![]() The clinical presentation of a P kellicotti infection can range from severe respiratory distress due to a pneumothorax to nondescript respiratory signs (e.g., coughing, dyspnea) to entirely asymptomatic. While not common, P kellicotti infection should not be forgotten when a dog presents with respiratory signs. Once in the lungs, they encyst, develop into adult flukes, reproduce, and release eggs which are eventually coughed up, swallowed, and passed in the dog’s feces. The metacercariae excyst in the lumen of the dog’s duodenum, penetrate the intestinal wall, and make their way into the peritoneal cavity, through the diaphragm, and into the lungs. 2,3 A dog becomes infected by ingesting a crab or crayfish infected with metacercariae. The first intermediate host is a snail of the Pomatiopsis genus, and the second is either a crayfish ( Cambarus species, Orconectes species) or a freshwater crab. This fluke uses 2 intermediate hosts to complete its life cycle. P kellicotti can be found throughout much of the eastern United States, and the adult flukes (7.5 to 12 mm × 4 to 6 mm) are found in cysts in the lungs of a variety of wild and domestic mammals, including dogs and cats. ![]() While P westermani is worth mentioning as it is of canine and zoonotic concern, it is not currently found in the United States. The main lung flukes that infect dogs are from the genus Paragonimus, with Paragonimus kellicotti and Paragonimus westermani being most notable. The Parasitology series is brought to you by Merck Animal Health, the makers of Bravecto® (fluralaner) and Sentinel® (milbemycin oxime/lufenuron). A patient’s clinical and geographic history are helpful indicators of when a fluke infection should be more strongly considered as a potential diagnostic differential. Fluke-infected dogs can present with a range of clinical signs that often overlap with those of many other diseases, such as lethargy, hyporexia, vomiting, and diarrhea. The major categories of flukes are respiratory (lung), intestinal, hepatopancreatic, and vascular (blood). The epidemiology and pathophysiology of the flukes that infect dogs are varied and complex however, flukes are generally categorized based on the primary organ they infect. 1,2 However, many trematodes still warrant consideration as canine parasites in the United States. Trematodes are more often thought of as agents of cattle or small ruminant infections or human tropical diseases than as parasites of dogs and cats. With many dogs being kept to a primarily indoor lifestyle, trematode or “fluke” infections of companion animals have decreased in notoriety in recent years.
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