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stomach was a concern. Several abdominal radiographs with contrast were performed. The radiographs were suspicious of an intestinal partial obstruction because the contrast material was not moving through her intestines. An abdominal exploratory was performed which revealed thickened loops of intestine containing small circular granulomas, and very enlarged abdominal lymph nodes. Because of most of the small intestine was involved, biopsies were taken as opposed to removing the diseased bowel. Histopathology revealed a granulomatous enteritis with Heterobilhazia americanum eggs present.
Heterobilharziasis is a rare infection of dogs mainly in the Southern Atlantic and Gulf Coast States. Animals such as raccoons and nutria can serve as a reservoir for the infection. The intermediate host is the fresh water snail. Infection is acquired by skin penetration of one stage of the parasites life cycle. The immature parasite remains in the skin for a few days and then migrate via the lungs through the bloodstream to the liver, where they mature and finally travel to the mesenteric vein in the abdomen. The eggs work there way from those veins through the intestinal wall and are eventually shed in the feces. This process causes significant inflammation in the bowels which leads to symptoms like vomiting and diarrhea. These eggs can not usually be found using normal fecal floatation methods and require a special technique. If left untreated, liver fibrosis and failure may ensue. Treatment involves Praziquantel, a drug usually used to treat tapeworms, but at ten times the dosage for tapeworms.
Sandy recovered normally and post treatment, her vomiting had ceased. We continue to run periodic fecal floatations to monitor her therapy.
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