Severe tongue necrosis associated with pine processionary moth (Thaumetopoea wilkinsoni) ingestion in three dogs

The pine processionary moth (Thaumetopoea wilkinsoni) is an insect of medical significance in the eastern Mediterranean. This report describes three exposure cases in dogs due to ingestion of this moth's caterpillars in Israel. All three dogs were observed in direct contact with caterpillars or pinecones in infested gardens. The disease course and progression of signs were acute in all three cases, and included vomiting and severe tongue swelling. Physical examination findings included hyperthermia, tachypnoea, respiratory distress, cyanosis and tongue oedema, labial angioedema, ptyalism, bilateral submandibular lymphadenomegaly and conjunctivitis. Severe tongue necrosis and sloughing of its distal portion occurred 2-5 days after admission to the hospital. All dogs recovered and were discharged within 2-7 days of admission. Two staff members, attending one of the dogs, experienced an itchy rash and wheals on their arms, wrists and necks. To the best of our knowledge, this should be the first report of severe oral lesions and tongue necrosis due to contact with T. wilkinsoni caterpillars.