Case Study of Canine Ehrlichiosis in a Dog

This article is about a case study of canine ehrlichiosis in a dog.

Case Presented in Veterinary Clinic

A male Labrador dog that was eight and a half years old and weighed 19 kg was presented at the College of Veterinary Science’s Teaching Veterinary Clinical Complex in Guwahati, Assam, India. The dog had a history of inappetence, fever, weakness, anemia, nasal bleeding, ecchymotic hemorrhages in different sites, scanty faces, hemoglobinuria, reduced eyeball with mild corneal opacity, and reluctant walking, which may have been caused by joint pain. History revealed tick infestation previously.

Some pictures are missing, So hypothetical or related images are shown below

Complete History of the Dog

The on-duty veterinarian took a complete history from the owner of the dog. The details are

Medical History: Nasal bleeding, fever, anorexia, pale gums due to anemia, hemoglobinuria, hemorrhages on different skin sites, dyspnea, and dehydration. The patient had a history of tick infestation.

Surgical History: No previous history of surgery.

Medication: No previous or ongoing medication.

Vaccination History: No vaccination or deworming history.

Social History: The animal, sometimes goes outside with the owner, but is always closely monitored.

Family History: No Family history known by the owner.

Physical Examination of the Dog

The veterinary doctor performed a complete physical examination on the dog. The dog was first examined generally from the distance just to ensure how it behaves, it was noticed that dog was depressed and dehydrated due to loss of bodily fluids. After a general examination, routine protocols were adopted.

Vital Parameters:

Temperature: 104 °F (normal temp in dogs is on average 101.5  °F)

Pulse Rate: 140 bpm with arrhythmias (normal pulse rate in dogs is in the range of110-130 bpm)

Note: Pulse/heart rate varies with size, breed, etc. Large dogs have lower pulse rates than small dogs

Respiration Rate: 12/min (normal breathing rate is 15-30 breaths/min)

Weight: 19 kg (41.8 pounds)

HEENT (Head, eyes, ear, nose, and throat):

There were no anomalies in the head, no ocular discharge but reduced eyeballs, no obvious ear problems, bleeding from the nose, and lymphadenopathy.

Examination of all Organ Systems:

Cardiovascular System: CRT (capillary refill time) is > 3 sec. Arrhythmias with increased pulse rate were observed.

Note: For the assessment of the cardiovascular system the best approach is to auscultate the heart and observe any abnormality in heart sounds and patterns, apart from that, check the blood vessels, for example, distensions in veins, pulses in arteries, and capillary refill time.

Pulmonary System: Wheeze-like sound observed due to shortness of breath.

Note: For the evaluation of the pulmonary system, the protocol is to observe the lungs and air passageways. For this first see the breathing rate and pattern (tachypnea, or dyspnea) After that, auscultate the lungs and bronchial sounds.

Gastrointestinal System: No signs of diarrhea or vomiting, but some gut sounds were observed.

Note: For GIT evaluation, look for diarrhea, vomiting, dehydration, colic, etc.

Musculoskeletal System: Some weakness observed.

Genitourinary System: Polyuria with urine containing hemoglobin.

Nervous system: no signs

Skin: Hair coat was rough with ecchymotic hemorrhages on different sites.

Confirmatory Laboratory Testing:

The veterinary doctor decided to take CBC and BCP tests. The results of the test were:

The blood serum creatinine level was 1.7 mg/dl and BUN was 210 mg/dl. The AST and ALT levels were 178 u/l and 124 u/l,
respectively, revealing that the liver was in a stressful condition.

Further Tests For Confirmation

On the basis of clinical signs and lab reports, the tentative diagnosis was made and the doctor suspected that it was the case of canine ehrlichiosis. For confirmation, the on duty veterinarian decided to examine blood smear to check the presence of Ehrlichia species. Peripheral blood was taken from the animal and subjected to direct microscopic examination using Giemsa stain. Microscopic examination of stained blood smear revealed E. platys, intracytoplasmically in the thrombocytes. Further, the diagnosis of E. platys was confirmed through PCR. Thus on the basis of laboratory and
clinical examination ehrlichiosis was confirmed in the Labrador.

A similar case was reported in a German shepherd bitch presented to department of Veterinary Clinical Complex (VCC), PGIVER, Jaipur. In such case blood smear confirmed the presence of E.canis in the monocytes and neutrophils. The blood smear image is shown below. See full case here.

Treatment Options

Once the blood sample collected, the Labrador was treated with Fenbedazole @ 7.5 mg/kg, Iron oral supplement. After
laboratory confirmation as ehrlichia positive, the dog was administered Doxycycline capsule @ 10 mg/kg, PO twice daily after food for 1 month. Moreover, Diminazine diaceturate injection @ 7 mg/kg was administered deep IM at 48 hours interval for 2 occasions.

Other supportive treatments included, Pantoprazole @ 40 mg/20 kg was mixed with IV fluid at 12 hours interval for initial 7 days, Ondansetron @ 1 mg/kg IM at 12 hourly for 7 days. Vitamin B complex @ 2ml along with fluid twice daily for 10 days, Colloid therapy @ 10 ml/kg together with Dextrose Normal Saline intermittently for 15 days.

About the Case

This was the case study of canine ehrlichiosis in a dog. A dog was presented in the clinic with nasal bleeding, fever, anorexia, pale gums due to anemia, hemoglobinuria, hemorrhages on different skin sites, dyspnea, and dehydration. After the examination of clinical signs and further confirmation by lab tests, the dog was diagnosed with canine ehrlichiosis.

Links Related to Case

How to Deal with Ticks in Dogs?

Overview of Canine Ehrlichiosis

References

Bangl. J. Vet. Med. (2014). A CASE REPORT OF CANINE EHRLICHIA INFECTION IN A LABRADOR DOG AND ITS
THERAPEUTIC MANAGEMENT. Available here.

Research Journal for Veterinary Practitioners,Therapeutic Management of Canine Ehrlichiosis in a German Shepherd Bitch. Available here.