title: Identification of Heterobilharzia americana infection in a dog residing in Indiana with no history of travel.
abstract: METHODS
  A 1-year-old castrated male dog residing in Indiana was examined because of intermittent vomiting of 4 months' duration.
  
  
  RESULTS
  The dog's condition did not resolve with medication. Diagnostic imaging revealed a possible partial obstruction at the ileocecal junction. An exploratory laparotomy was performed. The jejunum contained diffusely distributed, nodular, intramural lesions; 2 biopsy specimens were collected from representative lesions. The pancreas was grossly swollen, and pancreatitis was presumed present. No other abnormalities were observed in the abdomen. Histologic examination of the submitted biopsy specimens revealed infection with Heterobilharzia americana.
  
  
  RESULTS
  After diagnosis, the dog was treated with fenbendazole suspension (48 mg/kg [21.8 mg/lb], PO, q 24 h) for 10 days. This treatment was subsequently repeated 11 and 80 days later. One week after the end of the last fenbendazole treatment, several H americana eggs were detected in a fecal sample via saline sedimentation, and the dog was given praziquantel (25 mg/kg [11.4 mg/lb], PO, q 8 h) for 2 days. No gastrointestinal signs were evident 4 months after that treatment.
  
  
  CONCLUSIONS
  The dog described in this report was the first autochthonous canine case of H americana infection in Indiana, to the authors' knowledge; this case has confirmed that the distribution of this parasite in the Midwestern United States is broader than previously known. Increased awareness of the distribution of H americana should aid veterinarians in early, noninvasive diagnosis and appropriate treatment of affected animals. Repeated treatments and recheck fecal examinations may be necessary when managing these cases.
authors.forename: Jessica Y
authors.initials: JY
authors.lastname: Rodriguez
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Camp
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Lenz
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Kazacos
authors.forename: Karen F
authors.initials: KF
authors.lastname: Snowden
mesh_terms: D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000969:Antinematodal Agents / Q000627:therapeutic use; D004283:Dog Diseases / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000601:surgery; D004285:Dogs; D005243:Feces / Q000469:parasitology; D005273:Fenbendazole / Q000627:therapeutic use; D007077:Ileal Diseases / Q000000981:diagnostic imaging / Q000469:parasitology / Q000662:veterinary*; D007080:Ileocecal Valve / Q000000981:diagnostic imaging; D007196:Indiana; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000469:parasitology / Q000662:veterinary*; D008297:Male; D011223:Praziquantel / Q000627:therapeutic use; D011859:Radiography / Q000662:veterinary; D012551:Schistosomatidae / Q000145:classification / Q000302:isolation & purification*; D016896:Treatment Outcome; D014201:Trematode Infections / Q000469:parasitology / Q000601:surgery / Q000662:veterinary*; D014839:Vomiting / Q000662:veterinary
chemical_list: D000871:Anthelmintics; D000969:Antinematodal Agents; D005273:Fenbendazole; D011223:Praziquantel