title: Anaphylactoid reaction in a heartworm-infected dog undergoing lung lobectomy.
abstract: METHODS
  A 7-year-old 23-kg (50.6-lb) spayed female Border Collie with a history of heartworm disease was evaluated for respiratory distress.
  
  
  RESULTS
  Computed tomography of the thorax revealed possible pulmonary bullae or blebs, and on the basis of these findings, a tentative diagnosis of bullous emphysema was made.
  
  
  RESULTS
  Exploratory median sternotomy revealed gross pathological lesions in the right caudal lung lobe; the most peripheral portion appeared discolored (pale pink), and a clear line of demarcation was observed. Upon excision of the affected lung lobe, a worm segment was noticed both on the remaining stump of the lung lobe in the dog and in the removed lobe. At this time, the dog had an anaphylactoid reaction. The reaction was successfully treated with fluid therapy, antihistamines, and corticosteroids. Lung lobectomy of the right caudal lobe resulted in clinical resolution of the bilateral pneumothorax. However, during the postoperative period, the dog developed a hemothorax and was returned to surgery. As no obvious cause for the hemothorax was seen at the second surgery, the dog was treated for a potential coagulopathy with fresh frozen plasma, which provided clinical resolution of the hemothorax. Parasitological examination of the worm segment confirmed a Dirofilaria immitis infection. The dog was discharged 5 days after surgery and treated with doxycycline for 30 days and monthly administration of heartworm preventative was prescribed.
  
  
  CONCLUSIONS
  Heartworm infection should be a differential diagnosis in dogs with spontaneous pneumothorax. Anaphylactoid reactions associated with accidental dissection of adult heartworms should be managed with treatment aimed at cardiovascular stabilization.
authors.affiliation: Department of Molecular and Biological Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Carter
authors.forename: Guillaume
authors.initials: G
authors.lastname: Chanoit
authors.forename: Cheryl
authors.initials: C
authors.lastname: Kata
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000707:Anaphylaxis / Q000188:drug therapy / Q000209:etiology / Q000662:veterinary*; D000818:Animals; D004183:Dirofilaria immitis / Q000302:isolation & purification; D004184:Dirofilariasis / Q000150:complications / Q000469:parasitology / Q000601:surgery*; D004283:Dog Diseases / Q000188:drug therapy / Q000209:etiology*; D004285:Dogs; D005260:Female; D005440:Fluid Therapy / Q000662:veterinary; D006633:Histamine Antagonists / Q000627:therapeutic use; D008168:Lung / Q000601:surgery*
chemical_list: D000305:Adrenal Cortex Hormones; D006633:Histamine Antagonists