A 7 Year old male neutered Labrador Retriever was referred to us with a month history of a cough that had not responded to two courses of antibiotics and an anti-inflammatory.
Blood tests had shown a high eosinophil count which is a type of white blood cell that can increase with allergy, parasites and sometimes with inflammatory bowel disease involving eosinophils.
He had also had a blood test for Angiostrongylus vasorum which is the most common lungworm we see in the UK, which was negative.
He was coughing especially after rest although he still had good exercise tolerance.
An Xray of the chest did not show very obvious changes but a CT scan showed thickening of his airways (green arrows), inflammation around his airways and nodules some with cavities in (purple arrows).
An Endoscopy was carried out which showed a large amount of fluid in his airways on both sides and worms were seen moving around his airways. The fluid was sent away for analysis, the results of which showed a very large number of the eosinophil white blood cells that were high in his blood.
Eosinophils in the airway fluid can be seen with asthma, eosinophilic bronchopneumonia (an allergic type of inflammation in the lungs and airways) and lungworm.
A PCR test (that looks for genetic material for a particular organism) on the fluid was done for the less common lungworm Crenosoma vulpis which is a fox lungworm and this was positive.
He was treated with the anti-parasite Panacur (fenbendazole) for five days and as the lung worm can cause an allergic type reaction in the lungs and suddenly killing the worms can potentially cause a massive allergic reaction, he was also treated with the steroid prednisolone tapering the dose over two weeks. The cough completely resolved.
This was an interesting case as although lung worm was suspected based on the high eosinophil count in the blood, the test for Angiostrongylus had been negative and the less common lungworm Crenosoma vulpis was found. Both lungworms are caught from ingestion of snails or slugs which carry the larvae. Angiostrongylus can also cause bleeding problems and neurological signs.
Prevention of both worms can be obtained by the use of monthly oral Milbemaxm the monthly spot on with Advocate or monthly oral taking of Nexguard Spectra.