Use of corticosteroids during treatment in dogs infected with Dirofilaria Immitis. Is it a risk or a benefit?

Abstract

D-dimer, a biomarker resulting from fibrin degradation, is a key protein used in the diagnosis of pulmonary thromboembolism (PTE). PTE is a life-threatening complication in dogs infected with Dirofilaria immitis, however, there are conflicting results regarding treatment with glucocorticoid therapy in these patients. This study aims to investigate the effects of glucocorticoids on d-dimer in dogs with heartworm disease before, during and after adulticidal therapy. Plasma of 48 dogs infected with D. immitis undergoing adulticide therapy, was analyzed on days 0, 30, 60 and 90. Furthermore, parasite burden, presence or absence of pulmonary hypertension, and presence or absence of microfilariae, were determined on day 0, and nearly 40% of the dogs studied received corticosteroids. The results showed that the use of anti-inflammatory doses of glucocorticoids do not produce significant variations in D-dimer. Dogs not receiving corticosteroids appeared to have higher baseline D-dimer levels at the start of treatment, which decreased within the first 30 days to maintain then a mean value of 0,1μg/mL. On the other hand, dogs receiving corticosteroids started with slightly lower baseline levels of this biomarker, which remained relatively stable throughout the 90-day period. More studies are necessary, but results indicated that in specific cases, such as high microfilariae load, prior treatment with glucocorticoids at anti-inflammatory doses of 0.5mg/kg BID could be recommended to minimize possible reactions such as PTE in heartworm disease.