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Gurltia paralysans is a rare metastrongylid nematode of domestic cats that is found mainly in the veins of the spinal cord subarachnoid space and parenchyma. Endemic regions for G. paralysans mainly include Chile and Argentina. The ante mortem diagnosis of gurltiosis is difficult and based primarily on neurological signs, epidemiological factors, and the exclusion of other causes of feline myelopathies. The purpose of this retrospective case series was to describe clinical, imaging, and pathologic characteristics in nine domestic cats naturally infected with G. paralysans. Imaging tests included radiography, myelography, computed tomographic myelography (myelo-CT), and magnetic resonance imaging (MRI). Neurological signs included paraparesis, paraplegia, pelvic limb ataxia and proprioceptive deficits, pelvic limb tremors, lumbosacral hyperesthesia, and tail trembling or atony. Complete blood count findings included a decrease in the mean corpuscular hemoglobin concentration value in eight cats. Eosinophilia in peripheral blood was observed in three cats, and thrombocytopenia was observed in three cats. Cerebrospinal fluid analysis revealed mononuclear pleocytosis in five cases. Myelo-CT showed diffuse enlargement of the spinal cord at the midthoracic, lumbar, and sacral regions in all cats. Magnetic resonance image findings in the thoracic and lumbar region demonstrated multiple small nodular areas of T2 hyperintensity in the periphery of the spinal cord parenchyma. Localized intraparenchymal areas of increased T2 intensity were also observed in the thoracolumbar spinal cord and lumbosacral conus medullaris. In conclusion, G. paralysans should be considered as a differential diagnosis for domestic cats in endemic regions that have this combination of clinical and imaging characteristics.

Gurltia paralysans (order Strongylida; family Angiostrongylidae) is a metastrongyloid parasite that causes chronic meningomyelitis in domestic cats in South America. The geographic distribution of G. paralysans includes rural and peri-urban areas of Chile and Argentina. However, feline gurltiosis has recently been reported in other South American countries, including Uruguay, Colombia, and Brazil, and was also recently reported in Tenerife, Canary Islands (Spain). Feline gurltiosis is increasingly detected in domestic cats in southern Chile and its apparent geographic range is also increasing, together with an awareness of the disease among veterinarians. The life cycle of the parasite is unknown, but is probably indirect, involving gastropods as the intermediate host, as in other metastrongyloid nematode species. The clinical signs of G. paralysans infection include progressive pelvic limb ataxia, paraparesis, paraplegia, faecal or urinary incontinence, and/or tail paralysis. A definitive diagnosis of feline gurltiosis is still challenging and only possible with necropsy, when adult G. paralysans nematodes are detected within the spinal cord vasculature, together with macroscopic lesions, and characteristic morphological features. A semi-nested PCR method was recently developed for the in vivo diagnosis of this neglected parasite. Current treatment options include macrocyclic lactones and mylbemicn oxime, but the prognosis is poor in severe cases. In this article, we review G. paralysans infection in cats, focusing on the diagnosis shortcomings and the future directions of research into its biology and the associated neurological disease. Comprehensive updates on the epidemiology and clinical features, diagnosis, treatment, and prevention of feline gurltiosis are provided.

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Gurltia paralysans is a metastrongyloid nematode which belongs to the Angiostrongylidae family and presents tropism for veins of the subarachnoid space in vivo of domestic and wild felids causing a progressive and chronic clinical manifestation of paraparesis/paraplegia. The geographic distribution of G. paralysans includes rural and periurban areas of South America and was recently reported in Europe. To date, a definitive diagnosis of feline gurltiosis is still conducted by post-mortem examination of the spinal cord in affected animals. A presumptive diagnosis of feline gurltiosis can also be achieved based on data of compatible clinical signs and associated epidemiological risk factors. The aim of this preliminary study was to evaluate the commercial serological test Angio Detect TM® (IDEXX Laboratories) as a possible diagnostic method of feline gurltiosis in vivo. For the study, 10 domestic felines (Felis catus) which originated from a high endemic area of Southern Chile, were analyzed. All felines presented chronic paraparesis or severe paraplegia. Subsequently, commercial Angio Detect TM® serological tests for the detection of closely related Angiostrongylus vasorum in canids were performed according to manufacturer's instructions. Conducted serological tests were positive in seven of ten felines showing paraplegia/paraparesis and presumably infected with G. paralysans, and four of them were additionally necropsied, and presented macroscopic findings compatible with feline gurltiosis. Furthermore, the presence of adult female and male G. paralysans specimens at the level of the subarachnoid vasculature in affected spinal cord segments were observed during necropsy. Histopathology demonstrated severe eosinophilic meningomyelitis, coagulopathies with thrombosis in G. paralysans-parasitized leptomeningeal veins. Results of this preliminary study suggest a cross-reaction between A. vasorum-specific antigens, which also parasitize blood vessels in vivo, and G. paralysans when using an Angio Detect TM® test, which suggests its helpful use as a new diagnostic method for feline gurltiosis in live domestic felines. Additional specific antigen research will be required in order to better understand the sensitivity and specificity of A. vasorum antigens used in this test and for existing cross-reactivity with G. paralysans-derived antigens for future a suitable intra vitam immunodiagnosis of neglected feline gurltiosis.

Gurltia paralysans is an uncommon neuroparasite that affects domestic cats in South America. The authors herein report a case of an adult male domestic cat with a three-month history of progressive hindlimb paralysis. Neuroanatomical evaluation indicated compromise of the thoracolumbar and lumbosacral spinal cord segments. An authorised euthanasia was performed because of the guarded prognosis. Postmortem examination findings included leptomeningeal vein congestion and varicose veins, especially in the T9–T13 spinal cord segments. One male and 11 female adult G paralysans nematodes were recovered from the spinal subarachnoid veins of the affected areas. Histopathological examination revealed dilatation and congestion of several leptomeningeal vessels and parasitic eggs within both nematodes and intravenous thrombi. Several mononuclear inflammatory cells surrounded a mineralised section of nematodes in the meningeal space. Feline gurltiosis should be considered as an important differential diagnosis in cats with neurological signs secondary to thoracolumbar and/or lumbosacral spinal cord lesions.

Gurltia paralysans is an angio-neurotropic metastrongyloid nematode that infects domestic and wild cats, invading the veins of the subarachnoid space of the spinal cord and mainly causing progressive paralysis of the pelvic limbs. The definitive diagnosis of feline gurltiosis can only be achieved by post-mortem examination that reveals the presence of the nematode in the spinal cord vein vasculature. An early diagnosis with conclusive results is required since laboratory and imaging findings are not sufficient. Therefore, the purpose of this study was to detect the presence of G. paralysans, via semi-nested PCR, in samples of cerebrospinal fluid (CSF) and the sera of domestic cats naturally infected with the parasite. A total of 12 cats with a diagnosis suggestive of feline gurltiosis were selected, and they underwent a complete neurological and imaging examination. DNA samples were analysed by semi-nested PCR, with universal (AaGp28Sa1/AaGp28Ss1) and specific (Gp28Sa3/Aa28Ss2) primers, for G. paralysans (G. paralysans 18S rRNA gene, partial sequence; ITS 1, 5.8S rRNA gene, and ITS 2, complete sequence; and 28S rRNA gene, partial sequence) and Aelurostrongylus abstrusus, obtaining amplifications of 356 and 300 bp, which indicated the presence or absence of nematode DNA, respectively. The presence of G. paralysans was detected in the CSF of four out of nine cats, and the sera of seven out of seven cats. In the sera analysis of five out of seven cats, a mixed infection with A. abstrusus was found, despite no alterations of the respiratory tract being observed during the necropsies. It is proposed that serum samples could be more effective than CSF in detecting the parasite by PCR analysis. Sequencing analysis showed high percentages of identity with G. paralysans, which indicated the feasibility of detection and the sensitivity/specificity of the method used, suggesting the implementation of semi-nested PCR as a routine diagnostic test for early and timely detection of feline gurltiosis.