Solution for case 3

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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.

Case 3

Presentation:

A 5 year old castrated male Rottweiler Labrador mix canine was presented at AcaseAweek Clinic for lethargy and inappetence for the past 4 days. He was still drinking water, and urinating normally. The diet consists of adult dry food, Alpo, of which he is eating less of. He has also lost a lot of weight recently.  Vaccinations were giving 12 days ago, and the dog is currently on ivermectin.

Physical Exam:

The patient weighed 20 kg (44 lbs) on physical exam, he was lethargic. His temperature was 103.2, pulse rate was 100 and respiration rate was 40. Mucus membranes were pink, and CRT was less than 2 seconds.  On physical exam there were enlarged pre-scapular and popliteal lymph nodes.  All other systems were within normal limits.

CBC and Blood Chemistry:

On general blood chemistry, all the values fell within normal limits except for ALT which was slightly increased, 166 (10-100).         The complete blood count revealed a hematocrit of 28.1 (37.0 – 55.0), hemoglobin of 10.2 (12.0 – 18.0), granulocytes of 3.1 (3.3 – 12.0), neutrophils of 1 (2.8 – 10.5), eosinophils of 2.1 (0.5 - 1.5) and platelets of 36 (175 – 500).

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Solution to this case