See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/280390389

Diagnosis and therapy of 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 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 0.2 mg/kg BW once effectively eliminated C. plica infection.

Keywords Capillaria plica, dog, diagnosed, treatment

The Capillaria plica (syn. Pearsonema plica) edema and muscle membrane hyperplasia. Consequently, this (Eckert et al. 2005) belongs to the 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 (, ) (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 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 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 . 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 , 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. (2014) noticed that the treatment with fen- one hand, this situation results from the life cycle of the par- bendazole or ivermectin caused a short-term improvement. asite. Domestic and dogs, having limited contact with the It was levamisole, with which metabolites are excreted in 94% external environment, are rarely exposed to infection with via urine, which proved effective. C. plica. On the other, making an accurate intravital diagno- Our observations indicate that the course of C. plica in- sis is complicated. Females periodically excrete eggs in spite fection includes blood eosinophilia, urine hematuria, numer- of a parasitic infection, and so one may not always yield an ac- ous struvite crystals, erythrocytes, leukocytes, and bacteria, curate diagnosis, by an examination of the urine sediment without other symptoms. Treatment with fenbendazole in the (Kirkpatrick and Nelson 1987). However, symptoms associ- first period was not effective. The use of ivermectin proved to ated with the inflammation of the bladder, sporadic renal fail- be effective in the elimination of C. plica. Examinations per- ure, hematuria, dysuria or pollakiuria may suggest a C. plica formed 6 months after the end of treatment showed that the infection (Callegari et al. 2010; Van Ven 2002). dog was free from the infection and no recurrence of the in- The available data on domestic carnivores indicate that the fection was noted. Urine and blood parameters were at nor- infection is diagnosed mainly in cats, which have more fre- mal physiological levels. The dog felt well and did not show quent contact with the external environment. In Italy, there was any signs of relapse. a case of a young 8-month-old European cat diagnosed with a difficult, painful urination, a fever of 40.5°C, and a painful and enlarged bladder, which was examined by palpation. Exami- References nations of the urine sediment demonstrated heamaturia, larval nematode forms and fragments of adult . No eggs Basso W., Spänhauer Z., Arnold S., Deplazes P. 2014. Capillaria were found in the deposits (Rossi et al. 2011). plica (syn. Pearsonema plica) infection in a dog with chronic Capillaria plica infection 548

pollakiuria: Challenges in the diagnosis and treatment. Para- silvestris Schreber, 1777) and domestic cats (Felis catus L.) sitology International, 63, 40–142. DOI: 10.1016/j.parint. from the Eifel, Pfalz region and Saarland, Germany. Euro- 2013.09.002 pean Journal of Wildlife Research, 54, 95–100. DOI: 10. Bédard Ch., Desnoyers M., Lavallée M.C., Poirier D. 2002. Capil- 1007/s10344-007-0116-0 laria in the bladder of an adult cat. The Canadian Veterinary Low D.L. 1999. Parassitosi delle vie urinarie superiori ed inferiori Journal, 43, 973–974 del cane e del gatto. In: (Eds. C.A Osborne, D.R Finco) Ne- Callegari D., Kramer L., Cantoni A.M., Di Lecce R., Dodi P.L., Grandi frologia e urologia del cane e del gatto. UTET, Turin, Italy, G. 2010. Canine bladderworm (Capillaria plica) infecton as- 949–953 sociated with glomerular amyloidosis. Veterinary Parasitology, Pagnoncelli M.I., Franca R.T., Martins D.B., via Howes F., dos Anjos 168, 338–341. DOI: 10.1016/j.vetpar.2009.11.008 Lopes S.T., Mazzanti C.M. 2011. Capillaria sp. in a cat. Acta Cazelles C., Bourdeau P., Vidal J. 1989. Capillariose vésicale chez un Scientiae Veterinariae, 39, 987–989 chien: a propos dun cas. Point Veterinaire, 21, 41–44 Rossi M., Messina N., Ariti G., Riggio F., Perrucci S. 2011. Symp- Eckert J., Friedhoff K.T., Zahner H., Deplazes P. 2005. Lehrbuch der tomatic Capillaria plica infection in a young European Parasitologie für die Tiermedizin. Enke Verlag in MVS Medi- cat. Journal of Feline Medicine & Surgery, 13, 793–795. zinverlage Stuttgart, pp.329 DOI: 10.1016/j.jfms.2011.07.006 Knaus M., Shukullari E., Rosentel J., Rehbein S. 2014. Efficacy of a Senior D.F., Solomon G.B., Goldschmidt M.H., Joyce T., Bovee K.C. novel topical combination of fipronil, (S)-methoprene, epri- 1980. Capillaria plica infection in dogs. Journal of the Amer- nomectin and praziquantel against feline urinary bladder ican Veterinary Medical Association, 176, 901–905 worm (Capillaria plica) infection. Veterinary Parasitology, Schuster R., Kaufmann A., Hering S. 1997. Investigations on the en- 202, 45–48 DOI: 10.1016/j.vetpar.2014.02.038 doparasite fauna of the domestic cat in eastern Brandenburg. Kirkpatrick C.E., Nelson G.R. 1987. Ivermectin treatment of urinary Berliner und Münchener Tierärztliche Wochenschrift, 110, capillariasis in a dog. Journal of the American Veterinary 48–50 Medical Association, 191, 701–702 Van Veen L. 2002. Bladder infection with Capillaria plica in a male Krone O., Guminsky O., Meinig H., Herrmann M., Trinzen M., dog. Tijdschrift voor diergeneeskunde, 127, 393–394 Wibbelt G. 2008. Endoparasite spectrum of wild cats (Felis

Received: October 29, 2014 Revised: February 2, 2015 Accepted for publication: March 31, 2015

View publication stats