The sensitivity of direct faecal examination, faecal flotation and centrifugal sedimentation / flotation in the diagnosis of canine spirocercosis

Abstract

A variety of faecal examination methods have shown variable sensitivity in identifying larvated Spirocerca lupi (S. lupi) eggs. The purpose of this study was to determine which faecal examination method, including a novel modified centrifugal flotation method, was most sensitive in the diagnosis of spirocercosis. Faeces were collected from 33 dogs diagnosed with spirocercosis by oesophageal endoscopy at the Onderstepoort Veterinary Academic Hospital between 2008 and 2009. If the first evaluation was negative, a second faecal sample was evaluated 24-48 h later. Ten faecal examinations using 1 g aliquots of faeces were performed per sample. Four faecal examination methods were evaluated; direct faecal examination using saline, direct faecal flotation, a modified faecal centrifugal flotation and a laboratory performed faecal sedimentation/flotation. The direct and modified centrifugal flotation methods were each performed using four faecal flotation solutions; NaNO3 (Specific gravity (SG) 1.22), MgSO4 (SG 1.29), ZnSO4 (SG 1.30) and saturated sugar (SG 1.27). The sedimentation/flotation method utilized MgSO4 (SG 1.29). The modified centrifugal flotation method required centrifugation (1400 G) of a prepared faecal suspension (1 g faeces suspended in 5 ml of flotation solution) after which 0.1 ml of the supernatant was aspirated from the surface using an adjustable volume micropipette for microscopic examination. The 10 faecal examination tests were statistically analysed using the Friedman test (nonparametric equivalent of analysis of variance) p=0.000, z value = 0.05. The sensitivity of the tests ranged between 42 % and 67 %, with the NaNO3 solution showing the highest sensitivity in both the direct and modified centrifugal flotation methods. The modified NaNO3 centrifugal method ranked first with the highest mean egg cell count (45.24 ± 83). The modified centrifugal NaNO3 method was found to be superior (i.e. higher egg counts) and significantly different (p<0.001) compared with the routine saturated sugar, ZnSO4 and MgSO4 flotation methods. The direct flotation method/technique using NaNO3 flotation fluid was also superior and significantly different (p<0.001) when compared to the same technique using ZnSO4 or MgSO4 flotation fluids. Neoplastic transformation of oesophageal nodules was confirmed in 15 % (n=5) of dogs and a further 18 % (n=6) had both neoplastic and non-neoplastic oesophageal nodules. S. lupi eggs were demonstrated in 40 % of dogs with neoplastic nodules and in 72.9 % of dogs with non-neoplastic nodules. The mean egg count in the non-neoplastic group (61) was statistically greater (p=0.02) than that of the neoplastic group (1). The results show that faecal examination using the direct and modified centrifugal flotation methods with the NaNO3 flotation fluid are the most sensitive methods in the diagnosis of spirocercosis. The modified centrifugal flotation method using this solution has the highest mean egg count. The study also found that dogs with neoplastic nodules shed significantly fewer eggs than dogs with non-neoplastic nodules. Copyright