case encountered at paklihawa periphery by vets for animal welfare

1. Case study: Dirofilariasis
dog
Vets for animal welfare
Presentor :-
subash Rimal
Anil Adhikari
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2. Case history
• Species:- dog (street, non described)
• Breed:- local
• Sex:- male
• Age:- approximately 8 yrs.
• Severe depression
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3. Cont.
• Hind limb and subcutaneous edema
• Pale mucous membrane
• Alopecia
• Dermatitis
• Tick infestation
• Fluid oozing from edematous hind limb 3

4. Clinical finding
• Auscultation of heart and lungs revealed muffling sound
• Temperature:- 37.3°C
• Heart rate:- 123/min
• Respiration rate:- 31/min
• Encephalopathy sign was noted.
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5. Laboratory finding
• Abdominocentasis was performed which reveals
serosanguinous fluid come.
• Ascetic fluid was examined with the help of refractometer and
revealed:-
• Total protein :- 4mgldl
• Specific gavity :- 1.032
(modified transudate)
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6. Cont.
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7. Cont..
• Blood examination
• PCV:- 20%
• Hb level:- 5.5g/dl
• Total serum protein :- 8g/dl (hyperproteninia)
• Reticulocytosis, methylene blue stained blood smear
examination (regenerative anaemia)
• Stress leucogram
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8. Cont..
• Abdominal USG revealed a large amount of anechoic fluid and
one large vascular structure located between right liver lobe
and diaphragm
• The liver surface was irregularand suggestive of hepatic
fibrosis
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9. USG of liver
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10. Tentative diagnosis
• Chronic hepatitis
(due to USG analysis, subcutaneous edema)
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11. Differential diagnosis
• Congestive heart failure
• Cirrhosis
• Kidney disease
• Kidney damage
• Weakness or damage to veins in your legs
• Severe, long-term protein deficiency 11

12. Pathogenesis of edema
venous stenosis
venous hypertension
release of fluid
accumulation of fluid in peritoneal cavity
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13. Pathogenesis of edema cont..
Hypoproteinaemia
plasma colloidal osmotic pressure decrease
increase in hydrostatic pressure
fluid scape from circulation
accumulation of fluid in cavity
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14. Cont…
• Liver cirrhosis or renal damage
less kidney profusion
release of rennine from kidney
which acts on angiotension
release of aldesteron
retension of more sodium in circulation
ascitis 14

15. Treatment
• Normal saline (IV)
• Prednisolon:- 1.5 mg/kg PO for 2 weeks q 12 hours
• Lactulose :- 0.1ml/kg PO q 12hrs
• Metronidazole :- 8mg/kg PO q 12 hrs
• Spironolactone:- 1mg/kg PO q 12hrs
• Ursodoxycholic acid :- 10mg/kg PO q12hrs
• Enrofloxacin :- 0.5ml im for 5 days
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16. Prognosis
• The dog died in the next day
• Post mortem was performed
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17. Postmortem finding
• Presence of milky fluid while opening thorax (chylothorax)
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18. Cont..
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19. Cont
• Severe heartworm present in pulmonary artery caudal
venacava and right ventricle
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20. Cont..
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21. Cont.
• Lungs:- interstitial pneumonia
• Serosanguinous fluid in abdominal cavity
• Liver:- enlarged , irregular surface on pappation , firm
• Nematode and cystode parasites present in abdominal region
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22. Cont.
Liver
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23. Parasite on
intestine
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24. 24

25. Discussion
• Pathophysiology
Heartworm causes physiological trauma on heart and affected
vessels may become thrombosed, dilated, thickened and
functionally incompetetant .
which leads vasoconstriction and hypoxia
pulmonary hypotension
congestive heart failure leads edema 25

26. Pathophysiology cont.…
• Chylothorax
(accunulation of chylous fluid in the plural space )
Chyle, fluid containing high concentration of chylomicrons and
lymph.
heartworm
CRHF
RUPTURE OF LYMPHATIC VESSELS
CHYLOTHORAX 26

27. Conclusion
• This dog was died due to severe heartworm (dirofilaria) in
which a typical chylothorax , ascitis ,subcutaneous edema and
fibrosis of surface of liver was noted.
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28. Acknowledgement
• Prof. Dr. D. K Singh.
• Keshav Kharel
• Vets for animal welfare team
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29. References
• D.K. Singh, A. Adhikari, S. Rimal, K. Singh (2018). Chylothorax due
to Heartworm (Dirofilariasis) in a Dog , The Blue Cross .15:83-86
• VEGAD, J.L. 2007 A TEXT BOOK OF VETERINARY GENERAL
PATHOLOGY. INTERNATIONAL BOOK PUBLISHING DISTRIBUTING
CO. , LAKHKNOW UP INDIA ( second edition)
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