Liver flukes in cats

Liver flukes in cats

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Liver flukes in cats and dogs: A neglected neglected disease {#s0005}


A neglected neglected disease is defined by the World Health Organization as "a disease that does not receive the necessary attention, because of a lack of political commitment or prioritization, a lack of resources, poor coordination or integration between different programmes or sectors of society, and a lack of commitment on the part of individuals and communities that results in the lack of needed services and preventive or curative care. Neglected neglected diseases include malaria and human African trypanosomiasis, for which elimination is feasible". In the case of feline and canine *Dipylidium caninum* tapeworm infection, elimination is a daunting task given the complexity of the disease and the fact that the parasite is found only in canids ([@bib0045]). Moreover, cats can only become infected with the parasite following a process of exposure to faeces contaminated with larvae shed from a canid reservoir host ([@bib0010]). The life cycle of *D. caninum* is mntned by the cat-eating dog, as the definitive host, and by *R. sanguineus* s.l. ticks, as the intermediate host ([@bib0010]). Humans are the accidental and dead-end hosts.

This neglected disease is not the only one to be neglected in its entirety by the scientific community: the feline *Dipylidium caninum* tapeworm is the only member of the genus *Dipylidium* to be recognised in humans (with human infection by *D. caninum* being reported in only seven countries: Brazil, Ecuador, India, Japan, Panama, Paraguay and Puerto Rico) and the only member of the *Dipylidium* genus to be considered a neglected disease.

In veterinary medicine, *D. caninum* is an important helminthic infection, and it is estimated that at least 500,000 dogs and 25,000 cats in North America and Europe are infected with this parasite ([@bib0105]).

The *D. caninum* tapeworm is a large, flat, unsegmented tapeworm, 1--3 mm in length, with a mean length of 2 mm, which dwells in the small intestine of dogs. In humans, the parasite is a segmented worm and is about 9--10 cm in length. In dogs, the tapeworm dwells in the small intestine, colon or caecum ([@bib0105]). In cats, the tapeworm, after ingesting larvae shed in dog faeces, dwells in the caecum ([@bib0105]).

*D. caninum* tapeworms are excreted in the faeces of infected dogs, in the soil and water, as well as in the hr of the infested dog. They can be easily transmitted to cats through direct contact with contaminated soil or fomites ([@bib0105]). A dog can harbour several thousands of the tapeworm's progeny, the dog's immune system controls their development until they reach maturity and then they are expelled in its faeces. When a cat eats contaminated faeces, a first phase of development takes place, but after about 30 days the larvae hatch and move towards the stomach, where the adult worms start maturing. The adult worm is exsheathed in the cat's stomach for about 10 days and then leaves the cat through the intestinal wall and reaches the intestine of the definitive host ([@bib0045]). Dogs become infected through the ingestion of larval faeces contning infective stages. Once the dog is infected, the tapeworm undergoes development and the larvae hatch in the small intestine and pass to the caecum, colon, or rectum, the number of eggs produced in the dog's faeces depends on the dog's age and weight and on the amount of faeces the dog eats ([@bib0105]).

In most cats, *D. caninum* tapeworm infections are considered of low importance because of the low percentage of cats with faecal parasite egg counts greater than 5,000 eggs per gram of faeces (epg) ([@

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