Heartworm Disease Part II Flashcards

(30 cards)

1
Q

what is the primary screening test for heartworm in dogs?

A

antigen tests

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2
Q

what is the primary screening test for heartworm in cats?

A

antibody tests

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3
Q

what does heartworm antigen testing test?

A

protein released from adult female reproductive tract

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4
Q

why should cats be tested for both heartworm antigen and antibody?

A

much less sensitive due to low worm burdens

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5
Q

what does a positive heartworm antibody test indicate?

A

exposure, not active infection necessarily

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6
Q

how can you confirm diagnosis of heartworm in a cat after a positive antibody test?

A

antigen testing and/or echo

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7
Q

what is the most sensitive microfilaria test?

A

modified Knott’s test or some other concentration test

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8
Q

should you test dogs for microfilaria that are heartworm positive by antigen test?

A

yes- always

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9
Q

how many cats with heartworm disease are amicrofilaremic?

A

more than 2/3

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10
Q

if an animal is microfilaremic, what should you check?

A

confirm species as Dirofilaria immitis
rule out Acanthocheilonema reconditum

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11
Q

what is the primary manifestation of heartworm disease on radiographs?

A

pulmonary disease

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12
Q

what is the dose of ivermectin for heartworm?

A

6-12 microgram/kg

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13
Q

what stages of larvae to macrolides kill?

A

L3 and L4

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14
Q

which dogs should be on heartworm preventative?

A

every dog over 8 weeks of age

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15
Q

what should felines be on to prevent heartworm disease?

A

macrolide preventative

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16
Q

what are the goals of heartworm treatment?

A

kill Wolbachia
eliminate microfilaria
kill adult worms
minimize pulmonary parenchymal and arterial pathology
treat right CHF and significant PHTN if present

17
Q

why do we pre-treat for 1-2 months with doxycycline and a macrolide before giving melarsomine dihydrochloride?

A

melarsomine dihydrochloride only toxic to L5 and adults

18
Q

can melarsomine dihydrochloride be given to cats?

19
Q

when does peak worm death occur?

A

1-3 weeks post treatment of melarsomine dihydrochloride

20
Q

what are the ancillary therapies for heartworm?

A

exercise restriction
doxycycline
ivermectin
corticosteroids

21
Q

what can be found of physical exam with heartworm with the heart?

A

no abnormalities
weight loss and cachexia
loud and/or split S2
murmur of tricuspid valve regurgitation +/- right-sided thrill
S3 gallop
jugular venous distension, hepatosplenomegaly, abdominal effusion

22
Q

who cannot be antigen positive?

A

puppies <6 months old

23
Q

why is detection of microfilaria an insensitive method of diagnosis for heartworm?

A

prevalence of occult infection

24
Q

what are the causes of occult infection?

A

iatrogenic
immune-mediated
unisex infection
prepatent infection

25
what is echo used to evaluate for in dogs with heartworm disease?
severity of pulmonary hypertension caval syndrome cor pulmonale parasite burden concurrent heart disease
26
why is extra-label use of ivermectin at 50 microgram/kg not recommended?
anaphylactic shock: rapidly microfilaricidal
27
can melarsomine dihydrochloride be given to dogs with caval syndrome?
no
28
can you give melarsomine dihydrochloride to cats?
no
29
what are the possible side effects of melarsomine dihydrochloride?
local pain/inflammation GI signs neurologic complications pulmonary edema renal and hepatic toxicity pulmonary thromboembolism death
30
what are the ancillary therapies for heartworm in dogs?
exercise restriction doxycycline ivermectin corticosteroids heparin/antiplatelet agents oxygen, phosphodiesterase inhibitors RCHF therapy