Review updates the clinical picture for canine angiostrongylosis
Bottom line
Version 1
A new review in the Journal of Veterinary Emergency and Critical Care pulls together recent evidence on canine angiostrongylosis, highlighting how Angiostrongylus vasorum can present far beyond classic respiratory disease and why diagnosis still depends on combining clinical suspicion with multiple testing methods. The authors, Iris Elgueta, Daniel Lewis, Eric R. Morgan, and Jenny Helm, describe updated understanding of pathophysiology, including cardiorespiratory, coagulopathic, and neurologic manifestations, and summarize current diagnostic and treatment options such as modified Baermann testing, serology, molecular assays, and commonly used anthelmintics including moxidectin/imidacloprid, milbemycin oxime, and fenbendazole. The review lands as the parasite remains an emerging and geographically expanding concern, with recent literature continuing to document severe and sometimes fatal presentations, including central nervous system involvement. (onlinelibrary.wiley.com)
Why it matters: For veterinary professionals, the message is practical: canine angiostrongylosis should stay on the differential list for dogs with respiratory distress, unexplained bleeding, or neurologic signs, especially because no single test is perfect and delayed recognition can worsen outcomes. Guidance from ESCCAP and prior reviews supports a multimodal approach, using fecal larval detection alongside antigen or antibody testing where appropriate, while remembering that timing of infection and intermittent larval shedding can complicate interpretation. (esccapuk.org.uk)
What to watch: Expect this review to reinforce broader use of structured diagnostic workups and prevention discussions in practices seeing dogs from endemic, or newly emerging, risk areas. (esccapuk.org.uk)
Key facts
- Article type
- Review
- Journal
- Journal of Veterinary Emergency and Critical Care
- Topic
- Canine angiostrongylosis
- Parasite
- Angiostrongylus vasorum
- Key clinical signs
- Cardiorespiratory, coagulopathic, and neurologic signs
- Diagnostics
- Modified Baermann testing, serology, and molecular assays
- Treatment options
- Moxidectin/imidacloprid, milbemycin oxime, and fenbendazole
- Clinical takeaway
- No single test is perfect; diagnosis depends on clinical suspicion and multiple testing methods
Version 2
A new review in the Journal of Veterinary Emergency and Critical Care offers an updated synthesis of canine angiostrongylosis, focusing on pathogenesis, diagnostics, and therapeutic options for Angiostrongylus vasorum infection in dogs. The paper underscores that this is not just a pulmonary parasite problem: affected dogs may present with cardiorespiratory disease, bleeding disorders, or neurologic signs, creating a diagnostic challenge that can easily spill into emergency and critical care settings. (onlinelibrary.wiley.com)
That challenge has been building for years. Earlier reviews established canine angiostrongylosis as an emerging disease in Europe, and more recent literature has continued to describe broader distribution, changing epidemiology, and a wide clinical spectrum. A 2024 case report also described the first suspected autochthonous case in a domestic dog in the United States, a reminder that the disease may no longer be viewed only as a European concern. (pubmed.ncbi.nlm.nih.gov)
The new review appears to bring together several strands that have been developing across the literature: better recognition of hemostatic dysfunction, increased awareness of atypical presentations, and more nuanced use of diagnostics. Prior evidence shows that fecal testing with the modified Baermann technique remains important, but it has practical limitations, including intermittent larval shedding and lower sensitivity in some settings. Antigen-based in-clinic testing and other serologic methods can improve case finding, while PCR and related molecular tools may help clarify equivocal cases. Expert guidance from ESCCAP emphasizes that testing should be interpreted in context, rather than as a one-test answer. (pmc.ncbi.nlm.nih.gov)
Therapeutically, the review aligns with established options that most clinicians will recognize: moxidectin/imidacloprid, milbemycin oxime, and fenbendazole remain central treatments, with supportive care dictated by severity and organ involvement. That matters because severe angiostrongylosis can involve pulmonary hypertension, hemorrhage, or neurologic complications, and published reviews on hemostatic dysfunction stress that anthelmintic therapy often needs to be paired with case-specific stabilization and coagulation support. (pubmed.ncbi.nlm.nih.gov)
Industry and expert commentary around the disease has been consistent even when not tied directly to this paper: clinicians are being urged to think beyond the “typical” coughing dog. ESCCAP’s diagnostic recommendations frame angiostrongylosis as a key differential in dogs with respiratory, coagulopathic, or neurologic signs, and recent case literature has reinforced that severe or disseminated infection can still be missed until late in the course of disease. (esccapuk.org.uk)
Why it matters: For veterinary teams, this review is useful less because it introduces a brand-new drug or test, and more because it consolidates a changing clinical picture. In practice, the biggest takeaway is probably operational: if a dog presents with unexplained dyspnea, bleeding tendency, syncope, or neurologic abnormalities, especially in a region with known or possible exposure risk, clinicians may need to move angiostrongylosis higher on the rule-out list. That has implications for diagnostics, anesthesia planning, surgery decisions, transfusion preparedness, and pet parent counseling about prevention and follow-up. (esccapuk.org.uk)
The review may also help bridge primary care and emergency care perspectives. Recent educational coverage for practitioners continues to stress lungworm recognition and treatment workflows, suggesting that awareness is still evolving in day-to-day practice. For hospitals in nontraditional areas, the US case report is especially relevant: even a low-incidence disease can become a high-consequence miss when presentations are atypical. (todaysveterinarypractice.com)
What to watch: The next step is likely not a single breakthrough, but better integration of prevention, earlier testing, and region-specific surveillance as the parasite’s footprint and clinical recognition continue to evolve. (pubmed.ncbi.nlm.nih.gov)