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Risk factors… 2019 JVIM article

Title: Risk factors and select cardiac characteristics in dogs naturally infected with Trypanosoma cruzi presenting to a teaching hospital in Texas

Authors: Alyssa C. Meyers, Sarah A. Hamer, Derek Matthews, Sonya G. Gordon, and Ashley B. Saunders

Journal/Date of Publication: Journal of Veterinary Internal Medicine, 2019

DOI: 10.1111/jvim.15516

Objective: To report epidemiologic and select cardiac characteristics associated with T. cruzi infection in dogs presenting to a teaching hospital in Texas.

Type of Study: Retrospective

Conclusions:

  1. Infected dogs were generally younger and more likely to have ventricular arrhythmias and ECG abnormalities.
  2. Dogs with infected housemates had a significantly higher risk of infection.
  3. Increased awareness and consideration of T. cruzi testing are needed for dogs presenting with cardiac issues in endemic areas.

Clinical Application:

  1. Awareness: Clinicians in endemic areas should consider Chagas disease when diagnosing cardiac conditions in dogs.
  2. Testing: Testing is crucial for dogs with unexplained ventricular arrhythmias or those with infected littermates.
  3. Risk factors: Younger dogs and those with infected housemates are at higher risk and should be tested proactively.
  4. Management: While treatment remains challenging, identifying Chagas disease can aid in managing cardiac symptoms and providing a prognosis.
  5. Further Evaluation: Dogs with multiple ECG abnormalities, particularly including ventricular arrhythmias, should be assessed for Chagas disease especially when there are other historical or clinical findings consistent with T. cruzi infection.
  6. Differential Diagnosis: T. cruzi infection can mimic other cardiac diseases, underscoring the need for differential diagnosis in breeds predisposed to arrhythmogenic right ventricular cardiomyopathy (example: boxers, bulldogs), dilated cardiomyopathy (example: doberman pinscher), and tricuspid valve dysplasia (example: retrievers).
map of Texas showing T. cruzi infection prevalence of dogs in study in each of the state's ecoregions as described in the caption
Figure 1. Distribution of Trypanosoma cruzi infection across Texas ecoregions in 375 dogs presenting to Texas A&M University’s Small Animal Veterinary Medical Teaching Hospital between 2010 and 2016 that received T. cruzi serology testing or had T. cruzi histological findings. Twelve dogs resided outside Texas, and percent positive are depicted by a pie chart. Circles are proportional to the number of dogs sampled per ecoregion. Map was created using ArcGIS and the base layer is from Gould Ecological Regions created by Texas Parks and Wildlife Department GIS laboratory, downloaded from http://aampo-mpo.opendata.arcgis.com/.

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