• Hedgehog trematode infection

• Brachylaemus erinacei (Intestines and bile ducts, transmission via slugs and snails B156.7.w7, B228.9.w9, B337.3.w3)
• 5-10mm long, 1-2mm across, lancet shaped. (B228.9.w9, B284.6.w6, B291.12.w12); with an outer spine. (B291.12.w12)
• Eggs are small (30-35µm x 17-21µm), asymmetrically ovoid, appear lidded and contain a miracidium. (B228.9.w9, B284.6.w6, D66)

• Brachylaemus erinacei - Brachylaemus (Genus)

• General:
  • Persistent restlessness or hyperactivity. (B22.27.w3, J15.21.w1, B337.3.w3).
    • May include compulsively digging at the floor or trying to climb the sides of a container and appearing stressed). (P35.2.w1)
  • Reduced appetite or anorexia. (P35.2.w1)
  • Restlessness, ravenous appetite combined with rapid weight loss. (B291.12.w12)
  • Agitated when syringe-feeding is attempted - may toss head away from syringe. (P35.2.w1)
  • Weight loss (P35.2.w1)
  • Anaemia may be present. (P35.2.w1, B291.12.w12)
  • Weight loss, restlessness, climbing of enclosure walls, inappetance. (B284.6.w6)
  • Fatalities if heavy infection is untreated. (P35.2.w1, B228.9.w9, B291.12.w12)
• Gastro-intestinal:
  • Faeces pale yellowish to greenish brown, generally runny, slimy and smelly and with heavy infections may contain blood. (P35.2.w1)
  • Green mucoid faeces. (B151); faeces mucoid/slimy. (B284.6.w6)
  • Melaena (bloody faeces). (B22.27.w3, J15.21.w, B284.6.w6).
  • Haemorrhagic enteritis with severe infection. (B228.9.w9)
  • Euparyphium melis may also cause haemorrhagic enteritis in severe infection. (B228.9.w9)
  • Watery faeces, may be haemorrhagic and have an unpleasant smell. (B291.12.w12)

Gross pathology:

• Gastro-intestinal: Severe to haemorrhagic enteritis. (B291.12.w12)
• Liver: inflammation of the bile ducts. (B291.12.w12)

Note: Often there may be an associated gastrointestinal bacterial infection. (D107) [See: Colibacillosis (with special reference to Waterfowl and Hedgehogs), Proteus Infection in Waterfowl and Hedgehog, Salmonellosis (with special reference to Waterfowl and Hedgehogs)]

Transmission:

• Via ingestion of intermediate host snails; variations in incidence of the fluke infection may be related to the distribution of the intermediate host snails. (B228.9.w9, B291.12.w12)

Morbidity:

• Incidence appears to be very variable; the distribution of the intermediate host snail may be a factor affecting this. (B228.9.w9)

Mortality:

• Heavy infections may be rapidly fatal. (B228.9.w9, B291.12.w12)
• Fatality may also result from flukes entering the bile ducts. (B284.6.w6, D66) 
• N.B. Secondary bacterial infections may occur. (B291.12.w12)

Diagnosis:

• Unipolar eggs in direct faecal smears. (J15.21.w1)
  • May be easily missed on examination of faecal samples due to the small size of the eggs. (B228.9.w9, B291.12.w12)
• On post mortem examination, flukes in the intestines or bile ducts (B156.7.w7, B151)
• Faecal smear: microscopic examination for eggs (30-35 µm x 17-21 µm), slightly asymmetrical ovoids, yellow-brown, capped at one end and containing a miracidium. N.B. easily overlooked. (P35.2.w1, B228.9.w9)
• Faecal analysis may under-diagnose infection, particularly if sedimentation techniques are not used. (B228.9.w9)
• Faecal analysis; sedimentation is suggested. Small (30-35 µm x 17-21µm), slightly asymmetrical thick-shelled, yellowish-red, with an operculum (cap) at one end. Within the egg a miracidium containing two reserve bodies may be seen.(B291.12.w12)

Treatment:

• Praziquantel (Droncit Injectable, Bayer, plc.)  (J15.21.w1); 10-15mg orally (B156.7.w7); 20mg/kg orally (B228); 5.68mg/kg (0.1ml/kg) (B151). 10-20 mg/kg body weight intramuscular or intravenous. (B284.6.w6); 
• Praziquantel (Droncit, Bayer plc.) 1/4 to 1/2 tablet i.e. 12.5-25mg praziquantel orally (J154.1981.w1); 25 mg (1/2 a Droncit (Bayer plc.) 50mg tablet) per hedgehog for individuals above 500g bodyweight, 1/4 tablet (12.5mg) per individual for hedgehogs below 500g bodyweight. (B291.12.w12)
• Praziquantel (Droncit, Bayer plc.) 0.1 ml or 1/8 tablet  for under 200g bodyweight, 0.2ml or 1/4 tablet for 200-500g, 0.4ml or 1/2 tablet for 500g-1kg. Usually single dose, additional doses may be required, but at intervals of at least 48 hours. (D107)
• Praziquantel 10-20 mg/kg by intramuscular or subcutaneous injection. (B284.6.w6)
• Niclosamide 200mg/kg (B156.7.w7, B228.11.w11, D66)
• Mebendazole 25mg twice daily for hedgehogs of less than 500 g bodyweight, 50 mg twice daily for hedgehogs greater than 500 g bodyweight, orally: administer for five days then repeat treatment after two to three weeks. (B22.27.w3)
• Mebendazole (e.g. Telmin, Janssen Animal Health) 100mg/kg orally daily for five days in food (reduce dose to 50% i.e. 50mg/kg for animals under 500g bodyweight). (B228.11.w11)
• Suggested therapy for associated bacterial infection: Potentiated sulphonamides (e.g. Tribrissen (Trimethoprim/ Sulphonamide) 24% (Schering-Plough Animal Health), 30 mg/kg once daily intramuscularly or subcutaneously, for five to eight days, or Zaquilan (Schering-Plough Animal Health) 20-40 mg/kg orally once daily), or Amoxycillin / Clavulanic acid (30-50 mg/kg twice daily orally, subcutaneously or intramuscularly) or Enrofloxacin (10 mg/kg twice daily subcutaneously, intramuscularly or orally). (D107)
  • Supportive therapy, as required: Fluid therapy if the hedgehog is not eating and drinking. Buscopan (Boehringer Ingelheim Limited) is recommended (0.1-0.2 ml/kg no more frequently than every eight hours, not for prolonged use) if squeals indicate that the hedgehog is suffering from intestinal cramping. Probiotics, digestive enzymes, vitamins and Kaolin may also be useful. (D107)

Prevention:

• In captivity infection may be prevented by not feeding hedgehogs with snails (the intermediate host). (B291.12.w12)

Reports of infection:

• Brachylaemus erinacei infection on the jejunum/small intestine recorded in 2/74 hedgehogs at post mortem examination, July 1976 to November 1986, in the UK. (J3.128.w2)
• Agamodistomum pusillum occurs subcutaneously and in the mesentry while Euparyphium melis, Harmostomum erinacei, Harmostomum helicis and Harmostomum spinulosum occur in the intestines of European hedgehogs (Erinaceus spp.). (J18.38.w1)
• Brachylaemus erinacei ova detected in faecal samples of 13.7% of 789 hedgehogs from Jersey. (P35.2.w1)
• Brachylaemus erinacei in European hedgehogs: reported incidence varies from very low (e.g. 1%) to 80%. Also in Erinaceus spp. may be found Agamodistomum pusillum, Euparyphium melis, Dollfusinus frontalis. In Atelerix algirus - Algerian hedgehog, Dollfusinus frontalis has been recorded in the frontal sinuses and nasal sinuses. (B228.9.w9)
• Eggs of Brachylaemus erinacei were found in 1.6% of faecal samples from 1,849 hedgehogs Erinaceus europaeus in Germany, collected1974-1983 (J166.91.w1)
• Eggs of Brachylaemus erinacei were found in 2.3% of faecal samples from 1,175 hedgehogs Erinaceus europaeus in Germany, collected 1984-1991. (J166.100.w1)
• Faecal samples (643 total) from hedgehogs collected in three successive winters revealed Brachylaemus erinacei in 11/230 hedgehogs in one year only. (J77.97.w1)
• Capillaria spp, Brachylaemus erinacei and coccidia were found in 93% of 232 gastrointestinal tracts of hedgehogs Erinaceus europaeus from Germany, winter 1980-81. (J162.28.w1)
• Agamodistomum pussilum, Harmostomum erinacei and Harmostomum spinulosum in European hedgehogs (all with snails as the intermediate hosts). (B258.w9)

• Physical Examination of Mammals
• Necropsy of Mammals
• Intramuscular Injection of Hedgehogs
• Intravenous Access (Venepuncture) of Hedgehogs
• Fluid Therapy for Hedgehogs
• Treatment and Care - General
• Environmental and Population Management - General
• Chapter 2 - B36 Field Manual of Wildlife Diseases - Specimen Collection and Preservation
• Chapter 3 - B36 Field Manual of Wildlife Diseases - Specimen shipment
• Appendix A - B36 Field Manual of Wildlife Diseases - Sample specimen history form

• Erinaceus europaeus - West European hedgehog

(List does not contain all other species groups affected by this disease)