New Insights Into Pathogenesis, Diagnostics, and Therapeutic Options for Canine Angiostrongylosis.

OBJECTIVE: To provide a comprehensive overview of Angiostrongylus vasorum infection in dogs, with a particular emphasis on recent developments in the understanding of disease pathophysiology and an update on developments in diagnostic and therapeutic options. ETIOLOGY: Angiostrongylus vasorum is a metastrongyloid parasite responsible for varied clinical presentations that primarily include cardiorespiratory, coagulopathic, and neurologic signs. Reports since the turn of the century confirm its continued spread beyond traditional endemic foci, drawing interest in its epidemiology, treatment, and control. DIAGNOSIS: A definitive diagnosis of angiostrongylosis was historically made with the modified Baermann technique to identify parasite larvae in feces; however, other contemporary diagnostic methods, such as serologic and molecular techniques, are now available to support clinical investigation. THERAPY: Once a diagnosis of angiostrongylosis is made, prompt treatment with anthelmintic drugs (e.g., moxidectin/imidacloprid, milbemycin oxime, fenbendazole) and supportive care should follow, dependent on the patient's clinical signs. This report also provides updates regarding effective prophylactic regimens. PROGNOSIS: Although angiostrongylosis in dogs can be fatal, and death may be sudden, the prognosis is highly variable and is related to the severity of clinical signs at presentation. Rapid identification and management of the disease with administration of an appropriate treatment can lead to complete clinical resolution.