Small Animal/Exotics

Compendium September 2000

WEBMED
Y O U R V E T E R I N A RY E D U C AT I O N A L A D V I S O R

FELINE HEARTWORM DISEASE
ALSO WORTH A LOOK
With respect to performing antigen and antibody tests on cats suspected of having heartworm disease, the following two web sites expertly interpret the various combinations of test results. Although neither site is as extensive as is the web site featured, they do offer quick access to information that is often difficult to obtain and/or confusing to understand:

H
Search for

ighlighted this month is a web site on feline heartworm disease that is an exceptionally well-done clinical resource. The site offers current information on topics ranging from the biology of the disease to the interpretation of antigen versus antibody test results to an excellent review of the various treatment and management options available today. Because feline and canine heartworm diseases are distinctly different, access to this web site is especially important for anyone who practices feline medicine and is definitely worth bookmarking for future reference. are well written and organized and offer information that is relevant to clinical practitioners (see Also Worth a Look). Of these three, the site featured in this column offers the most extensive information. I WEB ADDRESS http://www.vetmed.auburn.edu/ distance/cardio/all.html I NAME OF SITE Auburn University College of Veterinary Medicine, Feline Heartworm Disease I USE FEE None I SITE AUTHOR Ray Dillon, DVM, Diplomate ACVIM, Professor of Medicine, Auburn University College of Veterinary Medicine HOME PAGE. After reaching the university’s home page, users can “Search the Site” to access the home

Searching the Web
The initial search for heartworm disease
heartworm disease
Search

“Feline Heartworm Disease” by the Heartworm Society http://www.heartwormsociety. org/feline.htm “Feline Heartworm Disease” by Drs. David K. Rosen and Ann R. Donoghue http://www.heska.com/ HESKA/products/hw/ feline_hw_disease.htm

recovered more than 2000 web site addresses that included some reference to canine and/or feline heartworm disease. However, refining that search to feline heartworm disease
Search for feline heartworm disease
Search

yielded about 270 sites, and the search for canine heartworm disease
Search for canine heartworm disease
Search Search

revealed 266 sites. A majority of these sites (approximately 99%) clearly and exclusively target pet owners, and the information provided is therefore too superficial to be of educational value to veterinarians. Of the sites that do offer educationally based medical information on feline heartworm disease, three

Compendium September 2000

Small Animal/Exotics

page for feline heartworm disease (the URL provided is a link directly to the feline heartworm page). This page allows the user to access several areas, including an introduction and table of contents for each of four parts, or sections; any one of the four parts (biology, pathology and clinical presentation, diagnosis, or clinical management); terminology; abstracts on feline heartworm disease; a biographic sketch of Dr. Dillon; or the entire document. HIGHLIGHTS. Overall, this site is well written and applicable to the management of feline heartworm disease in clinical practice. Several photographs, graphs, and incidence charts are easy to access with a single click of the mouse. A built-in glossary of medical terms is available and is a useful device. A strong feature of this web site is its abundant use of links to published abstracts that are directly pertinent to the topic being discussed. The following site review briefly summarizes the major menu selections.

Part 1—Biology: The biology of Dirofilaria immitis infection in cats is well worth the few minutes it takes to read. Clearly, feline heartworm disease is not the same as canine heartworm disease, and a basic review of the differences adds considerably to the understanding of the clinical events related to this infection in cats. The life cycle of D. immitis, which is included in the presentation, reinforces the biologic explanation of the different clinical presentations of feline and canine heartworm disease. Part 2—Pathology and Clinical Disease: This section examines the general pulmonary pathology of heartworm disease in cats and its similarity to that in dogs and provides pertinent information on clinical presentation of the disease, including clinical signs, history, physical examination, clinical pathology, and blood chemistries and urinalysis. Part 3—Diagnosis: This section is particularly important for practicing veterinarians and reviews the three serologic methods of diagnosing feline heartworm disease and seven diagnostic parameters, ranging from antigen and antibody testing to echocardiography to tracheal cytol-

ogy. Each parameter is expertly summarized, and the indications and interpretations for each test are thoroughly discussed. Part 4—Treatment: This section discusses how the treatment of cats infected with D. immitis can be a lose–lose proposition and reviews in considerable detail the pros and cons of adulticidal therapy, postadulticidal consequences, efficacy of treatment, and conservative therapy using glucocorticoids. The author offers compelling reasons to prevent rather than treat this infection in cats and discusses the role of both ivermectin and selamectin. CRITIQUE. The educational strength of this web site clearly outweighs any negative aspects. Although most of the illustrations and maps are of good quality, the quality of some charts, including the D. immitis life cycle, is disappointing. In addition, when printing an image from the screen, all of the artifacts viewed in the on-screen image become enlarged and enhanced. Some of the radiographic and photomicroscopic images are particularly small. The occasional use of video in Part 3 to illustrate echocardiograms is, however, especially well done and significantly enhances the educational value of the site. Although the definitions of pertinent terms are generally of value to most practitioners, several of the definitions given are superficial. For example, type II alveolar cell hypertrophy is defined as “a large cell in the airspace that makes surfactant” without stipulation as to whether hyper-

Compendium September 2000

Small Animal/Exotics

trophy has detrimental clinical consequences to cats infected with D. immitis. Occasional misspelled words can be found, although they do not significantly detract from the presentation. In Part 2, the glossary-linked term hemglobinurea (sic) actually defines hemoglobinuria. Finally, the web site does not indicate the currency of the information being presented and when the most recent update was completed.

ABOUT THE AUTHOR
Richard B. Ford, DVM, MS, is professor of medicine, Department of Clinical Sciences, School of Veterinary Medicine, North Carolina State University, Raleigh. He is a Diplomate of the American College of Veterinary Internal Medicine and has an interest in promoting the Internet to enhance the practice of veterinary medicine.

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