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CASE STUDY: OCULAR w h at i s the THELAZIOSIS IN A difference? TRAVELLED DOG

There are two ways to prevent Angiostrongylosis:

> Moxidectin e.g. in Advocate®, completely prevents patent infection with lungworm (Angiostrongylus vasorum)

> Milbemycin oxime containing products reduce the level of lungworm burden but some worms can still develop Theo de Waal PhD MRCVS, associate professor, in the heart † School of Veterinary Medicine, UCD; Amanda Lawlor BAgrSc, senior technical officer, School of Veterinary Medicine, UCD; and Susan Roulston MVB MRCVS, present a case study on the

Advocate® Milbemycin oxime discovery of eyeworm in a three-year-old dog, and Lungworm free Some lungworms subsequent treatment of thelaziosis may remain

Thelaziosis is an infection of the eye caused by the nematode in a wide range of host species, including humans. Autochthonous transmission has been reported in an increasing number of European countries but, to our knowledge, it has not been reported in Ireland.1

CASE REPORT A three-year-old male Labrador X Poodle had travelled to southern Spain for a month in October 2018. The dog wore a deltamethrin collar during the stay in Spain and received routine anthelmintic treatment before re-entry into Ireland. In April 2019, the dog started to show signs of itchy eyes and was presented to a private veterinarian on May 14, 2019. On

Fleas Flea Larvae Roundworm Hookworm Whipworm Lungworm Fox Lungworm Heartworm (A. vasorum) (C. vulpis) (D. immitis) ophthalmic examination, a thread-like worm was seen wriggling Advocate® offers across the cornea of the left eye. The dog was sedated on the a broad spectrum of same day and on examination, the conjunctiva of the left eye Figure 1: Conjunctivitis and Thelazia callipaeda nematode in the eye of a internal and external was inflamed, especially the nictitating membrane. There were three-year-old Labrador cross that had travelled to Spain. Photo: Susan Oesophageal worm Ear Mites Sarcoptes/ Demodex Biting Lice Nasal worm Eye worm Skin worm (D. repens) Roulston. (S. lupi) Notoedres (E. boehmi) (T. callipaeda) parasite indications multiple small nodules on the conjunctiva. On flushing with sterile water, a worm emerged from under the upper lid (Figure 1) and was retrieved with fine forceps. The right eye showed The dog was treated with eye drops – one drop, twice daily for Use Medicines Responsibly Note: X-ray image for artistic purposes only; not intended to show clinical information or differences. † or pulmonary arteries. Products containing moxidectin & milbemycin similar inflammation of conjunctiva with multiple nodules and five to seven days and 10% imidacloprid and 2.5% moxidectin oxime are licensed to prevent angiostrongylosis; see SPCs/datasheets for details of how this is achieved in different ways. *Schnyder M et al, Vet. Parasitol. (2009);166:326- 332. Milbemycin oxime & afoxolaner study example: ~95% prevention worm count reduction, however 9 out of 10 dogs still had low numbers of lungworms, 1 dog was free of another worm identified on flushing. spot-on was applied. Three days later, the owner reported that lungworms, Lebon et al. Parasites & Vectors (2016) 9:485. Advocate for dogs contains imidacloprid & moxidectin POM-V (UK) POM (ROI). Advice should be sought from the medicine prescriber. Further information from the datasheet at www.noahcompendium.co.uk or at www.apha.ie or on request. ®Registered Trade Mark of Bayer AG. Bayer plc, 400 South Oak Way, Green Park, Reading, RG2 6AD. Tel: 0118 206 3000. Bayer Ltd., The Atrium, Blackthorn Road, Dublin 18. Tel: (01) 299 9313. L.GB.MKT.11.2018.19500 Veterinary Ireland Journal I Volume 9 Number 7 367

Bayer Advocate New 200x283.indd 1 26/04/2019 14:56 6081.10 Advocate Moxi-283x200_AW.indd 1 17/04/2019 15:24 Vet July.indd 367 02/07/2019 13:36 FOCUS > COMPANION ANIMAL

the eyes seemed normal with no more itchiness observed. Both moxidectin and milbemycin oxime is e‚ ective against T. One of the worms was submitted to the UCD veterinary callipaeda but slow-release insecticide collars do not seem parasitology laboratory for identification. It was identified as a to protect against thelaziosis.5 Monthly treatments female T callipaeda nematode (Figure 2), approximately 12mm with moxidectin spot-on or milbemycin oxime per os, when in length, using the morphological criteria as described by animals are travelling to endemic areas, is advised to reduce Otranto et al.2 the infection risk.5,6 TAPEWORM, Under the pet travel scheme pet owners are required to fulfil specific health requirements when travelling with their dogs in Europe (https://www.agriculture.gov.ie/pets/); however, the ROUNDWORM required tapeworm treatment will have no e‚ ect on this parasite and, therefore, pet owners need to be aware of the potential danger of importing parasites into non-endemic areas. & LUNGWORM? The vector , P. variegate, has not been recorded in Ireland and recent ecological niche models have shown that although large areas of mainland Europe are suitable for the development of P. variegate, its habitat in the United Kingdom and Ireland would be limited to the southern and eastern parts Figure 2: Thelazia callipaeda female nematode showing buccal capsule 1,7 and characteristic transverse cuticular striations. Photo: Theo de Waal. of England. This case highlights how easy it is to introduce foreign DISCUSSION diseases into Ireland from mainland Europe and that T. callipaeda is also known as the oriental eyeworm, and has veterinarians should always be vigilant when examining pets increasingly been being reported in recent years from many who have travelled. Only Milbemax provides European countries including Spain.3 It is a vector-borne, zoonotic helminth transmitted by male drosphilid fruit , REFERENCES such broad spectrum coverage Phortica variegata, in Europe.4 1. Palfreyman J, Graham-Brown J, Caminade C, Gilmore P, in a chewy, tasty tablet! Otranto D, Williams DJL. Predicting the distribution of Phortica variegata and potential for Thelazia callipaeda transmission in Europe and the United Kingdom. Parasites & Vectors 2018; 11(1): 272. 2. Otranto D, Lia RP, Traversa D, Giannetto S. Thelazia callipaeda (Spirurida, Thelaziidae) of carnivores and humans: morphological study by light and scanning electron microscopy. Parassitologia 2003; 45(3-4): 125- 133. 3. Miró G, Montoya A, Hernández L, Dado D, Vázquez MV, Benito M, et al. Thelazia callipaeda infection in dogs: a new parasite for Spain. Parasites & Vectors 2011; 4(1): 148. 4. Otranto D, Cantacessi C, Testini G, Lia RP. Phortica variegata as an intermediate host of Thelazia callipaeda under natural conditions: Evidence for pathogen transmission by a male vector. International Journal for Parasitology 2006; 36(10): 1167-1173. 5. Lechat C, Siméon N, Pennant O, Desquilbet L, Chahory S, Le Sueur C, et al. Comparative evaluation of the prophylactic activity of a slow-release insecticide collar and a moxidectin spot-on formulation against Thelazia callipaeda infection in naturally exposed dogs in France. Parasites & Vectors 2015; 8(1): 93. 6. Ferroglio E, Rossi L, Tomio E, Schenker R, Bianciardi P. Therapeutic and prophylactic e‚ icacy of milbemycin oxime (interceptor) against Thelazia callipaeda in Milbemax brand has been relied on by vets for over 15 years. naturally exposed dogs. Veterinary Parasitolohy 2008; Total Control is a simple and comprehensive parasite control package combining the oral 154(3): 351-353. treatments Milbemax and Credelio. 7. Otranto D, Brianti E, Cantacessi C, Lia RP, Maca J. Credelio™ chewable tablets for cats and Credelio™ chewable tablets for dogs contains lotilaner. Milbemax™ chewable tablets for dogs contains The zoophilic fruitfly Phortica variegata: morphology, milbemycin oxime and praziquantel. Legal category POM-V in UK, POM in IE. For further information call Elanco Animal Health on +44(0)1256 353131 or write to: Elanco Animal Health, Lilly House, Priestley Road, Basingstoke, Hampshire, United Kingdom RG24 9NL. For further information, consult ecology and biological niche. Medical and Veterinary the product SPC. Refer to the product packaging and leaflets for information about side effects, precautions, warnings and contra-indications. Always Entomology 2006; 20(4): 358-364. seek advice on the use of medicines from the prescriber. Use medicines responsibly www.noah.co.uk/responsible; www.apha.ie. Credelio, Milbemax, Elanco and the diagonal bar logo are trademarks of Elanco or its affiliates. ©2019 Elanco or its affiliates. PM-IE-19-0059. Date of preparation 07/19 368 Veterinary Ireland Journal I Volume 9 Number 7

Vet July.indd 368 02/07/2019 13:36 1116505_Milbemax_Vet Ad_2019 Design_A4_2019-07-01_v19 GM.indd 1 01/07/2019 17:12