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Hookworms 2 Flashcards

1
Q

Which conditions are most favorable for survival of A. caninum larvae?

A

Above freezing

Below 37 celcius

Clinical cases are most common in warm weather

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2
Q

How would you describe the eggs of A. caninum in fresh feces?

A

Oviparous (morula present)

Typical strongyle-type egg

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3
Q

Which stage of A. caninum is infective?

How long does it take for this stage to develop?

A

Sheathed L3

Egg to L3 takes 2-8 days

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4
Q

What is the prepatent period of A. caninum?

A

Swallowing: 16 days

Skin penetration: 30 days

Transmammary infection: 10-12 days

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5
Q

List the modes of infection for A. caninum

A

Ingestion of L3 in paratenic host

Skin penetration by L3

Transmammary

Transplacental (considered unimportant)

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6
Q

List the most likely migration pathway for Ancylostoma L3 based on the various modes of infection.

A

Skin penetration

  • blood-lung migration
    • trachea, coughed up, swallowed
    • somatic migration, hypobiotic larvae

Ingestion

  • mucosal migration
    • emerge as adults in the gut lumen

Lactogenic

  • direct development to adult in gut (has already undergone migration in the mother)
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7
Q

For what time period can Ancylostoma larvae be detected in the milk of a lactating female?

A

20 days post-whelping

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8
Q

Where do hypobiotic Ancylostoma larvae live in the host?

A

Muscles (from somatic migration)

Small intestine mucosa

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9
Q

Define “larval leak” as applied to Ancylostoma infections

A

In persistent infections, hypobiotic larvae are continually reactivated and find their way to the small intestinal lumen.

  • If the lumen is populated by adults, the larvae will probably pass in the feces.
  • If no hookworms are present, they will develop into adults.
  • If adult hookworms are killed by an anthelmintic, the larvae can quickly repopulate the gut.
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10
Q

Describe the pathogenesis of hookworm infections.

A

Blood sucking activity

  • Attach to a mucosal plug and macerate with teeth
  • Secrete proteolytic enzymes and anticoagulant
  • Lesions continue to bleed after worms move to new sites
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11
Q

When you see a puppy with severe anemia, what should your first differential be?

A

Hookworm infection

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12
Q

Describe the anemia that results from hookworm infections

A

Initially normocytic normochromic

Progresses to microcytic hypochromic over time due to iron deficiency

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13
Q

Describe the factors that influence the severity of hookworm infections.

A

Dosage of infecting L3’s

Age of host, immunity of host

Iron reserves (low in puppies)

Nutritional status

Stress factors, infections

Position of Jupiter. What you had for breakfast that morning. [JUST KIDDING PLEASE DON’T KILL ME JOSE]

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14
Q

List the clinical signs associated with canine hookworm infection.

A

Anemia

  • pale mucous membranes, decreased stamina, increased CRT

Melena

Unthrifty appearance

Respiratory signs, pneumonia

  • Larval migration through lungs

Dermatitis, usually interdigital

  • Inflammation as a reaction to L3 skin penetration
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15
Q

List the 4 clinical syndromes of canine hookworm disease

A

Peracute neonatal ancylostomiasis

Acute ancylostomiasis

Compensated ancylostomiasis

Decompensated ancylostomiasis

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16
Q

Describe peracute ancylostomiasis

A

Result of lactogenic transmission from the dam

  • 50-100 adults can be fatal
  • Signs
    • appear healthy first week, crash by second week
  • Worms suck blood as immature adults (may not see eggs)
  • Often fatal by 10-24 days of age
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17
Q

In the case of a peracute Ancylostoma infection, when will adults begin to lay eggs?

A

16 days (prepatent period)

THIS IS IMPORTANT

Puppies may be showing severe clinical signs (anemia, diarrhea, severe weakness), but you may not be able to detect eggs.

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18
Q

Describe acute ancylostomiasis

A

Older pups acquires a large number of L3 in a short period of time.

Signs: normocytic, normochromic anemia, melena, weakness.

Will see strongyle-type eggs in feces.

Will often die unless promptly treated.

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19
Q

Describe compensated ancylostomiasis

A

Chronic condition

Mature dogs with low number of hookworms

Asymptomatic unless stressed

Low to moderate numbers of strongyle-type eggs in feces

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20
Q

Describe decompensated ancylostomiasis

A
  • Occurs in mature, usually malnourished dogs
  • Moderate number of eggs + many worms
  • Will see melena, and may develop diarrhea
  • Thin, rough hair coat
  • Can be fatal
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21
Q

What are the lesions associated with LARVAL hookworms?

A
  • Skin penetration
    • erythematous papular or vesicular skin rash
  • Tracheal migration
    • petechial to ecchymotic hemorrhages in the lungs
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22
Q

What are the symptoms associated with ADULT hookworms?

A

Multifocal hemorrhagic enteritis

Generalized pallor

23
Q

What is the ONLY basis for antemortem diagnosis of peracute neonatal ancylostomiasis?

A

Signalment and clinical signs

Recall that in peracute infections, the patient will not yet be shedding eggs. Prompt treatment is important, or the patient may die.

24
Q

Describe the treatment for peracute neonatal ancylostomiasis.

A

Anthelmintics

Supportive care, including blood transfusions and CO2.

Poor prognosis.

25
Q

Describe the treatment for decompensated ancylostomiasis.

A

Anthelmintics

Nutritional support

26
Q

Which anthelmintics are most effective against ADULT hookworms?

A

Benzimidazoles

Macrocyclic lactones

Nicotinic agonists

*these have poor efficacy against hypobiotic larvae

27
Q

How do you prevent and control hookworms?

A
  • Identify and treat infected dogs
  • Sanitation: remove feces daily
  • Avoid keeping dogs on gravel, sand grass, and damp shady areas
  • Kill larvae in the environment
28
Q

How can you kill hookworm larvae in the environment?

A

Spray kennels and runs with 1% bleach

Apply sodium borate to grass (note: this will also kill the grass)

L3 killed by hard frosts

29
Q

Describe the drug regimen for a bitch to prevent lactogenic transmission of larvae to her pups.

A
  • Fenbendazole 50mg/kg/day
    • From 40 days of gestation to 14 days of lactation
  • Ivermectin 0.5mg/kg
    • Once 4-9 days before whelping, again 10 days later
30
Q

Where is Uncinaria stenocephala found in the US?

A

Northern US

L3 not killed by freezing

31
Q

Describe the buccal capsule of Uncinaria

A

Has cutting plates instead of teeth.

32
Q

Does Uncinaria undergo somatic migration?

A

No evidence for this.

Mucosal migration only.

33
Q

What is the host species of Ancylostoma tubaeforme?

A

Cats

34
Q

Name the modes of transmission for Ancylostoma tubaeforme

A

Ingestion of L3

Ingestion of paratenic host with L3

Skin penetration by L3

*No transmammary or transplacental transmission

35
Q

What are the clinical signs associated with Ancylostoma tubaeforme?

A

Clinical signs uncommon

Kittens more likely to show symptoms

Regenerative anemia, weight loss, diarrhea

36
Q

Identify these species

A

From left to right:

Ancylostoma caninum (dogs), Ancylostoma braziliense (dogs), Ancylostoma tubaeforme (cats), Uncinaria stenocephala (dogs and cats)

37
Q

Name the drugs used to treat feline hookworm infection

A

Febantel

Selamectin

Milbemycin

Pyrantel

38
Q

What is the primary host of Bunostomum phlebotomum?

A

Cattle

39
Q

What is the primary host of Bunostomum trigonocephalum?

A

Sheep and goats

40
Q

Where are Bunostomum worms most common?

Which mode of infection is most common?

A

Most common in Southern US. Prefer warm, moist climates.

41
Q

What is the prepatent period of Bunostomum?

A

4-8 weeks

42
Q

Describe the path of a Bunostomum larva once it penetrates the skin.

A

Skin penetration - blood stream - lung - trachea - small intestine

43
Q

Identify this species.

A

Bunostomum sp.

Note how the morula nearly completely fills the shell.

44
Q

Describe the clinical signs associated with Bunostomum infection.

A
  • Pruritis and alopecia at L3 entry sites
  • Progressive iron deficiency anemia
  • Hypoproteinemia
    • leads to edema
  • Anorexia, weight loss, poor growth
  • Fetid diarrhea, possibly with blood
45
Q

Describe this condition in this calf.

A

Bottle jaw

This is the result of hypoproteinemia from Bunostomum infection.

Haemonchus is not the only worm that can cause bottle jaw!

46
Q

How would you DEFINITIVELY diagnose a Bunostomum infection?

A

ID adults at necropsy

Culture feces to ID L3

47
Q

What drugs can you use to treat Bunostomum infections?

A

Benzimidazoles

Ivermectin

Levamisole

48
Q

What are the diseases associated with animal hookworms penetrating human skin?

A

Cutaneous larva migrans

Follicular dermatitis

Eosinophilic pneumonitis

Local myositis

Eosinophilic enteritis

49
Q

Describe cutaneous larva migrans

A

Animal hookworm L3 penetrates human skin

Larva tries to complete its life cycle, but cannot. Cannot penetrate deeper tissues.

Larva wanders, tunnels, and produces ridges on the skin.

50
Q

Which species can cause cutaneous larva migrans (CLM)?

A
  • Ancylostoma* spp.
  • Uncinaria*
  • Bunostomum*
  • Strongyloides*
  • Hypoderma* (cattle grubs)
  • Gasterophilus* (stomach bots)
51
Q

Describe this lesion.

A

Cutaneous larva migrans (CLM)

Lesions are erythematous and intensely pruritic.

Can persist for weeks to months.

Secondary bacterial infections common.

Lesions more severe is person is hypersensitized by prior exposure.

52
Q

The highest incidences of CLM cases in the U.S. coincide with which hookworm species?

A

Ancylostoma braziliense

53
Q

Name the two human hookworms

A
  • Ancylostoma duodenale*
  • Necator americanus* (85% of infections)
54
Q

Suppose you developed a vaccine against an enzyme that a hookworm uses to digest hemoglobin. Your vaccine causes the host to produce IgG against the antigen. Would it be an effective vaccine?

A

YES.

Hookworms are blood feeders and take in blood proteins with their meals, including IgG.

(Don’t assume that because hookworms live at mucosal surfaces, only IgA would be effective)

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