Hello, it's Anthony Chadwick from the Webinar Vet welcoming you to another episode of VETchat. Very fortunate today to have an old friend on the podcast with me, Ian Wright, who is the chairman of ESCCAP. The European, let's see if I get this right, society companion animal, parasites. Yeah, yep, that's right, yeah, European Scientific Council for companion animals. Close enough. I was, you knew, I knew what you were about here. You're the worm man, aren't you? That's it's close enough for government work, yep. So Ian, I know SAP's a really interesting story because of course as well you're, you're still very much a practising vet, so we'll talk a little bit about maybe. Some of the challenges, some of the things that you've seen different from maybe 10 years ago, in practise, but how do you as a Superman manage to do all of these things? Well, it's a lot of balls in the way, in the air, you know, I mean, I have a very, very supportive and understanding wife, that makes it, that makes it possible. And, you know, really good, really good support teams. I know people always say, oh, you know, I couldn't do it without, but, you know, I have a great, great team at the vets, and I have secretariats at SCAP that keep me organised. so without those three influences, you know, just everything would probably burn down, you know, but. No, no, I've got people who, who, you know, tell me where I need to be, what I need to be doing, and, keep busy. But on the whole you get there. Yeah, absolutely, absolutely. But, still enjoying it, still enjoying practise, and of course, still love my parasites. Yeah, I, I must admit, I think. I think it was parasitology, er, which I was taught by by Lord Trees or it was microbiology, one or other of them. And I think it was parasitology I got a credit on. And of course as a dermatologist, we all love to do a nice scraping. If you find a scabies mic, there's there's nothing quite like that whoop that goes up in the the back room with the microscope. Find something exciting crawling under that microscope, kind of makes your day, doesn't it really? I remember I always tell the tale, Ian, I was at a British veterinary dermatology study group meeting and we had a human doctor there who was talking about parasites and he he put a picture up on the PowerPoint and he said this is a . A scabies mate and of course he was showing a Kaylatiello mite which we all took a bit of fun at the end going up to him and saying, no it was Kayla Tella, no it's cabies, no it's Kaylala. On the 5th person went, I think he began to get a bit embarrassed that he'd backtrack he' got his parasites wrong. Happens to us all. Has to the best of us, doesn't it? So normally, normally I'll get a blurred picture of something that might be Sellotape or might be a tapeworm, and you're like, you know, which one, which one is it so. It's always, yeah, like a challenge. All good. But the practise up in Fleetwood, just small animals. Yeah, just, just small animals. Someone was asking me the other day if I could advise them on their cow, and I was like, it's a long time, other than, you know, bits of cow that might have like tapeworm cysts in, you know, it's a long time since I've seen a living, breathing cow as a patient, so, no, it's cats, cats and dogs for me, largely, bit of rabbits, small furies. Tortoises on the books, that's about as exciting as it gets, really. And I think looking first at the practise element, you, are you seeing a lot of change maybe over the last 10 years in just the people coming in? I know now there's definitely an an increase in the number of pets that are brought. From abroad, somebody goes on holiday, they, they see a cat, a scrawny cat in Cyprus or somewhere, their heart breaks and they decide to bring it back. And cats and dogs, these, these will potentially come with parasites that, at this point aren't that common in the UK. Is that something that you're seeing more of in your practise? Oh yeah. Absolutely, and I think, you know, perhaps there's an assumption that because I have a certain interest in this field, you know, that that would increase the likelihood of me seeing these cases. And you know, there are cases that come to me specifically because of my parasite interest. But even if I had no interest in parasites at all, there is. In an increasing trend, even in, you know, the relative, you know, peaceful suburbs of Fleetwood, you know, we, we're seeing this trend of people adopting from abroad, and I, I would say it's become more the sort of norm now, rather than it being an exceptional thing, maybe 1015 years ago. You know, it's very common now for people to either go online and they'll see, you know, a poor, you know, pet that they, they want to adopt, or as you say, they'll actually go on holiday and see the map. So, you know, as opposed, say, to pet travel, which took a sort of heavy knock in COVID and now with animal health certificates has become a little bit more difficult. Still seeing a pick up in pet travel again, but it's taken that knock back. I mean, importing, you know, rescue pets essentially from abroad has just been an upward and upward trend. And of course, you know, the illegal importation of puppies from abroad to meet demand as well, which is another sort of issue that's going on in the background. So, you know, these are, these are big concerns going forwards and. It means that, you know, if this is becoming more the norm, then a lot of pets will have been imported, especially over the COVID period. A lot of them unfortunately have behavioural problems, so you know, some don't, or they're very well handled, you know, the situation's recovered very well by their new owners, but if that situation doesn't happen, they can often be rehomed very quickly, and that means that that travel history, you know. The potential for them to have exotic parasites might be lost. So I think increasingly as as vets and and nurses in practise, we need to be aware that there might not be that obvious travel history and, you know, exotic parasites, more unusual parasites might be present. Yeah, I remember obviously as dermatologist, occasionally, probably 2 or 3 times within my dermatology career seeing Leishmania, you know, we went to every conference we went to with the SVD there was always a Leishmania talk because of course it's a huge problem in Italy, Spain, Portugal and then starting to see them in the UK and then I remember Sue Shaw actually had a case that seemed to have jumped. From one dog to the other, although there were no sandflies present but they thought were there fleas or whatever. Where are we up to with something like Leachmania now, is that something you're seeing? On a reasonably regular basis coming into your practise. Yes, it is, yeah, yeah, and I mean hopefully, I mean some Leishmania cases tragically don't live for very long, but if they're well managed, I mean some of theseishmania cases will live for many months or years. So you start to collect them and you know, they all require, if they're going to be well managed, they, they all require relatively close. Monitoring ongoing treatments. So I think we're all getting more practise at managing leishmania cases these these days. One of the misnomers, so, so we're having an increasing number of leania positive dogs coming in, and that means that hopefully, because some of them will be well managed and survive, you know, we're getting increasing total numbers of lemania in the country. And we're not unique in this regard, it's a, it's a huge phenomenon in Germany where, you know, they've had very large numbers of imported positive dogs, and the concern then becomes, you know, there's this, this feeling that it couldn't become endemic because we don't have the sandflies. I mean, we need to be a little bit vigilant there because the sandflies themselves are on the move. But if we assume for the foreseeable future, we're not going to have some flies, you know, Leishmania can still be transmitted in other ways. So, you know, it can be transmitted congenitally, can be transmitted venerially and through ways that we, we're not fully, you know, understanding. So, you know, there have been cases of horizontal transmission. Where we're just not 100% certain how that's occurred, maybe through licking of open sores, as has been suggested, dog bites has been suggested, blood transfusion, we know that it can occur that way, but also there is a little bit of an open question, no strong evidence, but a little bit of an open question as to whether biting flies may act as mechanical vectors, as well. So, You know, just because we don't have some flies doesn't mean that we shouldn't be vigilant, we shouldn't be taking sensible precautions, but the key is surveillance, really, it's screening dogs forage mania that are coming in, and dogs that have relevant clinical signs that may have associated with travel dogs or may have travel history. Because if we pick these cases up early, you know, the better our chances of preventing onward transmission, but also just of managing the case for the individual, you know, if it's closely monitored, if it's on treatment when it needs to be on treatments, you know, outcomes for the individual patient are likely to be better. And of course the other worry is that there is a zoonotic implication to Leishmania as well, but do you feel if they're on regular treatment that. Very much lessens the possibility of transfer to pet owners or whatever. Yes, yes, so I mean leishmania is a significant zoonosis and not to be taken lightly, but people tend to get in get infected from some fly bites in in endemic countries. I mean, I'm not actually aware of a single human case that's taken place away from sandflies in an immune competent human. So, you know, we, we shouldn't be, you know, taking too many chances. I mean, I did have a colleague that unfortunately took a blood sample from a Leishmania positive dog and accidentally stabbed herself with a needle, and I mean she contacted a GP and the GP was like. I just wait and see what happens, you know, you'll be fine. And you know, she was as it transpired, but I don't think I'd be taking those sorts of chances. I think that sort of sensible precautions, good hand hygiene, especially if you have got open sores, you know, avoiding prolonged contact with immune compromised individuals is very sensible, but I think if you're taking those sensible precautions. You know, I wouldn't be overly concerned about the immediate zoonotic risk from leishmania. You know, the, the main concern is the risk to other dogs by transmission and like I say, possibly through routes that you wouldn't expect. So that's, that's where that vigilance is really important. So taking you maybe away from the practise now, but into your position as as chair, obviously of a European organisation and. I, I think although the, the, the British Channel was an isolationist tool for many hundreds of years, that's, that's very much gone with all of the travel, both of our pets into Europe, but also pets coming from Europe. Where are you seeing, you know, with global warming, we're starting to see, ticks and so on that we've never really seen in. The UK like Dema centre, but what would be your maybe five top parasites that, as an organisation, SSCAP is, you know, particularly worried about? Probably the the more exotic, the better. If you say fleas, we know they're here. They've always been, so, so there are, you know, there are parasites like fleas and, and toxicarra around which there has been much debate, but they're, they're ubiquitous, so you know, they're in every country that you're likely to visit, you know, their, their prevalence might vary, but their, their distribution is, is very, very wide. I, the, the, the one that I used to be, reminded of from the, the, the dermatologist from Colorado because it was so high up and so dry, they basically said we don't get fleas in Colorado, so that was interesting. But you know, I also remember the story Bob Dryden told, I think it's Bob, isn't it, about going to a vet's practise, a vet's house for a meal in, in Florida and outside there was a brass plaque saying this is the house the fleas built. Cos he'd made so much money on, I think selling flea treatments to the many well yeah if you go to if you go to Florida, you know, so, so that is, you know, I mean it is true, yes, that there are areas that are way too dry for fleas and areas where they're just having the dream holiday, you know, Flo Florida is built for fleas, and pretty much every vector borne pathogen you you can imagine, but you know, by and large in Europe, pretty stable. Our concern, I mean our concern, yes, regards those parasites, but it's the rapidly changing distribution of some parasites which is likely to catch people out, and that is a major point of concern. So, you know, you have your, your old favourites in Europe, so you have your Leishmania and your heartworm are expanding, especially heartworm is expanding its distribution very rapidly. So, you know, it's moving northwards, especially northwards through Eastern Europe. So, you know, through the sort of Baltic countries, Romania, Bulgaria, and a lot of areas that you might not have expected, so that, you know, doesn't mean it's immediately likely to arrive in the UK and establish, but it means there's more and more countries where, you know, you might not be expecting it to be that it's arrived. And a similar thing at a slightly slower rate, but a slightly sort of similar thing is happening with Leishmania in that that sort of, you know, gradual increase in temperatures is allowing spread of sandflies, and then, you know, once you've got the vector with an increased distribution. Temperatures and movement of pets allow parasites to move into new areas. So you have parasites like heartworm, where the mosquitoes that can transmit it are almost everywhere, but it's temperature that keeps it out. So as soon as the temperature comes up, that's like the, the fuel, you know, that could ignite your your heartworm fire. And then dogs, infected dogs moving around or you know, wildlife reservoirs moving around the ignition that might allow it to establish in a new area. But you also have parasites like ellazia eyeworm, which is, you know, one of my new favourites, you know, that is transmitted via fruit flies. So fruit flies aren't parasitic, but they like feeding on eye secretions, that's how they transmit the worm. They have loved increased movement of vehicles, plant products, wind dispersal into warmer areas. So, you know, there are lots of factors driving their spread, but it's the changing climate directly that has allowed the fruit fly to expand right across Europe, including into parts of the UK. So then, you know, if you have infected dogs moving eyeward, Around, that is a new opportunity for Iworm to establish. So it's actually following its vector into new areas. And so you're seeing clinical cases of halaia, are you in? Yeah, absolutely, yeah, far more common than you might realise. And here again, surveillance is really important to watch out for on travel cases, but also to see where the travel cases are coming in. So little plug, I won't be forgiven if I don't have a little plug, the APHA with SAP have a free worm identification service for Falazia I worm, diophylaria ripens, which is a subcutaneous worm that's closely related to heartworm. And linguula serrata, which is called the tongue worm, it's a nasal pentastomid, it's a lovely little shrimp-like creature that that can live up your nose, you know, so if you think you've seen any of these in dogs and you've got cats and you've got specimens, you can send those specimens in, confirm their identification, but also they will contribute to surveillance data and mapping in the UK. What, what are the clinical signs of Thalasia, do you want to go over a quick sort of how you, so, so, so what all those three parasites that I've just mentioned have in common is that they could all establish in the UK. So, diophylaria ripens, mosquito transmitted, it doesn't need the warm temperatures that heartworm needs. Lingotua serata, nasal pentastomid is transmitted through raw, infected offal consumption. We have had an untraveled case in the UK, the year before last. We don't really understand how that happened. It may be that we've got a little bit of a reservoir already in our wildlife or livestock, but they, it was eating imported food. So it may have come in from imported food, but once it's here, it could start to cycle in our livestock, deer, sort of wildlife, sort of, you know, rabbits, you know, quite easily. So, you know, so that's another one that could establish. And then Falazia I worm in fruit flies. So Falasia, you tend to see the worms, just, I mean, you know, but what could be more exciting than finding some worms, either behind the third eyelid or wandering across the eye, and they cause, unsurprisingly, they cause eye irritations. You get conjunctivitis, ulcers, you know, so those are the sorts of signs that you'd be looking for there. Diophylaria ripens unfortunately is often subclinical for picking it up quickly, but when it does cause clinical signs, it can be nodules on the skin, or it can cause eye problems, or you can get just a lovely big incidental worm. So it's a famous case of one that came into the UK. From Greece, if I remember rightly, and no clinical signs, the dog, but when they did, a pre-scrotal incision for castrate, the worm climbed out and it was like, oh, it's like a 14 centimter long worm. So, you know, you may find them incidentally, he might get skin lesions. And then the most, the most common time that linguula is identified is when it's sneezed out on the carpet. You know, the owner, you know, gets on the big red phone, they're like horrified. I've got something that looks like an extra from Alien, and it's just been sneezed out on my carpet. But you know, there is, some potential for direct zoonotic risk with lingu tua, so it having been sneezed out on the carpet, you know, you, you'd want to treat it. So what treatments are they for the for the three cases? OK, so, so forlasia, there, there are licenced, macrocyclic lactones that you can use. There's there's products that you can use there. Diophylaria ripens for a long time. Moxidine amioloprid has been licenced, so you can use that. Occasionally with diophylaria ripens, you need to operate on nodules and with Fellasia, it's always good to actively flush the worms out of the eye as well. Lingotu is a bit tricky because there hasn't been, well, very many cases that have been followed through and written up, but it would appear that they're sensitive to macrocyclic lactones, and you can always just go in with a scope and physically fish them out as well, like some sort of bizarre hooked up game is going, pick out your lingoulas, and that's a good way of checking that you're clear of infection as well. Yeah. Perhaps just to finish, obviously tick-borne diseases now, what ticks are we starting to see? Kind of like derma centre of being travelling up, but what sort of diseases are we seeing more commonly like Babezia and so on. Well, yeah, so, so there's two phenomenon going on. So, you know, there are ticks that we've always had. So, so we've always had dermaenter, they just live in little pockets in the UK. I mean we have visiting derma centres as well, but there's an ongoing risk in endemic areas for dermaenter in the UK. But be easieria could establish. So, you know, if you're in one of the patches in Wales, southwest, southeast of England, just being aware if dogs present with IMHA or IMT that the Bezia could be the cause and that it might be in an untraveled dog, just like in the Harlow outbreak a few years ago, you know, that's really important, so we need to be aware there. We've got lots of ICoes ticks, always have done, but they are more active, you know, they're active for longer because of climate change, and because we've got increased green space, which is wonderful, it's a wonderful thing. We've got lots more forests, we've got increased green space in urban areas with wildlife corridors. You know, it's very easy for wildlife and ticks to get closer to people and for us to go out and enjoy the great outdoors and come into contact with Io these ticks. So we just have to be aware of that potential for increased contact as as humans, but also for our pets that might be enjoying the, the great outdoors. And I mean with Ixos, we have the ongoing concern about Lyme. The the new player in town in the UK is tick-borne encephalitis virus, which we know is present in little pockets in the Thetford Forest and in the New Forest, which is like New Forest is absolutely beautiful. I'd encourage people to. Go and enjoy it, love the New Forest, but please take some tick precautions, cos it is like the inner circle of tick hell down there. Do we, do wear trousers and have socks that go over your trousers. Absolutely just abandon fashion. Just have your trousers in, in your socks. But those are new areas for tick-borne encephalitis virus, but unfortunately a poor human individual had a case in Yorkshire with no travel history, so we need just to be aware for the possibility if you've got a dog. Presenting with unexplained neurological signs that TBV might be present, and we are seeing, we appear to be seeing an uptick in looping ill cases in dogs as well, which of course always been present in the UK. And I think it's to do with increased awareness, but also just more ticks, more ticks active for longer, more opportunities for us to come into contact with them. And then finally, always want to be on the lookout for yhocephalus sanguinus, which mercifully we don't have in the UK. It's not quite warm enough yet, but if it's brought in with imported or travelled pets, it can set up shop and live in. Your home like fleas do, it loves a bit of central heating, loves a bit of humidity, and it will feed on anything that moves, and, you know, can transmit a wide range of pathogens. So, you know, we just need to be aware of that possibility as well. Ian, it's always fascinating to listen to you. You're obviously a huge enthusiast for all things creepy crawling. You. I am, yes, I'm just not quite at your level. But it it's been, it has been frustrating. No, my pleasure. I think bringing you up, bringing you up to date is so good that obviously you've got the SAP experience, but you're in practise and I found when I was doing my dermatology, having the first opinion element as well as the referral element was very good from a just seeing the bigger picture. Specialists, if they're only seeing one type of case it can it can limit them, so the fact that you're still in practise seeing all these, you, you're getting a really good idea, even up in, in the wild north of Fleetwood. Well yeah, it doesn't get any on this bit of peninsula, it doesn't get any further north than Fleetwood, so yeah. But if they're getting that far up, they're they're getting up, aren't they? They they're travelling. Absolutely. Ian, thank you so much. It's, it's really useful because some of these are obviously really important parasites and it's so important. I think also to understand the localities because more and more we need to look at how we localise and we personalise treatments for pets as well. I think my take home message would be, be vigilant. Never think it couldn't be Parasite A because it doesn't live here. It could always be parasite A, you know, if you've got relevant clinical signs, so, you know, it's just, it's just having that flexibility really and testing if you, if you think you might have something. Ian, thank you so much. I know how busy you are with the practise and with SSCAP, so thanks for coming on and hopefully see you very soon. Brilliant, my pleasure. Take care. Thanks. And listen, thanks everyone for listening and hopefully see you on a podcast or a webinar very soon. Take care and apologies for my shifting about. I have a bit of sciatica at the moment. So if my, if you're seeing this rather than just listening, you might have got a bit seasick with me. Swaying but thank you Ian. Alright, take care everyone, bye bye.