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Friday, November 21, 2008
Solution for case 3

Diagnosis:
A 4Dx snap test was performed and was positive for Anaplasma. Normal clinical signs seen with Anaplasma are fever, lymphadenopathy, splenomegaly, weight loss with a history of tick infestation. Lab finding are normally thrombocytopenia, non-regenerative anemia and decrease in white blood cells, hyperproteinemia, hyperglobulinemia, hypoalbuminemia, and increase ALT. Lymphadenopathy and polyarthritis is sometimes seen and petechial hemorrhages or epistaxis due to the thrombocytopenia.

The snap 4DX test identifies both IgM (acute exposure) and IgG (chronic exposure) antibody responses to Anaplasma platys (previously known as Ehrlichia platys) and it infects the platelets leading to thrombocytopenia.

Dogs become infected with Anaplasma spp. when a feeding tick inoculates the organisms. The rickettsia enters the granulocytes, platelets, or macrophages, where it survives and multiplies, and spreads throughout the body. Anaplasma is maintained in a tick vector/vertebrate reservoir host system. 

Other diagnostic tests:
Urinanalysis, bone marrow or lymph node biopsy, abdominal radiographs. We can also go for blood smear stained with Giemsa stain. PCR has also been developed for this condition. 

Differentials:
Rocky mountain spotted fever, multiple myeloma, chronic lymphocytic leukemia, lymphoma, ehrlichia and immune mediated thrombocytopenia. But, since this patient was positive for Anaplasma on the 4Dx snap test, the differentials can be ruled out.

Treatment:
Anaplasma species infections in dogs usually respond to treatment with doxycycline, a treatment regimen of 10mg/kg for 28 days is currently recommended. This patient was admitted to the clinic and IV LRS fluids were given at 180 ml/hr. He was also given doxycycline at 200 mg PO BID for 28 days. This will help clear the infection, but some side effects you must watch out for are nausea, diarrhea, vomiting, upset stomach, loss of appetite, dysphagia, and a possible hypersensitivity to the drug.

Protective immunity does not develop and re-infection may occur following treatment, which would require additional courses of therapy. Vaccines are not available to prevent infections. Therefore, control and prevention of ticks is the key.  Brown dog ticks transmit this infection.

Click here to see image of Anaplasma morula in a Neutrophil and diagnostics.

Click here for a case report of Anaplasma in young dog. 

Click here for more description about Anaplasma.

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posted by Dr Banga's Websites @ 12:00 AM  
1 Comments:
  • At September 23, 2017 at 10:20 PM, Blogger Dr.Prashant said…

    Initial Assessment: Stable patient.
    Patient is lethargic, anemic, loosing weight and pyrexic with swollen prescapular and popliteal L.N.. PCV and Hb are below low normal range indicates anemia. Thrombocytopenia, neutropenia and eosiniphilia along with above clinical signs are consistent with hemoprotozoan disease.
    Problem List: Lethargy, Anemia, Swollen L.N., Pyrexia, Weight loss, Thrombocytopenia, Neutropenia, eosinophilia
    Differential diagnosis: Anaplasmosis, Ehrlichiosis, IMHA, Liver disease, Lymphoma, Multiple myeloma
    Tentative diagnosis: IMHA
    Diagnostic plan: Biochemical profile , hemoprotozoa snap test, L.N. FNAC
    Definitive Diagnosis: ANAPLASMOSIS
    Snap test shows antibody against anaplasma in acute and chronic cases. Anaplasma infects thrombocytes and leading to thrombocytopenia.
    Treatment Plan: Patients needs to be admitted and give 180 mls/hr LRS fluid I.V..Doxycycline 200 mg PO bid for 28 days.
    Prognosis: fair

     
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