Diagnosis of canine intestinal parasites: Improved detection of Dipylidium caninum infection through coproantigen testing.

Intestinal parasites, including cestodes like Dipylidium caninum, are common in dogs in the United States of America (USA), but fecal flotation consistently, and, at times, dramatically, fails to identify many of these infections. To determine the extent to which including coproantigen testing for D. caninum would improve the identification of dogs infected with this cestode, we evaluated fecal samples from 877 dogs (589 pet and 288 from municipal shelters) from six USA states using zinc sulfate (specific gravity 1.24) fecal flotation with centrifugation along with coproantigen detection for Giardia sp., hookworms, ascarids, and Trichuris vulpis. For D. caninum, PCR of perianal swabs was included. Intestinal parasite infections were identified, using centrifugal fecal flotation or coproantigen, in 265 dogs (13.2 % pet, 64.9 % shelter). Dipylidium caninum infection was detected in 5.6 % of dogs with the combination of coproantigen and centrifugal fecal flotation, and 7.3 % of dogs when perianal swab results were included; prevalence varied by diagnostic method, population, and geographic region. In pet dogs, D. caninum infection was identified by fecal flotation (0), coproantigen (2.2 %), or perianal swabs (1.2 %). The same methods revealed infection in 0.3 %, 12.5 %, and 11.1 % of shelter dogs, respectively. Frequent use of praziquantel in shelter dogs (116/288; 40.3 %) may have reduced prevalence. Positive and negative agreement of D. caninum coproantigen with perianal swab PCR in pet dogs was 85.7 % and 98.8 %, respectively. Multiple logistic regression analysis accounting for region, population, and age found D. caninum infection to be more common in shelter dogs relative to pet (adjusted OR 4.91 [2.48, 10.24]) and in the Southcentral and Southeast regions relative to North (adjusted OR 9.59 [1.92, 174.13] and 17.69 [3.67, 318.09] respectively). Coproantigen testing also enhanced the detection of other intestinal parasites over fecal flotation alone, including Giardia sp. (14.7 % vs 3.3 %), hookworms (13.8 % vs 8.4 %), ascarids (2.9 % vs 2.2 %), and T. vulpis (2.9 % vs 1.4 %). Together, these data indicate that the coproantigen assay employed increases detection of D. caninum infections several fold, supporting the use of this test in clinical practice, and add to a growing body of research documenting enhanced diagnosis through implementation of multiple laboratory-based methods.

Evaluation of Anaplasma spp. seroprevalence in dogs and association with incidence of human anaplasmosis.

Point-of-care (POC) ELISA tests are routinely used in US veterinary practices to screen canine patients for antibodies to tick-transmitted pathogens. Results are also used to monitor spatial and temporal trends in canine seroprevalence, and these data can build awareness of the risk to humans of tick-transmitted diseases such as Lyme disease and anaplasmosis. This study utilized a second-generation test that has incorporated additional Anaplasma-specific peptides into a commercial POC ELISA test to allow detection of Anaplasma spp. antibodies earlier post-infection. A convenience population consisting of 19,894 canine samples from a US commercial diagnostic laboratory were tested using the second-generation POC ELISA test to describe regional Anaplasma spp. canine seroprevalence and assess correlation to anaplasmosis cases reported to Centers for Disease Control and Prevention by state. Antibodies to Anaplasma spp. were detected in 1646 samples (8.3%) with the Northeast and Midwest US census regions having the highest proportion of positive samples. At the state level, a significant correlation was found between canine Anaplasma spp. seroprevalence and human anaplasmosis incidence (r2 = 0.64). Although estimates of canine Anaplasma spp. seroprevalence presented here using the second-generation POC ELISA are generally increased, especially in the Northeast and Midwest, the regional distribution of canine samples testing positive for Anaplasma spp. antibodies is consistent with previous reports. The observed correlation with human anaplasmosis incidence indicates that results from the second-generation POC ELISA will continue to add value in epidemiological assessment of human anaplasmosis risk.

Evaluation of a quantitative enzyme-linked immunosorbent assay for feline leukemia virus p27 antigen and comparison to proviral DNA loads by real-time polymerase chain reaction.

Feline leukemia virus (FeLV) is an oncogenic retrovirus of cats. While higher viral RNA and proviral DNA loads have been correlated with progressive infections and disease, a similar correlation has been suggested for p27 antigen concentrations. This analytical study compared the results of a quantitative ELISA for p27 antigen with quantitative real-time PCR results for FeLV proviral DNA in patient samples. A significant positive correlation between copies of proviral DNA and the concentration of p27 antigen was identified (r = 0.761, P < 0.0001). Samples with high proviral DNA loads, at least 1 × 106 copies/mL of whole blood, typically had p27 antigen concentrations greater than 30 ng/mL in plasma. Samples with proviral DNA loads below this level all had concentrations of p27 antigen in plasma that were less than 10 ng/mL. Given this correlation, it is hypothesized that the concentration of p27 antigen at a given point in time may help to indicate the likelihood of a progressive or regressive infection similar to what has been demonstrated for proviral DNA loads.

Biologic variability of N-terminal pro-brain natriuretic peptide in adult healthy cats.

Objectives The biologic variability of N-terminal pro-brain natriuretic peptide (NT-proBNP) and its impact on diagnostic utility is unknown in healthy cats and those with cardiac disease. The purpose of this study was to determine the biologic variation of NT-proBNP within-day and week-to-week in healthy adult cats. Methods Adult cats were prospectively evaluated by complete blood count (CBC), biochemistry, total thyroxine, echocardiography, electrocardiography and blood pressure, to exclude underlying systemic or cardiac disease. Adult healthy cats were enrolled and blood samples were obtained at 11 time points over a 6 week period (0, 2 h, 4 h, 6 h, 8 h, 10 h and at weeks 2, 3, 4, 5 and 6). The intra-individual (coefficient of variation [CVI]) biologic variation along with index of individuality and reference change values (RCVs) were calculated. Univariate models were analyzed and included comparison of the six different time points for both daily and weekly samples. This was followed by a Tukey's post-hoc adjustment, with a P value of <0.05 being significant. Results The median daily and weekly CVI for the population were 13.1% (range 0-28.7%) and 21.2% (range 3.9-68.1%), respectively. The index of individuality was 0.99 and 1 for daily and weekly samples, respectively. The median daily and weekly RCVs for the population were 39.8% (range 17.0-80.5%) and 60.5% (range 20.1-187.8%), respectively. Conclusions and relevance This study demonstrates high individual variability for NT-proBNP concentrations in a population of adult healthy cats. Further research is warranted to evaluate NT-proBNP variability, particularly how serial measurements of NT-proBNP may be used in the diagnosis and management of cats with cardiac disease.

Analytical validation of an immunoassay for the quantification of N-terminal pro-B-type natriuretic peptide in feline blood.

The measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), a biomarker for heart stress detectable in blood, has been shown to have clinical utility in cats with heart disease. A second-generation feline enzyme-linked immunosorbent assay (Cardiopet® proBNP, IDEXX Laboratories Inc., Westbrook, Maine) was developed to measure NT-proBNP in routine feline plasma or serum samples with improved analyte stability. Results of the analytical validation for the second-generation assay are presented. Analytic sensitivity was 10 pmol/l. Accuracy of 103.5% was determined via serial dilutions of 6 plasma samples. Coefficients of variation for intra-assay, interassay, and total precision were in the ranges of 1.6-6.3%, 4.3-8.8%, and 10.1-15.1%, respectively. Repeatability across 2 lots for both serum and plasma had an average coefficient of determination (r(2)) of 0.99 and slope of 1.11. Stability of the analyte was found to be high. In serum samples held at 4°C for 24-72 hr, the mean percent recovery from time zero was ≥99%. In serum samples held at 25°C for 24 hr, the mean percent recovery from time zero was 91.9%, and for 48 hr, 85.6%. A method comparison of the first- and second-generation assays with a clinically characterized population of cats revealed no difference in the tests' ability to differentiate levels of NT-proBNP between normal cats and cats with occult cardiomyopathy (P < 0.001). Results from our study validate that the second-generation feline Cardiopet proBNP assay can measure NT-proBNP in routine feline plasma and serum samples with accuracy and precision.

Performance validation and method comparison of an in-clinic enzyme-linked immunosorbent assay for the detection of canine pancreatic lipase.

Diagnosis of pancreatitis is often difficult in dogs that present with acute vomiting, anorexia, and abdominal pain, as these clinical signs may occur with a variety of other illnesses. While quantitative reference laboratory methods specific for canine pancreatic lipase are available to aid in diagnosis, results are generally not available until the next day. The objective of the current study was to validate a semiquantitative in-clinic rapid test for the measurement of canine pancreas-specific lipase (cPL) and to compare its performance to the reference lab method. Comparison of the reference method for cPL to the in-clinic assay demonstrated 96-100% agreement for canine serum samples with normal levels of cPL and 88-92% agreement for samples with elevated levels of cPL. Common interfering substances such as bilirubin, lipids, or hemoglobin had no effect on assay performance. Both within-day and day-to-day variations ranged from 10% to 20% of the calculated cPL concentration, which demonstrated a high degree of precision for the in-clinic assay. Performance of 3 lots of the in-clinic assay with the same set of canine serum samples demonstrated high assay reproducibility, with interclass correlation coefficients of ≥0.93. Results of the in-clinic cPL assay, based on both visual and calculated cPL concentrations, were consistent throughout 15 months of storage. The in-clinic test provides immediate, semiquantitative results to supplement existing pancreatitis diagnostics at the time of acute illness. Because the reference and in-clinic methods are aligned, they can be used together as an immediate aid pet-side and as a fully quantitative follow-up test at the reference laboratory.

Quantitative measurement of C6 antibody following antibiotic treatment of Borrelia burgdorferi antibody-positive nonclinical dogs.

The detection of antibody to the Borrelia burgdorferi C6 peptide by use of enzyme-linked immunoassays is a widely accepted method for the diagnosis of Lyme disease spirochete infection in dogs and in humans. Antibody to the C6 peptide is highly specific for B. burgdorferi and declines following treatment of dogs and humans exposed to B. burgdorferi. A quantitative assay for determining C6 antibody levels was developed and used to measure changes in antibody levels following antibiotic treatment of B. burgdorferi antibody-positive nonclinical dogs. One hundred thirty-two client-owned dogs were used in the study; 64 were negative, 53 of 68 positive animals received treatment, and 15 were untreated controls. Test sera were collected at 3, 6, and 12 months from seropositive dogs receiving treatment and untreated controls. Dogs in the treated group were assigned to moderate-to-high (> or =29 U/ml)- and low (<29 U/ml)-C6-level groups because the change in the C6 level after treatment was dependent on the level prior to treatment. There were significant declines in the 30 dogs with moderate-to-high initial C6 levels that exceeded the maximal declines of the untreated control dogs in all cases at 6 months (16 data points) and 12 months (29 data points) posttreatment. There was little change in C6 level following antibiotic therapy in the 23 dogs with low initial C6 levels. The quantitative C6 antibody test can be used to measure changes in C6 antibody levels following treatment of antibody-positive nonclinical dogs.

Comparison of an indirect immunofluorescence assay, western blot analysis, and a commercially available ELISA for detection of Ehrlichia canis antibodies in canine sera.

OBJECTIVE: To examine the correlation between results for an indirect immunofluorescence assay (IFA) that uses Ehrlichia canis antigen as a substrate (ie, E canis-IFA), 2 western blot (WB) analyses, and a commercially available ELISA in the detection of E canis antibody in dog sera. SAMPLE POPULATION: 54 canine serum samples that were reactive on E canis-IFA and 16 canine serum samples that were E canis-IFA nonreactive. PROCEDURE: Serum samples were evaluated by use of 2 WB analyses and a commercially available ELISA. Correlation between results of the 3 testing modalities (ie, IFA, WB analyses, and the ELISA) was examined by use of nonreactive (E canis-IFA reciprocal titer, < 20), low-titer (reciprocal titer, 80 to 160), medium-titer (reciprocal titer, 320 to 2,560), and high-titer (reciprocal titer, 5,120 to > 20,480) serum samples. RESULTS: For all serum samples in the nonreactive (n = 16), medium-titer (17), and high-titer (18) groups, correlation of results among IFA, WB analyses, and the commercially available ELISA was excellent. A poor correlation was found between IFA results and those of WB analyses and the ELISA for serum samples in the low-titer group (19), with only 4 of the 19 serum samples having positive results on both WB analyses and the commercially available ELISA. CONCLUSIONS AND CLINICAL RELEVANCE: The discrepancy between E canis-IFA, WB analyses, and the commercially available ELISA results for the low-titer serum samples may be related to a high IFA sensitivity or, more likely, a lack of specificity associated with cross-reactivity among Ehrlichia spp.

Dogs vaccinated with common Lyme disease vaccines do not respond to IR6, the conserved immunodominant region of the VlsE surface protein of Borrelia burgdorferi.

A 25-amino-acid synthetic peptide (C(6) peptide) derived from an immunodominant conserved region (designated IR(6)) of the VlsE protein of Borrelia burgdorferi has been identified and used to construct immunoenzyme-based diagnostic procedures. These procedures have excellent sensitivity and specificity. Previous reports have demonstrated the usefulness of the C(6) peptide as an antigen for the serodiagnosis of human and canine Lyme disease. Results indicated that assays based on the C(6) peptide were nonreactive to sera from vaccinated nonexposed animals. The purpose of the present study was to confirm these results in a controlled trial by testing sera from experimentally vaccinated dogs known to be uninfected. Nine specific-pathogen-free beagles were assigned to one of three vaccine groups, each containing three dogs. Each group received one of three commercial Lyme vaccines: RECOMBITEK Lyme (Merial), LymeVax (Fort Dodge Animal Health), and Galaxy Lyme (Schering-Plough Animal Health). Each animal was administered a total of five doses of vaccine over a period of 39 weeks. Serum samples were collected prior to vaccination and then on a weekly basis from weeks 3 to 18 and from weeks 33 to 43. Selected samples were tested by the immunofluorescence assay (IFA) and the Western blot (WB) assay using whole-cell B. burgdorferi antigen extracts, and the results were compared to those obtained with two immunoenzyme-based procedures formatted by using the C(6) peptide. Serum specimens from all animals were reactive to the IFA and WB assay at week 5 and became highly reactive following the administration of multiple doses of vaccine. All serum specimens were uniformly nonreactive in the C(6) peptide immunoenzyme procedures at all time points throughout the study.

Evaluation of a canine C6 ELISA Lyme disease test for the determination of the infection status of cats naturally exposed to Borrelia burgdorferi.

The efficacy of a commercially available in-office kit (SNAP 3Dx, IDEXX Laboratories) for detection of antibodies directed against an invariable region (IR6) of the B. burgdorferi surface protein VlsE (Vmp-like sequence, Expressed), a surface antigen of the spirochete recognized during active infection has been evaluated in dogs. The present study was conducted to determine whether this in-office test could be useful for detection of antibodies to B. burgdorferi in cats. Cats owned by clients of a veterinary hospital located in an area hyperendemic for Lyme disease were included in the study. When possible, cats with an outdoor lifestyle, bite wounds, or current tick infestation were recruited for the study to help ensure that animals with a likelihood of exposure to natural infection by B. burgdorferi would be included in the test group. Of the 24 cats tested, 17 samples were positive for antibodies to B. burgdorferi by the C6 ELISA kit. For all 17 of these samples, a duplicate sample tested by immunofluorescent assay (IFA) was in agreement with the ELISA. Five samples were negative by both assays. Two samples that were negative by the C6 ELISA test had low IFA titers (1:100). One of these two discrepant samples was negative and one was positive for antibodies to B. burgdorferi by the Western blot test. It was concluded that the C6 ELISA test performed with good agreement with the IFA and Western blot tests for detection of antibody to B. burgdorferi in the majority of cats tested. The test offers the advantages of producing a result rapidly (approximately 8 minutes), and it requires only two drops of serum, plasma, or whole blood.

Utility of an in-office C6 ELISA test kit for determination of infection status of dogs naturally exposed to Borrelia burgdorferi.

Serologic evaluation for the diagnosis of Lyme disease has been confounded by several factors, including a high prevalence of clinically normal dogs testing seropositive, persistence of antibodies, and the introduction of vaccines that will induce antibodies detectable by immunofluorescent antibody assay, whole-cell ELISA, and Western blot assay. The utility of a commercially available in-office test kit (SNAP 3Dx, IDEXX Laboratories) for the simultaneous detection of Borrelia burgdorferi and Ehrlichia canis antibodies and Dirofilaria immitis antigen was evaluated for its ability to detect exposure to B. burgdorferi in both vaccinated and unvaccinated dogs from a highly Lyme-endemic area of Connecticut. The test kit is an ELISA that uses a synthetic peptide (C6) that duplicates the sequence of the IR6 region. The in-office C6 ELISA kit was found to be particularly useful in Lyme-endemic areas because it can be used conveniently and reliably in the clinic to determine a dog's infection status regardless of the vaccination history of the animal.