extraction. No dogs died during the heartworm extraction procedure. Four of 9 dogs have died (survival time 1; 676; 1815 and 2184 days). One dog died the day after the procedure secondary to continued respiratory distress; the other three died of non-cardiac causes. Five of nine are alive (median follow-up 1062 (range 648–1831) days. Eleven dogs had IH resolution. In 7/11 this occurred while undergoing stabilization for heartworm extraction. In 4/11 heartworm extraction was not recommended because of low IH burden. All dogs with IH resolution were discharged from the hospital. Four of 11 have died (survival time 6; 22, 58 and 835 days), and 6/11 are alive (median follow-up 523 (range 268–2081) days. One was lost to follow-up after 18 days. Five dogs were medically managed. In one of five dogs, extraction was not recommended because of low IH burden. In four of five extraction was recommended but declined. One of five has died (survival 26 days), and four of five are alive (follow-up 155, 371, 935 and 947 days). Two dogs were killed at the time of diagnosis. Fifteen of 27 dogs were considered to have caval syndrome. Conclusion The results suggest that patients with IH resolution have a good long-term prognosis. Most often IH resolution occurred while the dog was undergoing stabilization for heartworm extraction. When IHs are present, heartworm extraction should still be considered the treatment of choice and recommended as first-line therapy whenever possible. Graphical Abstract
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spelling doaj.art-26f0f49dc8754fa78ea23e7bfbeaacbf2023-12-03T12:13:45ZengBMCParasites & Vectors1756-33052023-04-011611710.1186/s13071-023-05677-5Management and outcome of intracardiac heartworms in dogsJorge Vila0Elisabeth Alost1Medvet New OrleansMedvet New OrleansAbstract Background Intracardiac heartworm (IH) disease is a serious condition that can become life threatening if the patient develops caval syndrome. We aim to describe the management and outcome of IH in dogs evaluated by Medvet’s New Orleans cardiology service from November 2015 to December 2021. Methods Records of 27 dogs with IH were examined retrospectively. Follow-up information was obtained from phone conversations with referring veterinarians and owners. Results Nine of 27 dogs had a previous diagnosis of heartworm disease and were undergoing “slow kill” treatment; 12/27 dogs' heartworm disease was a new diagnosis, and 6/27 had either scheduled or started adulticide therapy. Nine dogs had heartworm extraction. No dogs died during the heartworm extraction procedure. Four of 9 dogs have died (survival time 1; 676; 1815 and 2184 days). One dog died the day after the procedure secondary to continued respiratory distress; the other three died of non-cardiac causes. Five of nine are alive (median follow-up 1062 (range 648–1831) days. Eleven dogs had IH resolution. In 7/11 this occurred while undergoing stabilization for heartworm extraction. In 4/11 heartworm extraction was not recommended because of low IH burden. All dogs with IH resolution were discharged from the hospital. Four of 11 have died (survival time 6; 22, 58 and 835 days), and 6/11 are alive (median follow-up 523 (range 268–2081) days. One was lost to follow-up after 18 days. Five dogs were medically managed. In one of five dogs, extraction was not recommended because of low IH burden. In four of five extraction was recommended but declined. One of five has died (survival 26 days), and four of five are alive (follow-up 155, 371, 935 and 947 days). Two dogs were killed at the time of diagnosis. Fifteen of 27 dogs were considered to have caval syndrome. Conclusion The results suggest that patients with IH resolution have a good long-term prognosis. Most often IH resolution occurred while the dog was undergoing stabilization for heartworm extraction. When IHs are present, heartworm extraction should still be considered the treatment of choice and recommended as first-line therapy whenever possible. Graphical Abstracthttps://doi.org/10.1186/s13071-023-05677-5Heartworm diseaseIntracardiac heartwormsCaval syndromeDogsPimobendanSildenafil
spellingShingle Jorge Vila
Elisabeth Alost
Management and outcome of intracardiac heartworms in dogs
Parasites & Vectors
Heartworm disease
Intracardiac heartworms
Caval syndrome
Dogs
Pimobendan
Sildenafil
title Management and outcome of intracardiac heartworms in dogs
title_full Management and outcome of intracardiac heartworms in dogs
title_fullStr Management and outcome of intracardiac heartworms in dogs
title_full_unstemmed Management and outcome of intracardiac heartworms in dogs
title_short Management and outcome of intracardiac heartworms in dogs
title_sort management and outcome of intracardiac heartworms in dogs
topic Heartworm disease
Intracardiac heartworms
Caval syndrome
Dogs
Pimobendan
Sildenafil
url https://doi.org/10.1186/s13071-023-05677-5
work_keys_str_mv AT jorgevila managementandoutcomeofintracardiacheartwormsindogs
AT elisabethalost managementandoutcomeofintracardiacheartwormsindogs