Canine infection with Dirofilaria immitis, Borrelia burgdorferi, Anaplasma spp., and Ehrlichia spp. in the United States, 2013-2019

A Clinical Study on Urinary Clusterin and Cystatin B in Dogs with Spontaneous Acute Kidney Injury

Novel biomarkers are needed in diagnosing reliably acute kidney injury (AKI) in dogs and in predicting morbidity and mortality after AKI. Our hypothesis was that two novel tubular biomarkers, urinary clusterin (uClust) and cystatin B (uCysB), are elevated in dogs with AKI of different etiologies. In a prospective, longitudinal observational study, we collected serum and urine samples from 18 dogs with AKI of different severity and of various etiology and from 10 healthy control dogs. Urinary clusterin and uCysB were compared at inclusion between dogs with AKI and healthy controls and remeasured one and three months later. Dogs with AKI had higher initial levels of uClust (median 3593 ng/mL; interquartile range [IQR]; 1489-10,483) and uCysB (554 ng/mL; 29-821) compared to healthy dogs (70 ng/mL; 70-70 and 15 ng/mL; 15-15; p < 0.001, respectively). Initial uCysB were higher in dogs that died during the one-month follow-up period (n = 10) (731 ng/mL; 517-940), compared to survivors (n = 8) (25 ng/mL; 15-417 (p = 0.009). Based on these results, uClust and especially uCysB are promising biomarkers of AKI. Further, they might reflect the severity of tubular injury, which is known to be central to the pathology of AKI.

Efficacy of moxidectin, using various dose regimens, against JYD-34, a macrocyclic lactone resistant isolate of Dirofilaria immitis

BACKGROUND

Macrocyclic lactones (MLs) are the only class of drugs currently commercially available that are effective for preventing heartworm disease. The data presented in this article provide information on the efficacy of oral moxidectin against JYD-34, a known ML-resistant Dirofilaria immitis isolate, when dogs are treated under various dosing regimens.

METHODS

Fifty-two purpose-bred Beagle dogs were used in five laboratory studies. All dogs were inoculated with 50 D. immitis third-stage larvae (L3) (JYD-34 isolate) 30 days prior to the first treatment. Dogs were randomized to treatment (four to five animals in each group) with one, three, or five monthly doses of oral moxidectin ranging from 6 to 100 µg/kg body weight. In each study, control dogs were not treated. Five to 6 months after L3 inoculation, dogs were euthanized, and adult worms were counted to evaluate efficacy of the dosing regimens.

RESULTS

Adult heartworms were recovered from all control dogs, with an overall geometric mean of 29.7 worms (range 15.2 to 38.0, individual counts ranged from 8 to 51). Five monthly doses of 6 µg/kg provided 83.3% and 90.2%, efficacy, and the same number of monthly doses of 9 µg/kg demonstrated 98.8% and 94.1% efficacy. Three monthly doses of 30 and 50 µg/kg demonstrated 97.9% and 99.0% efficacy, respectively, while a single dose of 100 µg/kg demonstrated 91.1% efficacy.

CONCLUSIONS

Five monthly doses of 9 µg/kg provided similar or only marginally lower efficacy against JYD-34, a known ML-resistant isolate, compared to substantially higher doses administered for 3 months. This underscores the importance of duration of exposure to moxidectin when facing ML-resistant isolates. Repeated administration of lower doses of moxidectin are an alternative to higher doses in the prevention of heartworm disease associated with less susceptible or resistant isolates.

Heat Treatment Augments Antigen Detection of Dirofilaria immitis in Apparently Healthy Companion Dogs (3.8% to 7.3%): Insights from a Large-Scale Nationwide Survey across the United States

BACKGROUND

Heartworm disease (HWD) is a vector-borne disease caused by the filarial nematode Dirofilaria immitis. Low antigen levels caused by immune complex formation preclude HWD diagnosis. Heat treatment is an immune complex dissociation technique used to enhance antigen detection. Only a few studies have reported the benefits of heat treatment in nationwide surveys.

METHODS

To investigate the impact of heat treatment on the seroprevalence of HWD in companion dogs in the USA, serum samples (n = 3253) were analyzed for D. immitis antigen (DiroCHEK®, Zoetis) without and with heat treatment of the samples.

RESULTS

Compared to sera without heat treatment, heat treatment significantly increased overall prevalence from 3.8% (123/3253) to 7.3% (237/3253) (p < 10-4), expanding antigen detection from 32 to 39 of the 48 states and Washington District of Columbia included in this study.

CONCLUSIONS

This study represents the largest nationwide survey of HW antigen detection in dogs in the US applying heat treatment to canine sera. The heat treatment used herein has the advantage of requiring a low volume of serum, making it optimal for use in routine diagnosis. Heat treatment should be used routinely by reference laboratories and veterinary clinics in patients with a negative initial test.

Pre-treatment of canine plasma with heat, rather than acid, efficiently enhances Dirofilaria immitis antigen detection

BACKGROUND

The dissociation of antigen-antibody complexes has been utilized to enhance the accuracy of serological tests for infectious diseases, including Dirofilaria immitis. Currently, the antigen detected by available tests is primarily a glycoprotein found in the reproductive tract of female worms. However, this antigen can become inaccessible when bound to excessive circulating antibodies, leading to reduced test sensitivity and false-negative results. Acid and heat treatments of the sera or plasma have been established as reliable methods for inducing immune complex dissociation (ICD). Previous antigen testing for heartworm infection in dogs and cats has demonstrated that these treatments improve the diagnostic sensitivity without compromising specificity. This study aims to evaluate the performance of four distinct ICD methods in the detection of D. immitis antigen.

METHODS

We utilized twofold serial dilutions of a well-characterized plasma (ranging from 1:2 to 1:4096) obtained from a D. immitis-infected dog to simulate the diverse antigen levels encountered in real-life infected dogs. The presence of antigen in the diluted samples, both without treatment and treated with four ICD protocols, was assessed in triplicate visually using DiroCHEK® by observing color changes. OD values were also obtained using the microplate reader SpectraMax® i Series-Spectramax Id3. A Factorial ANOVA test was conducted to compare the OD values between samples with and without treatments.

RESULTS

The highest dilution at which color changes were observed was 1:128 for untreated samples and for samples subjected to acid treatments in ICD-3 and the hybrid ICD-4 protocol. In contrast, both heat treatment protocols (ICD-1 and ICD-2) exhibited color changes at a 512-fold dilution. The OD values in samples subjected to heat treatment were significantly higher than those in untreated samples, up to dilutions of 512-fold. Although OD values tended to be higher in samples subjected to acid treatment and the hybrid protocol compared to untreated samples up to a 128-fold dilution, this difference was not significant as the samples underwent further dilution.

CONCLUSIONS

Our findings affirm that heat treatments, rather than acid treatment, efficiently enhance the detection of D. immitis antigen by liberating the sequestered antigen from the immune complexes.

Comparison of the initial and residual speed of Ixodes scapularis kill on dogs treated with a single dose of Bravecto® Chew (25 mg/kg fluralaner) or Simparica TRIO® (1.2 mg/kg sarolaner, 24 µg/kg moxidectin, 5 mg/kg pyrantel)

BACKGROUND

Compliant ectoparasiticide product use is a comprehensive way to control ticks and reduce the risk of tick-borne pathogen transmission to dogs. Because the systemically acting isoxazoline ectoparasiticides require tick attachment for drug delivery, fast speed of kill is essential to minimize tick-borne pathogen transmission risk.

METHODS

Dogs of satisfactory tick-carrying capacity were randomly allocated to treatment groups and administered, per label instructions, Bravecto® Chews (minimum 25 mg/kg fluralaner), Simparica TRIO® (minimum 1.2 mg/kg sarolaner, 24 µg/kg moxidectin, 5 mg/kg pyrantel), or no treatment. Dogs were infested with approximately 50 unfed adult (35 female, 15 male) Ixodes scapularis on Day -2, 21 and 28. Live tick counts were performed at 4, 8, 12 and 24 h post-treatment (Day 0) and post-infestation on Day 21 and 28. Tick control efficacy was determined by comparing live tick means for each product-treated group to the untreated control group and each other at all time points using a linear mixed model. The percent of dogs free of live ticks was analyzed using the Fisher's exact test for treatment group comparison.

RESULTS

The untreated control group maintained adequate tick infestations throughout the study. Using geometric means, an existing I. scapularis infestation was controlled by 99.7% and 93.0% 12 h post-treatment and by 100% and 99.5% 24 h post-treatment, for Bravecto® and Simparica TRIO®-treated dogs, respectively. Ixodes scapularis infestations were controlled more quickly for Bravecto®- compared to Simparica TRIO®-treated dogs on Day 21 at 8 h (efficacy 74.0% vs. 0.0%, p = 0.003) and 12 h (efficacy 99.2% vs. 39.4%, p < 0.001) post-infestation and Day 28 at 8 h (efficacy 92.2% vs. 0.0%, p < 0.001) and 12 h (efficacy 99.6% vs. 27.7%, p < 0.001) post-infestation. On Day 28 post-treatment, the efficacy of Bravecto® and Simparica TRIO® to control a new I. scapularis infestation was 100% and 96.6%, respectively, by 24 h post-infestation. Of product-treated dogs, 100% of Bravecto®-treated dogs were free of live ticks by 24 h post-treatment or post-infestation. No treatment-related adverse reactions occurred during the study.

CONCLUSIONS

Ixodes scapularis infestations are controlled more quickly 21 and 28 days post-treatment for dogs administered a single dose of Bravecto® compared to dogs administered a single dose of Simparica TRIO®.

Modulation of Macrophage Redox and Apoptotic Processes to Leishmania infantum during Coinfection with the Tick-Borne Bacteria Borrelia burgdorferi

Canine leishmaniosis (CanL) is a zoonotic disease caused by protozoan Leishmania infantum. Dogs with CanL are often coinfected with tick-borne bacterial pathogens, including Borrelia burgdorferi in the United States. These coinfections have been causally associated with hastened disease progression and mortality. However, the specific cellular mechanisms of how coinfections affect microbicidal responses against L. infantum are unknown. We hypothesized that B. burgdorferi coinfection impacts host macrophage effector functions, prompting L. infantum intracellular survival. In vitro experiments demonstrated that exposure to B. burgdorferi spirochetes significantly increased L. infantum parasite burden and pro-inflammatory responses in DH82 canine macrophage cells. Induction of cell death and generation of mitochondrial ROS were significantly decreased in coinfected DH82 cells compared to uninfected and L. infantum-infected cells. Ex vivo stimulation of PBMCs from L. infantum-seronegative and -seropositive subclinical dogs with spirochetes and/or total Leishmania antigens promoted limited induction of IFNγ. Coexposure significantly induced expression of pro-inflammatory cytokines and chemokines associated with Th17 differentiation and neutrophilic and monocytic recruitment in PBMCs from L. infantum-seropositive dogs. Excessive pro-inflammatory responses have previously been shown to cause CanL pathology. This work supports effective tick prevention and risk management of coinfections as critical strategies to prevent and control L. infantum progression in dogs.

Efficacy of an oral combination of moxidectin, afoxolaner, and pyrantel pamoate for the prevention of heartworm disease in dogs

Dirofilaria immitis, the mosquito-borne agent of dirofilariosis, a chronic and sometimes fatal cardiopulmonary canine disease, is endemic in most warm and temperate regions in the world. The efficacy of an oral endectoparasiticide product (test product or TP) combining moxidectin, afoxolaner, and pyrantel pamoate was evaluated for the prevention of heartworm disease in dogs, in two laboratory and one field studies. In each laboratory study, 20 D. immitis-naïve beagle dogs were experimentally infected with D. immitis. Ten control dogs were sham-treated, and ten dogs were administered the TP targeting the minimum effective dose, six times monthly and starting 30 days post infection. At necropsy seven months after inoculations, no heartworms were found in any of the TP treated dog, whereas 19 to 42 live heartworms were found in the control dogs. In each study, treatment efficacy was 100% and the difference between treated and untreated groups was highly significant (p < 0.0001). A field study was conducted through the full transmission season in several heartworm-endemic regions of the United States. One hundred and twenty client-owned dogs that were negative for D. immitis at enrollment were administered twelve monthly oral doses of the TP at label dose. Blood tests for D. immitis antigen and modified Knott's tests for microfilariae remained negative through the full duration of the study, demonstrating that all dogs were protected from heartworm infection during the full transmission season. These studies demonstrated that TP administered monthly for at least six doses is effective at preventing dirofilariosis.

Filarial DAF-12 sense the host serum to resume iL3 development during infection

Nematode parasites enter their definitive host at the developmentally arrested infectious larval stage (iL3), and the ligand-dependent nuclear receptor DAF-12 contributes to trigger their development to adulthood. Here, we characterized DAF-12 from the filarial nematodes Brugia malayi and Dirofilaria immitis and compared them with DAF-12 from the non-filarial nematodes Haemonchus contortus and Caenorhabditis elegans. Interestingly, Dim and BmaDAF-12 exhibit high sequence identity and share a striking higher sensitivity than Hco and CelDAF-12 to the natural ligands Δ4- and Δ7-dafachronic acids (DA). Moreover, sera from different mammalian species activated specifically Dim and BmaDAF-12 while the hormone-depleted sera failed to activate the filarial DAF-12. Accordingly, hormone-depleted serum delayed the commencement of development of D. immitis iL3 in vitro. Consistent with these observations, we show that spiking mouse charcoal stripped-serum with Δ4-DA at the concentration measured in normal mouse serum restores its capacity to activate DimDAF-12. This indicates that DA present in mammalian serum participate in filarial DAF-12 activation. Finally, analysis of publicly available RNA sequencing data from B. malayi showed that, at the time of infection, putative gene homologs of the DA synthesis pathways are coincidently downregulated. Altogether, our data suggest that filarial DAF-12 have evolved to specifically sense and survive in a host environment, which provides favorable conditions to quickly resume larval development. This work sheds new light on the regulation of filarial nematodes development while entering their definitive mammalian host and may open the route to novel therapies to treat filarial infections.

Spatial and risk factor analyses of vector-borne pathogens among shelter dogs in the Eastern United States

BACKGROUND

Vector-borne infections pose significant health risks to humans, domestic animals, and wildlife. Domestic dogs (Canis lupus familiaris) in the United States may be infected with and serve as sentinel hosts for several zoonotic vector-borne pathogens. In this study, we analyzed the geographical distribution, risk factors, and co-infections associated with infection with Ehrlichia spp., Anaplasma spp., Borrelia burgdorferi, and Dirofilaria immitis in shelter dogs in the Eastern United States.

METHODS

From 2016 to 2020, blood samples from 3750 shelter dogs from 19 states were examined with IDEXX SNAP^® 4Dx^® Plus tests to determine the seroprevalence of infection with tick-borne pathogens and infection with D. immitis. We assessed the impact of factors including age, sex, intact status, breed group, and location on infection using logistic regression.

RESULTS

The overall seroprevalence of D. immitis was 11.2% (n = 419/3750), the seroprevalence of Anaplasma spp. was 2.4% (n = 90/3750), the seroprevalence of Ehrlichia spp. was 8.0% (n = 299/3750), and the seroprevalence of B. burgdorferi was 8.9% (n = 332/3750). Regional variation in seroprevalence was noted: D. immitis (17.4%, n = 355/2036) and Ehrlichia spp. (10.7%, n = 217/2036) were highest in the Southeast while seroprevalence for B. burgdorferi (19.3%, n = 143/740) and Anaplasma spp. (5.7%, n = 42/740) were highest in the Northeast. Overall, 4.8% (n = 179/3750) of dogs had co-infections, the most common of which were D. immitis/Ehrlichia spp. (1.6%, n = 59/3750), B. burgdorferi/Anaplasma spp. (1.5%, n = 55/3750), and B. burgdorferi/Ehrlichia spp. (1.2%, n = 46/3750). Risk factors significantly influenced infection across the evaluated pathogens were location and breed group. All evaluated risk factors were significant for the seroprevalence of D. immitis antigens.

CONCLUSIONS

Our results demonstrate a regionally variable risk of infection with vector-borne pathogens in shelter dogs throughout the Eastern United States, likely due to varying distributions of vectors. However, as many vectors are undergoing range expansions or other changes in distribution associated with climate and landscape change, continued vector-borne pathogen surveillance is important for maintaining reliable risk assessment.

The Presence of Dirofilaria immitis in Domestic Dogs on San Cristobal Island, Galapagos

This study's concept was outlined around the principle of conservation medicine in a biodiversity hotspot from the Neotropical realm: the Galapagos Islands. The wildlife balance has been modified by multi-host parasites introduced with some domestic animals (dogs and cats). The endemic and endangered species, the Galapagos sea lion (GSL, Zalophus wollebaeki), has been exposed to pathogens of canine and feline origin that could become a significant conservation problem for this species. One of these potential cases is the filarial heartworm infection, Dirofilaria immitis, which has been reported on other pinnipeds, with fatalities and clinical symptoms. Therefore, this study evaluated the presence of the microfilaria of D. immitis in dogs from Puerto Baquerizo Moreno, San Cristobal Island, where the largest rookery of GSLs lives and where the proximity to domestic dogs is the most intimate compared to other rookeries of the archipelago. Between July and September 2021, 587 blood samples were collected from owned dogs of Puerto Baquerizo Moreno. Overall, 10 dogs (1.7%) were positive for the presence of the microfilaria of D. immitis with a confidence interval of 0.7%-2.8%. No other filarial species were identified. Significant differences in prevalence between different dog categories were observed only for the age (p = 0.001). This study represents the first report of D. immitis, the agent of canine heartworm disease, in dogs from San Cristobal Island. Hence, the presence of the microfilaria of D. immitis in the blood of dogs could increase the risk of infection to which the GSL is exposed in the region.

Nationwide molecular survey of Dirofilaria immitis and Dirofilaria repens in companion dogs and cats, United States of America

Background

Heartworms, Dirofilaria immitis, are known to be widespread in dogs and cats in the USA, but there have been no country-wide prevalence studies performed to date. There have also been no large-scale studies to determine whether the closely related species, Dirofilaria repens, occurs in the USA.

Methods

To provide this large-scale data, we examined whole blood samples (n = 2334) submitted from around the USA to the Molecular Diagnostic Laboratory at Auburn University between 2016 and 2022. Quantitative PCRs for D. immitis (targeting 16S rRNA) and D. repens (targeting cytochrome c oxidase subunit 1 gene) were performed to determine the presence of Dirofilaria DNA. DNA sequencing was performed to confirm the results.

Results

Dirofilaria immitis DNA was found in 6.3% (68/1080) of the dogs from 17/39 states, and 0.3% (4/1254) of the cats from 4/42 states. None of the dogs or cats were positive for D. repens. The average 16S rRNA copy number of D. immitis in the dogs was 1,809,604 in 200 µl whole blood, while only a single copy was found in each of the four D. immitis-positive cats. The prevalence of D. immitis in dogs of different ages, sexes, and breeds did not differ significantly, but the prevalence in Southern states (7.5%, 60/803) was significantly higher than in the Western (1.7%, 1/58), Midwest (3.3%, 4/120), and Northeastern states (3.1%, 3/98) (P < 0.05). Dogs positive for D. immitis were identified in each study year (2016: 4.2%, 2/48; 2017: 9.8%, 4/41; 2018: 5.1%, 8/156; 2019: 4.9%, 15/306; 2020: 9.8%, 26/265; 2021: 4.9%, 13/264). Interestingly, dogs infected with Hepatozoon spp. (11.8%, 37/313) were significantly more likely to also be positive for D. immitis than dogs without evidence of Hepatozoon infection (3.9%, 30/760) (P < 0.0001).

Conclusions

To our knowledge, this is the first nationwide molecular survey of Dirofilaria spp. in dogs and cats in the USA, and the largest molecular survey of canine and feline dirofilariosis worldwide. Further studies are warranted to combine PCR with standard heartworm diagnostics to better understand the prevalence of Dirofilaria spp. and aid in determining the risks posed to dogs and cats in the USA.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-022-05459-5.

Serological survey for maternal antibodies to Borreliella burgdorferi and Anaplasma phagocytophilum in dogs from endemic and non-endemic regions of the United States

In North America, the tick-borne pathogens Borreliella burgdorferi (Lyme disease; LD) and Anaplasma phagocytophilum (anaplasmosis) are a significant health threat to dogs. Little is known regarding the seroprevalence of maternal antibodies (Abs) to these pathogens in young dogs. The analysis of maternal antibody (Ab) profiles is important as it could bear on the interpretation of currently available diagnostic assays and the potential for vaccine interference in pups. In this pilot study, sera from 32 client-owned dogs (6-24 weeks of age; 3 serum samples per dog) from four veterinary hospitals in the United States were screened for IgG against B. burgdorferi and A. phagocytophilum using whole cell lysate immunoblots and recombinant protein-based ELISAs. As a control, the sera were also screened for Abs to canine parvovirus and canine distemper virus using a commercially available colorimetric assay. Maternally derived Abs against B. burgdorferi including the diagnostic antigen VlsE were detected in 2 of the 32 dogs, accounting for 12.5 % of dogs from LD endemic regions, and as expected, the Ab levels declined over time. Differentiating between maternal Ab and infection-induced Ab is of importance in interpreting serological tests for tick-borne diseases in young dogs and in making decisions regarding treatment and timing of vaccination.

2022 AAHA Canine Vaccination Guidelines

These guidelines are an update and extension of previous AAHA peer-reviewed canine vaccination guidelines published in 2017. Vaccination is a cornerstone of canine preventive healthcare and one of the most cost-effective ways of maintaining a dog's health, longevity, and quality of life. Canine vaccination also serves a public health function by forming a barrier against several zoonotic diseases affecting dogs and humans. Canine vaccines are broadly categorized as containing core and noncore immunizing antigens, with administration recommendations based on assessment of individual patient risk factors. The guidelines include a comprehensive table listing canine core and noncore vaccines and a recommended vaccination and revaccination schedule for each vaccine. The guidelines explain the relevance of different vaccine formulations, including those containing modified-live virus, inactivated, and recombinant immunizing agents. Factors that potentially affect vaccine efficacy are addressed, including the patient's prevaccination immune status and vaccine duration of immunity. Because animal shelters are one of the most challenging environments for prevention and control of infectious diseases, the guidelines also provide recommendations for vaccination of dogs presented at or housed in animal shelters, including the appropriate response to an infectious disease outbreak in the shelter setting. The guidelines explain how practitioners can interpret a patient's serological status, including maternally derived antibody titers, as indicators of immune status and suitability for vaccination. Other topics covered include factors associated with postvaccination adverse events, vaccine storage and handling to preserve product efficacy, interpreting product labeling to ensure proper vaccine use, and using client education and healthcare team training to raise awareness of the importance of vaccinations.

Trypanosoma cruzi and Other Vector-Borne Infections in Shelter Dogs in Two Counties of Oklahoma, United States

Trypanosoma cruzi is an emerging zoonotic vector-borne parasite infecting dogs and other mammals in the United States. In this study we evaluated shelter dogs in one northeastern and one southeastern county in Oklahoma for prevalence of exposure to T. cruzi. Dogs were tested for antibodies against T. cruzi using the Chagas STAT PAK^® assay and for T. cruzi in circulation by PCR. In addition, dogs were tested for evidence of infection with other vector-borne organisms using the SNAP^® 4Dx^® Plus Test and PCR. Overall, 26 of 197 (13.2%) shelter dogs had detectable antibodies against T. cruzi and 3 of 189 (1.6%) dogs were PCR positive. In addition, we found that 42 of 197 (21.3%) shelter dogs had evidence of exposure to or were infected with at least one vector-borne agent other than T. cruzi based on serology and/or PCR; 9 of 42 (21.4%) of these dogs were also positive for T. cruzi antibodies. Other infections identified in dogs included Anaplasma phagocytophilum, Anaplasma platys, Babesia sp. (Coco), Dirofilaria immitis, Ehrlichia canis, Ehrlichia chaffeensis, Ehrlichia ewingii, and Hepatozoon americanum. This study serves to boost state-wide veterinary and public health awareness of T. cruzi and other vector-borne pathogens infecting shelter dogs in Oklahoma. Results indicate the need for more comprehensive screening of shelter dogs in Oklahoma for exposure to vector-borne agents to enhance surveillance and to identify dogs in need of additional specific veterinary care.

A newly developed droplet digital PCR for Ehrlichia canis detection: comparisons to conventional PCR and blood smear techniques

Canine monocytic ehrlichiosis caused by Ehrlichia canis infection is a life-threatening vector-borne disease in dogs worldwide. Routine blood smear has very low sensitivity and cannot accurately provide a quantitative result. Conventional PCR (cPCR) and real-time PCR (qPCR) are widely used as molecular methods for E. canis detection. qPCR is quantitative but relies on standard curves of known samples. To overcome this difficulty, this study developed a new E. canis quantitative detection method, using droplet digital polymerase chain reaction (ddPCR). ddPCR was evaluated against cPCR and blood smears. PCR amplicons and genomic DNA (gDNA) from 12 microscopic positive samples were used to identify the limits of detection (LODs) in ddPCR and cPCR. Our ddPCR was assessed in 92 field samples, it was compared with cPCR and blood smears. ddPCR showed LOD = 1.6 copies/reaction, or 78 times more sensitive than cPCR (LOD = 126 copies/reaction), using PCR amplicons as a template, whereas both ddPCR and cPCR had equal LODs at 0.02 ng gDNA/reaction. In addition, ddPCR had 100% sensitivity and 75% specificity for E. canis detection compared to cPCR and no cross-reaction with other blood pathogens was observed. ddPCR identified more positive samples than cPCR and blood smear. ddPCR improved the overall performance of E. canis detection, with a better LOD and comparable sensitivity and specificity to cPCR. The technique might be helpful for diagnosis of E. canis in light infection, evaluating the number of E. canis and follow-up after treatment.

Tick-Borne Pathogens, Babesia spp. and Borrelia burgdorferi s.l., in Sled and Companion Dogs from Central and North-Eastern Europe

Ticks are important vectors of numerous pathogens of medical and veterinary significance. The aim of the current study was to determine the prevalence of Babesia spp. and Borrelia burgdorferi s.l. in sled and pet dogs from Central and North-Eastern Europe. Neither Babesia spp. nor Borrelia burgdorferi s.l. infections were detected in sled dogs from seven countries (Poland, Lithuania, Latvia, Estonia, Belarus, Russia and Finland). The DNA of Babesia spp. was detected in 100% of symptomatic and 5.4% of asymptomatic pet dogs from Poland. Similarly, the DNA of Babesia spp. was identified in 82% of symptomatic and 3.8% of asymptomatic pet dogs from Ukraine. The DNA of Borrelia burgdorferi s.l. was detected in 4.4% of pet dogs. Molecular typing confirmed the presence of Babesia canis and Borrelia burgdorferi sensu stricto (s.s.) in selected samples. Four dogs were co-infected by B. canis and Borrelia burgdorferi s.l. Tick-borne pathogens constitute a serious health threat to pet dogs in Central and South-Eastern Europe, but were not observed among sled dogs from the same region of Europe nor in the Baltic countries.

Serologic evidence of selected vector-borne pathogens in non-owned dogs in the southeast US

Vector-borne pathogens (VBP) associated with ectoparasitism are of concern for animal health, and there are many gaps in surveillance and reporting data. The purpose of this study was to test for four VBPs in a subset of non-owned dogs from county humane societies in Alabama and Georgia that were admitted to the Auburn University College of Veterinary Medicine Hoerlein Spay/Neuter Program for health exams and routine procedures, including bloodwork and testing with the 4Dx® SNAP® Plus (IDEXX Laboratories, Inc., Westbrook, Maine). Visualized ectoparasites were noted and preserved for identification and analysis. From May-October 2019, residual blood (n = 114) was used for preparing blood smears and DNA extraction and PCR. Out of 114 samples, 35.1% (40/114) were seropositive for one or more VBP: Dirofilaria immitis antigen (20.2%; 23/114) and Ehrlichia spp. antibodies (20.2%; 23/114); six VBD-positive dogs (15%) tested positive for both. No dogs had detectable antibodies to Borrelia burgdorferi or Anaplasma spp. (0%; 0/114). Microfilariae of D. immitis were present in 7 blood smears, all from dogs that were D. immitis antigen positive. Morulae or DNA of Ehrlichia or Anaplasma spp. were not identified in any sample. Fleas were documented in 20.4% (23/113) of dogs, 9.7% (11/113) were infested with ticks, predominantly Amblyomma americanum, and co-infestations were noted in 2.7% (3/113). Our data indicate that there is substantial VBP risk in Alabama and Georgia, and that the reservoir potential of domestic animals, especially non-owned animals, along with potential wildlife reservoirs warrants further investigation.

Identification of Rickettsia spp. and Babesia conradae in Dermacentor spp. Collected from Dogs and Cats Across the United States

In the United States, Dermacentor variabilis and Dermacentor andersoni are considered key vectors for Rickettsia rickettsii, the causative agent of Rocky Mountain spotted fever. Through regional surveillance, a wide diversity of Rickettsia spp. have been documented in D. variabilis, and Dermacentor spp. has been suggested as potential vectors for various other pathogens, including Babesia spp. and Ehrlichia canis. To better define the prevalence and diversity of pathogens in Dermacentor spp. across the United States, 848 ticks collected from dogs and cats in 44/50 states in 2018–2019 were tested by PCR for Rickettsia spp.-specific 17 kDa and ompA gene fragments; a subset of Dermacentor spp. was also tested with PCR, targeting fragments of the 18S and large subunit region rRNA genes of Babesia spp. and 16S rRNA genes of E. canis. Rickettsia spp. was identified in 12.5% (106/848) of ticks. Species detected include Rickettsia montanensis (n = 64 ticks), Rickettsia bellii (n = 15 ticks), Rickettsia rhipicephali (n = 13 ticks), Rickettsia peacockii (n = 8 ticks), Rickettsia amblyommatis (n = 3 ticks), Rickettsia cooleyi (n = 1 tick), and unclassified Rickettsia spp. (n = 2 ticks). Ticks with R. montanensis and R. bellii were submitted from every U.S. region; R. rhipicephali was predominantly detected in ticks from the southern half of the United States, and all R. peacockii-positive ticks were D. andersoni that originated from the Rocky Mountain states. Ehrlichia canis was not detected in any Dermacentor spp., and Babesia conradae was detected in two Dermacentor albipictus. Because most ticks had fed on dogs or cats before submission, these findings do not implicate a given Dermacentor sp. as a primary vector of these agents, but in regard to Rickettsia spp., the data do support other published work showing D. variabilis harbors a diversity of Rickettsia species with unknown implications for animal and human health.

Epidemiologic, Clinical and Immunological Consequences of Co-Infections during Canine Leishmaniosis

Simple Summary

Canine leishmaniosis (CanL), the most severe, visceralizing form of disease caused by Leishmania infantum transmitted by phlebotomine sand flies. CanL is frequently diagnosed in the Mediterranean basin and South America, although it is also found in other regions, including the United States (U.S.). Dogs in these regions are at risk for co-infections, prominently tick-borne diseases. Our review examines epidemiologic, clinical, and immunologic mechanisms found during the most common eight CanL co-infections reported in published literature. Co-infections alter immunologic processes and disease progression impacting CanL diagnosis, therapeutic responses, and prognosis.

Abstract

Canine leishmaniosis (CanL) is a vector-borne, parasitic disease. CanL is endemic in the Mediterranean basin and South America but also found in Northern Africa, Asia, and the U.S. Regions with both competent sand fly vectors and L. infantum parasites are also endemic for additional infectious diseases that could cause co-infections in dogs. Growing evidence indicates that co-infections can impact immunologic responses and thus the clinical course of both CanL and the comorbid disease(s). The aim for this review is to summarize epidemiologic, clinical, and immunologic factors contributing to eight primary co-infections reported with CanL: Ehrlichia spp., Anaplasma spp., Borrelia spp., Babesia spp., Trypanosoma cruzi, Toxoplasma gondii, Dirofilaria immitis, Paracoccidioides braziliensis. Co-infection causes mechanistic differences in immunity which can alter diagnostics, therapeutic management, and prognosis of dogs with CanL. More research is needed to further explore immunomodulation during CanL co-infection(s) and their clinical impact.

Identity of Microfilariae Circulating in Dogs from Western and South-Western Romania in the Last Decade

Dirofilaria infections in dogs are recognized as widespread mosquito-borne diseases with zoonotic potential, that are caused by the filarioid nematode (Onchocercidae) species Dirofilaria immitis and Dirofilaria repens. The long-term survey conducted in western and south-western Romania was undertaken in order to provide valuable data on the occurrence of Dirofilaria infections in dogs. Blood samples from 1088 dogs, originating from 73 localities of 11 western and south-western counties in Romania, were collected and examined using the modified Knott test. Subsequently, all of the microscopically positive samples were subjected to molecular analysis for confirmation. Altogether, the data obtained showed the percentage of dogs with circulating microfilariae to be 21.42% (233/1088) of dogs tested in the investigated region. The identified species, in cases of monoinfections, were D. immitis, D. repens, and Acanthocheilonema reconditum in 106 (9.74%) samples, 102 (9.38%) samples, and 1 (0.09%) sample, respectively. Twenty-four (2.21%) samples were simultaneously positive for D. immitis and D. repens. There was no association (p > 0.05) between infection status and breed; however, sex and lifestyle were positively associated (p < 0.05) with the percentage of dogs with circulating microfilariae and might be regarded as risk factors for infection. The results of the present investigation indicate potential zoonotic risks for humans living in the screened area and support the imperative to increase awareness among both veterinarians and physicians, regarding the continuous spread of these zoonotic filariae.

Heartworm disease - Overview, intervention, and industry perspective

Dirofilaria immitis, also known as heartworm, is a major parasitic threat for dogs and cats around the world. Because of its impact on the health and welfare of companion animals, heartworm disease is of huge veterinary and economic importance especially in North America, Europe, Asia and Australia. Within the animal health market many different heartworm preventive products are available, all of which contain active components of the same drug class, the macrocyclic lactones. In addition to compliance issues, such as under-dosing or irregular treatment intervals, the occurrence of drug-resistant heartworms within the populations in the Mississippi River areas adds to the failure of preventive treatments. The objective of this review is to provide an overview of the disease, summarize the current disease control measures and highlight potential new avenues and best practices for treatment and prevention.

An Accessible Alternative to Melarsomine: "Moxi-Doxy" for Treatment of Adult Heartworm Infection in Dogs

Canine heartworm infection, caused by the filarial parasite Dirofilaria immitis, represents a serious and expanding animal welfare concern that is expected to increase due to the effects of climate change and the COVID-19 pandemic. A body of evidence has emerged to support the use of a non-arsenical adulticide treatment protocol, using moxidectin and doxycycline to kill adult heartworms over a prolonged period. While a three-dose protocol using the arsenical drug melarsomine is currently the safest and most effective treatment for heartworm infection, this drug is not available in some countries and is inaccessible for many owners and animal shelters. Moxidectin-doxycycline (moxi-doxy) provides a viable alternative to no treatment at all, in cases where arsenical treatment is not possible. Based on current evidence, the most effective non-arsenical treatment regimen is doxycycline 10 mg/kg PO q 12 or 24 h for 28 days, combined with topical moxidectin at label dose. Moxidectin is repeated monthly until no antigen detected (NAD) status is confirmed. Sustained release injectable moxidectin, in combination with doxycycline, may provide an alternative in remote regions or in settings where significant compliance or accessibility concerns exist, but more studies are needed. In moxi-doxy protocols, doxycycline should be repeated annually until NAD. This review summarizes the safety and efficacy of moxi-doxy, addresses controversies surrounding this treatment approach, and provides detailed recommendations for treatment regimens and post-treatment testing.

The Contribution of Wildlife Hosts to the Rise of Ticks and Tick-Borne Diseases in North America

Wildlife vertebrate hosts are integral to enzootic cycles of tick-borne pathogens, and in some cases have played key roles in the recent rise of ticks and tick-borne diseases in North America. In this forum article, we highlight roles that wildlife hosts play in the maintenance and transmission of zoonotic, companion animal, livestock, and wildlife tick-borne pathogens. We begin by illustrating how wildlife contribute directly and indirectly to the increase and geographic expansion of ticks and their associated pathogens. Wildlife provide blood meals for tick growth and reproduction; serve as pathogen reservoirs; and can disperse ticks and pathogens-either through natural movement (e.g., avian migration) or through human-facilitated movement (e.g., wildlife translocations and trade). We then discuss opportunities to manage tick-borne disease through actions directed at wildlife hosts. To conclude, we highlight key gaps in our understanding of the ecology of tick-host interactions, emphasizing that wildlife host communities are themselves a very dynamic component of tick-pathogen-host systems and therefore complicate management of tick-borne diseases, and should be taken into account when considering host-targeted approaches. Effective management of wildlife to reduce tick-borne disease risk further requires consideration of the 'human dimensions' of wildlife management. This includes understanding the public's diverse views and values about wildlife and wildlife impacts-including the perceived role of wildlife in fostering tick-borne diseases. Public health agencies should capitalize on the expertise of wildlife agencies when developing strategies to reduce tick-borne disease risks.

Exposure to Major Vector-Borne Diseases in Dogs Subjected to Different Preventative Regimens in Endemic Areas of Italy

Vector-borne diseases (VBDs) are globally widespread arthropod-transmitted diseases with a significant impact on animal and human health. Many drivers have recently spurred the geographic spread of VBDs in dogs. This study has evaluated the exposure to most important VBDs in dogs under different preventative treatments in different regions of Italy, i.e., Veneto, Friuli Venezia-Giulia, Umbria, Giglio Island (Tuscany), Abruzzo and Latium. Serological analyses were performed to detect antibodies against Leishmania infantum, Babesia canis, Anaplasma phagocytophilum/Anaplasma platys, Ehrlichia canis/Ehrlichia ewingii, Borrelia burgdorferi, Rickettsia conorii and the circulating antigen of Dirofilaria immitis. Dogs were categorized according to the treatment schedule usually received, and the association between seropositivity and possible risk factors was statistically evaluated. Overall, 124/242 (51.2%) dogs tested positive for at least one pathogen, while 34 (14.0%) were exposed to two or more pathogens. The most detected seropositivity was against R. conorii, followed by Anaplasma spp., L. infantum, B. canis, and the other pathogens under study. Significant statistical associations were found according to geographical provenance, history of tick infestation, lifestyle and inadequate prophylactic treatments. Random/irregular treatments have been identified as a clear risk factor. These results show that adequate prophylactic treatment protocols are overlooked by dog owners, despite the availability of several effective products, with possible implications in veterinary medicine and on public health.

Ticks infesting dogs and cats in North America: Biology, geographic distribution, and pathogen transmission

A diverse array of ixodid and argasid ticks infest dogs and cats in North America, resulting in skin lesions, blood loss, and disease. The ticks most commonly found on pets in this region are hard ticks of the genera Amblyomma, Dermacentor, Ixodes, and Rhipicephalus, as well as the more recently established Haemaphysalis longicornis. Soft tick genera, especially Otobius and Ornithodoros, are also reported from pets in some regions. In this review, we provide a summary of the complex and diverse life histories, distinct morphologies, and questing and feeding behaviors of the more common ticks of dogs and cats in North America with a focus on recent changes in geographic distribution. We also review pathogens of dogs and cats associated with the different tick species, some of which can cause serious, potentially fatal disease, and describe the zoonotic risk posed by ticks of pets. Understanding the natural history of ticks and the maintenance cycles responsible for providing an ongoing source of tick-borne infections is critical to effectively combatting the challenges ticks pose to the health of pets and people.