TREATMENT AND PREVENTION
The use of anthelmintics is generally contraindicated because the death of the nematodes incites a severe inflammatory reaction to the sudden release of antigens and cessation of production of parasite-derived immunosuppressant molecules.
Fenbendazole was, however, used successfully to treat NA in grey-headed flying-foxes (P. poliocephalus) (Reddacliff et al. 1999). Treatment regimens are generally based on high-dose corticosteroid therapy aimed at controlling or reducing inflammation. Treatment early in the course of disease is more likely to be successful. The prognosis for affected animals is poor. Recovery, even with treatment, is rare. If animals do recover, they are frequently left with residual neurological deficits.In zoological populations, prevention involves the control and removal of the definitive (rats) and intermediate (slugs and snails) hosts. Environments, habitats and husbandry practices should be managed to discourage attracting and harbouring definitive and intermediate hosts. Food should be fresh and, where appropriate and practical, washed to remove contamination with slug and snail slime. The cool damp nights of autumn and winter favour the emergence of terrestrial gastropods to seek food. It is at these times that control measures should be enhanced. A study in dogs demonstrated that a combination of milbemycin and afoxolaner (NexGard Spectra®, Boehringer Ingelheim), administered at monthly intervals, effectively prevents canine A. vaso- rum infection (Lebon et al. 2016). This may be considered as a preventative option in managed native Australian mammals in higher risk environments.