Parasitology partII lecture

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Marytaylor
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223616
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Parasitology partII lecture
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2014-06-05 15:11:49
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Heartworms Nematodes Equine
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Parasitology, Vet Tech
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  1. Phylum – 
    Class – 
    Order – 
    Superfamily – 
    Genus –
    • Phylum – Nematoda                         
    • Class – Nematode                           
    • Order – Spiruridae
    • Superfamily – Filarioidea              
    • Genus – Dirofilaria
  2. Most animals which include domestic and non-domestic cats and dogs have definitive heartworms. Our major problem in the US is with Dirofilaria immitis infecting the definitive host. Microfilaria lives _______ Adults live up to ___________.
    • 4-5 years
    • 7 years
  3. Definitive host (natural host that grow to natural length and reproduce at their natural rate) for Dirofilaria is the ____________.
    Non – Definitive hosts (don’t grow as much and not going to reproduce as much) = ______ (2nd) and _______(3rd).
    • Canidae (dogs, wolves, foxes)
    • ferrets
    • cats
  4. Average number of dirofilaria you find in a cat is _____.So that precludes us from using certain tests for cats – we have to use _______ test for cats
    • 1 ½
    • antibodies
  5. The 1st case of heartworm disease was identified in the canine population  ____ in ______, more than with the first case of feline heartworm disease found in the ______. Heartworm disease also affects other mammals worldwide including wolves (Definitive Host), ferrets, foxes, sea lions and, in rare instances, humans.
    • 1937 Hennepin County, Minnesota
    • 1920’s
  6. Heartworm Diseases means the animal
    • 1. has heartworms but also means
    • 2. the animal suffers from the debilitating symptoms associated with the infection of heartworms
  7. A 3 basic cosmopolitan distribution:
    1st – 
    2nd – 
    3rd –
    • 1st – Gulf Coast
    • 2nd – East Coast – 2007 high cases of Heartworm incidents in the MS delta area
    • 3rd – Great Lakes
  8. A new subspecies of heartworm called the ______ was identified and documented in a recent article. The strain was isolated from a naturally infected dog in Northeastern Georgia in _____.
    • MP3 strain
    • 2006
  9. Heartworm - Although _______ is the etiology with ______ as the definitive host in the US and ____________ is transmitted by the flea – it is a ___________often seen in the canine a new heartworm has been diagnosed in the canine in North America.
    • Dirofilaria immitis
    • dogs 
    • Acanthocheilonema reconditum
    • falarid (not heartworm)
  10. ___________ is now diagnosed in the NE. Large cats (lions), primarily from Africa, are the definitive host. This genus and species it has been seen in ____, is considered the non-definitive host and has the same life cycle as Dirofilaria immitis in the animal just does not proliferate well.
    • Dirofilaria ripens
    • dogs
  11. The transmission of Dirofilaria immitis has not been documented in ______ and even with the importation of microfilaremic dogs, it is doubtful the climate this far north will permit maturation of infective larvae. ______________ appears to be the most important factor contributing to further dissemination of the disease
    • Alaska 
    • Relocation of infected, microfilaremic dogs
  12. There is a concepts known as a _________ where you can wait 45 days and still have the same efficacy of the once a month L3 – L4 killers, like Ivermectin.
    reach back effect
  13. Why is the upper midwestern states one of the major centers of heartworm disease?
    Lack of compliance with respect to the administration of preventatives, and the occurrence of infection in dogs that are receiving preventatives is, therefore, likely because of the lack of certainty as to when to start and stop heartworm therapy.
  14. __% of all dogs positive on occult test for Dirofilaria immitis, are known to be negative for microfilaria (today).
    Causes:
    • 50% 
    • 1. Same sex and can’t reproduce
    • 2. Body getting better to fight infective WBC (monocytes, macrophages & neutrophils) attacks the microfilaria
  15. Acanthocheilonema reconditum is transmitted by the ____ – _____ of the blood – not ______.
    Treat with
    • flea
    • filarid; microfilaria
    • ¼ mL ivermectin /40lbs
  16. Heartworm symptoms noted by the owner are:
    • 1. coughing
    • 2. loss of stamina – gen refer to caval syndrome- because blood is not able to get through the heart to get the oxygen to get out into the muscles 
    • 3. ascites – definitely caval syndrome, blood is backing up from the heart, it can’t get thru the heart and its congesting the liver – called hyperemia of the liver and you’re getting plasma out in the abdomen,
    • 4. front legs bowed outward – seen a lot in Beagles - they seem to breath easier.
  17. 5 Blood Sample tests used to diagnose heartworm
    • a. Direct Smear
    • b. Modified Knot’s Test not used anymore
    • c. Difil Test – best microfilaria test 84% efficacy 
    • d. Hematocrit Tube – Pack Cell Volume (PCV) above occasionally see microfilaria above the WBCs buffy coat poorest test
    • e. Occult Test - Best Heartworm Test – 2 forms antibodies and antigens
  18. What is the best test to check for microfilaria for heartworm?
    What is the poorest test to check for microfilaria for heartworm?
    • Difil Test - 84% efficacy
    • Microhematocrit Tube
  19. What is the best heartworm blood test and the poorest heartworm test?
    • Occult Test 2 forms antibodies and antigens
    • Hematocrit Tube
  20. What are 4 methods to Diagnose Heartworm Disease?
    • 1.    Blood Samples 
    • 2.    History – usually reason dog is in your clinic – coughing, loss of stamina, ascites, front legs bowed out
    • 3.    Radiology – confirms the severity of the infection. 
    • 4.    Echocardiography - produce equal sign
  21. A heartworm heart has an _______ – silhouette that implies you have right ventricle, pulmonary artery and right atrium involvement or at least right ventricle and pulmonary artery. Tells you if you are dealing with a caval syndrome.
    inverted D
  22. ________ – fresh blood is taken from the vein and a drop is placed on the slide. Cover and observe for microfilaria in motion. 64% effective
    Direct Smear
  23. __________ – utilizes formaldehyde 2% and a centrifuge method to localize the microfilaria at the bottom of a tube. 84% effective
    Modified Knot’s Method
  24. ____________ –1 ml of blood with 1mL of lysing solution - is mixed with 1 ml of lysing solution and filtered through difil paper. Paper is stained and viewed under 4X or 10X. (This concentrates the micro.) This is the most reliable of the microfilaria test. 84% effective
    Difil (Millipore filtration) Test
  25. ___________ – blood is spun down for a PCV check. View above the buffy coat (WBCs) to see the microfilaria moving around. Poorest of the diagnostic blood test when checking for microfilaria.
    Microhematocrit Tube
  26. Filariae of Acanthocheilonema reconditum in a Difil test. The anterior end (arrow) is ______________ than that of Dirofilaria immitis.
    __________is Dirofilaria immitis.
    • blunter (blunt head and hooked tail)
    • Pointed head
  27. Two types of Occult Test are still on the market:
    • Antibody Test
    • Antigen Test -occult of choice and the most diagnostic test on the market today.
  28. _________ – Test of choice for non-definitive host where you are getting 1 ½ adults (cat, ferret) because the _______ test requires that the animal has 3-4 females to produce enough antigen to be positive.
    • Antibody Test
    • antigen
  29. Two types of Antibody Test:
    • 1. MAT – microfilariae antibody test detects antibodies to the microfilaria
    • 2. DAT – dirofilariae antibody test – most commonly used – detects antibodies to heartworms
  30. _____ and ___________ systems are available for detecting circulating heartworm antigens. The difference in the sensitivity of the various antigen test are statistically insignificant. If you don’t have ____ adults you don’t have enough antigens
    • ELISA
    • immunochromatographic test
    • 3-4
  31. Any test that detects antigens or antibodies is considered an ______.
    Occult Test
  32. It was once written that all antigen test required at least ________to get a positive antigen occult test. This rigid fact is not held as absolute today.
    A graded test reaction can be recognized by ____ test systems but quantitative results are not displayed by _________.
    • three mature females
    • ELISA
    • immunochromatographic tests
  33. The 2 largest vet labs in the US are : 
    These 2 labs checked over ______ dogs in 2010 for heartworms. These were exclusively antigen test, not antibody test.
    • Idexx and Antech
    • 63,000
  34. Why Aren’t More Dogs Protected From Heartworms Each Year? Alanco survey
    • 24% of all pet owners spend nothing at veterinary hospitals
    • Clients do not understand heartworm disease
    • Pricing of treatment and prevention deter many clients from starting on a prophylaxis regiment
  35. Why Do Clients Actually go to the Vet Hospital
    1/3 of all pet owners go for ________
    1/3 of all pet owners go ___________
    According to research, the two items that are critical in persuading clients to further health care for their pets is ___________________.
    • vaccinations alone
    • only when their animals are ill
    • Communication and consistency
  36. The antigen or ELISA test can be run individually or as a group of tests, which is called _____________.
    batch testing
  37. 4 Causes of false negatives:
    • blood sample is not warmed up to room temperature
    • infection is light
    • female worms have yet to mature, or
    • they are only males in this infection.
  38. Why are ELISA Test Not as Sensitive to Heartworms in Cats?
    • 1. Due to low heartworm burden Average in a cat is 1-2
    • 2. Immature female heartworms in the early stages of the life cycle do not produce enough antigen
    • 3. A male heartworm infection
  39. After an acute death of a cat, where heartworm status was not known, nearly ___% to ___% of cats diagnosed with a heartworm infection by necropsy had at least one female heartworm.
    50 to 70%
  40. The most useful tests to confirm heartworm infection in cats are
    • Antibody test - the test of choice
    • thoracic radiographs or 
    • an echocardiography (but because you don’t have the numbers you are not going to have the silhouettes so thoracic radiographs and echocardiography are not going to be as diagnostic).
  41. Radiographs of the thoracic cavity of the dog are often used to determine the severity of heartworm disease and the effect on the heart and lungs. Not a diagnostic test, but it can be. The changes typically seen in canine radiographs include
    • 1. enlargement of the pulmonary artery at 1 o’clock
    • 2. enlargement of the right side of the heart commonly called the “inverted D”.
  42. Changes in Radiography in the Cat?
    Even though the number of worms in the cat heart is only one or two in number, obviously the changes are going to be less sever, but it occurs. Changes include:
    • 1. enlargement of the main lobar and peripheral pulmonary arteries and
    • 2. the pulmonary artery is greater than 1.6 times the width of the ninth rib. Look like equal signs on radiographs. Due to the decrease in number = no “Inverted D.”
  43. There are two views that are a must for determining the SEVERITY of heartworm infection.
    • Lateral View
    • Ventral Dorsal View
  44. Radiology 
    ___________ – Determines the size of the heart. Heart more than five ribs in length and sits on the sternum. (denotes enlarged heart).
    ___________ -  a. Enlarged Pulmonary Artery –1 o’clock b. Enlarged Right Side of Heart – Inverted D
    • Lateral View
    • Ventral Dorsal View
  45. Echocardiography - The body wall of adult heartworms is highly echogenic and produces distinctive, short parallel-sided images with the appearance of ____________ where the imaging plane cuts across loops of the parasite. Echocardiography can provide definitive evidence of heartworm infection; however, it is not an efficient method of making this diagnosis, particularly in lightly infected dogs, since the worms often are limited to the peripheral branches of the pulmonary arteries which are beyond the echographic field of view.
    “equal signs” (=)
  46. Macrocyclic lactones includes the following preventive medications - most important heartworm preventatives given every 30 days. List drug name and manufacturer.
    • A. Ivermectin - Merial
    • B. Milbemycin oxime - Novartis
    • C. Selamectin - Pfizer
    • D. Moxidectin - Bayer
  47. The macrocyclic lactones are highly therapeutic possessing anthelmintic activity against _________, ____ and _________, and in some instances ___________.
    microfilaria; 3rd; 4th stage larvae; young adult heartworms (S5a)
  48. List 7 Preventives for Heartworm Disease, manufacturer, how applied, Proprietary name and  non-propietary name
    • 1. Diethylcarbamazine citrate – Originally Pfizer - oral - Nemacide, Dirocide, Filaribits, etc.
    • 2. Ivermectin – Merial - oral - Heartgard (for dogs and cats)
    • 3. Milbemycin oxime – Novartis - oral - Interceptor (for dogs and cats) 
    • 4. Milbemycin oxime & Lufenuron (preventative reproduction of fleas) –Novartis -oral - Sentinel 
    • 5. Selamectin – Pfizer - topical - Revolution (for dogs and cats)
    • 6. Moxidectin – Ft. Dodge - injectable Proheart6
    • 7. Moxidectin + Imidacloprid (Advantage) - Bayer - topical - Advantage Multi (for dogs only) now for dogs and cats
  49. Oral preventatives have been on the veterinary market since the _____. The first oral preventative on the market was _________, a tablet administered _____. Tablet that would kill larvae _______ it would not kill larvae ________.
    • 1960’s
    • diethylcarbamazine citrate
    • daily
    • Stage 3
    • Stage 4
  50. Diethylcarbamazine citrate required mandatory _______ before it can be administered to the dog because any interruption of product administration can allow microfilaria to develop into adults. This product will also produce an _________ with microfilaria resulting in vomiting and death, thus the animal has to be tested prior to administering this preventative.
    • microfilaria testing
    • anaphylactic reaction
  51. Three basic products that we still have on the market that we know will react with microfilaria causes vomiting and shock
    • Diethylcarbamazine citrate – known as DEC, 
    • Dichlorvos which is an organophosphate & 
    • Milbemycin oxime (Interceptor)
  52. ___% of the dogs today that are positive for heartworms are not going to have microfilaria - that use to be __- __% twenty years ago 
    • 50%
    • 10-20%
  53. Name the Liquid Diethylcarbamazine Phosphate (a non-macrocyclic lactone) 
    Proprietary & non-proprietary name.
    Styrylpyridinium chloride diethylcarbamazine phosphate (Styride Caricide)
  54. List 3 oral heartworm preventatives
    • Diethylcarbamazine citrate (DEC)
    • Ivermectin
    • Milbemycin oxime OR Milbemycin oxime with Lufenuron
  55. Ivermectin is a member of the family of ________ as is Selemectin (Revolution – Pfizer)
    Avermectins
  56. Avermectin class contain 2 distinct families 
    • (1) Avermectin family and
    • (2) Milbemycin family
  57. List the products in Avermectin
    Non-proprietary, proprietary and administration
    • Ivermectin (Heartgard) – oral
    • Selamectin (Revolution) – topical
    • Doramectin – topical and injectable (not for HW prevention). 
    • Eprinomectin – topical and injectable (not for hw prevention). 
    • Doramectin and Eprinomectin are primarily for large animals – cattle, sheep & horses
  58. List the products in Milbemycin
    Non-proprietary name and administration
    • Milbemycin oxime – oral
    • Moxidectin – topical and injectable
  59. Mechanism of Actions of Avermectins and Milbemycins - Kill animal by ____
    There are two modes of action for the above two:
    The primary mode of action is in binding of __________________ in the synapse between __________ and _________ in nematodes and arthropods.
    • hypoxia
    • glutamate chloride channels (glutamate is a neuron transmitter in the CNS)
    • inhibitory interneurons (what we call the association neurons)
    • excitatory motor neurons
  60. Heartgard for Dogs and Cats
    Active ingredient __________
    Generic Ivermectins (Non proprietary)
    • pryrantel pamotate & ivermectin
    • Iverhart Plus
    • Tri-Heart Plus
  61. It is well known that some ________ (autosomal recessive inheritance) and other __________ dogs are unusually sensitive to high dose of ivermectin (in excess of 16 times
    the minimum effective prophylaxis dose)
    • Collie dogs
    • glycoprotein deficient
  62. Sentinel produced by _______incorporated the product ______ and combines the ovitrol properties (does not kill the adult flea, but effectively break’s the flea’s life cycle by inhibiting egg development.) It prevents the formation of _________, a substance needed for the egg shell structure and skeletal formation in larvae.
    • Novartis Co. 
    • Lufenuron
    • chitin
  63. List 2 topically applied products for heartworm prevention on the market today.
    • 1. Selamectin (Revolution - Pfizer) and 
    • 2. Moxidectin with imidacloprid (Advantage Multi – Baylor)
  64. What product prevents heartworm, ovitrol for flea eggs, kills ascarids and ancylostoma and kills sarcotic mange. 
    Revolution 
  65. Selamectin is a derivative of the avermectin endectocide known as ________, a major difference from its cousin Ivermectin. It is used in its purest form as a cattle dewormer. You can apply topically or as injectable.
    doramectin
  66. Selamectin –“Revolution” - Pfizer - What makes this product so different is that it is the first topical medication to protect against ___________. Introduced in _____.
    • heartworms and fleas
    • 1990s
  67. Selamectin - List 5 other medical attributes:
    Safe for cats and dogs as young as ____old. Also safe for collies
    • prevents heartworms disease in cats & dogs
    • kills fleas on cats & dogs 
    • prevents flea eggs from hatching on cats & dogs,
    • treats and controls ear mites in cats & dogs, 
    • treats roundworm and hookworms in cats 
    • treats and controls sarcoptic mites on dogs. 
    • 6 weeks 
  68. Derived from the earlier product “Advantage”, the product ______ was advanced by the Bayer corporation as the once a month topical to kill and prevent fleas. Bayer then combined product with the Fort Dodge product ______ to produce the product now known as ________.
    • Imidacloprid
    • Moxidectin
    • Advantage Multi
  69. __________ (Moxidectin injectable) was designed to be injected once every ______ to prevent the development of heartworms and the injected microfilaria. A Ft. Dodge product. In less than one year after this product hit the market, dogs were dying and being examined at the TVMDL. Shortly after that the product was taken off the market by Ft. Dodge.
    • Proheart 6
    • 6 months
  70. Macrocyclic lactones chemoprophylaxis will, 1. clear _______ from the blood of dogs with patient infections by exerting a direct or indirect microfilaricidal effect, depending on the specific product used, and 2. _________ by gradually suppressing embryogenesis.
    • microfilariae
    • retarding repopulation
  71. With uninterrupted dosing, elimination of microfilariae is usually complete within ____ of oral dosing with monthly macrocyclic lactones or one month following moxidectin injection
    6-12 months
  72. If dogs are pathologically unable to receive heartworm treatment with Immitacide, then the alternative is to put the animal on macrocyclic lactones to:
    • Deplete the microfilaria
    • Sterilize the adults
    • Shorten the life of the adults
  73. Adult heartworms can live up to ______ Microfilaria can live up to _____. We use to think Adult live up to ____ & Microfilaria live up to _________
    • 7 years 
    • 4-5 years 
    • 4-5 years
    • 2-3 years
  74. Treatments For the Adults -
    List the non-proprietary name, proprietary name
    developed by
    How administered
    Dosage
    • Melarsomine dihydrochloride (Immiticide)
    • developed by Rhone Merieux, later purchased by the Merial Company
    • IM injections or SQ in lumbar muscles of two (24 hr. interval),
    • Dosage is approximately 1 mL/22#.
  75. Immiticide is administered in ___________ where mild swelling and some soreness can occur.
    deep epaxial lumbar muscles
  76. Standard protocol for Immiticide calls for ______________. 
    two injections some 24 hours apart
  77. Alternative protocol for Immiticide (used for caval syndrome dogs) is the treatment of choice of the American Heartworm Society. Dogs that are at a greater risk you want a gradual kill so they do 2 stages of eliminations using
    3 injections 1 does initially send dog home no exercise then 4-6 weeks with a 2nd dose treatment they give 2 shots 24 hours apart
  78. All macrocyclic lactones have a “reach back” of ______. As melarsomine has not been demonstrated to kill worms under four months of age, three doses of a macrocyclic lactone (or an injection of Moxidectin) will kill most _________ and allow immature worms to reach the age that they will be susceptible to melarsomine
    • two months
    • pre-cardiac larvae (4th stage)
  79. Drug used as an adulticide since the mid-sixties
    Give the Non-proprietary name/Proprietary name
    How administered
    Kill rates
    Dosage
    • Thiacetarsamide sodium/Caparsolate
    • Given intravenously 4 – 6 six injections
    • Kill rates are variable from 20% to 80%
    • 0.1mL/# IV twice a day for two days
  80. Carparsolate was once used every six months to kill adults (thought of as a preventative) the dogs died from _____ at _______.
    • liver failure
    • 6 years
  81. List 3 Adulticides Not In Use Today
    • Thiacetarsamide sodium/Caparsolate
    • Levamisole HCl
    • Fenthion (Talodex)–(organophosphate)
  82. 2 reactions to adult treatment
    • 1st if he has reaction to the adult treatment - he’s going to vomit within 12 hours and if he does – stop the adult treatment. Wait about 6 weeks and start again – he won’t vomit then he will build up a resistance to it.
    • 2nd reaction if he doesn’t vomit during the adult treatment, around 2-3 weeks later when all the adults have moved to the lungs now you are going to see massive coughing, gaging and if he’s exercising coughing up blood because these worms even though they are dead are in the parenchymal of the lungs and they are slicing up the alveoli – that is causing the bleeding.
  83. ________ is the drug of choice although there has been a history of multiple treatments that have failed or lost popularity
    Ivermectin 
  84. Beside ivermectin (the cattle liquid dewormer at ¼ mL per 40 pounds), some clinics use ________ and some _______________ 
    • milbemycin (Interceptor)
    • selamectin (Revolution). 
  85. ________ – is still the only drug approved by the FDA for use with microfilaria.
    Dithiazine Iodine (Dizan)
  86. ______ – any medicine that the liver views as foreign 
    Xenobiotics 
  87. _____________ - used for something that the FDA has not approved it for
    Off label (extra label means the same thing)
  88. List the 2 approving agencies
    • EPA – Environmental Protection Agency - approves Heartgard
    • FDA – Food & Drug Administration
  89. Adult worms, when treated with the adulticide, will die in ___________. They are swept to the lungs where they become lodged in the alveoli and are decomposed by _____________
    The lungs are very susceptible to internal hemorrhage and tissue abuse, and thus we DO NOT exercise the dogs for at least ____
    • 10 days to 2 weeks
    • neutrophils, macrophages (monocytes), and some lymphocytes (really not a macrophage)
    • 6 weeks.
  90. If dog stops eating, take temperature. If temperature is elevate that means you have a _____________. This means that the adults are dying and are going to be swept to the lungs and now you have an infection
    verminous (means worm) pneumonia
  91. What are the Classification of Heartworm Disease
    • Class 1. Asymptomatic to mild heartworm disease. No radiographic signs or signs of anemia. May have loss of condition and the occasional cough. No laboratory problems. TREATMENT!
    • Class 2. Moderate heartworm disease. Radiographic signs (show silhouette to be varied) are present and anemia is obvious with PCV less than 30%. Mild proteinuria due to escape of the damage to the nephrons where microfilaria have damaged the nephron. Mild elevation of laboratory data – ALT is up, ALP is up, BUN kind of up but not to far. Will have some lose of condition with cough. Must stabilize prior to treatment. Consider TREATMENT! 
    • Class 3. Severe heartworm disease. Ususally a CAVAL dog. Radiographic signs, significant anemia, stabilize and alternate dosage. NO! May want to consider macrocyclic lactones for 2-3 years – just not treating the adults
  92. Pre-treatment Prior to Immiticide with doxycycline (antibiotic) helps to kill _______, and endosymbiont that inhibits filarial nematodes, including D. immitis
    Wobachia
  93. Caval Syndrome Also known as __________, this condition develops in heavily infected dogs (long standing class 3 or beyond) when large numbers of adult heartworms partially obstruct blood flow through the tricuspid valve and also interfere with valve closure.
    List 2 symptoms that are characteristic features of this syndrome.
    • Dirofilarial Hemoglobinuria (since microfilaria are seen in the urine)
    • Severe congestion of the liver
    • jugular pulsations
  94. Confirmation of CAVAL syndrome can be made with 
    • echocardiographic examination and
    • radiograph visualization
  95. Left side heart failure Houston TX. = ____ - blood backs up to the ________.
    Right side heart failure = ________ - blood backs up to the ____
    • Mitral valve insufficiency - lungs
    • heartworms - liver
  96. Wolbachia thought to be a ______ years ago and was reported as such. We know that Wolbachia is a ______ that is found with the filarid nematode Dirofilaria immitis.
    • bacteria 
    • rickettsia
  97. Most filarial nematodes, including D. immitis, harbor obligate, intracellualar, gram negative bacteria belonging to the Genus 
    Wolbachia (Rickettsiales). 
  98. It is hypothesized that Wolbachia contribute to pulmonary and renal inflammation through its surface protein ________ producing endotoxins. Studies are underway to determine the effects of suppressing Wolbachia rickettsia populations with _____________ 3-4 weeks prior to adulticide therapy.
    • WSP (Wolbachia Specific Protein)
    • doxycycline (clindamycin – prop name) 
  99. ________ & _______ have a symbiotic relationship. Each depends on the other for survival.
    • Dirofilaria immitis
    • Wolbachia 
  100. Dr. Graham, President of the Heartworm Association and served on the TVMA says “We put dogs on doxycycline because the antibiotics help to reduce the spread of heartworm infections by:
    • 1. Circulating microfilaria become non-infective
    • 2. Makes the adult heartworms easier to kill. 
    • 3. Reduces post treatment side effects of the dying worms in the pulmonary arteries
  101. Molting Time In Mosquito - Conversion of S1 to S3 Totally Temp. Dependent - 
    30 celsius or __ F = __ days
    26 celsius __ F = __ days
    22 celsius __ F = __ days
    18 celsius __ F = __ days
    12 celsius __ F = _____
    • shorter
    • 30 celsius or 86 F = 8 days
    • 26 celsius 79 F = 12 days
    • 22 celsius 72 F = 17 days
    • 18 celsius 65 F = 29 days
    • 12 celsius 54 F = death 
  102. Susceptibility To Infection - 
    10 HW Dogs Exp. To 100L3 = 10 Dogs Get HW - Number of Adults develop in the heart normally = __
    10 HW Cats Exp. To 100L3 = 7 Cats Get HW - Number of Adults develop in the heart normally = __
    Future infections are based on ______= in 3 months giving 100 L3 (infective S3 larvae) to a previously infected dog as above, less hw will survive due to the antibody production from the dog. 
    • 8
    • 1-2 
    • Immune Recognition
  103. Generally speaking cats do not have microfilaria of either type in their blood on only about __% of positive dogs do. Only about __% of the cats are positive for microfilaria of either type D immitis or A. reconditum
    • 50%
    • 20%
  104. Differentiation of D. immitis and Acanthocheilonema
    Movement: D. immitis ___________, Acanthocheilonema _____________
    Size: D. immitis –____ length ___ width, Acanthocheilonema– ___ length  __um width
    Head: D. immitis – head is ___, Acanthocheilonema – head is _____
    • undulates in one spot; moves quickly across the field
    • 320 um length 7-8 um width; 280 um length  6-7 um width
    • tapered; blunt
  105. ________ is the most common symptom of toxicity such as acidosis resulting from increase CO2.
    ___________ are the final symptom of shock when the animal has gone through Compensatory, Progressive, and Irreversible stages of shock.
    • Vomiting
    • Dilated pupils
  106. In feline medicine, heartworm treatment with an adulticide is controversial, why?
    there are not approved adulticides for cats.
  107. In dogs, heartworm disease is classified within a system based on clinical signs. Once the dog is diagnosed, a treatment plan needs to be developed. Options include:
    • an adulticide only
    • an adulticide and microfilaricide, or
    • just a microfilaricide
  108. In recent years, the drug of choice to kill adult heartworms has been __________________.
    This medication does not eliminate the ____ and ___ stages of heartworm or __________.
    • melarsomine dihydrochloride (Immiticide)
    • L3; L4 ; microfilaria
  109. Class 1 Heartworm Treatment
    Give two injections _________ apart.
    a. It is recommended to give one injection on one side of the ______, and the other injection on the opposite side with __ gauge needles.
    b. Once the medication is injected and the needle removed, _____ should be placed on the injection site for a few minutes.
    c. _____ after treatment, check the status of the dog with an ______. If still positive, retreat the dog using the same protocol.
    • 24 hours
    • lumbar area
    • 22
    • pressure
    • Six months
    • antigen test
  110. Class 2 and 3 Treatments
    ___________ signs must be stable.
    Give one injection wait ____ followed by two injections given _____ apart.
    • Congestive heart failure
    • 30 days
    • 24 hours
  111. It is imperative the dog be placed on restricted exercise for at least _____. This decreases the possibility for thrombo-embolisms in the lungs as the adult heartworms start dying from the adulticide and then become dislodged and travel to the lungs to be reabsorbed by
    • 6 weeks
    • neutrophils and macrophages (monocytes outside the blood stream).
  112. Aspirin therapy has been studied both short term (4days) and long term (up to 1 year) infections. Given a standard aspirin of __ mg p/day, dogs infected with hw for 1 yr showed less initial proliferation plus less flow obstruction during arteriography. Aspirin an NSAID appears to have a protective effect on the vascular endothelium as well as anti-platelet and anti-inflammatory effects. It was also noted that a dosage of aspirin decrease to __ mg/# produced the same effect, so you may want to give baby aspirin which is __mg/day
    • 325
    • 3
    • 81
  113. Heartworm infections can be so severe it causes a syndrome called _________, also known as ___________ or ____________.
    • caval syndrome
    • vena cava syndrome
    • dirofilarial hemoglobinuria
  114. Treatement for CAVAL Syndrome - Surgical removal is usually done through the right external jugular vein. If the removal is successful, symptoms of the heart murmur will dissipate or vanish and the __________ will disappear in 24 hours. Since all the worms will not be removed during this surgical procedure, ______ treatment should be considered to rid the body of the remaining heartworms.
    • hemoglobinuria 
    • adulticide 
  115. Can you name the vessels and chambers the alligator forceps will enter and traverse to remove the adult heartworms from the heart? 
    • Jugular vein
    • Subclavian vein
    • Brachiocephalic vein
    • Cranial vena cava
  116. ____ – cats outnumbered dogs in the US
    2007 – ___  million cats to ___million dogs in the US
    2010 – there were 37.5 cat owning household, avg household has _____ cats, 12% have ________.
    • 2005
    • 81.7; 72
    • 2 or more; 4 or more
  117. 2005 – ___ billion spent on animals in general (American Pet Manufactures survey)
    2007 – ___ billion 
    • 18.6
    • 24.5
  118. According to Dr. Graham the rate of hw infection in a hw endemic are is about _______ that in dogs. The reason hw disease in cats is difficult to dx is simply cats have a _________, so it is harder to detect the protein secreted by the female worms thus the antigen test is of no
    value.
    • one-tenth 
    • lower worm burden
  119. Why is the antibody test that is used for cats is often skewed in our results?
    antibody test just detects exposure and not necessarily active infection. Also it detects proteins, that could be ascarids, ancylostoma, trichuris as well as Dirofilaria immitis
  120. Prevalence in cats is at __% to __% of population. Dr. Graham said ________
    • 5%; 15
    • 1 out 10 (10%)
  121. Heartworms are found more often in cats _______ in the body cavities, systemic arteries, and CNS than in dogs. Because cats are the _________.
    • migrating
    • non-definitive host
  122. Previously the life span of adult in a cat was _______ while it was _________ in the dog. This was the prevailing opinion for the last 25 years. Today we note that adults in dogs can live up to ____ and _____ in cats
    • 2 to 3 years
    • 4 –5 years
    • 7 years
    • 2 –5 years
  123. AFTER KATRINA MANY infections in the US increases immediately
    HW: Dogs – ___% increase; Cats – __% increase
    FeLV – __% increase. This use to be the primary cause of death in cats
    FIV – __% increase Feline HW Disease – Feline AIDS
    • 48.8%; 4.2%
    • 2.6%
    • 3.6%
  124. Signs of heartworm disease in cats usually develop during one of two stages: 
    • 1. arrival of the immature S5 in the pulmonary artery,
    • 2. death of adult heartworms.
  125. Hw generally attach themselves to the _________ in the right ventricle if they are out of the pulmonary artery. When they reproduce if it is a male and female they will release their grip and rip and get carried by the blood up into the lungs. The 2 hw can obstruct the pulmonary artery to the point that no blood or little blood can get through and the cat will literally die from _______. This is a par acute situation because it can’t breathe or get oxygen to the body. They will normally die within _____.
    • chordae tendineae
    • hypoxia
    • 5-10 minutes
  126. This initial phase of heartworm is often diagnosed as _________but is actually part of a syndrome now known as ______________.
    • asthma or allergic bronchitis
    • heartworm-associated respiratory disease. (HARD)
  127. Comparative Disease Risk in Cats in the US
    Kidney disease – __%
    D. mellitus – ___%
    FeLV – __%
    FIV – __% has kind of taken over for FIV as the primary causes of diseases seen in cats today.
    Hw infection – ___% possibility of infection
    • 1.1%
    • 1.5%
    • 2.3%
    • 2.5%
    • 2.14%
  128. Death from heartworms in cats and dogs is due to __________________ referred to as ____________.
    • pulmonary thrombo-embolism (Thombo is clot/Embolism clot starts to move)
    • PTE pulmonary thromboembolism
  129. Cats are seldom microfilaremic when examined. Why? 
    They may both be males, or both be females or because there are not enough microfilaria being produced by one hw if it is a male and female in there, so antibodies can easily take out the microfilaria. 
  130. What test would you use on a cat if you suspect microfilaria?
    Millipore filtration test
  131. Thoracic radiography does show inverted D or 1’oclock pulmonary enlargement nor does the Echocardiography rarely show the body wall of an adult heartworm in hw of cats
    because of the number
  132. Diagnostic Hang-ups in Cats Earliest Detection Times
    Antibody – 
    Radiology – 
    Echocardiography – 
    Antigen (if enough female worms) –
    • 2 months
    • 4-6 months
    • 6 months
    • 6 months
  133. Hw Prevention in Cats
    List Non-prop, propr name, manufacturer and how applied.
    • 1. Selamectin NP name (Revolution) – topical - Pfizer
    • 2. Ivermectin (Heartgard) – oral - Merial
    • 3. Milmbemycin (Sentinel) – oral – Novartis
    • 4. Imidacloprid – Moxidectin (Advantage Multi) – topical - Bayer
  134. What year was Sodium Carparsolate (Thiacetetarsamide sodium) invented
    1947
  135. What year did Dr. Kune develops the chemical Diethylcarbamazine citrate for prevention of hw. 1st preventative that we had.
    1962
  136. What year was the 1st once a month – Heartgard (Ivermectin) release by Merial 
    1986 
  137. What year was the 1st injectable Injection – Proheart6 (Moxidectin) – on the market given 
    every 6 months for the treatment of heartworm, rounds, and whips
    2001 
  138. Nematodes of the Equine
    Phylum – 
    Order – 
    Family – 
    Sub-family – ____________ (small strongyles) & ___________(large strongyles)
    • Phylum – Nematoda
    • Order – Strongylida
    • Family – Strongyloidea 
    • Sub-family – Cyathostominae (small strongyles) & Strongylinae (large strongyles)
  139. Most common cause of death in horses in the US is ____ which causes pain,  and pain is caused by intestinal parasites. Most common parasites is one of these large strongyles, ________
    • colic
    • Strongylus vulgaris
  140. Large Strongyles - There are as many as 56 species of this sub-family known as _______, and as many as 15 to 20 different species can commonly be found in one host; however, 3 species of the sub-family Strongylinae are of importance to us as health care professionals because they ____________ and 1 is the primary cause of death of horses etiology is ______. All large strongyles are known as “______” or “______”.
    • Stronglinae
    • migrate viscerally
    • Strongylus vulgaris
    • bloodworms; redworms
  141. 3 species of the sub-family Strongylinae are of importance to us as health care professionals because they migrate viscerally
    • 1. Strongylus vulgaris Smallest but most dangerous
    • 2. Strongylus equinus (limited distribution in US) rarely seen anymore but is possible
    • 3. Strongylus edentatus seen commonly – larger one
  142. Morphologically there exists a ring of fence of projections (mouth) known as the _______ that surround the mouth. They do not have teeth or cutting plates, but they do have a strong mouth that allows them to hang on to the mucosa. Large strongyles can cause some bleeding, but they are not blood suckers, they eat ________along the mucosa and they do not cause bleeding, unless they are sucking close to blood vessel. 
    • corona radiata
    • glycoproteins 
  143. Prepatent period for Strongylus vulgaris is _____ the other S. edentatus & equinus around ______
    • 6 months
    • 11 months
  144. Strongylus vulgarus Migration
    • 3rd stage larvae is ingested by the horse.
    • 3rd stage larvae will cast its covering and enters wall of the cecum and ventral colon.
    • larvae penetrates to submucosa & 3rd stage molt to 4th stage in one week
    • 4th stage now penetrates small arteries and aorta and will wander progressively to the  cranial mesenteric artery (a major supplier to intestines) in 11-21 days/not that important, but could say 3 weeks
    • after 2-4 months of migration in the cranial mesenteric artery, the 4th stage enters the surrounding tissue and molts to 5th stage, which enters lumen of colon.
    • Reproduction begins in about 6 months. When adults  reproduce, they will pass an egg, they will go through the feces, hit the ground, hatch into 1st stage then molt to the 2nd stage then molt to 3rd stage – that is the infective stage
  145. The Small Strongyles - There are about 40 species available and almost all can parasitize the equine; however, like T. leonina, they do not __________ like the large strongyles
    migrate viscerally
  146. Pinworms
    Phylum – 
    Order – 
    Family – 
    3 Genus – 
    • Phylum – Nematoda
    • Order – Ascaridae
    • Family – Oxyuroidea
    • Genus – Oxyuris, Enterobius, Probstymeria 
  147. The Oxyurid or “equine pinworm”, known as _____ is parasites with a _____life cycle. They like the strongyles inhabit the ________ of the horse. Often their life cycle is confused with the “________” _________, human pinworm which also inhabits the appendix, large intestine and female genitalia
    • Oxyuris equi
    • direct 
    • cecum and the colon
    • seatworm of man
    • Enterobius vermicularis
  148. _________, caused by the eggs attached to the skin around the anus causes the major problem
    Pruritus ani
  149. _________ “the minute pinworm” – not common mostly in the NE, but is mentioned since it is an oxyurid of the horse and its entirelife cycle is completed in one location, the ______. Adult females produce sexually mature offspring – no molting or incubation periods. Worms number in the millions in a short period of time due to no prepatent period. This parasite fortunately is not considered pathogenic.
    • Probstmayria vivipara
    • large intestines (cecum and colon)
  150. The Ascarid of Equine
    Phylum – 
    Order – 
    Family – 
    Genus – 
    The equine ascarid, as species, is closely related to Ascaris suum of hogs.
    • Phylum – Nematoda
    • Order – Ascaridae
    • Family – Ascaridoidea
    • Genus – Parascaris
  151. ____________ is the only ascarid in the horse and is the largest of all the ascarids of all domestic animals
    Parascaris equorum
  152. Parascaris equorum can be passed
    They do not ________ just like Toxocara. 
    • transmammary, intrauterine, oral consumption
    • penetrate the skin
  153. Gasterophilus intestinalis
    Male and female flies reproduce laying eggs on the hairs of the forelegs and ________. After 5 days, the horse consumes the eggs with hatching and migration of larvae to __________. Larvae remain in the tongue for 30 days and then move to the lumen to be swallowed. The intestinalis will attach to the _______ and live for about 10 - 11 months. They release their grip and fall in the feces. Pupal cases will release botflies in 3 to 9 weeks. Times will vary based on temperature or humidity. Egg hatch with male and female flies reproducing.
    • shoulders
    • dorsal surface of the tongue
    • stomach
  154. Gasterophilus nasalis 2nd most common
    Female and male flies reproduce with eggs being laid on the _____________. Eggs hatch in 5 days, crawl towards the mouth and then _________. Larvae burrow into the pockets between the ______. Back there 1 month. In about 2 – 4 weeks they will move to the lumen and be swallowed. The larvae will attach to the _______. In about 10 - 11 months, the larvae will release and pass out the horse. Pupal cases (just like eggs) will hatch in 3 to 9 weeks.
    • intermandibular spaces
    • between the lips
    • molar teeth
    • duodenum
  155. Gasterophilus hemorrhoidalis
    The flies lay their eggs on ______. These hatch in 2-4 days when the horse drinks water, penetrated the epidermis of the lips, and burrow into the ____________. In about 2 - 4 weeks they migrate out into the lumen and end up in the ______. In about 11 months they lose their grip and pass out in the feces in their pupal cases. The adult bot flies will emerge in 3 to 9 weeks.
    • the lips
    • mucus membranes (cheek) of the mouth
    • duodenum
  156. You can actually see if they have a gap in the tongue that is _________
    back between the molar teeth, that’s ______, 
    In the mucus lining of the mouth _________.
    • G. intestinalis
    • G. nasalis
    • G. hemorrhoidalis
  157. Medications To Remove Bots
    • Carbon disulfide –Parvex Plus
    • Dichlorvos –Equigard (organophosphate)
    • Trichlorfon –Combot (organophosphate)
    • Ivermectin –Ivermec -now the drug of choice
  158. Why do we wait 1 month after the first frost to deworm for bots?
    Because after the 1st frost all the eggs are dead and 30days allows for the time for anything in the mouth to get to the stomach and duodenum. So deworming will kill everything that is in the intestines and duodenum.
  159. _________ is the “intestinal threadworm of the horse,” 
    Strongyloides westeri
  160. S. westeri is common in the small intestinal mucosa of the young foal. ___ and ____ are the two domestic animals most commonly infected via nursing 4-7 days after foaling. Passed _________.
    • Foals; piglets
    • transmammary
  161. _________ is shared with the equine and swine
    _________ is shared with the equine and ruminants
    • Strongyloides westeri
    • Trichostrongylus axei 
  162. The minute Stomach worm -
    Phylum – 
    Order – 
    Family – 
    Genus -
    • Phylum – Nematode
    • Order – Strongylida
    • Family – Trichostrongylidae
    • Genus - Trichostrongylus
  163. 4 stomach worms in ruminants = 
    • Haemonchus contortus,
    • Haemonchus placei,
    • Ostertagia ostertagi,
    • Trichostrongylus axei
  164. 5 stomach worms in equine =
    Family _________.
    • Trichostrongylus axei
    • Habronema muscae
    • Habronema microstoma
    • Habronema majus
    • Draschia megastoma
    • Spiruroidea
  165. Equine Stomach Worms
    Phylum – 
    Order – 
    Super Family – 
    Family –
    • Phylum – Nematode
    • Order – Spirurida
    • Super Family – Spiruroidea
    • Family – Habronema
  166. In the horses that experience habronemiasis we call that _____________ nickname – ______. These are passed in feces. Flies like ________ (house fly) and ________ (stable fly) pick these up and drop them on moist areas of the horse.
    • cutaneous habronemiasis 
    • summer sores
    • Musca domestica; Stomoxys calcitrans
  167. 3 tapeworms of the horse.
    Intermediate host of Tapeworms is
    • Anoplocephala (use to be Paranoplocephala) magna, mamillana, perfoliata.
    • mites  
  168. Parasites in horses
    5 parasites of the Cecum & Colon: 
    __________ of the eye in horses & cows, __________ is in dogs & cats
    Under the skin is _________,
    Cranial mesenteric artery is _____________
    • Strongylus vulgaris, S. edentatus, S. equinus, small strongyles, Anoplocephala perfoliata
    • Thelazia lacrymalis; Thelazia californiensis
    • Onchocerca cervicalis
    • Strongylus vulgaris
  169. Nematodes of Ruminants - Stomach Worms
    Phylum – 
    Order – 
    Family –
    • Phylum – Nematoda
    • Order – Strongylida
    • Family – Trichostrongyloidea
  170. __________ – found in the ruminants & horses
    __________ –“twisted st. worm"
    __________ – "wire and barber pole”
    __________ – “medium or brown st. worm”
    • Trichostrongylus axei
    • Haemonchus contortus
    • Haemonchus placei
    • Ostertagia ostertagi
  171. Strongylid parasites of ruminants are Nematodes of the Order ______. This name includes genus’ 
    • Strongylida
    • Ostertagia, Haemonchus, Cooperia, Trichostrongylus, Telodorsagia, Mecistocirrus, Oesophagostomum, Bunostomum, Chabertia, Camelostrongylus, and Lamanema
  172. All coccidia in farm animals (chicken, turkey, horses, cow, sheep, goats etc) they are ALL _______ genus. In dogs and cats it’s going to be an ___________ Exception is pig they have 
    • Eimeria
    • Isospora canis & Isospora felis
    • Eimeria and Isospora
  173. ____________ are considered the most pathogenic of all helminths to parasitize the ruminant
    stomach worms
  174. ___________(“hookworm”) cattle (definitive host)
    ____________ (hookworm) sheep and goats (definitive host). Note: both above can be found in all ruminants
    • Bunostomum phlebotomum
    • B. trigonocephalum
  175. “Nodular Worm Disease” of cows and sheep.
    Family:
    List 2:
    • Syngamoidea
    • Oesophagostomum columbianum
    • Oesophagostomum radiatum 
  176. _______ – known as the “sheep nodular worm.” Larvae are consumed and mature in
    the intestines and pass to the large intestines where they penetrate the wall and form black nodules that can be seen through the mucosa
    Oesophagostomum columbianum
  177. _________ – “cow nodular worm” similar to sheep nodular worm but these nodules are formed in the small intestines
    Oesophagostomum radiatum
  178. Lungworms of Ruminants
    Phylum – 
    Order – 
    Super Family - 
    Family – 
    • Phylum – Nematoda
    • Order – Strongylida
    • Super Family - Metastrongyloidea
    • Family – Trichostrongyloidea
  179. Dictyocaulus viviparous “______” nickname
    Husk
  180. Lungworms in ruminants - Etiology is numerous but disease is scientifically called ___________ with life cycles all identical
    Dictyocauliasis 
  181. Lungworms of Ruminants - Super Family of Lungworm
    Super Family – ________ – is another lungworm that inhabits the lung of the ruminant but is classified as a super family since it has an indirect life cycle requiring the ______________ as its intermediate host.
    • Metastrongyloidea
    • earthworm or snail
  182. __________ is a member (4th member) of the metastrongyloidea super family known as a lungworm, but can also inhabit the circulatory system in other species. Most verminous pneumonias attributed to this parasite.
    Protostrongylus rufescens
  183. Lungworm migration
    • Eggs laid in the lungs. Coughing is one of the side effects
    • The eggs may hatch or may be passed intact. 
    • Note: lungworms and intestinal worms pass larvae 
    • Eggs are coughed up, swallowed, and passed out in the feces.
    • Eggs hatch in soil and larvae are consumed
    • Larvae penetrate the intestine –blood –lungs 
  184. Lungworm parasites are found at any time in the tracheal-lung tree of young animals ________. Recognition is seasonal (summer/rain) Symptom: _______.
    • 4-18 months old
    • coughing/weight loss
  185. Nematodes of Swine Species - Porcine
    Phylum – 
    Order – 
    Family – 
    • Phylum – Nematoda
    • Order – Ascaridae
    • Family – Ascaridoidea
  186. Pathology of Ascaris suum: when they migrate through the hepatic portal system they will cause areas of consolidation and in pigs we call that “_________” = liver that will constitute condemnation of the liver 
    Transtracheal migration causes cough known as “_______”
    • milk spots
    • thumps
  187. Deviated septum called Atrophic rhinitis caused by 
    Bordetella bronchiseptica
  188. Ascaris suum like the roundworms of Toxocara and Parascaris, these parasites live in the ________.
    small intestines
  189. __________ is the largest nematode of the human intestines and the most prevalent parasite of humans in the world. ___% of world’s population being positive
    • Ascaris lumbricoides
    • 25%
  190. Most all of our intestinal parasites feed on the ________. Ascaris suum and Ascaris lumbricoides do not feed on the surface mucosa lining, but do obtain nourishment solely from the contents of the
    • glycoproteins
    • pig or human intestines. They eat what you eat.
  191. Other Nematodes of Swine
    Phylum – 
    Order – 
    Family – 
    • Phylum – Nematoda
    • Order – Strongylida
    • Family – Strongylidea
  192. _______ – known as the “common kidney worm” is unique in that it has a direct and indirect life cycle. (________ is intermediate host)
    • Stephanurus dentatus
    • Earthworm 
  193. Intestinal Parasite of Swine
    Phylum – 
    Order – 
    Family –
    • Phylum – Nematoda
    • Order – Rhabditida
    • Family – Rhabdiasoidea
  194. Our rhabditoids (intestinal threadworms) are also found in swine as ____________.
    The ________route is the primary means of infection explaining why piglets often are positive for A. suum and Strongyloides at ____.
    • Strongyloides ransomi, S. suis, and S. westeri
    • transmammary
    • two weeks
  195. 3 stomach worms of porcine
    • Hyostrongylus rubidus (red stomach worm)
    • Physocephalus sexalatus 
    • Ascarops strongylina
  196. Once classified as a nematode due to its _______, _____________ is now known to be the tapeworm of swine. Nickname is the _______________. It is indirect as all tapes are, using the _____________ as intermediate host (3 months)
    • pseudo-coelom
    • Macracanthorhynchus hirudinaceus
    • “thorny-headed” worm of swine
    • Maybeetle, dung beetle and water beetles

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