Comparative efficacy of levamisole, ivermectin and moxidectin against the lungworm Crenosoma striatum in rehabilitating Western European hedgehogs (Erinaceus europaeus)

Abstract Background Anthelmintics are frequently used to treat verminous pneumonia in European hedgehogs ( Erinaceus europaeus ), but recommendations remain anecdotal due to limited scientific evidence regarding efficacy and safety. This randomized clinical trial compared the efficacy of a single subcutaneous injection of levamisole (27 mg/kg) versus ivermectin (3 mg/kg) against Crenosoma striatum by assessing larval shedding and clinical parameters. Hedgehogs ( n = 51 ) from two wildlife rehabilitation centres each received either treatment during autumn. Crenosoma striatum larval count per gram faeces (LPG) was measured via Mini-FLOTAC before, 12 and 24 days after treatment followed by a faecal larva count reduction test. Relative weight gain, respiratory clinical signs and mortality were obtained at similar time points. In a follow-up trial the next autumns, hedgehogs ( n = 12 ) received a single subcutaneous injection of moxidectin (3mg/kg) with similar LPG determination. Results Neither ivermectin nor levamisole resulted in significant LPG reduction 12 days after treatment with both scoring below 90%. Hedgehogs that received levamisole had significantly higher relative weight gain ( p = 0.041 ) compared to hedgehogs receiving ivermectin. Survival or clinical signs did not differ significantly. For moxidectin, all animals initially positive for lungworm and surviving became negative for C. striatum on day 12. Conclusions This and other studies suggest that moxidectin is effective at reducing C. striatum LPG in European hedgehogs. Contrary, a single injection of levamisole or ivermectin failed to significantly reduce LPG, suggesting treatment failure due to resistance or other factors. We provisionally recommend a single subcutaneous moxidectin injection at 1 mg/kg for crenosomosis but encourage further studies to optimize the dosage regimen.