Do you have lungworm on your differential?

Journal of Feline Medicine and Surgery, 2017

Author

Obi Veterinary Education
August 20, 2025

Paolo E. Crisi, Giovanni Aste, Donato Traversa, Angela Di Cesare, Elettra Febo, Massimo Vignoli, Domenico Santori, Alessia Luciani, Andrea Boari

Background
Feline lungworm infections, caused by Aelurostrongylus abstrusus, Troglostrongylus brevior, and Capillaria aerophila, are an emerging concern in respiratory diseases of domestic cats. Infection occurs through ingestion of intermediate or paratenic hosts, with clinical signs ranging from subclinical to severe respiratory distress. Diagnosis is complicated by overlapping symptoms with other respiratory diseases. This study aimed to describe the clinical, radiographic, and therapeutic aspects of feline lungworm infections in a referral hospital setting.

Methods
A retrospective study reviewed medical records of 26 cats diagnosed with lungworm infections between 2013 and 2015. Inclusion criteria included copromicroscopic confirmation, thoracic radiographic examination, absence of concurrent diseases, and post-treatment follow-up. Clinical presentation, hematology, radiographic findings, and response to anthelmintic treatment were analyzed.

Results
Of the 26 cats, infections were caused by A. abstrusus (n = 15), T. brevior (n = 3), C. aerophila (n = 1), or co-infections with T. brevior/A. abstrusus (n = 6) and T. brevior/C. aerophila (n = 1). Clinical signs included coughing (46.2%), increased vesicular breath sounds (38.5%), dyspnea (34.6%), and tachypnea (23.1%). Radiographic abnormalities were predominantly interstitial (92.3%) and bronchial (80.8%) patterns. Anthelmintic treatment with fenbendazole, moxidectin, emodepside, or milbemycin oxime resulted in recovery in 25/26 cats within 2–6 weeks. One kitten with severe infection died.

Limitations
The study was retrospective and limited to a single veterinary center, which may not fully represent the general feline population. Some cats had incomplete diagnostic workups, and histopathological confirmation of lungworm-induced lesions was not performed. The effectiveness of different anthelmintic treatments was not directly compared in a controlled study design.

Conclusions
Lungworms should be considered in cats presenting with respiratory signs, particularly in endemic regions. Copromicroscopic examination remains a key diagnostic tool, and thoracic radiography can provide supportive findings. Early diagnosis and appropriate anthelmintic treatment result in favorable outcomes in most cases. Further studies are needed to evaluate optimal treatment protocols and assess the epidemiological trends of feline lungworm infections.

Radiographic studies of a 7-year-old domestic cat infected by Aelurostrongylus abstrusus (cat 8) at referral (a,b) and 2 weeks (c,d) after therapy with moxidectin. Note the presence, at referral (a,b), of a moderate bronchial pattern, a well-defined alveolar pattern in the cranial lobes with small air bronchograms, and multiple nodular lesions through the lung fields. At day 14 (c,d), the cat showed the resolution of nodular lesions and a mild bronchointerstitial pattern

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