Open Veterinary Journal, (2016), Vol. 6(2): 84-88 ISSN: 2226-4485 (Print) Case Report ISSN: 2218-6050 (Online) DOI: http://dx.doi.org/10.4314/ovj.v6i2.3 Submitted: 26/01/2016 Accepted: 19/05/2016 Published: 13/06/2016 Urinary capillariosis in six dogs from Italy A. Mariacher1,2,*, F. Millanta2, G. Guidi2 and S. Perrucci2 1Istituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana, Viale Europa 30, 58100 Grosseto, Italy 2Dipartimento di Scienze Veterinarie, Viale delle Piagge 2, 56124 Pisa, Italy Abstract Canine urinary capillariosis is caused by the nematode Pearsonema plica. P. plica infection is seldomly detected in clinical practice mainly due to diagnostic limitations. This report describes six cases of urinary capillariosis in dogs from Italy. Recurrent cystitis was observed in one dog, whereas another patient was affected by glomerular amyloidosis. In the remaining animals, the infection was considered an incidental finding. Immature eggs of the parasite were observed with urine sediment examination in 3/6 patients. Increased awareness of the potential pathogenic role of P. plica. and clinical disease presentation could help identify infected animals. Keywords: Cystitis, Dog, Glomerular amyloidosis, Urinary capillariosis. Introduction Urinary capillariosis in dogs is caused by Pearsonema lower urinary tract maladies, both in domestic (Rossi plica (Trichurida, Capillariidae), a nematode that et al., 2011; Basso et al., 2014) and wild carnivores infects domestic and wild carnivores worldwide. (Fernández-Aguilar et al., 2010; Bork-Mimm and Clinical cases of canine urinary capillariosis have Rinder, 2011; Alić et al., 2015). These urinary disorders been reported in the United States (Senior et al., generally include pollakiuria, dysuria and hematuria, 1980; Kirkpatrick and Nelson, 1987) and Europe, may have chronic or recurrent clinical forms and do including France (Cazelles et al., 1989), Switzerland not improve after symptomatic or empirical antibiotic (Spillmann and Glardon, 1989; Basso et al., 2014), treatments (Senior et al., 1980; van Veen, 2002; Rossi Holland (van Veen, 2002), Poland (Studzińska et al., et al., 2011). 2015) and Italy (Callegari et al., 2010; Maurelli et al., Diagnosis of P. plica infection is based on examination 2014). Adult parasites live superficially attached to of the urine sediment, an assessment seldom the mucosa of the urinary bladder, while the ureters performed in the routine parasite diagnoses of dogs and renal pelvis are seldom affected (Bork-Mimm and cats (Otranto, 2015) as it is mostly reserved for and Rinder, 2011). symptomatic patients. Moreover, false negative results P. plica has an indirect life cycle that involves may commonly occur even when P. plica infection is earthworms (Lumbricina) as intermediate hosts established and symptomatic, due to a long prepatent (Senior et al., 1980) and domestic and wild carnivores period, irregular elimination of low numbers of eggs as definitive hosts (Anderson, 2000). P. plica is and difficulties in detecting immature or atypical eggs most often reported in dogs with access to outdoor (Senior et al., 1980; Rossi et al., 2011; Basso et al., environments, especially hunting dogs and kenneled 2014; Maurelli et al., 2014). This study describes six dogs (Senior et al., 1980; Callegari et al., 2010). The cases of urinary capillariosis in dogs, and highlights the red fox (Vulpes vulpes) is considered the wild reservoir variability of its clinical presentation. of P. plica for domestic animals in Europe (Davidson Case details et al., 2006; Magi et al., 2014), but the wolf (Canis Six cases of urinary capillariosis were examined in lupus) is emerging as an additional reservoir (Bagrade two different veterinary facilities in Italy. Diagnoses et al., 2009; Mariacher et al., 2015). Despite the high were based on the detection of mature and immature prevalence in the red fox, urinary capillariosis has been P. plica eggs in the urinary sediment of the six dogs. rarely reported in dogs in Italy (Callegari et al., 2010; Eggs were identified as P. plica based on: 1) mature Maurelli et al., 2014) and the real occurrence of the eggs are barrel-shaped, colorless and operculated, show disease is probably underestimated. a slightly pitted wall and bipolar plugs and measure Indeed, urinary capillariosis has often been regarded 55-68 μm x 24-29 μm (Basso et al., 2014); and/or as having minor clinical and pathological significance, 2) immature eggs are smaller, lack a shell and show due to frequent subclinical presentations and limitations rudimentary polar plugs (Basso et al., 2014). Clinical in its diagnosis (Otranto, 2015). However, in heavy details and findings at urine sediment examination are parasite loads, P. plica may be responsible for severe summarised in Tables 1 and 2 respectively. *Corresponding Author: Alessia Mariacher. Istituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana, 84 Viale Europa 30, 58100 Grosseto, Italy. Tel: +39 0564 456249. Email: [email protected] Table 1. Breed, gender, age and clinical data of six dogs with urinary capillariosis. A. Mariacheretal. http://www.openveterinaryjournal.com Journal Open Veterinary Case Season Geographic Breed Gender Age Household Presenting Physical Final diagnosis Treatment regimen Follow-up ID (month/year) origin (yrs) complaint examination Case 1 Winter Pisa (CI) Maremma MI 5 In+Out Weight loss, Pale mucous Glomerular Fenbendazole Negative (02/2012) hound (boar hunting) polyuria-polydipsia membranes amyloidosis 50 mg/Kg orally once a day for 7 days Case 2 Spring Siena (CI) MB MI 4 In+Out Leishmaniasis Slightly enlarged Leishmaniasis Fenbendazole Negative (05/2012) (game bird evaluation peripheral lymph 50 mg/Kg orally hunting) nodes once a day for 7 days Case 3 Autumn Pisa (CI) MB MI 4 Out Leishmaniasis Normal Leishmaniasis Fenbendazole Negative (09/2015) (dog shelter) evaluation 50 mg/Kg orally once a day for 7 days Case 4 Winter Udine (NI) MB MI 8 In Recurrent cystitis; Hematuria n.a. --- --- (12/2014) hematuria Case 5 Winter Udine (NI) Lhasa Apso MI 3 In Lethargy Fever Fever of unknown --- --- (01/2015) origin Case 6 Winter Udine (NI) American FN 9 In Urinary tenesmus Urinary Pelvic --- --- (01/2015) Staffordshire tenesmus hemangiosarcoma Season: Season of presentation; CI: Central Italy; NI: Northern Italy; MB: Mixed-breed; FN: Neutered female; MI: Intact male; Yrs: Years; In: Indoor; Out: Outdoor; n.a.: Not available; Follow-up: Follow up at 7 and 14 days after treatment, by urinary sediment examination; ---: Not treated/lost to follow-up case, andthedogonlyreceived symptomatictreatment found the infection was not promptly identified in this were observed. Because only moderate immature pyuria and eggs rare immature were eggs of and at urine sediment examination severe hematuria, physical examination the dog showed gross hematuria, had a history of recurrent cystitis and who hematuria. At lived indoors in an eight, aged dog mixed-breed male intact an was 4 Case urban setting. The patient Case 4 after treatment. negative for parasite eggs at seven and fourteen days a day for seven days), was and treated with fenbendazole the (50 mg/Kg orally urine once sediment was with slight pyuria and hematuria. Urinary capillariosis of parameters were in their normal range. Mature he had eggs no history of urinary signs and renal function dog was presented for an evaluation of leishmaniasis, who was recently rescued from Case 3 was an intact male a mixed-breed dog aged four, dog shelter. The Case 3 and fourteendaysaftertreatment. urine sediment was negative for parasite eggs at seven (50 mg/Kg orally once a day for seven days), and the Urinary capillariosis was treated with urine sediment fenbendazole (Fig. 2), along Typical with mature eggs of a slight pyuria. renal function parameters were in their normal range. leishmaniasis, with no history of during urinary hunting season. signs This and patient was referred The for dog had access to rural and forest environments Case 2 was an intact male mixed-breed dog aged four. Case 2 necrosis. interstitial nephritis, and scattered foci showed of glomerular tubular amyloidosis (Fig. biopsy was performed a month Histopathology later. 1), chronic treatment. Due to worsening negative for proteinuria, parasite eggs a starting seven days renal after days). Urine sediment examination was repeatedly fenbendazole (50 mg/Kg orally once a day for seven Animal Health),dietaryproteinrestriction,and MSD canis for (1:40) titer IgG positive low a for except negative for slight pyuria was also present. Serological tests were of mature capillariosis was diagnosed based on the Society, presence 2013) Interest Renal (International III and stage at disease kidney nephrotic syndrome. Urinary polyuria/polydipsia and was diagnosed with chronic during hunting season. The The dog dog had access to rural and was forest environments referred five. aged hound Maremma for male intact an was 1 Case Case 1 P. plica P. The dog was treated with ramipril (VASOTOP; (VASOTOP; ramipril with treated was dog The . were identified in the urine sediment, along P. plica P. Leishmania eggs in the urinary sediment; a P. plica P. sp. and tick-borne diseases, were identified in the , (2016), Vol. 6(2):84-88 Vol. , (2016), Ehrlichia Ehrlichia P. plica P. 85 http://www.openveterinaryjournal.com A. Mariacher et al. Open Veterinary Journal, (2016), Vol. 6(2): 84-88 Table 2. Findings at urine sediment examination in six dogs with urinary capillariosis. Case ID SG pH PU/CU WBC RBC Hyaline casts Crystals Bacteria Epithelial cells Case 1 1010 6.5 9.56 + 0 0 0 0 + Case 2 1030 8.0 0.25 + 0 0 0 0 + Case 3 1060 7.0 0.18 + + 0 Struvite 0++ +++ Case 4 1050 6.0 n.a. ++ ++++ + 0 0 +++ Case 5 1060 5.0 n.a. + 0 0 0 0 + Case 6 1030 8.0 n.a. + ++++ 0 Struvite 0+ + SG: Specific gravity; PU/CU: Protein/creatinine ratio; WBC: White blood cells, RBC: Red blood cells; n.a.: Data not available. Normal ranges for these parameters are as follows: SG: 1030-1040, pH: 5.5-7.0, PU/CU: 0.1-0.5, WBC: 0, RBC: 0, casts: 0, crystals: 0, bacteria: 0, epithelial cells: 0/+ Case 5 Case 5 was an intact male Lhasa Apso aged three, who lived indoors in an urban setting.