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Antiparasitic treatment… 2022 JVIM article

Title: Antiparasitic treatment with itraconazole and amiodarone in 2 dogs with severe, symptomatic Chagas cardiomyopathy

Authors: Elizabeth L. Malcolm, Ashley B. Saunders, Jordan P. Vitt, Bruno G. Boutet, and Sarah A. Hamer

Journal/Date of Publication: Journal of Veterinary Internal Medicine, 2022

DOI: 10.1111/jvim.16422

Objective: To describe 2 dogs with severe, symptomatic Chagas cardiomyopathy characterized by myocardial dysfunction and electrocardiographic abnormalities that were managed with a combination of cardiac medications and antiparasitic treatment with itraconazole and amiodarone.

Type of Study: Case Report

Conclusions:

  1. The combination of itraconazole and amiodarone was used to manage symptoms of Chagas cardiomyopathy.
  2. Both dogs died suddenly within six months, highlighting the challenges in treating advanced Chagas disease and the need for more effective antiparasitic protocols.

Clinical Application

  1. Combination therapy with itraconazole and amiodarone can be considered for managing symptomatic Chagas cardiomyopathy, though close monitoring is essential due to potential adverse effects.
  2. Early detection and treatment of T. cruzi infection are critical as advanced cases have poor prognosis.
  3. Awareness of antiparasitic treatment limitations emphasizes the importance of preventive measures against Chagas disease in endemic areas.
four-panel figure of transthoracic echocardiographic images of the 2 dogs in the study as described in the caption
Figure 1. Transthoracic echocardiographic images documenting dilatation of the right ventricle (RV) in both dogs with chronic Chagas cardiomyopathy. Case 1 includes images obtained in right parasternal short axis (A) and long axis (B) views to show very severe right atrial and ventricular enlargement compared to the left heart. Case 2 includes images obtained from right parasternal short axis (C) and left apical long axis (D) views to show moderate to severe right ventricular enlargement. LA, left atrium; LV, left ventricle; RA, right atrium

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