Cerebrospinal Nematodiasis in 20 Camelids

Abstract

BackgroundInformation about the clinical and clinicopathologic aspects of cerebrospinal nematodiasis (CN) in camelids is limited.HypothesisClinical and therapeutic variables will be identified as factors predictive of survival.AnimalsClient‐owned camelids suspected of having CN admitted to Purdue University between 1995 and 2015.MethodsA retrospective study was performed. A diagnosis of CN was based on cerebrospinal fluid (CSF) eosinophilic pleocytosis or postmortem findings.ResultsEleven alpacas and 9 llamas met the inclusion criteria. Seventy‐five percent of the camelids were male (27% castrated and 73% intact). Common clinical abnormalities included proprioceptive deficits (100% of animals), recumbency (55%), tachypnea (55%), and ataxia (40%). Among the 85% of treated animals, 100% received PO fenbendazole, and 88% received a nonsteroidal anti‐inflammatory drug. The survival rate to discharge was 45%. Plasma fibrinogen concentration, creatine kinase activity, and serum creatinine concentration were significantly higher in nonsurvivors. Blood eosinophil count, platelet count, and total CO 2 were significantly lower in nonsurvivors. Factors associated with survival were species, sex, absence of treatment with corticosteroids, and clinical improvement. There was no association between recumbency at admission and survival. A plasma fibrinogen concentration above >266 mg/dL was an excellent diagnostic test to predict survival in the presence of neurological signs or CSF eosinophilia.ConclusionsAlthough prognosis for CN in camelids is guarded, presence of recumbency at admission is not predictive of nonsurvival. Male camelids and llamas appear more likely to die from CN. Corticosteroid treatment is contraindicated in animals diagnosed with CN.

Treatment of cerebrospinal nematodiasis in a Boer Buck

“…1 Common current therapies used in camelids for this condition include the anthelmintics ivermectin and fenbendazole, along with a concurrent non-steroidal anti-inflamamtory (NSAID) such as flunixin meglumine or meloxicam. 2 In the author's hospital, camelids suspected to be presenting with parelophostrongylosis are initially treated with intravenous flunixin meglumine (1.1-2.2 mg/kg, once) and oral fenbendazole (50 mg/kg, every 24 hour, for five days). Additionally, intramuscular ivermectin (0.2 mg/kg, once) may be administered as well.…”

“…Steroidal anti-inflammatories have been described for these cases, but camelids administered steroids for this condition had decreased survival. 2 Adverse effects of frequent NSAID use in ruminant species include abomasal ulceration, so clients should be cautioned to monitor for signs of an abomasal ulcer, such as bruxism or melena. Ivermectin may not be necessary if febendazole is administered, but may prove useful in managing gastrointestinal nematodiasis with respect to anthelmintic resistance in the herd.…”

“…2 Camelids presented with varying degrees of neurological severity ranging from a widebased pelvic limb stance to complete recumbency that may have been progressive or acute in onset. 2 Most of the camelids in the retrospective study by Bertin and Taylor had normal mentation and appetite before and at presentation to the hospital. Atypical clinical signs in camelids included abnormal mentation, cranial nerve deficits suggesting migration within the brain, and occasionally cervical scoliosis.…”

“…Atypical clinical signs in camelids included abnormal mentation, cranial nerve deficits suggesting migration within the brain, and occasionally cervical scoliosis. 2 While cervical scoliosis is rare in the majority of aberrant hosts, it is commonly reported in horses infected with Parelaphostrongylus tenuis, along with a unilateral lack of sensation in the cervicothoracic region. 5 The increase of these signs in horses may be due to the predilection of parasitic migration within the grey matter of the spinal cord, whereas in other affected species lesions are found in the white matter, even in camelids that display cervical scoliosis.…”

Meningeal Worm Infection in Central Iowa Goat Herds II: Individual Cases and Treatment Using a Camelid Therapeutic Protocol

“…Steroidal anti-inflammatories such as dexamethasone have also been reported, although they have been linked to an increased mortality rate. 1 Anthelmintics: Ivermectin (0.2 mg/kg, once SC) and fenbendazole (50 mg/kg/day x 5 days, PO) 7 have been utilized to kill any larvae still aberrantly migrating through the host in camelids.…”