Abstract
Angiostrongylosis is a crucial differential diagnosis in any dog with respiratory, bleeding, neurological, or syncopal signs of unknown etiology in endemic areas. Many cases of angiostrongylosis have a fatal outcome; subclinical angiostrongylosis also has been reported. The most common method for supporting diagnosis of angiostrongylosis has been identification of Angiostrongylus vasorum first stage larvae in the feces by the Baermann-Wetzel method. Although considered as gold standard, this method has technical and sampling challenges and cannot detect infections during prepatency or in case of intermittent shedding of the larvae. A rapid in-clinic antigen test has been developed for serologic detection of A. vasorum infections using blood samples (Angio Detect™, IDEXX Laboratories Inc., Westbrook, Maine, USA). The study reported here was conducted to determine diagnostic sensitivity and specificity of the Angio Detect test kit by comparing Angio Detect testing results using serum or plasma samples with the results of Baermann-Wetzel testing using matched fecal samples. Samples from 214 dogs [with clinically suspected (N=195) or diagnosed angiostrongylosis (N=19)] were used for this evaluation. Baermann-Wetzel testing was performed independently at commercial reference laboratories or at university hospitals. All serum/plasma samples were blinded and randomized before testing with Angio Detect. The Angio Detect test was positive for 34 of the 35 cases found positive by the Baermann-Wetzel method; sensitivity of the Angio Detect test was 97.1% (95%CI: 85.1%-99.9%). The Angio Detect test was negative for 177 of 179 samples that were negative by the Baermann-Wetzel test; specificity was 98.9% (95%CI: 96.0%-99.9%). In cross-reactivity testing, all 89 samples from dogs confirmed to be infected with other common nematodes (Dirofilaria immitis, D. repens, Crenosoma vulpis, hookworms, ascarids, or whipworms) were all negative for A. vasorum by the Angio Detect antigen test. Angio Detect provides a rapid and reliable method for diagnosis of A. vasorum in clinically suspected dogs at risk for infection. The test requires minimal steps by the operator and provides results in 15min, allowing the clinician to initiate treatment for positive dogs before leaving the clinic.