Page 20 - Summer 12

Are We Lungworm Aware? – by Nick Thompson, UK
Are We Lungworm Aware, or Lungworm Advertising Aware?
You can't move at the moment for pictures of cute puppies looking at snails on their artificial chewy bones. The consequence of this multimedia onslaught is that I'm frequently asked what the actual risk of getting dis- ease from lungworm, Angiostrongylus vasorum, is. I didn't have any accurate figures, so I thought I'd do some research.
It seems, after extensive investigation, and talking to industry insiders, that there is ‘no hard science on the actual level of infection in the UK’. The industry also don't know how many dogs with lungworm get clinical disease (breathing, circulation, neurological or gut problems). i.e. if 100 dogs had evidence of lungworm on poo samples, they don't know how many of those would go on to get actual disease, and how quickly.
There is one scientific paper on the subject, published by Bristol University in 2010 (see Ref), part funded by Novartis, who make Milbemax, a lungworm-active wormer, describing a study that looked at sick dogs in the South West area (an area known to be endemic for lung- worm) whose diseases were not a ‘specific non-parasitological diagno- sis’, i.e. unclear cases.
Of these, 16% of the dogs were found to be positive for lungworm on a single stool test (more would have been found had they used the best test - a 3 days’ stool, non-pooled sample). They don’t say that the diseases they found were definitely due to lungworm as we don’t know what hap- pened after the dogs were treated for lungworm, unfortunately.
So that’s it. A solitary UK study in an endemic area, part-supported by a worming company, and we don’t know if any of the diseases in any of the dogs was actually due to lungworm.
Everything else we see in the media or hear from professionals is opinion, conjecture or extrapolation from other countries. You wouldn’t think the evidence was so flimsy if you looked at all the television, magazine and internet adver- tising, would you?
Treatment
The conventional recommended treatment is to use Advocate spot-on (pesticide) continually, and use Milbemax pharmactutical worming tablet every month. A pesticide and a drug every month, ‘just in case’ you get a disease, the incidence of which, in the whole of the UK, we have not a clue and the incidence of subsequent disease we know even less; a bit hit-and-miss, I feel.
In my practice, I’m going to take a pragmatic view. I’m in Bath, in the South West, so I’m going to assume all dogs coming to me from this area may have exposure, therefore I’m going to advise all my dog clients to get a Baermann worm egg count done on 3 days’ stool samples every six months to see if lungworm is present. If it is, I’ll recommend they have a seven day course of Panacur. If they don’t, I’ll recommend they use a herbal product prophylactically (my preference is Verm-X crunchies daily) for intestinal hygiene control between tests.
I will not, unless absolutely necessary, be using monthly pharmaceuticals until the evidence becomes a little more convincing. We are, after all, a profession led by EBM, Evidence Based Medicine, not glossy adverts.
Ref: Morgan, E.R., et al., Angiostrongylus vasorum infection in dogs: Presentation and risk factors. Vet. Parasitol. (2010), doi:10.1016/j.vetpar.2010.06.037
Book review
‘Repertory of Veterinary Homeopathy’ John Hoare
Publisher: Saltire Books
ISBN 978-1-908127-01-3
Just published, this book has been long awaited and anticipated by many. And, I can understand why! The author – a well-known and much respected veterinary surgeon and homeopath has collected his extensive knowledge and passed it
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on in this book to future generations of experi- enced and novice veterinary homeopaths alike. Nothing can beat personal tested experience – what we all gain with time but here’s a chance to get ahead of the game.
This book is written for vets and not as a self-help book for pet owners. And, by distinguishing in this way, the author has come up with a truly useful publication, destined to be a favorite in the consult room – especially for those of us still in the con- ventional game with 10-15 minutes consults at the best of time. Quick answers are sometimes called for and here you can find them in easy-to- read tables which make the choice between two or more similar remedy diagnoses more straight-forward.
The book is divided into several chapters each addressing either an organ system or a symptom complex (e.g. ‘emergency care). Each chapter has an introduction to certain conditions in the related organ system and suggestions to rubrics in the repertory fitting the possible symptoms seen. But most of the chapter comprises of tables – one for each symptom and modality and keynotes for each commonly prescribed local remedy. Blank cells are left for any additions you might want to make to each remedy should the information in the tables not be enough (which I think is unlikely!).
Often – as we know all too well – you have the choice between two remedies and the only differ- entiation would be the (heat) modalities. Here the tables are divided exactly this way.
The chapters are as follows:
1 EmergencyCare
2 Pyrexiaofunknownorigin
3 TheEars
4 TheEyes
5 TheCardio-VascularSystem 6 TheDigestiveSystem
7 TheEndocrineSystem
8 TheMusculo-SkeletalSystem 9 TheNervousSystem
10 TheFemaleReproductiveSystem 11 TheMaleReproductiveSystem 12 TheRespiratorySystem
13 TheSkin
14 TheUrinarySystem
At the end you find ‘Index of remedies’ and ‘Index to the repertory’, both alphabetical.
A word about the author: John (Jack) Hoare qualified as a vet in 1965. In 1984 he attended his first introductory seminar in Homeopathy for Vets and despite being rather skeptical, attended another session at the Royal London Homeopathic Hospital four years later. He used homeopathy in his own practice for some years and in 1999 found himself using solely homeopathic remedies successfully in over 80% of cases presented to him. Before his retirement he had a homeopathic referral practice in Lyme Regis.
If you haven’t already acquired this little gem then it should be high on your list to do so. The waiting time is over – it has arrived!
Malene Jorgensen
VetMFHom, MRCVS