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Salmon Poisoning Disease and Elokomin Fluke Fever in Dogs

By Otto M. Radostits, CM, DVM, MSc, DACVIM (Deceased), Professor Emeritus, Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan ; David A. Ashford, DVM, MPH, DSc, Assistant Area Director, International Services, APHIS, USDA ; Craig E. Greene, DVM, MS, Professor, Department of Small Animal Medicine, College of Veterinary Medicine, University of Georgia ; Eugene D. Janzen, DVM, MVS, Professor, Production Animal Health, Faculty of Veterinary Medicine, University of Calgary ; Bert E. Stromberg, PhD, Professor, Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota ; Max J. Appel, DMV, PhD, Professor Emeritus ; Stephen C. Barr, BVSc, MVS, PhD, DACVIM, Professor of Medicine, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University ; J. P. Dubey, MVSc, PhD, Microbiologist, Animal Parasitic Diseases Laboratory, Beltsville Agricultural Research Center, USDA ; Paul Ettestad, DVM, MS, State Public Health Veterinarian, Epidemiology and Response Division, New Mexico Department of Health ; Kenneth R. Harkin, DVM, DACVIM, Associate Professor, College of Veterinary Medicine, Kansas State University ; Delores E. Hill, PhD, Parasitologist, U.S. Department of Agriculture ; Johnny D. Hoskins, DVM, PhD, Small Animal Consultant ; Jodie Low Choy, BVSc, BVMS, IVAS Cert, Menzies School of Health Research; University Avenue Veterinary Hospital, Northern Territory, Australia ; Barton W. Rohrbach, VMD, MPH, DACVPM, Associate Professor, Department of Comparative Medicine, Veterinary Teaching Hospital, University of Tennessee ; J. Glenn Songer, PhD, Professor, Department of Veterinary Science and Microbiology, University of Arizona ; Joseph Taboada, DVM, DACVIM, Professor and Associate Dean, Office of Student and Academic Affairs, School of Veterinary Medicine, Louisiana State University ; Charles O. Thoen, DVM, PhD, Professor, Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University ; John F. Timoney, MVB, PhD, Dsc, MRCVS, Keeneland Chair of Infectious Diseases, Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky ; Ian Tizard, BVMS, PhD, DACVM, University Distinguished Professor of Immunology; Director, Richard M. Schubot Exotic Bird Health Center, Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University

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Salmon poisoning disease is an short-term, infectious disease of the dog family, in which the infective agent is transmitted through the various life cycle stages of a flatworm known as a fluke. The name of the disease is misleading because no poison is involved. Elokomin fluke fever resembles salmon poisoning disease but infects a wider range of animals, including members of the dog family (dogs, foxes, wolves), ferrets, bears, and raccoons. These two disorders occur only in the Pacific Northwest region of the United States, from San Francisco to the coast of Alaska.

Salmon poisoning disease is caused by the bacterium Neorickettsia helminthoeca. Sometimes the disease is complicated by a second agent, Neorickettsia elokominica, which causes Elokomin fluke fever. Animals become infected by eating trout, salmon, or Pacific giant salamanders that are infected with cysts that contain the larval stage of the rickettsia-infected flukes. It is the rickettsiae bacteria that cause the disease; the fluke infection itself produces few or no signs of disease. Transmission by dog to dog contact is rare.

In salmon poisoning disease, signs appear suddenly, usually 5 to 7 days after eating infected fish. In some cases, however, the onset of signs may take as long as 33 days. Signs usually continue for 7 to 10 days before culminating in death in up to 90% of untreated animals. A high fever may be seen initially, which peaks in 1 to 2 days and then gradually returns to normal. Frequently, animals have abnormally low body temperature before death. Fever is accompanied by depression and complete loss of appetite in virtually all cases. Persistent vomiting usually occurs by day 4 or 5, followed by diarrhea that may be severe or contain blood. Dehydration and extreme weight loss occur. The lymph nodes may be enlarged. Nasal or eye discharges may be present.

Elokomin fluke fever is generally a milder infection than salmon poisoning disease. The severe gastrointestinal signs seen with salmon poisoning disease are less common in Elokomin fluke fever infections. However, disease of the lymph nodes may occur more often. Death occurs in only about 10% of untreated cases. Flukes embedded in the duodenum account for little tissue damage.

In both infections, fluke eggs can usually be seen on fecal examination, which helps with the diagnosis. The eggs are oval, yellowish brown, and rough--surfaced. If your veterinarian cannot find fluke eggs in your dog’s feces, then lymph fluid may be examined for evidence of the bacteria.

Currently, the only means of stopping this disease is to prevent the consumption of uncooked salmon, trout, steelhead, and similar freshwater fish. In dogs that recover, there is a strong, long-lasting immunity to future infections. However, dogs that have been infected with Neorickettsia helminthoeca are still vulnerable to Neorickettsia elokominica and vice versa.

Various drugs may be given to treat these infections. Early treatment greatly increases the chances for survival. Animals that die from these infections have usually received delayed treatment. Death is often because of dehydration, electrolyte and acid-base imbalances, and anemia. Therefore, your veterinarian will prescribe general supportive treatment to maintain fluid levels and acid-base balance, while meeting nutritional requirements and controlling diarrhea. In some cases, blood transfusions may be helpful.

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