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Questions and Answers
What is the life cycle of tick borne diseases caused by Babesia and Rickettsia species?
What is the life cycle of tick borne diseases caused by Babesia and Rickettsia species?
Tick borne diseases cycle through the tick and host, with sporozoites injected via saliva during feeding, leading to infection of erythrocytes.
What are some clinical signs associated with Babesiosis?
What are some clinical signs associated with Babesiosis?
Clinical signs may include anaemia, fever, pallor, splenomegaly, and organ dysfunction.
How is a diagnosis of Babesiosis made?
How is a diagnosis of Babesiosis made?
Diagnosis is made by demonstrating the presence of Babesia organisms in infected erythrocytes or by PCR.
What are the treatment options for Babesiosis?
What are the treatment options for Babesiosis?
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What preventative strategies are available for tick borne diseases?
What preventative strategies are available for tick borne diseases?
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Which tick is a known vector for Babesia canis?
Which tick is a known vector for Babesia canis?
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Babesia gibsoni is commonly found in Europe.
Babesia gibsoni is commonly found in Europe.
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What is the main clinical finding in dogs infected with Babesia rossi?
What is the main clinical finding in dogs infected with Babesia rossi?
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What is a common clinical sign of severe Babesia infection?
What is a common clinical sign of severe Babesia infection?
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Explain the role of Rhipicephalus sanguineus as a vector.
Explain the role of Rhipicephalus sanguineus as a vector.
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Which of the following statements are true? (Select all that apply)
Which of the following statements are true? (Select all that apply)
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What is the main vector for Ehrlichia canis?
What is the main vector for Ehrlichia canis?
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What is the reservoir for Ehrlichia canis?
What is the reservoir for Ehrlichia canis?
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What is a common clinical sign observed in a dog infected with Babesia?
What is a common clinical sign observed in a dog infected with Babesia?
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The tick must be attached for more than 24 hours to transmit Babesiosis.
The tick must be attached for more than 24 hours to transmit Babesiosis.
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Collecting blood from the ______ can improve the diagnosis of Babesiosis on a blood smear.
Collecting blood from the ______ can improve the diagnosis of Babesiosis on a blood smear.
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How long can Ehrlichia transmission occur post-tick attachment?
How long can Ehrlichia transmission occur post-tick attachment?
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What is the acute phase duration of Ehrlichiosis?
What is the acute phase duration of Ehrlichiosis?
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Which breed of dog appears more susceptible to developing chronic infection with Ehrlichia?
Which breed of dog appears more susceptible to developing chronic infection with Ehrlichia?
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Which cells can reveal Ehrlichia morulae in a blood smear?
Which cells can reveal Ehrlichia morulae in a blood smear?
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What is the treatment of choice for Ehrlichiosis?
What is the treatment of choice for Ehrlichiosis?
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Untreated dogs with Ehrlichiosis may become asymptomatic carriers for years.
Untreated dogs with Ehrlichiosis may become asymptomatic carriers for years.
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The spleen and its ______ seem important in determining the pathogenesis of chronic Ehrlichiosis.
The spleen and its ______ seem important in determining the pathogenesis of chronic Ehrlichiosis.
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What type of increased globulins is typically seen in chronic Ehrlichia canis infection?
What type of increased globulins is typically seen in chronic Ehrlichia canis infection?
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What diagnostic method can confirm active infection of Ehrlichia?
What diagnostic method can confirm active infection of Ehrlichia?
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Imidocarb has been suggested for use in resistant infections of Ehrlichia canis, but studies have shown it to be effective.
Imidocarb has been suggested for use in resistant infections of Ehrlichia canis, but studies have shown it to be effective.
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What is typically the outcome of treatment for Paddy with Doxycycline?
What is typically the outcome of treatment for Paddy with Doxycycline?
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What is a preventive measure for Rickettsial disease?
What is a preventive measure for Rickettsial disease?
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Study Notes
Learning Objectives
- Understand the life cycle of tick-borne diseases caused by Babesia and Rickettsia species.
- Identify clinical signs related to infection.
- Discuss diagnosis methods for these conditions.
- Explore treatment options for Babesiosis and Rickettsial disease.
- Summarize preventative strategies available for these diseases.
Babesiosis Overview
- Tick-borne parasitic disease primarily affecting erythrocytes in dogs, potentially leading to severe anemia.
- Most prevalent in France; Babesia canis increasing in southern France and reported in untravelled dogs in the UK.
- Canine babesiosis is emerging in specific UK areas, including Essex and Kent.
History of Babesiosis
- First recognized in Africa during the 1890s; nine genetically distinct intraerythrocytic parasites identified.
- Babesia species categorized as large or small forms, differing by region based on tick vectors.
Key Tick Vectors
-
Dermacentor reticulatus
- Common in southern Europe, with reports of 45-70% infection rates in French practices.
- Established in northern Europe including Poland and Germany.
- Presence in pockets of the UK, primarily in west Wales and Devon.
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Rhipicephalus sanguineus
- Worldwide distribution in warm, humid areas; vector for Babesia canis and Babesia vogeli.
- Rare in the UK; limited association with imported animals due to colder climate.
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Babesia gibsoni
- Associated with chronic disease, found globally but rarely in Europe.
- Detected in Ixodes ricinus ticks in the UK, indicating a potential range expansion.
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Babesia rossi
- Primarily reported in South Africa; affects over 10% of dogs in veterinary care.
- Leads to severe clinical signs transmitted by Haemaphysalis elliptica tick.
Life Cycle of Babesia
- Transmission occurs via tick saliva after 48-72 hours of attachment.
- Sporozoites infect erythrocytes, differentiating into merozoites for reproduction.
- Zygotes penetrate tick salivary glands and transform into infectious merozoites within eggs.
Clinical Signs of Infection
- Anaemia and systemic inflammatory responses lead to variable clinical signs.
- Common symptoms: pyrexia, pallor, splenomegaly, and potential collapse in severe cases.
- Severe manifestations may include acute kidney injury, hepatic dysfunction, and disseminated intravascular coagulation.
- Babesia vogeli infections typically present mild to subclinical signs.
Diagnosis of Babesiosis
- Diagnosis primarily through detection of parasites in erythrocytes, with Babesia canis forming characteristic pairs.
- PCR is the most sensitive method; blood collection from lower flow areas enhances detection.
- Common hematological findings include normocytic normochromic anemia, autoagglutination, and thrombocytopenia.
Treatment Approaches
- Focus on symptomatic supportive care and parasite clearance.
- Imidocarb dipropionate is the primary treatment for Babesia canis, given off-label in the UK.
- Blood transfusions may be indicated for severe anemia; supportive intravenous fluids help maintain balance.
- Side effects of imidocarb can include excessive salivation and gastrointestinal issues.
Case Study - Clinical Presentation
- Example case of Harry, a 10-year-old male dog presenting with lethargy and hematuria post-vacation in France.
- Examination revealed pale mucous membranes and significant splenomegaly; presence of Dermacentor reticulatus ticks noted.### Clinical Presentation
- Anaemia indicated by pale mucous membranes and increased heart rate, alongside pyrexia and lymphadenopathy signifying an inflammatory response.
- Travel history noted and unusual ticks found on the dog; consideration for imported diseases raised.
Diagnostic Testing
- Blood samples indicated moderate anaemia (PCV 20%) with haemolysed serum.
- A spun microhaematocrit tube analysis performed.
Differential Diagnoses for Haemolysis
- Mechanical Damage: Haemangiosarcoma, Vasculitis, Disseminated Intravascular Coagulation, Heart Valve Disease.
- Toxins: Onion, Garlic, Acetaminophen, Zinc, Naphthalene.
- Immune-Mediated Destruction: Primary and secondary immune-mediated haemolysis, neonatal isoerythrolysis, transfusion reactions.
- Inherited Diseases: Osmotic fragility syndrome, Phosphofructokinase deficiency, Pyruvate kinase deficiency.
- Infectious Diseases: Mycoplasmosis, Babesiosis, Leptospirosis.
- Miscellaneous Causes: Hypophosphataemia, haemolytic uraemic syndrome.
In-Saline Agglutination Test
- Marked macroscopic agglutination observed; microscopic examination ruled out rouleaux formation.
- Suggestive of immune-mediated haemolytic anaemia, with Babesia infection as a likely differential due to travel history.
Blood Smear Analysis
- Revealed moderate numbers of intracellular Babesia canis organisms confirmed through PCR.
Complete Blood Count and Biochemistry
- Mild neutrophilia and monocytosis observed, indicative of inflammation.
- Moderate thrombocytopenia noted; normal coagulation screen results.
- Mild azotaemia identified; otherwise unremarkable biochemistry.
Urinalysis
- Free-catch urine sample showed marked discoloration with free haemoglobin and intact red cells.
- High specific gravity (1.042) indicating pre-renal azotaemia; negative PCR for concurrent Ehrlichia and Leishmania.
Treatment Protocol
- Intravenous fluid therapy initiated to support fluid volume and promote hemoglobin excretion.
- Treatment with imidocarb (5mg/kg IM) for parasite elimination; doxycycline (10mg/kg q24h) prescribed for potential concurrent Ehrlichia infection.
- Other dog assessed with negative Babesia PCR and treated with clindamycin until results were available.
Patient Monitoring and Recovery
- Harry’s condition worsened, leading to repeat PCV revealing worsened anaemia (PCV 14%) with ongoing agglutination and spherocyte detection.
- Dexamethasone administered (0.4 mg/kg IV) resulting in improved PCV over 48 hours.
- Abdominal ultrasound and cPLi normal; vomiting managed with maropitant (1 mg/kg SC).
- On discharge, Harry’s PCV improved to 24%, thrombocytopenia resolved, and no Babesia noted.
Preventative Measures
- Emphasis on preventing tick attachment through topical and oral treatments.
- Importance of prompt tick removal to limit disease transmission.
Rickettsial Disease Overview
- Rickettsiae are intracellular organisms affecting white cells and platelets; infection results in clinical signs of deficiencies and dysfunction.
- Includes genera Ehrlichia (includes Ehrlichia canis) and Anaplasma (includes Anaplasma phagocytophilum).
Ehrlichiosis and Epidemiology
- Ehrlichia canis found worldwide, particularly in tropical and temperate areas, primarily transmitted by Rhipicephalus sanguineus (the brown dog tick).
- Reservoir is wild and domestic dogs; transmission can occur rapidly after tick attachment.
Clinical Signs of Ehrlichiosis
- Initial incubation period of 8-20 days, with three phases: acute, subclinical, and chronic.
- Acute phase includes fever, anorexia, lymphadenomegaly; haematology shows thrombocytopenia, leucopenia, and anaemia.
Diagnosis of Ehrlichiosis
- Identification of Ehrlichia morulae in leukocytes is diagnostic, supplemented by serology and PCR for confirmation.
Treatment Options
- Treatment of choice for Ehrlichia canis infection typically involves antibiotics, particularly doxycycline.### Treatment of Ehrlichia Infections
- Doxycycline is the primary treatment (5 mg/kg every 12 hours or 10 mg/kg every 24 hours for 21 days), effective within 1-3 days.
- Imidocarb dipropionate suggested for resistant infections, but ineffective against Ehrlichia canis.
- Chloramphenicol (25-50 mg/kg every 8 hours for 21-28 days) recommended for puppies under five months to prevent enamel staining from tetracyclines.
Case Study: Paddy
- Paddy, a 4-year-old Labrador, presented with acute blindness and ocular discomfort following a trip to Spain.
- Examination revealed bilateral uveitis and intraocular hemorrhage; treated with topical steroids.
- Laboratory results showed increased globulins (monoclonal) and pancytopenia (non-regenerative anemia, neutropenia, thrombocytopenia).
Diagnosis Process
- Monoclonal spike in globulins indicative of possible lymphoproliferative disease or response to infection.
- Positive Ehrlichia PCR indicates active infection post travel history.
Treatment Response
- Paddy treated with Doxycycline; significant recovery observed, with uveitis resolution and normalization of blood parameters.
Ehrlichia Transmission and Susceptibility
- Ehrlichia can be transmitted within 3-5 hours after tick attachment.
- Susceptible breeds include German Shepherds and Springer Spaniels.
Microscopy Findings
- Ehrlichia morulae typically found in monocytes during blood smear microscopy.
- Acute phase of ehrlichiosis lasts approximately 1-4 weeks.
Anaplasma Phagocytophilum
- Causes granulocytic ehrlichiosis, first identified in Scottish sheep in the 1930s.
- Diagnostic features include inclusion bodies in neutrophils and potential neutropenia and thrombocytopenia.
- Treatment involves Doxycycline (10 mg/kg every 12 hours for 10-21 days).
Anaplasma Platys
- Affects platelets leading to cyclic thrombocytopenia; first reported in the US in 1978.
- Symptoms can vary by geography; severe bleeding episodes more common in the Mediterranean.
- Diagnosis through microscopy, serology, or PCR; treated with Doxycycline or Enrofloxacin.
Prevention of Rickettsial Diseases
- Strategies include preventing tick attachment and rapid removal using acaricides like permethrin (repellent effect) and fipronil (fast acting).
- Vigilance and prompt tick removal can reduce transmission risks, particularly for Anaplasma which requires 24-48 hours for transmission following tick attachment.
Summary of Learning Objectives
- Understand the life cycle of tick-borne diseases like Babesia and Rickettsia.
- Recognize clinical signs of these infections.
- Determine diagnostic approaches.
- Evaluate treatment options for Babesiosis and Rickettsial disease.
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Description
Dive into Week Two, Lesson Three of Canine Infectious Diseases, where you'll explore the tick-borne diseases caused by Babesia and Rickettsia. Understand their life cycles and significance in both the UK and worldwide. This lesson is essential for veterinary students and professionals alike.
