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Studzińska:Makieta 1.Qxd See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/280390389 Diagnosis and therapy of Capillaria plica infection: Report and literature review Article in Acta Parasitologica · September 2015 DOI: 10.1515/ap-2015-0081 · Source: PubMed CITATIONS READS 2 110 4 authors, including: Maria Studzińska Marta Demkowska-Kutrzepa University of Life Sciences in Lublin University of Life Sciences in Lublin 30 PUBLICATIONS 104 CITATIONS 18 PUBLICATIONS 26 CITATIONS SEE PROFILE SEE PROFILE Krzysztof Tomczuk University of Life Sciences in Lublin 58 PUBLICATIONS 146 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: Analysis of the relative importance in long-term studies of the factors regulating the seroprevalence of Toxocara spp. in bank voles (Clethrionomys glareolus) in N.E. Poland View project All content following this page was uploaded by Krzysztof Tomczuk on 07 November 2016. The user has requested enhancement of the downloaded file. All in-text references underlined in blue are added to the original document and are linked to publications on ResearchGate, letting you access and read them immediately. DOI: 10.1515/ap-2015-0078 © W. Stefański Institute of Parasitology, PAS Acta Parasitologica, 2015, 60(3), 545–548; ISSN 1230-2821 CASE REPORT Diagnosis and therapy of Capillaria plica infection: report and literature review Maria B. Studzińska1*, Justyna Obara-Gałek2, Marta Demkowska-Kutrzepa1 and Krzysztof Tomczuk1 1Department of Parasitology and Invasive Diseases. Faculty of Veterinary Medicine. University of Life Sciences in Lublin Poland; 2Vera Veterinary Clinic, Sandomierz 27-600, Poland Abstract Worldwide, data on Capillaria (Pearsonema) plica infections of the urinary tract in domestic carnivores are limited. Never- theless, cystitis with hematuria, dysuria or pollakiuria may suggest a C. plica infection. A three-year old dog from Poland show- ing pollakiuria and hematuria was presented. At urine analysis, C. plica eggs were found in the urine sediment. The dog was unsuccessfully treated with a daily oral dose of fenbendazole 50 mg/kg BW for 5 days, while a single subcutaneous adminis- tration of ivermectin 0.2 mg/kg BW once effectively eliminated C. plica infection. Keywords Capillaria plica, dog, diagnosed, treatment The nematode Capillaria plica (syn. Pearsonema plica) edema and muscle membrane hyperplasia. Consequently, this (Eckert et al. 2005) belongs to the Capillariidae family infection may cause pollakiuria, dysuria and hematuria (Cal- (http://www.ncbi.nlm.nih.gov). It occurs worldwide in carni- legari et al. 2010; Pagnoncelli et al. 201; Rossi et al. 2011). In- vores, mostly in wild animals (foxes, wolves) (Knaus et al. deed the diagnosis of the infection involves the examinations 2014; Krone et al. 2008). This infection is rarely reported in of the urine, to search for characteristic eggs in urine sediment domestic carnivores. C. plica is a fragile, threadlike, yellow- or immature or mature parasites. This infection is often diag- ish and small nematode (13 and 60 mm long and 0.048–0.090 nosed accidentally, when testing urine deposits. mm wide). In the life cycle of C. plica, carnivores play the A three-year old entire German shepherd dog showing pol- role of the definitive host, while earthworms are intermediate lakiuria and hematuria from two days was examined in a vet- hosts. The final host is infected orally by ingesting the worms, erinary clinic in Poland. Clinical examinations showed the which are first-stage larvae (L1). After spending two months internal temperature of 38.8°C, with pink mucous membranes, in the intestine, as third stage larvae (L3) C. plica worms reach and moist, unchanged and testable lymph nodes. The urethra the urinary bladder where they grow to sexual maturity and was without pathological alternations, except for a small amount penetrate the bladder mucosa. It may also localize in the ure- of a bloody efflux. The examination of abdominal palpation thra and renal pelvis. The female lays eggs, which are spread showed no signs of pain. In addition, morphological and bio- into the environment with urine. The eggs of C. plica measure chemical blood and urine examinations were carried out. The 55–67 × 26–29 µm. They are gray, barrel-shaped, and have urine was centrifuged (400 × g) for 3 min, and the sediment was buttons on both poles. The pre-patent period is 58–63 days examined microscopically at a 200x and 400x magnification. (Low 1999; Senior et al. 1980). C. plica infection is rarely as- The results of these examinations are presented in Table I. sociated with clinical disease and the infection is often diag- The urine sediment showed numerous struvite crystals, ery- nosed accidentally, when examining urine sediment. However, throcytes, leucocytes and bacteria. Additionally, the presence heavily infected animals may show signs of clinical cystitis, of C. plica eggs was demonstrated (Fig. 1). *Corresponding author: [email protected] Capillaria plica infection 546 Table I. The results of urine test in the following days of treatment Parameter 1day 3 day 5 day 7 day 14 day 21 day Colour brown pale brown dark yellow yellow yellow yellow Clarity cloudy cloudy light cloudy clear clear clear pH 8.0 7.5 7.5 7.0 6.5 6.5 Specific gravity 1.010 g/L 1.010 g/l 1.014 g/l 1.02 g/l 1.025 g/l 1.025 g/l Protein 3.050 g/L 1.00 g/l none none none none Blood +++ ++ + none none none The urine sediment Squamous epithelium singular singular singular singular singular singular Leucocytes* 3–5–7 3–5–7 1–2 1–2 1–2 1–2 Erythrocytes* numerous numerous few none none none Bacteria few few few few few few C. plica eggs + + + + – – *in the visible area 1–5 days –fenbendazole treatment, 7 day – ivermectin treatment, 14, 21 days – control Figure 1. Urinary sediment (40x), eggs of C. plica 547 Studzinska et al. On the basis of the clinical symptoms and results of urine Post-mortem examinations conducted in Germany showed analysis, inflammation of the urinary bladder resulting from the presence C. plica in one wild and one domestic cat. The C. plica infection was diagnosed. To eliminate the infection, prevalence achieved 7% and 6%, respectively (Krone et al. fenbendazole (Panacur, Intervet) was administered daily per 2008). However, it increased to 12% in other regions of Ger- os, at a dose of 50 mg/kg for 5 consecutive days. In addition, many (Schuster et al.1997). the treatment included a 7-day sc injection of cephalexin Capillariosis has been also reported in dogs, among which (Ceporex Injection, Shering), at a daily dose of 25 mg/kg. hunting races are more vulnerable to the infection. In Italy, Thereafter, the treatment was continued by oral administra- a case of C. plica infection in an 8 year old jagd terrier was de- tion of cephalexin (Cefaseptin, Vetoquinol) at 25 mg/kg twice scribed. Initially, glomerular disease was diagnosed. However, a day consecutively for seven days. Moreover, carprofen the dog’s health status suddenly deteriorated. Urine examina- (Cefaseptin, Vetoquinol) was injected sc at a daily dose of tion demonstrated the presence of C. plica eggs. The dog was 4 mg/kg for the first two days. The dog was fed a therapeutic put down. Histopathological examinations showed chronic in- urinary diet (Urinary S/O, Royal Canin), because of a large terstitial nephritis and glomerular amyloidosis. A chronic in- amount of struvite crystals in the urine. flammation of the bladder and renal pelvis with the infiltration The control examination of urine was performed three- of mononuclear cells in the submucosa was found. It was the times, on days 3, 5 and 7 from the beginning of the treatment first case of glomerular amyloidosis in a dog affected with with fenbendazole. Hematuria decreased gradually in the sed- bladder capillariosis (Callegari et al. 2010). iment from the second day of treatment, and disappeared com- The intensity of C. plica infection in dogs is generally low, pletely after a week. A significant decrease of struvite crystals and is therefore not always accompanied by clinical symp- was visible on the third day of treatment. However, the pres- toms. Hematuria, dysuria and pollakiuria, and secondary bac- ence of C. plica eggs found in the urine 7 days from the be- terial infections may be early symptoms of capillariosis ginning of the treatment with fenbendazole. Thus it was (Callegari et al. 2010; Cazelles et al. 1989; Van Ven 2002). decided to treat the dog with a single sc injection of ivermectin The infection of C. plica has been occasionally described (Ivomec 1% Injection, Merial), at a dose of 0.2 mg/kg. The outside Europe. In Brazil, (Pagnoncelli et al. 2011) the first effectiveness of treatment was controlled by a double exami- case of urinary bladder capillariosis was diagnosed intra-vi- nation of urine sediments on days 7 and 14 after ivermectin ad- tally in a cat in 2008. However, the cat died with symptoms in- ministration (14 and 21 days from the beginning of the cluding dysuria, urinary incontinence, and eosinophilia, treatment). The control examination showed the efficacy of despite the treatment. In Canada, bladder capillariosis was re- ivermectin (Tab. I). ported in a 4 year old cat, which had been bitten. Examination of the urine apart from the hematuria and its large number of amorphous crystals revealed the presence of C. plica eggs. Discussion (Bedard et al. 2002). Effective treatment involves benzimidazole, levamisole or The data on the infection of C. plica in domestic carnivores are ivermectin (Callegari et al. 2010; Van Veen 2002). On the one very limited, both in Europe and the rest of the world. On the hand, Basso et al.
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