When 4-year-old Kili first got some sort of cough, the mixed race pit bull owners thought he was choking on something.
But then it got worse – he suffered a central nervous system infection, lost weight, hid from light, and had muscle tremors, among other things.
The vets at Kahului Animal Hospital could not figure out what was going on and ran numerous tests for several weeks from the end of January while treating Kili. Eventually they diagnosed rat lungworm disease, a disease rare in Maui aside from an increase in cases in 2017.
After hearing the doctor’s diagnosis and seeing Kili suffer, his owners decided to put him to sleep.
“No question, it was the right thing” Veterinarian Terry Smith said Monday.
Animals cannot transmit the disease to humans and the number of cases has been low, but Smith wants to raise awareness among pet owners not to lose their vigilance.
The disease is caused by small parasitic roundworms or nematodes that live in rats, slugs, and slugs. Rats house the worm and direct larvae through their feces, which are eaten by slugs and slugs that are later eaten by rats, repeating the cycle. The worms become dangerous when they enter other animals or people. According to the Ministry of Health, the disease affects the brain and spinal cord.
Kili’s owners and vets noticed a huge difference in the dog after contracting the disease. He went from “lively” and “Loading around” and “Do mischief” to be “awake all night” Smith, who runs the veterinary clinic with his vet Debbie Dorsey, shook and developed two large lumps on each side of his jaw.
Through much testing and care, including staying with Smith and Dorsey, Smith finally determined in late February that it was lungworm disease in rats. Laboratory tests confirmed this last week.
“It was first and foremost a diagnostic challenge” Said Smith. “There is no simple test.”
He also noticed how much Kili’s family loved him by allowing Smith to run multiple tests to find a cure.
Smith performed an autopsy after Kili’s death and collected blood and tissue samples to be sent to the laboratory of the Daniel K. Inouye College of Pharmacy at the University of Hawaii at Hilo. Blood tests showed nothing, but the tissue samples were key.
Since the test results confirmed the diagnosis on March 24, Smith has called government officials, including the Department of Health, to inform them of his results. He would also like to receive informational posters in veterinary practices across the state.
Kili’s home is in the Twin Falls area of east Maui, which has other domestic animals, livestock, and farming, all of which are potentially susceptible to rat lungworm disease, said Smith, who suspects Kili may have eaten a snail.
Health Ministry spokeswoman Janice Okubo said in an email on Monday that the ministry is not tracking down pets infected with the disease because pets do not transmit the disease to humans. However, Okubo advised people to wash the products before consuming them to prevent ingestion of organisms that could transmit a rat lungworm disease that is endemic to rodents, slugs, and slugs in Hawaii.
There have been no confirmed human rat lungworm disease so far this year in Maui County, according to DOH, although two confirmed cases have been confirmed in Hawaii County. Last year there was one case in Maui county and two cases each in Hawaii and Honolulu counties. The majority of rat lungworm cases in the state are on the island of Hawaii.
Maui county had a high rate of rat lungworm infections in humans in 2017. Seven cases have been reported, including four residents and three visitors.
Some people with the disease have mild or no symptoms. Symptoms may include severe headache and stiffness of the neck, tingling or painful feelings in the skin or extremities, mild fever, nausea, and vomiting, according to the DOH.
Temporary facial paralysis is a potential symptom, as is sensitivity to light. Symptoms usually begin one to three weeks after exposure, but can range from one day to six weeks after exposure.
Okubo said rainy seasons often mean slugs and slugs in gardens and yards, which can put an increased risk of rat lungworm disease for both humans and pets.
For more information, see health.hawaii.gov/docd/disease_listing/rat-lungworm-angiostrongyliasis/.
The University of Hawaii College of Tropical Agriculture and Human Resources has information on slug and slug control at manoa.hawaii.edu/ctahr/farmfoodsafety/rat-lungworm/.
* Melissa Tanji can be reached at firstname.lastname@example.org.
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