# Successful Transvenous Extraction of Adult Dirofilaria immitis Parasites from a Naturally Infected Domestic Ferret (Mustela putorius furo)

## TL;DR

A 2-year-old ferret was successfully treated for heartworm disease through a surgical procedure to remove the parasites, marking a first in ferret care.

## Contribution

This is the first documented case of complete surgical removal of adult Dirofilaria immitis parasites in a naturally infected domestic ferret.

## Key findings

- Surgical transvenous extraction successfully removed two adult heartworms from an asymptomatic ferret.
- The ferret recovered well post-surgery with no complications observed during follow-up.
- This case improves understanding of managing heartworm disease in ferrets.

## Abstract

Heartworm disease is a severe and neglected cardiovascular condition in domestic ferrets. Isolated cases of natural infection have been previously reported. However, knowledge of the disease is still considered poor. An unsterilized 2-year-old domestic male ferret was diagnosed using a heartworm antigen test. The animal was asymptomatic and had a good physical appearance. A surgical transvenous extraction was performed, and two worms (one female and one male) were removed. The patient evolved favorably, and repeated diagnostic tests 35 days after surgery showed improvement in the parameters previously evaluated. This clinical case was the first in which it was possible to extract all the parasites from a ferret by endovascular therapy and improves the knowledge of the management of heartworm disease in ferrets.

Heartworm disease caused by Dirofilaria immitis is a serious and underdiagnosed cardiovascular condition in domestic ferrets. Hemodynamic changes caused by parasitization in ferrets cause a potentially fatal syndrome, but its clinical findings and treatment have not yet been standardized. The objective of this study was to describe the clinical case of a successful surgical extraction in a ferret infected by D. immitis. The patient was a 2-year-old, 1.5 kg asymptomatic male domestic ferret. The infection was diagnosed using a commercial test for the detection of D. immitis antigens. Subsequently, their clinical status was evaluated using serological and imaging diagnostic tests, and it was finally decided to perform surgical extraction of the adult worms. The ferret was anesthetized and placed in the left lateral decubitus position to perform a venotomy in the right jugular vein. Endoscopic extraction basket-shaped devices were used in the right atrial cavity under fluoroscopic guidance following the Seldinger endovascular surgery technique. With careful handling, two adult parasites were manually removed. A transthoracic echocardiogram performed after the procedure confirmed the absence of heartworms. The ferret recovered without complications and was discharged within 24 h. In the clinical review, 30 days after surgery, no notable alterations or symptoms were observed. This case report describes the first complete surgical removal of adult D. immitis parasites in a naturally infected ferret.