title: Elusive Angiostrongylus vasorum infections.
abstract: BACKGROUND
  The parasitic nematode Angiostrongylus vasorum causes severe clinical signs in dogs. The disease is often challenging because infected animals are often presented with clinical signs overlapping those of other diseases.
  
  
  METHODS
  The present article describes six angiostrongylosis cases (Cases 1-6) that represent key examples of how canine angiostrongylosis may be extremely confounding. The six animals presented clinical signs compatible with canine angiostrongylosis but they were subjected to clinical examinations for other diseases (e.g. dirofilariosis or immune-mediated disorders) before achieving a correct diagnosis.
  
  
  RESULTS
  In Case 1 clinical, radiographic and ultrasound examinations' results resembled a lung neoplasia. Case 2 was a dog with a mixed infection caused by A. vasorum and Dirofilaria immitis. Case 3 was a critically ill dog presented in emergency for an acute onset of dyspnoea caused by lungworm infection. The dog died a few hours after presentation despite support and etiologic therapy. Case 4 was a dog presented for chronic hemorrhages and ecchymoses caused by thrombocytopenia of unknown origin, thought to have an inherited, immune-mediated or infective cause. Case 5 was referred for neurological signs due to a suspected discospondylitis. Case 6 was erroneously diagnosed infected only with D. immitis although the dog was infected only with A. vasorum. A timely administration of an anthelmintic (mostly moxidectin) showed to be effective in treating the infection in those dogs (i.e. Cases 1,2, 4 and 5) that did not suffer with severe lung haemorrhages yet.
  
  
  CONCLUSIONS
  Dogs 1-5 were referred in two regions of Italy that are considered non-endemic for A. vasorum. These findings indicate that veterinarians should include angiostrongylosis in the differential diagnosis of cardio-respiratory distress also in non-endemic regions and should perform appropriate diagnostics in the presence of compatible signs even if the clinical picture is atypical.
authors: Faculty of Veterinary Medicine, University of Teramo, 64100, Teramo, Italy. angdicesare@gmail.com.
authors: Angela
authors: A
authors: Di Cesare
authors: Faculty of Veterinary Medicine, University of Teramo, 64100, Teramo, Italy. dtraversa@unite.it.
authors: Donato
authors: D
authors: Traversa
authors: Novara Day Lab - IDEXX Laboratories Italia, S.P. 9, 28060, Granozzo con Monticello, Italy. simone.manzocchi@gmail.com.
authors: Simone
authors: S
authors: Manzocchi
authors: Faculty of Veterinary Medicine, University of Teramo, 64100, Teramo, Italy. silvanameloni@hotmail.it.|Veterinary Hospital "Città di Pavia", Viale Cremona 179, 27100, Pavia, Italy. silvanameloni@hotmail.it.|Veterinary Clinic "LidoVet", Via Poggio di Venaco 16, 00121, Ostia, Italy. silvanameloni@hotmail.it.
authors: Silvana
authors: S
authors: Meloni
authors: Faculty of Veterinary Medicine, University of Teramo, 64100, Teramo, Italy. eleonora.grillotti@gmail.com.|Veterinary Pratice "Centro Italia", Via Biancifiori 3, 02100, Rieti, Italy. eleonora.grillotti@gmail.com.
authors: Eleonora
authors: E
authors: Grillotti
authors: Istituto Veterinario di Novara, S.P. 9, 28060, Granozzo con Monticello, Italy. edoardo.auriemma@gmail.com.
authors: Edoardo
authors: E
authors: Auriemma
authors: Bayer Sanità Animale, Viale Certosa 130, 20156, Milan, Italy. fabrizio.pampurini@bayer.com.
authors: Fabrizio
authors: F
authors: Pampurini
authors: Veterinary Pratice "Centro Italia", Via Biancifiori 3, 02100, Rieti, Italy. garofani@libero.it.
authors: Cecilia
authors: C
authors: Garofani
authors: Veterinary Pratice "Poggio dei Pini" Strada 40, 09012, Capoterra, Cagliari, Italy. palmasoriano@tiscali.it.
authors: Fabrizio
authors: F
authors: Ibba
authors: Veterinary Hospital "Città di Pavia", Viale Cremona 179, 27100, Pavia, Italy. luigivenco@libero.it.
authors: Luigi
authors: L
authors: Venco
mesh_terms: D000801:Angiostrongylus / Q000145:classification*; D000818:Animals; D004283:Dog Diseases / Q000175:diagnosis / Q000469:parasitology* / Q000473:pathology; D004285:Dogs; D005260:Female; D008297:Male; D017206:Strongylida Infections / Q000175:diagnosis / Q000469:parasitology / Q000473:pathology / Q000662:veterinary*