# Lungworm in Dogs: Angiostrongylus and Oslerus Diagnosis Guide


## Key Takeaways

- Canine lungworm infections, primarily by *Angiostrongylus vasorum* and *Oslerus osleri*, present with diverse clinical signs including chronic cough, respiratory distress, and bleeding disorders (*A. vasorum*), while *Angiostrongylus cantonensis* causes neurological signs due to larval migration in the central nervous system.
- Diagnosis is challenging due to variable clinical signs and limitations of standard faecal flotation; key diagnostic modalities include the Baermann technique for *A. vasorum* L1 larvae, antigen ELISA for *A. vasorum*, CSF analysis and qPCR/LAMP for *A. cantonensis*, and bronchoscopy with BAL cytology/PCR for *O. osleri*.
- *Angiostrongylus vasorum* is transmitted via ingestion of infected gastropods (slugs/snails), with dogs as definitive hosts, while *A. cantonensis* is zoonotic, with rats as definitive hosts and dogs as dead-end hosts, infected by ingesting molluscs. *Oslerus osleri* has a direct life cycle with L1 larvae passed in faeces, leading to kennel-associated transmission.
- Treatment for lungworm infections involves specific antiparasitic drugs such as fenbendazole and macrocyclic lactones (e.g., moxidectin, milbemycin oxime), with supportive care often required for severe cases, particularly those with neurological or coagulopathic complications.
- Prevention strategies focus on minimizing exposure to intermediate hosts (slugs and snails) and utilizing prophylactic anthelmintics, with some monthly heartworm preventatives offering protection against *A. vasorum* but not necessarily all lungworm species.

---

If your [dog](/knowledge/veterinary-medicine/clinical-methods/dog) has a persistent cough, unexplained bleeding, or sudden neurological signs, lungworm infection should be on your veterinarian's diagnostic list. Lungworms are parasitic nematodes that live in the airways, pulmonary arteries, or heart of dogs. The three most clinically relevant genera are *Angiostrongylus* (including *A. vasorum* and *A. cantonensis*), *Oslerus* (specifically *O. osleri*), and *Crenosoma* (the fox lungworm). While *Crenosoma vulpis* is a common cause of chronic cough in dogs, this guide focuses on the diagnostic approach for *Angiostrongylus* and *Oslerus* infections, which present unique challenges due to their varied clinical signs and the limitations of standard faecal testing [<a href="#ref-1">1</a>][<a href="#ref-2">2</a>][<a href="#ref-3">3</a>].

**Owner Triage Summary:** If your dog is coughing persistently, especially if the cough worsens with exercise or excitement, or if you notice bleeding (nosebleeds, blood in the urine, bruising) or neurological signs (weakness, wobbliness, seizures), contact your veterinarian immediately. Lungworm infections can be life-threatening, but they are treatable when diagnosed early. Do not attempt any home remedies; some can be harmful, and effective treatment requires prescription antiparasitic drugs [<a href="#ref-1">1</a>][<a href="#ref-2">2</a>][<a href="#ref-4">4</a>].

## At a Glance: Key Features of Canine Lungworms

| Feature | *[Angiostrongylus vasorum](/knowledge/parasites/pet-parasites/angiostrongylus-vasorum)* (French Heartworm) | *Angiostrongylus cantonensis* (Rat Lungworm) | *Oslerus osleri* (Tracheal Worm) |
| :--- | :--- | :--- | :--- |
| **Primary Location in Dog** | Pulmonary arteries & right heart | Central nervous system (CNS) | Trachea & bronchi (submucosal nodules) |
| **Definitive Host** | Canids (foxes, dogs, wolves) [<a href="#ref-1">1</a>][<a href="#ref-5">5</a>] | Rats (rodents) [<a href="#ref-6">6</a>][<a href="#ref-7">7</a>][<a href="#ref-8">8</a>] | Canids (dogs, foxes, wolves) [<a href="#ref-3">3</a>] |
| **Accidental Host (Dog)** | Yes (a primary host) | Yes (dead-end host) [<a href="#ref-6">6</a>][<a href="#ref-7">7</a>] | Yes (a primary host) |
| **Typical Clinical Signs** | Respiratory distress, cough, bleeding disorders, non-specific signs [<a href="#ref-1">1</a>][<a href="#ref-2">2</a>] | Eosinophilic meningitis: neurological signs (wobbliness, paralysis, seizures), fever [<a href="#ref-6">6</a>][<a href="#ref-4">4</a>] | Chronic productive cough, often in young dogs (< 2 years) [<a href="#ref-3">3</a>][<a href="#ref-9">9</a>] |
| **Key Diagnostic Test** | Faecal Baermann, antigen ELISA, qPCR on faeces [<a href="#ref-1">1</a>][<a href="#ref-10">10</a>] | CSF analysis (eosinophilic pleocytosis), qPCR/LAMP on CSF [<a href="#ref-6">6</a>][<a href="#ref-4">4</a>] | Bronchoscopy & BAL cytology, biopsy histopathology, PCR [<a href="#ref-3">3</a>][<a href="#ref-9">9</a>] |
| **Geographic Hotspots** | Europe (endemic), South America, North America (expanding) [<a href="#ref-1">1</a>][<a href="#ref-2">2</a>][<a href="#ref-11">11</a>] | Hawaii, Southeast Asia, Australia, southern US, Brazil [<a href="#ref-6">6</a>][<a href="#ref-4">4</a>][<a href="#ref-12">12</a>] | Worldwide, but sporadic; often associated with kennels [<a href="#ref-3">3</a>] |

## Understanding the Parasites: Biology and Life Cycle

To diagnose these infections effectively, it is crucial to understand their unique life cycles and the reasons they cause disease.

### *Angiostrongylus vasorum*: The French Heartworm

*A. vasorum* is a metastrongyloid nematode that resides in the pulmonary arteries and the right side of the heart of canids [<a href="#ref-2">2</a>][<a href="#ref-5">5</a>]. The adult worms produce eggs that hatch in the lungs, releasing first-stage larvae (L1). These L1 larvae are coughed up, swallowed, and passed in the faeces. They then infect terrestrial gastropods (slugs and snails), which act as intermediate hosts. Dogs become infected by ingesting an infected slug or snail [<a href="#ref-1">1</a>][<a href="#ref-11">11</a>]. The larvae migrate from the gut to the liver and then to the pulmonary arteries, where they mature into adults [<a href="#ref-2">2</a>]. This parasite is a significant cause of morbidity and mortality in dogs, and its distribution is expanding across Europe and into new regions [<a href="#ref-1">1</a>][<a href="#ref-11">11</a>][<a href="#ref-13">13</a>]. The clinical presentation can be highly variable, ranging from a mild cough to severe, fatal cardiopulmonary disease and coagulopathies (bleeding disorders) [<a href="#ref-1">1</a>][<a href="#ref-2">2</a>].

### *Angiostrongylus cantonensis*: The Rat Lungworm

*A. cantonensis* is the rat lungworm, a zoonotic parasite that causes eosinophilic meningitis in accidental hosts, including dogs and humans [<a href="#ref-6">6</a>][<a href="#ref-7">7</a>][<a href="#ref-8">8</a>]. In its natural life cycle, the parasite lives in the pulmonary arteries of rats. L1 larvae are passed in rat faeces and ingested by molluscs (snails and slugs). Dogs become infected by ingesting infected gastropods or potentially by consuming water contaminated with L3 larvae that have emerged from dead snails [<a href="#ref-8">8</a>]. In dogs, the L3 larvae migrate to the central nervous system (CNS) and cause severe inflammation, known as canine neural angiostrongyliasis (CNA) [<a href="#ref-6">6</a>][<a href="#ref-4">4</a>]. Unlike *A. vasorum*, the dog is a dead-end host for *A. cantonensis*, meaning the parasite cannot complete its life cycle in the dog [<a href="#ref-6">6</a>]. The clinical signs are primarily neurological and can be severe [<a href="#ref-6">6</a>][<a href="#ref-4">4</a>][<a href="#ref-12">12</a>]. Research has identified different strains (haplotypes) of *A. cantonensis*, with some, like haplotype Ac13 in Australia, being implicated in more clinical cases in dogs, possibly due to increased virulence [<a href="#ref-7">7</a>].

### *Oslerus osleri*: The Tracheal Worm

*O. osleri* is a nematode that lives in nodules within the submucosa of the trachea and major bronchi [<a href="#ref-3">3</a>][<a href="#ref-9">9</a>]. These nodules contain adult worms and can cause significant airway obstruction and inflammation. The life cycle is direct; L1 larvae are passed in the faeces of infected dogs and are infective to other dogs upon ingestion. This direct transmission means that *O. osleri* is often seen in kennel environments or in young dogs from the same litter [<a href="#ref-3">3</a>]. The parasite is found worldwide but is considered sporadic. Diagnosis is often delayed because faecal examinations are frequently negative, as the L1 larvae are shed intermittently and may not be detected with routine flotation methods [<a href="#ref-3">3</a>][<a href="#ref-9">9</a>].

## Clinical Signs and Differential Diagnoses

The clinical signs of lungworm infection vary significantly depending on the parasite species involved.

### Respiratory Signs (Common to All)

- **Chronic cough:** This is the most common presenting sign for *A. vasorum* and *O. osleri* [<a href="#ref-1">1</a>][<a href="#ref-2">2</a>][<a href="#ref-3">3</a>][<a href="#ref-9">9</a>]. The cough may be soft, dry, or productive.
- **Respiratory distress:** Difficulty breathing, tachypnoea (rapid breathing), and exercise intolerance are common, especially with *A. vasorum* [<a href="#ref-1">1</a>][<a href="#ref-2">2</a>].
- **Other respiratory signs:** Nasal discharge, sneezing, and wheezing can also be observed.

### Bleeding Disorders (More Specific to *A. vasorum*)

*A. vasorum* infection can cause a coagulopathy, leading to a range of bleeding signs [<a href="#ref-1">1</a>][<a href="#ref-2">2</a>]. These can include:
- Epistaxis (nosebleeds)
- Petechiae or ecchymoses (small or large bruises)
- Haemoptysis (coughing up blood)
- Melena (digested blood in faeces)
- Prolonged bleeding from minor wounds

### Neurological Signs (Specific to *A. cantonensis*)

Infection with *A. cantonensis* primarily manifests as neurological disease due to larval migration in the CNS [<a href="#ref-6">6</a>][<a href="#ref-4">4</a>][<a href="#ref-12">12</a>]. Signs can include:
- Ataxia (wobbliness, incoordination)
- Pelvic limb weakness or paralysis
- Head tilt
- Circling
- Seizures
- Depression or altered mentation [<a href="#ref-14">14</a>]

### Differential Diagnoses

The clinical signs of lungworm infection overlap with many other common canine diseases. A thorough diagnostic workup is essential to rule out other causes.

| Clinical Sign | Differential Diagnoses |
| :--- | :--- |
| **Chronic Cough** | Infectious tracheobronchitis (kennel cough), collapsing trachea, chronic bronchitis, heart disease (e.g., mitral valve disease), other parasites (e.g., *Crenosoma vulpis*), neoplasia (lung cancer) [<a href="#ref-15">15</a>] |
| **Bleeding Disorders** | Rodenticide (rat poison) toxicity, immune-mediated thrombocytopenia, von Willebrand disease, other coagulopathies |
| **Neurological Signs** | Canine distemper virus, other causes of meningitis (bacterial, fungal, immune-mediated), brain tumours, toxins, idiopathic epilepsy [<a href="#ref-14">14</a>] |

## Veterinary Examination and Diagnostic Approach

A definitive diagnosis of lungworm requires a combination of clinical suspicion, signalment, and specific laboratory tests. The diagnostic plan will be tailored based on the suspected parasite and the clinical presentation.

### Initial Assessment and Signalment

- **History:** A detailed history is crucial. Questions about the dog's lifestyle (e.g., access to snails/slugs, hunting behaviour, kennel history), travel history, and onset and progression of clinical signs are important.
- **Physical Examination:** A full physical exam will assess body condition, heart rate, respiratory rate and effort, lung sounds (e.g., crackles, wheezes), and neurological function. The presence of a cough elicited on tracheal palpation is a common finding, particularly with *O. osleri* [<a href="#ref-9">9</a>].
- **Signalment:** *O. osleri* is most commonly diagnosed in dogs under two years of age [<a href="#ref-3">3</a>][<a href="#ref-9">9</a>]. *A. vasorum* and *A. cantonensis* can affect dogs of any age, but young to middle-aged dogs are often overrepresented.

### Faecal Diagnostics

Faecal examination is a cornerstone of lungworm diagnosis, but it has significant limitations.

- **Baermann Technique:** This is the test of choice for detecting L1 larvae of *A. vasorum* and *Crenosoma vulpis* in faeces [<a href="#ref-1">1</a>][<a href="#ref-10">10</a>]. It relies on the active migration of larvae out of the faecal sample into water. It is more sensitive than simple faecal flotation for these parasites. However, larval shedding can be intermittent, so repeated samples over several days may be needed.
- **Faecal Flotation:** Standard centrifugal flotation can sometimes detect L1 larvae, but it is less reliable than the Baermann technique [<a href="#ref-10">10</a>]. It may also detect spurious parasites (parasites from prey animals that are not infective to the dog), which can complicate interpretation [<a href="#ref-16">16</a>]. For *O. osleri*, faecal flotation is often negative, making it an unreliable diagnostic method [<a href="#ref-3">3</a>].
- **Limitations:** Faecal tests are not useful for diagnosing *A. cantonensis* infection in dogs, as the parasite does not reach the lungs to shed larvae in this dead-end host [<a href="#ref-6">6</a>][<a href="#ref-4">4</a>]. Furthermore, a negative faecal test does not rule out lungworm infection.

### Blood Tests (Serology and Haematology)

Blood tests can provide supportive evidence and, in some cases, a definitive diagnosis.

- **Haematology and Biochemistry:** A complete blood count (CBC) may reveal eosinophilia (increased eosinophils), though this is not always present. Biochemistry may show changes indicative of organ damage (e.g., liver enzymes, kidney values).
- **Antigen and Antibody ELISA for *A. vasorum*:** Commercial ELISAs are available to detect circulating *A. vasorum* antigen (indicating active infection) and antibodies (indicating exposure) [<a href="#ref-1">1</a>]. These tests are highly useful, with reported sensitivities and specificities of 95.7% and 94.0% for the antigen test, and 81.0% and 98.8% for the antibody test, respectively [<a href="#ref-1">1</a>]. A positive antigen test confirms active infection, while a positive antibody test indicates the dog has been exposed to the parasite.
- **PCR on Peripheral Blood for *A. cantonensis*:** Research has shown that *A. cantonensis* DNA can be detected in the peripheral blood of infected animals using real-time PCR [<a href="#ref-12">12</a>]. This offers a less invasive alternative to CSF collection, which requires a lumbar puncture. While promising, this test may not be as sensitive as CSF analysis and is not yet widely available [<a href="#ref-12">12</a>].

### Advanced Diagnostics

For a definitive diagnosis, especially in cases where faecal and blood tests are inconclusive, more advanced procedures are necessary.

#### Bronchoscopy and Bronchoalveolar Lavage (BAL)

Bronchoscopy allows direct visualisation of the airways. This is particularly valuable for diagnosing *O. osleri*, where characteristic nodules can be seen protruding into the tracheal or bronchial lumen [<a href="#ref-3">3</a>][<a href="#ref-9">9</a>]. A BAL is performed during bronchoscopy to collect fluid and cells from the lower airways.

- **Cytology:** Cytological examination of BAL fluid can reveal parasitic larvae, eggs, and inflammatory cells (e.g., eosinophils, neutrophils) [<a href="#ref-3">3</a>][<a href="#ref-15">15</a>]. For *O. osleri*, larvae can be identified in BAL cytology, but differentiating them from other similar parasites like *Filaroides hirthi* can be challenging [<a href="#ref-3">3</a>].
- **Molecular Testing:** DNA can be extracted from BAL fluid or from cells collected on stained slides. PCR and sequencing can then be used to definitively identify the parasite species [<a href="#ref-3">3</a>][<a href="#ref-15">15</a>]. This is especially useful for confirming *O. osleri* infection [<a href="#ref-3">3</a>].

#### Cerebrospinal Fluid (CSF) Analysis

If *A. cantonensis* is suspected based on neurological signs, a CSF tap (lumbar puncture) is the diagnostic test of choice.

- **CSF Analysis:** CSF from affected dogs typically shows a marked eosinophilic pleocytosis (increased numbers of eosinophils in the CSF) [<a href="#ref-6">6</a>][<a href="#ref-4">4</a>]. This finding is highly suggestive of neuroangiostrongyliasis.
- **Molecular Testing on CSF:** Real-time PCR (qPCR) and, more recently, Loop-mediated Isothermal Amplification (LAMP) assays can detect *A. cantonensis* DNA in CSF [<a href="#ref-6">6</a>][<a href="#ref-4">4</a>]. These tests provide a definitive diagnosis and can differentiate between *A. cantonensis* and the closely related *A. mackerrasae*, which co-exists in parts of Australia [<a href="#ref-4">4</a>]. The LAMP assay (Angie-LAMP) offers a rapid, sensitive, and accessible alternative to qPCR, which is not always available [<a href="#ref-6">6</a>].

#### Imaging

- **Thoracic Radiographs (X-rays):** Radiographs are useful for evaluating the lungs and heart. In *A. vasorum* infection, a diffuse interstitial or bronchial pattern is common, and in severe cases, pulmonary consolidation or effusion may be seen [<a href="#ref-2">2</a>]. In *O. osleri* infection, radiographs may show nodular densities in the tracheal or bronchial walls, though these can be subtle [<a href="#ref-9">9</a>].
- **Computed Tomography (CT):** CT provides a more detailed view of the airways and lung parenchyma. In *O. osleri* infection, CT can clearly identify the characteristic airway mural nodules, which aids in diagnosis and surgical planning if needed [<a href="#ref-9">9</a>].

## Evidence-Based Management and Treatment

Treatment for lungworm infection must be prescribed by a veterinarian. The specific drug and duration of treatment depend on the parasite species involved and the severity of the disease.

### Treatment of *Angiostrongylus vasorum*

The goal of treatment is to eliminate the adult worms and L1 larvae. Several antiparasitic drugs are effective.

- **Fenbendazole:** This is a common and effective treatment. A typical protocol is 50 mg/kg orally once daily for 7 to 21 days [<a href="#ref-15">15</a>].
- **Macrocyclic Lactones:** Drugs like moxidectin and milbemycin oxime are also highly effective against *A. vasorum*. A single oral administration of a chewable formulation containing fluralaner, moxidectin, and pyrantel (BRAVECTO TriUNO) has been shown to be highly effective (99.0%) in preventing the establishment of infection and treating existing infections [<a href="#ref-17">17</a>]. This offers a convenient single-dose option for both treatment and prevention [<a href="#ref-17">17</a>].
- **Supportive Care:** Dogs with severe respiratory distress or bleeding disorders may require hospitalisation, oxygen therapy, and supportive care. Corticosteroids may be used to reduce inflammation, but their use should be carefully considered.

### Treatment of *Angiostrongylus cantonensis*

Treatment of CNA is challenging and aims to kill the migrating larvae in the CNS while managing the severe inflammatory response.

- **Anthelmintics:** Fenbendazole and macrocyclic lactones (e.g., milbemycin, moxidectin) are commonly used, but the optimal protocol is not well-established. The goal is to kill the larvae slowly to avoid a massive inflammatory reaction.
- **Corticosteroids:** Anti-inflammatory doses of corticosteroids (e.g., prednisone) are often used concurrently to reduce CNS inflammation and swelling, which can be life-threatening. This is a critical component of therapy.
- **Prognosis:** The prognosis is guarded, especially in severe cases. Early diagnosis and aggressive treatment improve the chances of recovery [<a href="#ref-12">12</a>].

### Treatment of *Oslerus osleri*

Treatment aims to eliminate the adult worms within the tracheal nodules.

- **Fenbendazole:** This is the most commonly recommended treatment. A protocol of 50 mg/kg orally once daily for 14 to 26 days has been shown to be effective [<a href="#ref-15">15</a>][<a href="#ref-9">9</a>]. Longer courses may be needed in some cases.
- **Macrocyclic Lactones:** Milbemycin oxime and other macrocyclic lactones have also been used successfully.
- **Follow-up:** Repeat bronchoscopy may be recommended to confirm resolution of the nodules, especially in severe cases [<a href="#ref-9">9</a>]. Clinical signs typically resolve within weeks of starting treatment [<a href="#ref-9">9</a>].

### Unsafe Home Remedies

There are no safe or effective home remedies for lungworm infection. Over-the-counter dewormers are not effective against these parasites. Giving human medications or unproven natural remedies can be toxic and delay appropriate veterinary care, leading to a worse outcome. Always consult your veterinarian for a proper diagnosis and treatment plan.

## Prevention and Control

Prevention strategies focus on reducing the dog's exposure to infective larvae and, where appropriate, using prophylactic medications.

- **Reduce Exposure to Intermediate Hosts:** Limit your dog's access to slugs and snails. This can be achieved by:
    - Removing potential habitats from the yard (e.g., piles of wood, stones, or leaves).
    - Supervising dogs when they are outdoors, especially in damp, vegetated areas.
    - Preventing coprophagy (eating faeces), which can be a source of infection for some parasites [<a href="#ref-16">16</a>].
- **Water Safety:** For *A. cantonensis*, be aware that infective larvae can emerge from dead snails into water [<a href="#ref-8">8</a>]. Ensure dogs do not drink from stagnant puddles or bowls left outside that may contain snails.
- **Prophylactic Anthelmintics:** In endemic areas, regular use of antiparasitic drugs that are effective against lungworms may be recommended by your veterinarian. For example, the fluralaner/moxidectin/pyrantel combination has been shown to be effective for the prevention of *A. vasorum* infection [<a href="#ref-17">17</a>]. Monthly heartworm preventives that contain moxidectin or milbemycin may also offer some protection against *A. vasorum*.

## Prognosis

The prognosis for lungworm infection depends on the parasite species and the severity of the disease at the time of diagnosis.

- ***A. vasorum*:** With prompt and appropriate treatment, the prognosis is generally good to excellent. Most dogs recover fully. However, severe cases with significant bleeding disorders or respiratory failure have a more guarded prognosis [<a href="#ref-2">2</a>].
- ***A. cantonensis*:** The prognosis is more variable and depends on the severity of neurological signs. Mildly affected dogs can recover fully with treatment, but severe cases can be fatal or result in permanent neurological deficits [<a href="#ref-6">6</a>][<a href="#ref-4">4</a>][<a href="#ref-12">12</a>].
- ***O. osleri*:** The prognosis is generally good with treatment. Clinical signs usually resolve, and recurrence is uncommon if the full course of treatment is completed [<a href="#ref-9">9</a>].

## Limitations and When to Contact a Veterinarian

This article provides a comprehensive overview of lungworm diagnosis in dogs, but it cannot replace a professional veterinary consultation. The information presented here is educational and is not a substitute for veterinary diagnosis or treatment.

**This article cannot predict the specific risk or outcome for your individual dog.** Breed, age, lifestyle, and geographic location all influence the risk of exposure and the severity of disease. Only a veterinarian can perform the necessary tests to determine if your dog has a lungworm infection and prescribe the appropriate treatment.

**Contact your veterinarian immediately if you observe any of the following red flags:**
- A persistent cough that lasts more than a few days.
- Difficulty breathing or rapid, laboured breathing.
- Any signs of bleeding, including nosebleeds, bruising, or blood in the faeces or urine.
- Any neurological signs, such as incoordination, weakness, head tilt, circling, or seizures.
- Lethargy, loss of appetite, or weight loss.

Early diagnosis and treatment are key to a successful outcome.

## Frequently Asked Questions

### Can I get lungworm from my dog?
No, you cannot get *Angiostrongylus vasorum* or *Oslerus osleri* directly from your dog. However, *Angiostrongylus cantonensis* (rat lungworm) is a zoonotic parasite, meaning humans can become infected by ingesting infected snails or slugs, not from direct contact with an infected dog [<a href="#ref-6">6</a>][<a href="#ref-8">8</a>].

### How often should I test my dog for lungworm?
There is no single universal recommendation. Your veterinarian may recommend annual or more frequent testing based on your dog's risk factors, such as lifestyle (hunting, scavenging), geographic location, and whether they are on a preventive medication that covers lungworms. In endemic areas, routine screening may be advised [<a href="#ref-13">13</a>].

### Is a negative faecal test enough to rule out lungworm?
No. A single negative faecal test, even with the Baermann technique, does not rule out lungworm infection. Larval shedding can be intermittent, and for *O. osleri* and *A. cantonensis*, faecal tests are often negative or not useful [<a href="#ref-6">6</a>][<a href="#ref-3">3</a>]. Your veterinarian may recommend repeat testing or more advanced diagnostics like blood tests, bronchoscopy, or CSF analysis.

### What is the difference between heartworm and lungworm?
Heartworm (*Dirofilaria immitis*) is a different parasite that lives in the heart and major blood vessels of the lungs. It is transmitted by mosquitoes. Lungworms, such as *A. vasorum*, are transmitted by slugs and snails. While both can cause respiratory and cardiac signs, they require different diagnostic tests and preventive medications. Some monthly preventives cover both parasites.

### My dog is on a monthly heartworm preventive. Is he protected against lungworm?
Some monthly heartworm preventives that contain moxidectin or milbemycin oxime also provide protection against *A. vasorum*. However, not all heartworm preventives are effective against all lungworm species. For example, they may not protect against *O. osleri* or *A. cantonensis*. Check with your veterinarian to confirm the spectrum of protection for your dog's specific medication [<a href="#ref-17">17</a>].

### What should I do if I see my dog eating a snail or slug?
Do not panic, but be observant. A single exposure does not guarantee infection. Contact your veterinarian to discuss the risk and whether a preventive dose of medication or monitoring is appropriate. In areas where *A. cantonensis* is endemic, this is especially important.

### How long does it take for a dog to show signs after eating an infected snail?
The pre-patent period (time from infection to the appearance of larvae in faeces) for *A. vasorum* is about 5 to 7 weeks. Clinical signs can appear before this, as the larvae migrate and cause damage. For *A. cantonensis*, neurological signs can appear within 1 to 3 weeks after infection. For *O. osleri*, the pre-patent period is longer, around 10 to 18 weeks.

### Can lungworm be cured?
Yes, lungworm infections are curable with appropriate veterinary treatment. The success rate is high, especially when the disease is diagnosed early. Treatment typically involves a course of prescription anthelmintic medication, and in some cases, supportive care. The prognosis is generally good for *A. vasorum* and *O. osleri*, and guarded to good for *A. cantonensis*, depending on the severity of neurological signs [<a href="#ref-9">9</a>][<a href="#ref-17">17</a>].


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        "@type": "Answer",
        "text": "Do not panic, but be observant. A single exposure does not guarantee infection. Contact your veterinarian to discuss the risk and whether a preventive dose of medication or monitoring is appropriate."
      }
    },
    {
      "@type": "Question",
      "name": "How long does it take for a dog to show signs after eating an infected snail?",
      "acceptedAnswer": {
        "@type": "Answer",
        "text": "The pre-patent period for Angiostrongylus vasorum is about 5 to 7 weeks. For Angiostrongylus cantonensis, neurological signs can appear within 1 to 3 weeks after infection. For Oslerus osleri, the pre-patent period is longer, around 10 to 18 weeks."
      }
    },
    {
      "@type": "Question",
      "name": "Can lungworm be cured?",
      "acceptedAnswer": {
        "@type": "Answer",
        "text": "Yes, lungworm infections are curable with appropriate veterinary treatment. The success rate is high, especially when the disease is diagnosed early. Treatment typically involves a course of prescription anthelmintic medication."
      }
    }
  ]
}
</script>

## Sources

<a id="ref-1"></a>[<a href="#ref-1">1</a>] [Serological and faecal detection of Angiostrongylus vasorum in dogs from Austria.](https://pubmed.ncbi.nlm.nih.gov/34879952/)

<a id="ref-2"></a>[<a href="#ref-2">2</a>] [Is the Angiostrongylus vasorum infection in domestic dogs underestimated or misdiagnosed? A comprehensive presentation of four lethal cases.](https://pubmed.ncbi.nlm.nih.gov/37275619/)

<a id="ref-3"></a>[<a href="#ref-3">3</a>] [Diagnostic Investigation of Two Cases of Oslerus osleri Infection in Dogs: Microscopic Challenges and Molecular Characterisation.](https://pubmed.ncbi.nlm.nih.gov/42053983/)

<a id="ref-4"></a>[<a href="#ref-4">4</a>] [Using cerebrospinal fluid to confirm Angiostrongylus cantonensis as the cause of canine neuroangiostrongyliasis in Australia where A. cantonensis and Angiostrongylus mackerrasae co-exist.](https://pubmed.ncbi.nlm.nih.gov/35284889/)

<a id="ref-5"></a>[<a href="#ref-5">5</a>] [First report of Angiostrongylus vasorum in an African golden wolf (Canis lupaster) in Algeria.](https://pubmed.ncbi.nlm.nih.gov/39468624/)

<a id="ref-6"></a>[<a href="#ref-6">6</a>] [Angie-LAMP for diagnosis of human eosinophilic meningitis using dog as proxy: A LAMP assay for Angiostrongylus cantonensis DNA in cerebrospinal fluid.](https://pubmed.ncbi.nlm.nih.gov/37126515/)

<a id="ref-7"></a>[<a href="#ref-7">7</a>] [Isolate-specific rat brain transcriptional responses to rat lungworm (Angiostrongylus cantonensis).](https://pubmed.ncbi.nlm.nih.gov/39971741/)

<a id="ref-8"></a>[<a href="#ref-8">8</a>] [Rat lungworm (Angiostrongylus cantonensis) active larval emergence from deceased bubble pond snails (Bullastra lessoni) into water.](https://pubmed.ncbi.nlm.nih.gov/37232239/)

<a id="ref-9"></a>[<a href="#ref-9">9</a>] [Computed tomographic and bronchoscopic diagnosis of Oslerus osleri infection in a dog.](https://pubmed.ncbi.nlm.nih.gov/37798816/)

<a id="ref-10"></a>[<a href="#ref-10">10</a>] [A Taq-Man-based multiplex quantitative PCR for the simultaneous detection and quantification of Angiostrongylus vasorum, Crenosoma vulpis, and species of respiratory capillarids in canids.](https://pubmed.ncbi.nlm.nih.gov/38097033/)

<a id="ref-11"></a>[<a href="#ref-11">11</a>] [Re-Evaluation of a Hyperendemic Focus of Metastrongyloid Lungworm Infections in Gastropod Intermediate Hosts in Southern Germany.](https://pubmed.ncbi.nlm.nih.gov/40872310/)

<a id="ref-12"></a>[<a href="#ref-12">12</a>] [Detection of rat lungworm (Angiostrongylus cantonensis) infection by real-time PCR from the peripheral blood of animals: a preliminary study.](https://pubmed.ncbi.nlm.nih.gov/38862687/)

<a id="ref-13"></a>[<a href="#ref-13">13</a>] [Epidemiological Mapping of Canine Angiostrongylosis in Portugal: Findings from a Nationwide Prevalence Survey.](https://pubmed.ncbi.nlm.nih.gov/40711307/)

<a id="ref-14"></a>[<a href="#ref-14">14</a>] [Eosinophilic meningoencephalitis caused by rat lungworm (Angiostrongylus cantonensis) migration in a white-eared opossum (Didelphis albiventris) with concurrent distemper virus in southern Brazil.](https://pubmed.ncbi.nlm.nih.gov/35192069/)

<a id="ref-15"></a>[<a href="#ref-15">15</a>] [Infection with the fox lungworm (Crenosoma vulpis) in two dogs from New England - Two clinical reports and updated geographic distribution in North America.](https://pubmed.ncbi.nlm.nih.gov/35431072/)

<a id="ref-16"></a>[<a href="#ref-16">16</a>] [Prevalence of spurious parasites identified in feces of dogs and correlation with true canine parasitism.](https://pubmed.ncbi.nlm.nih.gov/40220699/)

<a id="ref-17"></a>[<a href="#ref-17">17</a>] [Efficacy of a single oral administration of a formulation of fluralaner, moxidectin and pyrantel (BRAVECTO® TriUNO) in dogs for the treatment and prevention of angiostrongylosis.](https://pubmed.ncbi.nlm.nih.gov/42509566/)

<a id="ref-18"></a>[<a href="#ref-18">18</a>] [Angiostrongylus vasorum, Aelurostrongylus abstrusus, Crenosoma vulpis and Troglostrongylus brevior Infections in Native Slug Populations of Bavaria and Baden-Wuerttemberg in Germany.](https://pubmed.ncbi.nlm.nih.gov/35889992/)

<a id="ref-19"></a>[<a href="#ref-19">19</a>] [Assessing the effects of seasonal variation and climatic factors on gastrointestinal and pulmonary parasitism in dogs and cats from the Azores archipelago - Portugal.](https://pubmed.ncbi.nlm.nih.gov/41047072/)

<a id="ref-20"></a>[<a href="#ref-20">20</a>] [Survey of Gastrointestinal Parasites and Lungworms in Cats and Dogs from Terceira and São Miguel Islands, Azores.](https://pubmed.ncbi.nlm.nih.gov/39204248/)

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