Hindlimb Lameness Secondary to Bilateral Femoral Artery Occlusion in a Dog with Systemic Arterial Dirofilariasis

전신성 동맥 사상충증에 이환된 개의 양측성 대퇴동맥의 폐쇄

  • Choi, Woo-Shin (College of Veterinary Medicine, Chungbuk National University) ;
  • Song, Jin-Young (College of Veterinary Medicine, Chungbuk National University) ;
  • Lee, Young-Jae (College of Veterinary Medicine, Chungbuk National University) ;
  • Lee, Dong-Hoon (College of Veterinary Medicine, Chungbuk National University) ;
  • Kim, Ju-Hyung (College of Veterinary Medicine, Chungbuk National University) ;
  • Chang, Jin-Hwa (College of Veterinary Medicine, Chungbuk National University) ;
  • Kang, Ji-Houn (College of Veterinary Medicine, Chungbuk National University) ;
  • Chang, Dong-Woo (College of Veterinary Medicine, Chungbuk National University)
  • Accepted : 2012.08.16
  • Published : 2012.08.30

Abstract

A 3-year-old, intact male Pungsan dog was presented for a 2-week history of a non-weight-bearing lameness of left hindlimb with anorexia. The dog had no history of trauma, and never been routinely vaccinated or treated with heartworm preventatives. The complete blood count showed severe leukocytosis and neutrophilia with left shift. Serum biochemistry showed hypoalbuminemia, azotemia, and increased hepatobilliary enzyme activity. A canine heartworm antigen test was positive. Thoracic radiographs were consistent with heartworm disease as evidences by main pulmonary artery enlargement, right-sided cardiomegaly, and interstitial lung pattern. Echocardiography revealed pulmonary valvular regurgitation and pulmonary hypertension. Selective femoral arterial angiogram was performed, and bilateral femoral arterial occlusion was identified. The dog died after angiogram, and necropsy was performed. At necropsy, adult heartworm and a large blood clot were found within the lumen of left and right femoral artery. This case report describes an unusual migration of heartworm to femoral artery that caused hindlimb lameness.

3세 수컷 풍산견이 2주동안 지속된 좌측후지 파행과 식욕저하로 내원하였다. 환자의 외상 병력은 없었으며, 백신과 심장사상충 예방은 하지 않았다. 전혈구검사에서 중증의 백혈구 증가증과 호중구 핵좌방이동이 확인되었고, 혈액화학검사에서 저알부민혈증, 질소혈증, 간담도계 효소수치의 상승을 확인되었으며, 심장사상충 항원 키트에서 양성으로 확인되었다. 흉부 방사선 검사에서는 주폐동맥의 확장, 우심비대, 폐의 간질패턴이 관찰되었으며, 심장사상충 감염소견과 일치하였다. 이후 실시된 심초음파 검사에서 페동맥판역류와 폐성 고혈압이 확인되었다. 선택적 대퇴동맥 혈관 조영술에서 양측성 대퇴동맥의 폐쇄가 확인되었고, 환자는 혈관조영술후 폐사하였고 부검이 실시되었다. 부검결과 심장사상충 성충과 혈전이 좌우측 대퇴동맥 내강을 폐쇄시키고 있는 것이 확인되었다. 본 증례보고는 심장사상충이 대퇴동맥으로 비정상적 이주를 하여 후지의 파행을 유발한 케이스이며, 이를 보고하고자 한다.

Keywords

References

  1. Bredal WP, Gjerde B, Eberhard ML, Aleksandersen M, Wilhelmsen DK, Mansfield LS. Adult Dirofilaria repens in a subcutaneous granuloma on the chest of a dog. J Small Anim Pract 1998; 39: 595-597. https://doi.org/10.1111/j.1748-5827.1998.tb03715.x
  2. Burt JK, Lipowitz AJ, Harris JA. Femoral Artery Occlusion by Dirofilaria Immitis in a Dog. Vet Radio 1977; 18: 166-169. https://doi.org/10.1111/j.1740-8261.1977.tb00582.x
  3. Carastro SM, Dugan SJ, Paul AJ. Intraocular Dirofilariasis in dogs. Compend Contin Educ Pract Vet 1992; 14: 209-217.
  4. Cornegliani L. Vercelli A, Bo S, Conombo S. Two cases of cutaneous nodular Dirofilariasis in the cat. J Small Anim Pract 2003; 44: 316-318. https://doi.org/10.1111/j.1748-5827.2003.tb00161.x
  5. Dantas-Torres F, Lia RP, Barbuto M, Casiraqhi M, Crovace A, Caligiani L, Genchi C, Otranto D. Ocular Dirofilariosis by Dirofilaria immitis in a dog: first case report from Europe. J Small Anim Pract 2009; 50: 667-669. https://doi.org/10.1111/j.1748-5827.2009.00846.x
  6. Goggin JM, Biller DS, Rost CM, Debay BM, Ludlow CL. Ultrasonographic identification of Dirofilaria immitis in the aorta and liver of a dog. J Am Vet Med Assoc 1997; 210: 1635-1637.
  7. Frank JR, Nutter FB, Kyles AE, Atkins CE, Sellon Rk. Systemic arterial Dirofilariasis in five dogs. J Vet Intern Med 1997; 11: 189-194. https://doi.org/10.1111/j.1939-1676.1997.tb00089.x
  8. Liu SK, Krushna DM, Tashjian RJ. Adult Dirofilaria immitis in the arterial system of a dog. J Am Vet Med Assoc 1966; 148: 1501-1507.
  9. Nelson CT, Mccall JW, Rubin SB, Buzhardt LF, Dorion DW, Graham W, Longhofer SL, Guerrero J, Robertson-Plouch C, Paul A. 2005 Guidelines for the diagnosis, prevention and management of heartworm (Dirofilaria immitis) infection in dogs. Vet Parasitol 2005; 133: 255-266. https://doi.org/10.1016/j.vetpar.2005.07.008
  10. Oh HW, Jun HK, You MJ, Hayasaki M, Song KH. Ectopic migration of an adult heartworm in a dog with Dirofilariasis. Korean J Parasitol 2008; 46: 171-173. https://doi.org/10.3347/kjp.2008.46.3.171
  11. Olmstead ML, Butler HC. Five-Hydroxytryptamine antagonists and feline aortic embolism. J Small Anim Pract 1997; 18: 247-259.
  12. Otto GF. Occurrence of the heartworm in unusual locations and in unusual hosts. Heartworm Symp 1974: 6-13.
  13. Patton CS, Garner FM. Cerebral infarction caused by heartworms (Dirifilaria immitis) in a dog. J Am Vet Med Assoc 1970; 156: 600-605.
  14. Schaub RG, Meyers KM. The effect of an aortic embolus on establishment of collateral circulation. Fed Proc 1974; 33: 338.
  15. Slonka GF, Castleman W, Krum L. Adult heartworms in arteries and veins of a dog. J Am Vet Med Assoc 1977; 170: 717-719.
  16. Turk RD, Gaafar SM, Lynd FT. A note on the occurrence of the nematodes, Dirofilaria immitis and Ancylostoma braziliense in unusual locations. J Am Vet Med Assoc 1956; 129: 425.
  17. Venco L, Kramer L. Genchi C. Heartworm disease in dogs: unusual clinical cases. Vet Parasitol 2005; 133: 207-218. https://doi.org/10.1016/j.vetpar.2005.04.010