TEST YOURSELF
Companion quiz
Below are eight pictures from animals with infectious
diseases, can you name them and suggest a treatment?
1 2
This is a blood film from a 3-year-old cross-breed
recently imported from the south of Italy. What
can you see?
4 5
This is a cytospin preparation from an 8-year-old
Cavalier King Charles Spaniel with a 5-day history
of lethargy and a cough. What infection is present?
7 8
This is an impression smear of a gastric biopsy
taken from a dog with chronic vomiting. What are
the spiral organisms?
This is a blood film from a 6-year-old Domestic
Shorthair cat with FIV. The cat presented dull and
depressed having been relatively well until
recently. Haematology revealed a hematocrit of
0.14 l/l with little evidence of regeneration. What
parasite is evident on the blood smear?
This is an endoscopic picture of a dog with mild
haematuria. What parasite is present within the
bladder and ureteral opening?
This is cytology of an abdominal effusion from an
8-year-old Siamese cat with ascites and pyrexia.
What organism is visible?
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3
This is a bone marrow smear from a 7-year-old
Greyhound that was imported from Spain four
years ago. The dog has a mild generalized
lymphadenopathy and moderate proteinuria
consistent with a protein-losing nephropathy.
What is present in the macrophage in the centre
of the picture?
6
This is a peripheral blood smear of a dog recently
imported from Cyprus, which was being
investigated for lethargy, depression and weight
loss. What is this parasite and how would you
treat it?
Acknowledgement: Student Companion
would like to thank Paola Monti and Jon
Wray for the use of their photographs in
this feature.
Answers: Answers are available in the
online edition of Student Companion –
please visit www.bsava.com.
© BSAVA 2017 · STUDENT Companion · 31
 TEST YOURSELF

Companion quiz answers

1 This is a Dirofilaria immitis microfilaria.
Microfilaria are produced by adult
worms living in the right ventricle and
pulmonary artery and represents an
active heartworm infection. Adult
worms are usually killed by using the
arsenic-based compound
melarsomine, although there are
many potential complications such
as thromboembolic events. As a
result direct removal of the worms
using an intravascular approach is a
potential alternative.
4 This dog has pneumocystosis.
Pneumocystosis, which is a fungal
infection of the respiratory system,
and a Pneumocystis carinii cyst is
visible in the picture. Infection is rare
and very uncommon in
immunocompetent dogs. Cavalier
King Charles Spaniels with IgG
deficiency are reported in the
literature. Treatment with
trimethoprim sulfonamide is usually
recommended alongside appropriate
supportive care.
8 This cat is infected with Toxoplasma
gondii, with crescent-shaped
tachyzoites pictured. Treatment is
usually based on clindamycin
(10 mg/kg orally q12h) for a minimum
of four weeks (give with water or food
in cats to avoid with oesophagitis),
ideally until one week post-resolution
of clinical signs. Azathromycin and
trimethoprim sulfonamide have also
been suggested.

2 These are haemoplasmas which are 5 This is Capillaria plica, which is a

small bacteria that live on the surface
of the red cell. Three forms are
recognized Mycoplasma: haemofelis,
Candidatus Mycoplasma
heamominutum and Candidatus
Mycoplasma turicensis. Their
presence can be diagnosed
cytologically, but they need to be
carefully differentiated from other red
cell membrane inclusions such as
stain deposits and Heinz bodies. A
PCR will confirm infection and allow
differentiation between the strains.
Treatment with doxycycline (10 mg/
kg orally q24h) for a minimum of 28
days is usually recommended. Care
should be taken to always follow
doxycycline with food or water to
prevent delayed oesophageal transit
and stricture formation.
3 These are Leishmania amastigotes
and confirm the dog has
leishmaniosis. This disease has a very
chronic course, with glomerular
nephritis usually being a late sign and
associated with a poor prognosis.
Allopurinol (10 mg/kg orally q12h) is
the mainstay of treatment and is
usually used in combination with
either meglumine antimoniate
(75–100 mg/kg s.c. q24h for four
weeks) or miltefosine (2 mg/kg orally
q24h for four weeks). Both drugs
require a Special Import Certificate
from the VMD. Recent work using
domperidone appears to promote a
Th1 immune response with promising
results in some studies. This dog may
also benefit from an ACE inhibitor to
help reduce proteinuria.
nematode worm found in the bladder
and occasionally upper urinary tract
of dogs and foxes. Dogs are infected
by eating earthworms which are the
intermediate host. Normally,
infections don’t cause clinical signs
unless the worm burden is high, in
which case haematuria and dysuria
can be reported. Treatment with
fenbendazole is usually successful.
6 This is Hepatazoon canis. It’s not
endemic in the United Kingdom as
the vector is the brown dog tick
(Rhipicephalus sanguineus), which is
found in southern Europe. Unusually
infection is passed on by ingestion
of the tick rather than through the
tick feeding, as with other tick-borne
diseases. As the infection affects
neutrophils, signs of illness usually
relate to secondary infection due to
immunosuppression. Treatment is
with imidocarb every 14 days until
the parasitaemia resolves on blood
films, which usually takes about
eight weeks.
7 These are Helicobacter and their
significance is difficult to establish in
most cases as they are found in a
large proportion of normal dogs as
well as those with clinical signs. If no
other cause is found, a significant
number are present, or their presence
is associated with histological
changes then treatment is suggested.
A consensus as to the best treatment
regime has not been reached but
amoxicillin, metronidazole and
famotidine has been reported as
successful in recent clinical studies.

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© BSAVA 2017 · STUDENT Companion · 33