Need advice on dealing with lung worms

[jajeanpierre]

I lost a baby quad quad today to lung worms. He had been gaining weight and eating well. He was just starting to drop a tiny bit of weight when he crashed.

I got him in to the vet, but he died there.

I helped her with the necropsy and we found a live worm floating in the thoracic or abdominal cavity. The biggest surprise was the huge worms that were in the lungs and that had pierced through the lungs.

The lung worms were dead and looked like three (or was if four?) perfectly formed little springs. Imagine wrapping a wire around a pencil two and a half times--that's what they looked like. They even had some spring to them if you touched them. Really creepy. They seem to have lost that spring-like form in the preserving solution.

I did take some pictures of them in the vial. All the parasites, including his external parasites, are being sent to a lab in Miami that specializes in tropical parasites.

I need some advice on how to deal with the cages. I neglected to ask the vet--which I will do tomorrow.

The dead chameleon was housed with two other same-sized females for a few days, then just one female. He was housed in a screen cage. I'm thinking I should get a small Exo-terra class terrarium to house the female that was in the cage with him. The other female was separated a few days after they came to me because she wasn't gaining weight. She's in a mostly glass terrarium. I'll pitch all the live plants and just use plastic that I can throw in the dishwasher regularly. The glass terrariums will help with the humidity and will be easy to clean with some kind of disinfectant.

I am hoping they are not infested with adult lung worms, but need to assume they've been exposed to larvae/eggs that were being shed by the one that died.

The attached picture shows the worms that came out of one little 14g chameleon's lungs. The dime and pen will give some reference of size. There was no saving this baby at any time. The worms were too large to kill without killing the baby. Needless to say, his lungs were a mess. It's a very sad day.

 

[Carlton]

I lost a baby quad quad today to lung worms. He had been gaining weight and eating well. He was just starting to drop a tiny bit of weight when he crashed.

I got him in to the vet, but he died there.

I helped her with the necropsy and we found a live worm floating in the thoracic or abdominal cavity. The biggest surprise was the huge worms that were in the lungs and that had pierced through the lungs.

The lung worms were dead and looked like three (or was if four?) perfectly formed little springs. Imagine wrapping a wire around a pencil two and a half times--that's what they looked like. They even had some spring to them if you touched them. Really creepy. They seem to have lost that spring-like form in the preserving solution.

I did take some pictures of them in the vial. All the parasites, including his external parasites, are being sent to a lab in Miami that specializes in tropical parasites.

I need some advice on how to deal with the cages. I neglected to ask the vet--which I will do tomorrow.

The dead chameleon was housed with two other same-sized females for a few days, then just one female. He was housed in a screen cage. I'm thinking I should get a small Exo-terra class terrarium to house the female that was in the cage with him. The other female was separated a few days after they came to me because she wasn't gaining weight. She's in a mostly glass terrarium. I'll pitch all the live plants and just use plastic that I can throw in the dishwasher regularly. The glass terrariums will help with the humidity and will be easy to clean with some kind of disinfectant.

I am hoping they are not infested with adult lung worms, but need to assume they've been exposed to larvae/eggs that were being shed by the one that died.

The attached picture shows the worms that came out of one little 14g chameleon's lungs. The dime and pen will give some reference of size. There was no saving this baby at any time. The worms were too large to kill without killing the baby. Needless to say, his lungs were a mess. It's a very sad day.

Oh that's too bad! There could have been other reasons this particular cham ended up with such a heavy load. We know parasite populations can bloom if the cham is under other stress.

I would strip the cage down and clean it with a veterinary product that kills parasite eggs/larvae just to be safe, and test the other chams for parasites a couple of times to increase the chance you actually find them. Detecting parasites that live outside the GI tract can require a blood sample. Once you get the parasites identified you can design treatment for the other chams. But, deciding to treat can also mean you could lose another if its parasite load is too heavy. That's a hard choice, but if you have chams who are acclimating well and maintaining their weight it might be safer not to treat. Blood borne microfilaria may not be affected by the usual Panacur or Flagil that target intestinal types. I'm not very current on what's available now, but know that Ivermectin is one. I'm sure our vets can give much better advice on this.

 

[jajeanpierre]

Oh that's too bad! There could have been other reasons this particular cham ended up with such a heavy load. We know parasite populations can bloom if the cham is under other stress.

I would strip the cage down and clean it with a veterinary product that kills parasite eggs/larvae just to be safe, and test the other chams for parasites a couple of times to increase the chance you actually find them. Detecting parasites that live outside the GI tract can require a blood sample. Once you get the parasites identified you can design treatment for the other chams. But, deciding to treat can also mean you could lose another if its parasite load is too heavy. That's a hard choice, but if you have chams who are acclimating well and maintaining their weight it might be safer not to treat. Blood borne microfilaria may not be affected by the usual Panacur or Flagil that target intestinal types. I'm not very current on what's available now, but know that Ivermectin is one. I'm sure our vets can give much better advice on this.

Thanks.

My fear is they all have them and will just keep on shedding parasites eggs/larvae until they die, hopefully of old age.

I was hoping that the long-time breeders/keepers who have dealt with wild caught imports from that part of the world would chime in and let me know how they handled it. They are apparently fairly common according to the abstracts my vet sent me.

I still have a lot of questions of the vet I saw or my regular vet, but that can wait. Everyone (touch wood) seems to be gaining weight. One little baby is an eating machine. I'm going to get stool samples in before I worm as long as they are doing well.

I still haven't cleaned the cage yet--it is outside on a glass table. I'll wash it down with bleach and then run it through the dishwasher.

 

[kinyonga]

There's an article in the Chameleon News e-zine about lungworms titled Worms killed by Fenbendezole...it talks about them and that the worms can live outside the chameleon for a long time. Sorry I can't post the link right now.

 

[APailthorp]

http://www.chameleonnews.com/02JulVassilievWorms.html

 

[kinyonga]

Thanks APailthorp!

 

[jajeanpierre]

http://www.chameleonnews.com/02JulVassilievWorms.html

Thanks.

I could use some practical advice on how to deal with their cages. The vets are telling me to clean with a bleach solution, but the keepers are going to know the practicality of dealing with these chameleons that might shed eggs/larvae their whole lives. I would really appreciate some advice on just how to go forward.

I had found that article, thank you. There are other species of lung worms other than the ones cited in the article.

My vet did some research and sent me these abstracts:

http://www.ncbi.nlm.nih.gov/pubmed/19202762

http://www.pubfacts.com/detail/1964...sp.-Nematoda-Rhabdiasoidea-first-lung-worms-f

http://bug-de-lite.com/Panacur Article 2.html

Based on her research, we decided not to send the worms off for identification. It doesn't really matter what they are--treatment is the same regardless of the type of lung worm.

My worry is that there will be lung worms shedding constantly through the life of the chameleons. I now have 6 left from the last two shipments (December 2014 and February 2015). All but one are doing really well. Today I'll try to get a picture and a weight on the second adult male I have from the first shipment.

The one not doing so well has a skin infection and what the vets seem to think are abscesses in both hind legs. They are unsure of the source of the infection that caused the abscesses. It probably is an abscess forming from an infection somewhere else in his body, draining to one location--maybe from around the exposed bones on his back from rub injuries. There is a tiny mark near his vent that the vet thinks might be a puncture wound. Regardless of where the infection originated from, we are treating and hoping he will be able to isolate the abscess and wall it off. Surgery is out of the question, simply because both vets believe it will kill him. Believe me, she would love to go in and clean it up but she told me flat out the surgery would kill him.

After a few days of treatment (wiping his body with dilute Chlorhexadine solution twice a day and oral Baytril), he definitely went downhill dropping a few grams. I stopped the twice-a-day wiping, only mauling him once a day. He now seems to be rebounding. He's tolerating being wiped down better as well. Is he doing better because I only maul him once a day or because the treatment is starting to work? Probably a combination of both. Yesterday he was the highest weight he's ever been in my possession (59g up from the 36g he was when he arrived). The swelling in his foot has gone down. He has a new soft lump on the other hind leg now. Overall, he is just looking a lot better than he did when we first started treating him.

I've had him in to the vets three times--first for x-rays to try to identify the lump on his hind leg (which two vets now think is an abscess), a second time when he started to go down hill and a skin infection showed up, and just last week as he continued his downward slide.

I've had two different vets from two different clinics look at him and they both are in agreement over what they think is wrong and how to treat it.

I hope I can save him.

 

[ferretinmyshoes]

My fear is they all have them and will just keep on shedding parasites eggs/larvae until they die, hopefully of old age.

This shouldn't really be an issue if they are susceptible to the dewormer. Even though the dewormer is oral it is absorbed through the bloodstream so whenever the worm takes a blood meal it will be ingesting the dewormer and thus be killed by it. Even though it's not contained in the intestinal tract where the dewormer is being administered it will still be exposed to it. Whether or not it's susceptible (most likely will be) or that you kill them all (may take several rounds to get the whole life cycle) are the variables.

 

[jajeanpierre]

This shouldn't really be an issue if they are susceptible to the dewormer. Even though the dewormer is oral it is absorbed through the bloodstream so whenever the worm takes a blood meal it will be ingesting the dewormer and thus be killed by it. Even though it's not contained in the intestinal tract where the dewormer is being administered it will still be exposed to it. Whether or not it's susceptible (most likely will be) or that you kill them all (may take several rounds to get the whole life cycle) are the variables.

Thanks for weighing in.

In the article below, Dr. Vassiliev DVM of the Moscow Zoo claims that unlike mammals, he has not found Panacur to be effective for reptiles against lung worms in the lungs or nematodes outside the gastrointestinal tract or inactive in the tissues.

http://bug-de-lite.com/Panacur Article 2.html

Based on this article my vet sent me, if any of my animals have adult lung worms, they will be shedding larvae/eggs their whole lives.

I was going to wait until I could get a really fresh stool sample (less than 2 hours old) to the vet before I did any worming as long as they continue to do well and gain weight (touching wood furiously--they are all doing well except the one who has had three doses of Panacur and a clear fecal).

How would you suggest I proceed?

Thanks so much for any help or insight.

 

[ferretinmyshoes]

Guess I should have actually read all the links! I was trying to respond while I could and planned on reading them and getting the full articles later so I got lazy. If they re anything like the lungworms that livestock get (Dictyocaulus usually) they probably won't show up on a routine fecal exam. They are usually detected either via lung wash or a fecal method called the Baermann technique, in which large fecal samples (25–30 g) are wrapped in tissue paper or cheese cloth and suspended or placed in water contained in a beaker. The water at the bottom of the beaker is examined for larvae after 4 hr; in heavy infections, larvae may be present within 30 min. Obviously that size sample is completely unrealistic for chameleons. Therefore they pose a unique challenge in detection to know if the infection has been cleared or is still present.

If they continue to shed throughout life the biggest factor is going to be hygiene - cleaning any fecal material asap and I'd probably do a little bleach wash of the area where that BM fell. This will reduce the reintroduction of worms to the cham it came from. Handle the unaffected chameleons before any of the affected ones, including cleaning, feeding, etc. so that you're not inadvertently spreading any contaminated material. Any cage decor in their cages is always and forever theirs - no sharing. I have plastic sheets in addition to visual dividers between all my cages to prevent any cross contamination of nasties like that and as long as you keep everything separate and clean risk of further infection should be minimal. I kept papilloma virus contained to just one cham even though they were all in the same cage line using this method.

 

[jajeanpierre]

Guess I should have actually read all the links! I was trying to respond while I could and planned on reading them and getting the full articles later so I got lazy. If they re anything like the lungworms that livestock get (Dictyocaulus usually) they probably won't show up on a routine fecal exam. They are usually detected either via lung wash or a fecal method called the Baermann technique, in which large fecal samples (25–30 g) are wrapped in tissue paper or cheese cloth and suspended or placed in water contained in a beaker. The water at the bottom of the beaker is examined for larvae after 4 hr; in heavy infections, larvae may be present within 30 min. Obviously that size sample is completely unrealistic for chameleons. Therefore they pose a unique challenge in detection to know if the infection has been cleared or is still present.

If they continue to shed throughout life the biggest factor is going to be hygiene - cleaning any fecal material asap and I'd probably do a little bleach wash of the area where that BM fell. This will reduce the reintroduction of worms to the cham it came from. Handle the unaffected chameleons before any of the affected ones, including cleaning, feeding, etc. so that you're not inadvertently spreading any contaminated material. Any cage decor in their cages is always and forever theirs - no sharing. I have plastic sheets in addition to visual dividers between all my cages to prevent any cross contamination of nasties like that and as long as you keep everything separate and clean risk of further infection should be minimal. I kept papilloma virus contained to just one cham even though they were all in the same cage line using this method.

Thanks for the advice.

What concentration of bleach? Can I use it while the chameleon is in the cage?

I'm going to assume all the wild caughts are infected since they all came from the same exporter with shipments less than two months apart. I will treat them as if they will be infected. I hope there is an insect intermediary host so the life cycle can be broken, but I'm not counting on it.

Thanks for any advice you can give me.

 

[ferretinmyshoes]

There are several species of lungworms to consider - Rhabdias species are parthenogenic, meaning females can reproduce without males, and thus shedding can be for the life of the female. The eggs can sometimes be detected in normal fecals or transtracheal washes and are infectious if eaten or sometimes through the skin. Ivermectin subcutaneously or levamisole injected into the abdominal cavity at 2 week intervals has been effective. In low numbers they generally do not cause problems in itself but can predispose to secondary pneumonia from inflammation in the lungs.

Pentastomids - these need a mammalian intermediate host and have a characteristic appearance. Most likely not these.

Lung flukes can be seen from eating amphibian intermediate host - unlikely.

Sometimes roundworm or hookworms can have aberrant visceral migrations and end up in the lungs accidentally.

*Sourced from Reptile Surgery and Medicine by Doug Mader.

More to come as I do more research. Just wanted to post what I have from my texts at work while I'm here.

 

[ferretinmyshoes]

What concentration of bleach? Can I use it while the chameleon is in the cage?

10% bleach is the standard concentration used in vet med with the intent of killing viruses and parasites. I do use it while cham is in the cage since they're not walking through it. You can always squirt with some water and wipe up after it's been in contact for at least 10 minutes if you're worried. I usually don't because the next time the mistking goes off it gets washed away.

 

[jajeanpierre]

10% bleach is the standard concentration used in vet med with the intent of killing viruses and parasites. I do use it while cham is in the cage since they're not walking through it. You can always squirt with some water and wipe up after it's been in contact for at least 10 minutes if you're worried. I usually don't because the next time the mistking goes off it gets washed away.

Thank you!!!

I'll take everything you find to my vet for their guidance on how to proceed. The worms were so big in the lungs of the one that died, that killing them would absolutely have killed him as well.

Did you think the lesions in the lungs of Perry's quad were lung worms as well? He said they fell apart when he touched them. (Necropsy done after freezing.)

 

[ferretinmyshoes]

Did you think the lesions in the lungs of Perry's quad were lung worms as well? He said they fell apart when he touched them. (Necropsy done after freezing.)

Hard to say...I just posted some more thoughts to that thread as well.