Veterinary care should include diagnostic tests and subsequent treatment recommendations.
Diagnosis In-depth Diagnostic tests are needed to recognize lungworms and exclude other diseases. Tests may include:
A complete medical history and physical examination
Thoracic radiographs (chest X-rays) to exclude other causes of coughing. Some lungworm infections lead to characteristic or suggestive changes in the lungs.
Fecal examination for ova or larvae. These are not your typical intestinal worms and special methods called sedimentation techniques may be needed to find the microscopic ova (eggs) or offspring (larvae).
A heartworm test should be done to exclude the presence of intestinal worms because the symptoms are similar.
Additional diagnostic tests may be recommended on an individual pet basis, including:
Examination of respiratory secretions for ova or larvae. These secretions may be obtained by a procedure called a transtracheal or endotracheal wash. Sterile fluid is flushed into the lungs using a catheter. This may be done by local anesthetic in larger dogs, or under brief anesthesia in puppies or active dogs. Your veterinarian can discuss this with you if the suspicion for lungworm infection is high.
Bronchoscopy. A small soft flexible fiber optic tube is inserted into your pet's airway to allow examination within the windpipe and bronchial tree in this procedure. Certain parasites like Osleri osleri can be identified visually by this method. Furthermore, a number of problems not evident by X-rays may be seen, including laryngeal (voice box) diseases, polyps, foreign materials such as pieces of inhaled plant material, wood, bone, and some tumors. Samples of fluid from the lungs and bronchial tree can be examined under the microscope and fluid can be cultured for infection. This is especially useful with undiagnosed cases of cough.
A complete blood count (CBC) to check for signs of infection and to identify an increase in eosinophils. This cell type is often increased in parasitic infections.
Blood biochemistry tests should be normal in the case of lungworms. However, this test may be done if general anesthesia is planned or generalized illness is observed.
Feline leukemia (FeLV) test and FIV (feline AIDS virus) test
An echocardiogram (cardiac ultrasound) to rule out heart disease
Therapy In-depth
The principles of therapy for lungworms include killing the parasite and reducing tissue reaction if necessary. Most treatments are done on an outpatient basis or involve a very brief hospitalization. Treatments may include:
Treatment of tissue inflammation with prednisone for 5 to 10 days with expected side effects of increased water consumption, urination and appetite
Treatment of the parasite by killing it with an anti-parasitic drug. Some of these like fenbendazole are very safe. Others (high dose ivermectin) are more likely to cause side effects in about 5 to 10 percent of pets.
Aelurostrongylus abstrusus Treatment
Fenbendazole (Panacur) for 10 days
Ivermectin for 3 days to 5 days.
Paragonimus kellicotti Treatment
Fenbendazole (Panacur) for 10 days
Praziquantel (Droncit) every 8 hours for 2 days
Albendazole every 12 hours for 10 to 20 days
Ivermectin two treatments, 2 weeks apart
Capillaria aerophilia Treatment
Fenbendazole (Panacur) for 10 days
Albendazole for 10 to 20 days
Ivermectin one or two doses
