Vol. 21, No.
4 April 1999 V 20TH ANNIVERSARY
CE Refereed Peer Review
FOCAL POINT
★ Physaloptera infections in dogs
and cats are uncommon, are hard
to diagnose because of difficulty
in detecting eggs in routine fecal
flotations, and can be a cause of
chronic vomiting.
KEY FACTS
■ There appears to be no
correlation between worm burden
and severity of clinical signs or
histologic lesions.
■ Routine fecal flotations are often
negative and eosinophilia is not
common in animals infected with
Physaloptera.
■ Studies have not been
conducted to document the
best anthelmintic or most
appropriate dose to treat
Physaloptera infections in
dogs and cats.
■ Physaloptera infection should
be considered a diagnostic
differential for dogs with
chronic vomiting.
Physaloptera Infection
in Dogs and Cats
Iowa State University
Karen L. Campbell, DVM
Joanne C. Graham, DVM, MS
ABSTRACT: Physaloptera infection in dogs and cats is uncommon but may be underesti-
mated. Chronic vomiting is the most common sign of infection and may occur with a large
or small worm burden. Routine bloodwork, abdominal radiographs, and fecal flotations are
often normal, and gastroduodenoscopy (including gastric and duodenal biopsies to docu-
ment the extent of mucosal inflammation) is usually required to make a diagnosis. However,
any animal with chronic vomiting should be empirically treated for Physaloptera infection
before gastroduodenoscopy is performed. Treatment should be more aggressive than for
many other nematodes because there is some evidence that Physaloptera species may be
harder to eliminate.
N
ematodes of the genus Physaloptera (i.e., stomach worms) are an un-
common cause of chronic vomiting in dogs and are uncommon to rare
parasites in cats.1–3 However, Physaloptera species inhabit the stomach
and/or duodenum of many carnivorous animals worldwide and have pathogenic
potential.2–8 Diagnosis of Physaloptera infection can be difficult, and thus perhaps
their importance as a cause of clinical illness is underestimated.
Physaloptera species are often not suspected as the source of illness. Although
these nematodes are not commonly encountered by practitioners, a heightened
awareness of their properties may increase the index of suspicion early and
prompt empiric therapy with appropriate anthelmintics. Resolution of clinical
signs would prevent the need for gastroduodenoscopy to confirm a diagnosis.
The benefit to pets and owners would be the avoidance of a procedure that re-
quires anesthesia and its associated costs.
PREVALENCE
Estimates of the prevalence of Physaloptera species in animals in the United
States vary widely (1% to 50%).2,3,5,7,9–11 Necropsies of stray cats and dogs re-
vealed prevalences of 1% to 25% and 1% to 28%, respectively.2,5,12–16 A fecal
flotation study of dogs in Iowa found a prevalence rate of 1.6% in 1968 and
0.4% in 1988.17 A 1974 study of New Jersey dogs found 3% of fecal samples to
be positive.18 A recent study of 6458 fecal samples from dogs in U.S. animal
shelters found a 0.05% prevalence rate for Physaloptera eggs.19 The prevalence of
Physaloptera may be underestimated because adult worms can be confused with
ascarids and fecal samples are often negative in infected animals.1,2,5,9,10,12,20
In the United States, three species (Physaloptera praeputialis, Physaloptera rara,
Small Animal/Exotics 20TH ANNIVERSARY Compendium April 1999

and Physaloptera felidis) are found in dogs and

cats. Some researchers have reported P. rara to
be the most common Physaloptera species to
parasitize dogs and cats.1,5,9,10 P. rara and P. felidis
inhabit the stomach and duodenum, whereas P.
praeputialis inhabits only the stomach.

LIFE CYCLE
Physaloptera species have an indirect life cycle
and thus require an intermediate host to devel-
op into the infective stage (Figure 1). Definitive
hosts (carnivorous animals) cannot become in-
fected by ingesting eggs in the environment.5,9
Infected definitive hosts pass infective (embry-
onated) eggs, which can survive 40 days at
room temperature or 60 days at 4˚C (39˚F).5,9
Suitable intermediate hosts (i.e., flour beetles,
ground beetles, cockroaches, field crickets, and
camel crickets) ingest the eggs.5,7,9 First-stage
Figure 1—Life cycle of Physaloptera nematodes.
larvae hatch in the intestines of the intermedi-
ate host, migrate to the outer layers of the intes-
tines, encyst, and then molt to second-stage larvae in examination. The largest worm burden was eight.1 The
11 to 16 days. After another 12 days, they molt to the authors found no correlation between worm burden
infective third stage.5 and severity of clinical signs or histologic lesions.1
Either a paratenic (i.e., frogs, snakes, or mice) or Adult worms attach to the gastric or duodenal mu-
definitive (e.g., a dog or cat) host then ingests the inter- cosa and feed on blood and other tissue components.3,5,6,10,11
mediate host. Dogs and cats can also be infected by in- Attachment causes increased gastric mucus production,
gesting paratenic hosts.3,5,7,9,11 Larvae do not migrate erosions, gastritis, and enteritis. Mucosal damage leads
from the gastric or intestinal mucosa of definitive to lymphocytic–plasmacytic cellular infiltration, which
hosts.5,9,11 Adults develop and attach to the gastric or may be the cause of vomiting. Inflammatory lesions can
duodenal mucosa (Figure 2). Infective larvae require 56 alter electromechanical activity, which in turn leads to
to 83 days to develop into egg-laying adults.5–7,9,11 Eggs gastrointestinal stasis.
are passed in the feces of definitive hosts (Figure 1). As worms move from one feeding site to another,
tiny, bleeding wounds are created (Figure 3).2,3,6,7,9,11,20,23
PATHOPHYSIOLOGY This is in contrast to ascarids,
Opinions differ regarding the which migrate through but do
pathogenic potential of Physa- not attach to the gastric mucosa
loptera species. Some authors ar- on their way to the intestines. In
gue that infections are often in- a review of 18 dogs with Physa-
apparent and that only a large loptera infection, 50% had histo-
worm burden produces clinical logic gastritis and 11% had de-
signs.6,21 Others argue that clini- layed gastric emptying after 12
cal signs may occur when only to 18 hours of fasting. Four dogs
one or a few worms are present. (22%) regurgitated, presumably
Often the worm burden is low secondary to esophagitis induced
(typically 1 to 5 worms),1,9,10,22,23 by chronic vomiting.1,23
although one case report describes
a cat with 15 to 20 worms.9 In a CLINICAL DISEASE
recent review of 18 dogs with Dogs and cats of any age or
Physaloptera infection,1 all dogs breed can be infected with
had clinical signs of illness and Physaloptera species. The more
14 dogs had only one or two Figure 2—Endoscopic view of a Physaloptera nema- time animals spend outdoors,
tode in the gastric mucosa of a dog.
worms identified on endoscopic the more likely they are to become

INTERMEDIATE HOSTS ■ PARATENIC HOSTS ■ WORM BURDEN

Compendium April 1999 20TH ANNIVERSARY Small Animal/Exotics

infected. The most common one case report, a direct fecal

clinical sign is intermittent vom- smear from a dog revealed more
iting, 1,3,6,7,9–11,24 which can last Physaloptera eggs than did a sodi-
from a few weeks to many months. um nitrate flotation; this lends
Other clinical signs include diar- support to the theory that the
rhea, regurgitation, anorexia, eggs are too heavy to float in that
weight loss, melena, and lethar- particular flotation medium. 25
1,9,24,25
gy. Most patients maintain Animals may vomit worms that
a good appetite and a relatively can then be identified.3,8,24,27
1,10,20
normal energy level. Because Diagnosis of Physaloptera in-
the number of reports of clinical fection in many animals is made
disease in cats is small, it is diffi- via gastroduodenoscopy. On su-
cult to extrapolate data regarding perficial examination, adult worms
clinical signs. Based on case re- resemble ascarids. They are 1 to 6
ports, however, cats with Physa- cm in length (Figure 4), stout,
loptera infection may be more cream-colored to white, and
likely to experience diarrhea or Figure 3—Endoscopic view of the gastric mucosa of straight or coiled.1,5,6,8,9,11,28 There
melena.9,24 a dog demonstrating areas of multifocal erythema may be individual worms or clus-
Making a diagnosis of Physa- due to Physaloptera attachment and migration. ters of parasites.20 Worms may
loptera infection is difficult. Ma- embed in gastric or intestinal
ny owners do not realize that mucosa, making them difficult to
their pets are ingesting interme- see but helping to differentiate
diate hosts. Physical examina- them from ascarids.1,29 Visualiza-
tions are usually unremarkable. tion can be enhanced by clearing
Complete blood counts common- the stomach and duodenum of
ly are normal, but they may reveal material and distending the rugal
peripheral eosinophilia or anemia. folds so the entire surface area
Only 11% of 18 dogs with Physa- can be seen. Videoendoscopes
loptera infection had an elevated magnify the image and may im-
eosinophil count in one study.1 In Figure 4—Physaloptera nematode next to a 1-inch prove detection of worms (Figure
two case reports, one of three cats needle demonstrating the typically small size of 3). Worms should be removed for
with Physaloptera infection had an these parasites. identification.1,20
9,24
elevated eosinophil count. Two Gastric and duodenal mu-
case reports described mild ane- cosa may exhibit multifocal areas
mia in one dog and one cat with Physaloptera infec- of gross hemorrhage and increased granularity.1,9,10,20 If
24,25
tion. Serum chemistries, urinalysis, and abdominal ra- vomiting has caused esophagitis, the distal esophagus
diographs are routinely normal. may be erythematous and the lower esophageal sphinc-
Routine fecal flotation techniques often do not yield ter may be open.1 Mucosal biopsies should be per-
2,5,10,12,20,24
eggs. There is much speculation in the litera- formed to confirm the extent of inflammation regard-
ture as to why this is so. Some of the theories are that less of the visibility of gross lesions.20 Histopathology
adult worms do not produce large numbers of eggs, most commonly reveals mild to moderate lymphocyt-
there may be single-sex infections, nematodes may be ic–plasmacytic gastritis and/or enteritis (8 of 18 dogs in
immature and not producing eggs, the number of in- one study).1 Other findings include eosinophilic, neu-
fecting parasites is small, and the specific gravity of the trophilic, or catarrhal inflammation; glandular atrophy;
fecal flotation medium is too close to that of the eggs mucosal hemorrhage; and fibrosis. There may be no
and thus they do not float well.1,2,9,10,20,23 correlation between worm burden and the severity of
Because Physaloptera eggs are larvated, they may not mucosal lesions.1
float during fecal flotations. Eggs are small (30 to 34 ×
44 to 58 µm 5), round, and smooth and have thick TREATMENT
shells. Sodium dichromate flotation solution (specific Because Physaloptera infections are not commonly
gravity [SG] 1.36) is recommended over zinc sulfate recognized, studies addressing the efficacy of an-
(SG 1.18), magnesium sulfate (SG 1.25), sodium ni- thelmintics against this parasite have not been per-
trate (SG 1.25), or sugar (SG 1.23) solutions.9,23,26 In formed. Treatment information is extrapolated from

EOSINOPHILIA ■ FECAL FLOTATION ■ GASTRODUODENOSCOPY ■ HISTOPATHOLOGY

 Small Animal/Exotics 20TH ANNIVERSARY Compendium April 1999

case reports and studies in which Physaloptera infection
was an incidental finding. For example, the efficacy of
pyrantel pamoate against Physaloptera species in dogs
and cats was documented in a 1975 study examining
the anthelmintic’s effect on Uncinaria stenocephala and
Toxocara canis; oral pyrantel pamoate (5 mg/kg) dem-
onstrated 100% efficacy against Physaloptera species in
eight of eight infected dogs.14 Pyrantel pamoate was ef-
fective in two dogs in two case reports; the dose was
not given in one report, and 5 mg/kg was given and re-
peated in 2 weeks in the other.10,25 Recently, 15 dogs
each received 15 mg/kg with a repeated dose adminis-
tered 2 to 3 weeks later. Follow-up information was
available for 12 dogs: 10 (83%) had complete resolu-
tion of clinical signs whereas 2 (17%) continued to
vomit.1
Two case reports described apparent inefficacy of pyran-
tel pamoate in cats. One cat was diagnosed with Physa-
loptera infection despite prior treatment with an un-
known dose of pyrantel pamoate; the other cat did not
clear the infection following one 5-mg/kg dose but ap-
peared to clear it after two 5-mg/kg doses were given 2
weeks apart.9,24
Alternate anthelmintics
P ENDIU have been used to treat dogs
M
M’
over the past 14 years are summarized in Table I. Con-
trary to findings in previous studies, 52% of the dogs
in this group had multiple-worm infections whereas
35% had only one worm; worm burden in the remain-
ing 13% was unknown. In addition, 50% of worms
were immature; if worms can cause clinical disease be-
fore they are sufficiently mature to produce eggs, it may
explain why fecal flotations are so often negative. Lym-
phocytic–plasmacytic gastritis was not as common as
expected, and eosinophilic gastritis was more common
than expected. Duodenal pathology was surprisingly
common but was not often recognized grossly, thus
demonstrating the benefit of mucosal biopsies even
when tissues appear grossly normal.
All four anthelmintics used appeared to be effica-
cious against Physaloptera (Table I). However, higher
anthelmintic doses or longer treatment times may be
warranted based on previous studies; in addition,
some of these agents had previously been adminis-
tered to a few animals in this study, and these animals
were still harboring Physaloptera species. It is un-
known whether adjunctive therapy (e.g., antiinflam-
matory medications, histamine blockers, antiemetics)
is necessary, but based on mucosal biopsies it appears
to hasten healing and resolution of clinical signs. Be-

and cats. Fenbendazole (50 cause there is no tissue migratory larval stage, multiple
20th

CO

S

1 9 7
9 - 1
9 9 9 mg/kg for 3 days) cleared
ANNIVERSARY
A LookBack
The routine use of
gastroduodenoscopy for
determining the cause of
chronic vomiting has been a
great advancement in the
detection of Physaloptera
infections. The use of a
videoendoscope to magnify the
image enhances the sensitivity
of this diagnostic aid. Worms
attached to the gastric or
duodenal mucosa may be easily
visualized and removed for
identification. (Photo: Drs.
Campbell [left] and Graham.)
treatments are not necessary. If vomiting recurs within
clinical signs in two dogs, 56 days of anthelmintic administration, therapy was
one of which had also re- likely inadequate; if vomiting recurs after 56 days, re-
ceived metronidazole and
cimetidine. 1,20 Ivermectin
infection is likely. In either case, repeat treatment is
warranted.
given orally at 200 µg/kg to
two dogs1 and subcutane-
CONCLUSION
ously at 200 µg/kg to two
Physaloptera infection should be on the list of diag-
cats24 successfully resolved
nostic differentials for any animal with chronic vomit-
clinical signs. In a study as-
ing. It may also be considered in cats with chronic diar-
sessing the efficacy of le-
rhea. Animals should be treated with anthelmintics
vamisole in cats, all Physa-
accordingly. At Iowa State University, we recommend a
loptera species were expelled
trial course of 20 mg/kg of pyrantel pamoate for ani-
from two cats treated with
mals with chronic vomiting before they are anes-
8 mg/kg subcutaneously.16
thetized for gastroduodenoscopy and mucosal biopsies.
Studies have shown that
Physaloptera infections do not appear to be common,
oral milbemycin oxime (0.5
but for the small percent of animals infected, empiric
mg/kg in one dog) and oral
therapy with appropriate anthelmintics before addi-
diethylcarbamazine and
tional diagnostic tests are performed appears to be war-
oral oxibendazole (6.6
ranted.
mg/kg and 5 mg/kg, re-
spectively, in one dog) were
not effective.12,13 ACKNOWLEDGMENT
Details of Physaloptera The authors thank Drs. A.E. Jergens, O.L. Nelson,
infections in 29 dogs and and J. Ridgway, Department of Veterinary Clinical Sci-
6 cats diagnosed and treat- ences, Iowa State University, for contributions of case
ed at Iowa State University material.

PYRANTEL PAMOATE ■ ALTERNATE ANTHELMINTICS ■ ADJUNCTIVE THERAPY

 TABLE I
Summary of Physaloptera Infections in Dogs and Cats in Iowa (1985–1998)
Fecal Flotation
Clinical Signs Results
(duration)/Previous (flotation Eosinophil Method of Gastroduodenoscopy
Small Animal/Exotics

Signalment a Treatment medium) Count Diagnosis Findings Histopathology Treatment Outcome

3.25 M Vomiting – 1236 Gastroscopy Numerous NR Dichlorvos 30 Lost to

schnauzer (3 mo), (unknown) Physaloptera in mg/kg, repeated follow-up
9.0 kg hematemesis, stomach, multiple in 2 wk
weight loss/ gastric punctate
fenbendazole erosions

2.5 SF Intermittent – 633 Gastroduodenoscopy Numerous Normal gastric Pyrantel Clinical signs
miniature vomiting (1 (sodium nitrate) immature mucosa, pamoate 11 resolved
poodle 4.1 kg mo) Physaloptera, lymphocytic– mg/kg for 3
normal gastric and plasmacytic days, repeated
duodenal mucosa enteritis/fibrosis in 3 wk

3 CM golden Vomiting (2 – 486 Gastroscopy 1 Physaloptera in NR Dichlorvos 30 Clinical signs

retriever 29 kg mo, every (unknown) stomach, normal mg/kg resolved
meal)/prochlor- gastric mucosa
perazine and
isopropamide,b
20TH ANNIVERSARY

pyrantel
pamoate

1.5 M Great Postprandial – 608 Gastroscopy Multiple NR Dichlorvos 30 Clinical signs

Dane 46.8 kg vomiting (1 (unknown) Physaloptera in mg/kg resolved
mo) stomach,
roughened gastric
mucosa

0.5 F Labrador Vomiting (2 – 435 Gastroscopy Physaloptera Normal gastric Fenbendazole Clinical signs
retriever 27.3 wk), eructation (unknown) (unknown number) mucosa, 49 mg/kg for 3 resolved
kg in stomach, normal mucosal days, repeated
gastric mucosa bacteria in 3 wk

2 CM Postprandial – 1365/ Gastroscopy Immature Normal gastric Pyrantel Clinical signs

schnauzer vomiting (5 wk) (sugar 1050 Physaloptera mucosa pamoate 6.3 resolved
10.9 kg centrifugation) (unknown number) mg/kg for 6
days
Compendium April 1999
 TABLE I (continued)
3.5 F Samoyed Postprandial – 1206 Gastroscopy Physaloptera Normal gastric Fenbendazole Clinical signs
20 kg vomiting (6 wk) (sugar (unknown number) mucosa 50 mg/kg for resolved
centrifugation) in stomach, normal 3 days
gastric mucosa
Compendium April 1999

4 SF Labrador Postprandial – 2576 Gastroduodenoscopy 1 Physaloptera at Normal gastric Pyrantel Clinical signs
retriever 36.4 vomiting (1 (sodium proximal and duodenal pamoate 6.2 resolved
kg mo) nitrate) duodenum; leaves, mucosa mg/kg, repeated
twigs, and small in 2 wk
erosions in stomach

1.5 CM Great Vomiting (1–2 – 485 Gastroscopy, 1 Immature Mild gastric Pyrantel Clinical signs
Dane 48.8 kg mo), chronic (sodium colonoscopy Physaloptera in glandular pamoate 5 resolved
mixed-bowel nitrate) stomach (scope atrophy, normal mg/kg, repeated
diarrhea could not reach colonic mucosa in 2 wk;
duodenum) metoclopramide

2 SF fox terrier Postprandial – 656 Gastroduodenoscopy Multiple Moderate, Pyrantel Vomiting

8.6 kg vomiting (sodium Physaloptera in eosinophilic pamoate 10.5 continued for 1
(2–3 mo)/ nitrate) small intestine, gastritis; mild mg/kg; more wk, then
20TH ANNIVERSARY

fenbendazole multiple gastric chronic cimetidine resolved

erosions, increased lymphocytic–
mucosal friability plasmacytic
enteritis

6 CM Labrador Postprandial – 525 Gastroduodenoscopy Multiple immature Gastric Pyrantel Clinical signs
retriever 27.3 vomiting and/or (sodium Physaloptera in spirochetes, pamoate 5.5 resolved
kg regurgitation nitrate) proximal moderate mg/kg;
(1.5 mo) duodenum lymphocytic– metronidazole
plasmacytic
enteritis

4 SF beagle 15 Postprandial – 663 Gastroduodenoscopy 1 Physaloptera in Mild catarrhal Pyrantel Clinical signs
kg vomiting (every (sodium stomach gastritis, normal pamoate resolved
autumn) nitrate) duodenal 5 mg/kg,
mucosa repeated in
3 wk
Small Animal/Exotics
 TABLE I (continued)
Fecal Flotation
Clinical Signs Results
(duration)/ (flotation Eosinophil Method of Gastroduodenoscopy
Signalment a Previous Treatment medium) Count Diagnosis Findings Histopathology Treatment Outcome
Small Animal/Exotics

3 SF miniature Intermittent, NR 653 Gastroduodenoscopy 1 Immature Multifocal Pyrantel pamoate Clinical signs
pinscher 4.4 kg postprandial Physaloptera, lymphocytic 6.4 mg/kg, resolved
vomiting (1 yr) multiple erythemic gastritis with praziquantel 6.4
punctate lesions in multifocal mg/kg, febantel 32
gastric fundus hemorrhage, mg/kgb
moderate
lymphocytic–
plasmacytic
enteritis

5.5 SF mixed- Vomiting – 176 Gastroduodenoscopy Multiple (>10) Moderate Pyrantel pamoate Clinical signs
breed dog 9.7 (2 wk), (sodium Physaloptera in eosinophilic 20 mg/kg, repeated resolved
kg hematemesis nitrate) stomach, small gastritis, normal in 2 wk; sucralfate
punctate gastric duodenal
erosions mucosa

7.5 CM terrier Postprandial NR 497 Gastroduodenoscopy 1 Young adult Small gastric Pyrantel pamoate Clinical signs
20TH ANNIVERSARY

13.2 kg vomiting male Physaloptera mucosal 20 mg/kg, resolved for

(5 wk)/20 in duodenum, hemorrhages, repeated in 2 wk; 9 mo, then
mg/kg pyrantel multifocal linear moderate to prednisone; recurred;
pamoate duodenal erosions, severe diffuse metronidazole dewormer
increased duodenal plasmacytic was repeated;
granularity enteritis clinical signs
resolved

2 CM mixed- Vomiting (3 NR 516 Gastroduodenoscopy Physaloptera not Focal ulcerative, Pyrantel pamoate Cat vomited
breed cat 4.3 kg days, acute seen; diffusely purulent 8 mg/kg, the second
onset after hyperemic ulcerated gastritis, praziquantel 8 dose of the
ingesting gastric mucosa Physaloptera mg/kg, febantel 40 combination
aluminum foil) (cytology), mg/kgb; pyrantel product;
normal pamoate 20 mg/kg, vomiting
duodenal all repeated in 3 resolved
mucosa wk; cimetidine;
sucralfate
Compendium April 1999
 TABLE I (continued)

5 CM Postprandial – 354 Gastroduodenoscopy Numerous Moderate Pyrantel pamoate Clinical signs

miniature vomiting (2 mo) (sodium immature lymphocytic– 5 mg/kg; resolved
schnauzer nitrate) Physaloptera in plasmacytic metronidazole;
9.6 kg stomach, mildly gastroenteritis cimetidine;
erythematous gastric cisapride
Compendium April 1999

mucosa, moderate
duodenal granularity,
GE reflux and LES
dilation

0.5 F mixed- Vomiting (1 mo) – 1456 Gastroduodenoscopy Numerous Normal gastric Pyrantel pamoate Resolved after
breed dog (sodium immature mucosa, 10 mg/kg; three more
10 kg nitrate) Physaloptera in multifocal mild cimetidine episodes of
stomach, normal neutrophilic vomiting
intestinal mucosa enteritis

10 SF Vomiting (3 wk) NR 30 Gastroduodenoscopy Multiple immature Mild to Pyrantel pamoate Dog continues
Labrador Physaloptera in moderate 6.5 mg/kg, to need
retriever 36 stomach, gastric chronic repeated in 3 wk; prednisone
kg erosions and lymphocytic– metronidazole; to eliminate
increased granularity, plasmacytic prednisone vomiting
20TH ANNIVERSARY

granular duodenal gastroenteritis

mucosa

6.5 SF Vomiting (1 mo), – 7 Gastroduodenoscopy Large population Normal gastric Pyrantel pamoate Resolved after
Brittany weight loss (sodium of immature mucosa, mild 20 mg/kg, 2 more wk of
spaniel nitrate) Physaloptera plasmacytic repeated in 3 wk; vomiting
16.2 kg ARTICLE #1 CE TEST enteritis metronidazole
The article you have read qualifies for 1.5 con-
tact hours of Continuing Education Credit from
0.5 M Vomiting – the Auburn287 Gastroduodenoscopy
University 1 Immature
College of Veterinary Normal gastric Pyrantel pamoate Lost to
weimaraner and diarrhea (sodium and duodenal 22 mg/kg, follow-up
Medicine. Choose only the one best answer toPhysaloptera,
CE each
20.4 kg (2 wk)/jejunal nitrate) granular gastric and mucosa repeated in 3 wk;
of the following questions; then mark your an-
intussusception with duodenal mucosa, metronidazole
resection/anastomosis, swers on the test form inserted in Compendium.
PEG tube
dog licked Unicide (a placement
disinfectant used
to clean cages)
postoperatively
Small Animal/Exotics
 TABLE I (continued)
Fecal Flotation
Clinical Signs Results
(duration)/ (flotation Eosinophil Method of Gastroduodenoscopy
Signalment a Previous Treatment medium) Count Diagnosis Findings Histopathology Treatment Outcome
Small Animal/Exotics

3 F golden Anorexia, NR 0 Necropsy (multiple N/A Multiple N/A N/A

retriever vomiting, gastric Physaloptera, Physaloptera,
33.6 kg mixed-bowel lobular liver, icterus, submucosal
diarrhea (3 wk) GI hemorrhage) gastric edema,
intestinal
hemorrhage,
microhepatica
with fibrosis
and lipidosis
7 SF Labrador Vomiting NR 1032 Gastroduodenoscopy 1 Physaloptera at Eosinophilic Pyrantel Clinical signs
retriever 23.6 (7 mo) the pylorus, gastric gastritis pamoate 20 resolved
kg mucosa difficult to with fibrosis, mg/kg, repeated
biopsy moderate in 3 wk
lymphocytic–
plasmacytic
enteritis
0.5 CM Boston Vomiting (2 + 970 Fecal flotation, N/A N/A Fenbendazole 55 Clinical signs
20TH ANNIVERSARY

terrier 5 kg mo)/dichlorvos (sugar upper GI study mg/kg for 3 days, resolved

(5 mo centrifugation) (irregular mucosa repeated in 3 wk
previously) and filling defects)

6 F Labrador None noted NR 370 Examined submitted N/A N/A Pyrantel pamoate N/A
retriever 28.1 immature adult 16 mg/kg, repeated
kg worm in 3 wk

1 CM domestic Diarrhea (4 Adult male 384 Fecal examination N/A N/A Pyrantel pamoate Recurred
shorthair cat mo, waxed Physaloptera 9 mg/kg, repeated after 4 mo;
3.9 kg and waned in feces in 2 wk treated with
monthly), fenbendazole
vomiting 50 mg/kg for
3 days; lost to
follow-up

1 SF domestic Vomiting NR N/A Examination of N/A N/A Pyrantel Cat dewormed

shorthair cat vomitus pamoate 10 repeatedly;
3.5 kg mg/kg, repeated vomiting
in 3 wk resolved
Compendium April 1999
 TABLE I (continued)
1 M springer None noted + 864 Fecal flotation N/A N/A Fenbendazole N/A
spaniel 20 kg (sugar (Taenia and 55 mg/kg for
centrifugation) Ancylostoma) 3 days

0.75 M Small-bowel + 1062 Fecal flotation N/A N/A Pyrantel Lost to

domestic diarrhea (2 wk) (zinc sulfate pamoate 9.4 follow-up
Compendium April 1999

shorthair cat centrifugation) mg/kg

4.9 kg

0.5 F Shetland Poor growth, + 248 Fecal flotation N/A N/A Fenbendazole Lost to
sheepdog lethargy, (zinc sulfate 60 mg/kg for follow-up
4.2 kg vomiting, loose centrifugation) 3 days
stools, positive
for fecal fat

0.75 F beagle None— + N/A Fecal flotation N/A N/A Pyrantel N/A
10 kg routine physical (sugar pamoate 4.6
examination centrifugation) mg/kg

8 SF mixed- Vomiting NR N/A Necropsy (a dozen N/A No GI N/A N/A

breed dog 3.6 and/or Physaloptera in abnormalities
kg regurgitation pylorus, esophageal noted
(a few wk) foreign body)

1 M domestic Progressive NR N/A Necropsy (numerous N/A No GI N/A N/A

20TH ANNIVERSARY

shorthair cat dyspnea and Physaloptera in abnormalities

3.7 kg regurgitation, stomach) noted
megaesophagus
due to vascular
ring anomaly

9 SF domestic Depression, NR 624 Necropsy N/A No GI N/A N/A

shorthair catc anorexia, (Physaloptera abnormalities
diabetes [unknown number] noted
mellitus in stomach)

11 SF mixed- None— + N/A Fecal flotation N/A N/A NR N/A

breed dog 23.6 routine fecal (sugar (Toxocara, Eimeria,
kg examination centrifugation) Capillaria)
aAge (yr), sex (CM = castrated male; F = female; M = male; SF = spayed female), breed, weight.
bCombination product.
c Weight not recorded.

DSH = domestic shorthair; GE = gastroesophageal; GI = gastrointestinal; LES = lower esophageal sphincter; N/A = not applicable (unknown or test not performed); NR = not
reported, PEG = percutaneous endoscopic gastrostomy.
Small Animal/Exotics
Small Animal/Exotics 20TH ANNIVERSARY
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About the Authors
Drs. Campbell and Graham are affiliated with the Depart-
ment of Veterinary Clinical Sciences, Veterinary Teaching
Hospital, Iowa State University, Ames, Iowa.