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Canine ocular onchocerciasis in the United States: two new cases and a review of the literature. Mitzi Zarfoss, DVM. Abstract co-authors: Dubielzig, Eberhard, Schmidt.

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canine ocular onchocerciasis in the united states two new cases and a review of the literature

Canine ocular onchocerciasis in the United States: two new cases and a review of the literature

Mitzi Zarfoss, DVM

abstract co authors dubielzig eberhard schmidt
Abstractco-authors: Dubielzig, Eberhard, Schmidt
  • Purpose: The present report describes the histopathologic features of canine ocular onchocerciasis in two dogs from California. Pertinent literature, pathogenesis, clinical features, and treatment are discussed.
  • Methods: The cases were diagnosed via histopathology at the Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW) using light microscopy.
  • Results: Histopathologic examination of both globes revealed episcleral parasites surrounded by granulomas, lymphoplasmacytic uveitis, pre-iridal fibrovascular membranes, peripheral anterior synechiae, retinal degeneration, and optic cupping.
  • Conclusions: Ocular onchocerciasis should be a differential consideration in cases of canine conjunctival nodules or periorbital swelling in American dogs.
introduction ocular parasites in the u s
Introduction: Ocular parasites in the U. S.
  • Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW)
    • 1978-2004: 8,250 canine ocular tissues
introduction onchocerca spp
Introduction: Onchocerca spp.
  • Life cycle
    • Known insect intermediates:
      • Simulium (black flies)
      • Culicoides (gnats)
    • Wolbachia =

endosymbiotic intracytoplasmic hypodermic bacteria (Rickettsiaceae)

www.who.int

  • Anatomic localization: connective tissues and skin
  • Geographic location: worldwide
  • Species affected:
    • Ungulates, including horses: Onchocerca cervicalis
    • Humans: Onchocerca volvulus
    • Dogs
      • (peri)ocular and dermatologic localization
      • German Shepherds are overrepresented – why?
      • Onchocerca sp. yet to be determined… patent infection in our cases

www.globatlas.who.int

introduction clinical pictures from greece
Introduction: Clinical pictures from Greece
  • History:
    • Anamnesis: contact with livestock, questionable anthelminthic history
    • Concurrent infections with Ehrlichia spp. and Leishmania spp. reported in Greece
  • Physical examination:
    • Clinical signs
      • Acute: conjunctivitis, chemosis, erythema, periorbital swelling
      • Chronic: nodular masses of the retrobulbar space, eyelid, nictitans, conjunctiva, sclera
  • Diagnosis:

CBC (↑eos) /Chem

thoracic rads

surgical excision

histopathology

Courtesy of A. Komnenou

introduction our cases clinical presentation
Introduction: our casesclinical presentation
  • Case 1: 6 year-old MC GSDmix
    • Location: CA
    • One year history of red eye unresponsive to triple Abx
    • Progressed to a blind, painful eye
    • Enucleation and histopathology
  • Case 2: 10 year-old MC Labrador Retriever
    • Location: CA with travel to WA, ID, and NV
    • Lived with horses and cows
    • Two month history of buphthalmos, keratitis, central corneal ulceration, increased IOP (82 mmHg)
    • Enucleation and histopathology
results histopathologic examination at the coplow
Results: Histopathologic examination at the COPLOW
  • Case 1:

Figure 1: Gross and subgross photographs of the sectioned globe. Black arrows are directed at worm sections within a 1.5 cm epibulbar mass.

Figure 2: Higher magnification of Figure 1. Black arrows are directed at several worm sections.

results parasite morphology
Results: Parasite morphology

Figure 3: A close-up of a worm in longitudinal section.

Female cuticle had circumferential external ridges (black arrow), characteristic of O. lienalis.

Figure 4 : Worm sections: a black arrow is directed at a section of uterus. Intrauterine microfilariae were found in both cases, suggesting patent infection.

results histopathologic findings in case 2
Results: Histopathologic findings in Case 2

Figure 5 : Gross and subgross photographs. Arrows to ventral perilimbal mass; arrowheads to episcleral nodules containing worm sections and/or granulomatous inflammation.

Figure 6:

Several worm sections surrounded by well-demarcated granulomas characterized by macrophages, plasma cells, neutrophils, eosinophils, and fibrosis.

discussion
Discussion:
  • Histopathologic findings:
    • Parasites are surrounded by intense pyogranulomatous inflammation with an eosinophilic component
    • Mild lymphoplasmacytic uveitis
    • Pre-iridal fibrovascular membranes
    • Glaucoma with optic cupping and retinal degeneration
discussion diagnostic algorithm
Discussion: diagnostic algorithm
  • History of exposure to large animals, no preventative anthelminthics
  • +
  • Clinical signs suggestive of ocular onchocerciasis
      • Acute: conjunctivitis, chemosis, erythema, periorbital swelling
      • Chronic: nodular masses of the retrobulbar space, eyelid, nictitans, conjunctiva, sclera

Diagnostics:

CBC (peripheral eosinophilia), serum biochemistry

Thoracic radiography

Infectious dz titers ( Ehrlichia, Dirofilaria as endemic)

Skin snip

Biopsy/histopathology/surgical excision

discussion skin snip procedure
Discussion:Skin snip procedure

Place full thickness periocular or umbilical skin snip on a slide with a drop of 0.9% saline.

Cover with a slide and wait 60 minutes.

Examine under microscope (low power).

If microfilariae are found, remove skin snip and fix in formalin, 70% ethanol, or stain with Giemsa.

Ash, L. R. & Orihel, T. C. (1987) Examination of tissues. In: Parasites: A Guide to Laboratory Procedures and Identification. Eds L. R. Ash and T. C. Orihel. ASCP Press, Chicago. pp 83-89

Ash, L. R. & Orihel, T. C. (1997) Onchocerca volvulus. In: Atlas of Human Parasitology, fourth edn. Eds L. R. Ash and T. C. Orihel. ASCP Press, Chicago. pp 269-271

discussion treatment
Discussion: treatment

Hise, A. G., Gillette-Ferguson, I. & Pearlman, E. (2004) The role of endosymbiotic Wolbachia bacteria in filarial disease. Cellular Microbiology 6, 97-104

A. Komnenou, personal communication

goals
Goals:
  • Briefly review ocular parasites reported in the literature
  • Alert veterinary ophthalmologists that canine ocular onchocerciasis occurs in the U.S.
  • Describe histopathologic findings in canine ocular onchocerciasis
  • Describe clinical diagnosis and treatment
  • Identify unanswered questions
references
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