EMERGENCE OF A THROMBOCYTOPENIC DISORDER IN A GROUP OF WORKING DOGS OF SRI LANKA AIR FORCE

In Sri Lanka, tick bone diseases (TBD) are the most The first group of 9 explosive detecting dogs (8 common canine diseases, with Babes iosis and Labradors, 1 German shepherd of 1.5-2 years of age) at Ehrlichiosis diagnosed as the two most important TBDs Bandaranayake International Airport at Katunayake (Silva, 2016). Hepatozonosis has become common and developed fever, epistaxis and petechial hemorrhages symptoms similar to Ehrlichiosis caused by Anaplasma on the ventral abdomen in July 2016 with severe Spp have been suspected. thrombocytopenia (0.5-1/Field) and granular Despite a favorable climate for parasites and vectors, monocytes were seen in leishman stained blood smears. and large populations of stray dogs, information on Three out of 9 dogs were concurrently positive for epidemiology, diagnosis and management of Canine Babesia gibsoni. Seven dogs with slight paleness and Ehrlichiosis and Anaplasmosis is limited and there is a high amplitude pulse were administered subcutaneous high probability of introducing new tick borne parasites Imizole (1ml/ 20kg) and oral Doxycycline (5mg/ Kg 12 to Sri Lanka through the importation of dogs. hourly) while the remaining 2 dogs were administered The TBDs in dogs are reported to induce immuneDiminazine azeturate ('Berenil') intramuscularly and mediated thrombocytopenia caused by lysis of platelets oral Doxycycline (5mg/ Kg 12 hourly). Despite the through antiplatelet antibodies which have been treatment, all 9 dogs showed gradual to severe epistaxis identified in Ehrlichiosis, Babesiosis, Leishmaniasis, and petechial hemorrhages in ventral abdomen. After 4and Dirofilariasis (Lewis et al., 1996; Terrazzano et al., 8 days of treatment, all dogs were given oral 1996; Breitschwerdt et al., 1988). The pathogenesis of prednisolone (1mg/ kg twice daily). At this time, since 4 thrombocytopenia with several infectious agents is dogs still showed B. gibsoni, oral Clindamycin (15mg/ multifactorial, involving decreased production by the kg 12h) and intravenous Metronidazole (20 mg/ Kg 12 bone marrow and splenic sequestration, in addition to h) were also given. Weekly blood testing of the 9 dogs immune-mediated destruction (Mackin, 1995) indicated severe thrombocytopenia and anisocytosis, This communicat ion discusses the cl in ical which improved within a month in 3 dogs, and man ife sta tio ns and pro gno sis of a con dit ion prednisolone was gradually tapered down. At the end of characterized by immune mediated thrombocytopenia the outbreak, only 3 out of 9 dogs that were treated with resulting in severe bleeding tendencies and high the combinat ion of three drugs (Doxycycline , mortality in five groups of working dogs of the Sri Clindamycin, Metronidazole) with prednisolone, Lanka Air Force. The condition was successfully surv ived . The c linical p ictu re of those given man age d wi th o ral med ica tio n fo r ca usa tiv e intravenous supportive therapy worsened and they he mo pa ra si te s, or al hy dr at io n an d im mu ne succumbed to death. Necropsy of 6 dogs revealed suppression. severe hemorrhages in all internal organs and fatty SUMMARY: The complicated clinical manifestations of canine piroplasmosis with severe thrombocytopenia have been occasionally observed in dogs. This clinical communication describes an acute clinical condition characterized by severe bleeding tendencies with high fatality rates in five groups of working dogs of the Sri Lanka Air Force. It is a multifactorial condition in which known hemoparasites in dogs in Sri Lanka and A platys possibly play roles, requiring further investigation. The clinical condition was successfully managed with a combination of oral antibiotics and prednisolone. naplasma


INTRODUCTION CASE PRESENTATION
In Sri Lanka, tick bone diseases (TBD) are the most The first group of 9 explosive detecting dogs (8 commo n canin e disea ses, with Babes iosis and Labradors, 1 German shepherd of 1.5-2 years of age) at Ehrlichiosis diagnosed as the two most important TBDs Bandaranayake International Airport at Katunayake (Silva, 2016).Hepatozonosis has become common and developed fever, epistaxis and petechial hemorrhages symptoms similar to Ehrlichiosis caused by Anaplasma on the ventral abdomen in July 2016 with severe Spp have been suspected.thrombocytopenia (0.5-1/Field) and granular Despite a favorable climate for parasites and vectors, monocytes were seen in leishman stained blood smears.and large populations of stray dogs, information on Three out of 9 dogs were concurrently positive for epidemiology, diagnosis and management of Canine Babesia gibsoni.S even dogs with slight paleness and Ehrlichiosis and Anaplasmosis is limited and there is a high amplitude pulse were administered subcutaneous high probability of introducing new tick borne parasites Imizole (1ml/ 20kg) and oral Doxycycline (5mg/ Kg 12 to Sri Lanka through the importation of dogs. hourly) while the remaining 2 dogs were administered The TBDs in dogs are reported to induce immune-Diminazine azeturate ('Berenil') intramuscularly and mediated thrombocytopenia caused by lysis of platelets oral Doxycycline (5mg/ Kg 12 hourly).Despite the through antiplatelet antibodies which have been treatment, all 9 dogs showed gradual to severe epistaxis identified in Ehrlichiosis, Babesiosis, Leishmaniasis, and petechial hemorrhages in ventral abdomen.After 4and Dirofilariasis (Lewis et al., 1996;Terrazzano et al., 8 days of treatment, all dogs were given oral 1996; Breitschwerdt et al., 1988).The pathogenesis of prednisolone (1mg/ kg twice daily).At this time, since 4 thrombocytopenia with several infectious agents is dogs still showed B. gibsoni, oral Clindamycin (15mg/ multifactorial, involving decreased production by the kg 12h) and intravenous Metronidazole (20 mg/ Kg 12 bone marrow and splenic sequestration, in addition to h) were also given.Weekly blood testing of the 9 dogs immune-mediated destruction (Mackin, 1995) indicated severe thrombocytopenia and anisocytosis, Th is co mm un ic at io n di sc us se s th e cl in ic al which improved within a month in 3 dogs, and man ife sta tio ns and pro gno sis of a con dit ion prednisolone was gradually tapered down.At the end of characterized by immune mediated thrombocytopenia the outbreak, only 3 out of 9 dogs that were treated with resulting in severe bleeding tendencies and high the comb inat ion of thre e drug s (Dox ycyc line , mortality in five groups of working dogs of the Sri Clindam ycin, Metroni dazole) with prednis olone, Lanka Air Force.The condition was successfully surv ived .The c lini cal p ictu re of thos e giv en man age d wi th o ral med ica tio n fo r ca usa tiv e intravenous supportive therapy worsened and they he mo pa ra si te s, or al hy dr at io n an d im mu ne succumbed to death.Necropsy of 6 dogs revealed suppression.
severe hemorrhages in all internal organs and fatty all recovered in 6 days.The treatment was continued for Later in the month, similar clinical signs appeared in 3 one month and the pups were transferred back to other dogs at the Katunayake Airport, and all three were Diyathalawa thereafter.Labradors of 1.5-2 years of age.Two were treated 12 hourly with oral Doxycycline (5mg/ Kg), Clindamycin DISCUSSION AND CLINICAL SIGNIFICANCE (15mg/ kg 12h ) and Metronidazole (20 mg/ Kg) combination with Prednisolone (1mg/ kg), while the other Majority of dogs involved in this report were dog was treated only with Chloramphenicol (25mg/ Kg) Labradors, German Shepherds and Dobermans within the and Methylprednisolone (2mg/ Kg) 12 hourly.No age range of 5 months to 2 years.This multi factorial parenteral fluid was given and all dogs recovered.condition in dogs in which known hemoparasites and A. During this time a dog handler also suffered from fever platys, possibly play roles needs further investigation.with petechiation on palms and hands.He was suspected The Immune-mediated thrombocytopenia may occur in of a zoonotic disease though he was negative for dengue association with other autoimmune diseases in dogs such antigen PCR test and for Rickettsia.
as systemic lupus erythematosus and rheumatoid arthritis, In early August 2016, four pups (2 German shepherds however such possibilities in these dogs were ruled out and 2 Labradors, 5 months of age) developed a similar considering the infectious nature of the condition.condition with high fever and petechial hemorrhages on Furthermore, blood product transfusion, vaccine or any the ventral abdomen, immediately after being transferred other drug administrations had not been given prior to the from Diyathalawa breeding kennel to Anuradhapura Air incidence.Force camp.Blood pictures revealed severe Anaplasma platys can cause infectious cyclic 3 thrombocytopenia ranging from 0.35-1.35x 10 /ìl.Two thromobocytopaenia in infected dogs (Salinas-melendez pups also were positive for B. gibsoni in peripheral blood et al., 2014).Staining of buffy coat using Diff quick may smears and all were treated with Berenil (3mg/ kg) and increase the detection of the parasite.The Diff Quick stain Oral Doxycyline (5mg/ Kg bid).All 4 dogs died within when compared with conventional Leishman has been one week and postmortems revealed severe hemorrhages shown to detect hemoparasites with a higher predictive in the internal organs with fatty livers.
value.Further research in confirmation, distribution and In mid-August 2016, the same condition with fever and treatment of A. platys is warranted.petechiations were reported in 10 dogs (5 Labradror, 3 The clinical response to the condition appeared to be Doberman Pinscher, 1 German shepherd and 1 better when the 3 drugs were combined with Rotweiller, of 1.5 to 2 years) at Katunayake Air Force prednisolone, and when intravenous fluid in not Kennels.Their blood smears stained with Diff quick stain administered.Intravenous fluids can be fatal in such revealed severe thrombocytopenia ranging from 0.35situations due to plasma leakage (Silva, 2016)

SUMMARY: The complicated clinical manifestations of canine piroplasmosis with severe thrombocytopenia have been occasionally observed in dogs. This clinical communication describes an acute clinical condition characterized by severe bleeding tendencies with high fatality rates in five groups of working dogs of the Sri Lanka Air Force. It is a multifactorial condition in which known hemoparasites in dogs in Sri Lanka and A platys possibly play roles, requiring further investigation. The clinical condition was successfully managed with a combination of oral antibiotics and prednisolone.
://doi.org/10.4038/slvj.v65i1.31livers.
naplasma This work is licensed under a Creative Commons Attribution 4.0 International License.http . The prevalence and gibsoni was detected in peripheral blood smears stained significance of canine erlichiosis in Colombo, Sri with Diff Quick in all 4 and also in 2 out of 4 clinically Lanka.Sri Lanka Veterinary Journal, 52 (1 & 2A): 1-8.normal dogs.One sick and one healthy dog showed Breitschwerdt EB. (1988).Infectious thrombocytopenia intracellular bodies in their platelets resembling in dogs.Compendium of Continuing Education for Anaplasma platys.Practicing Veterinarians, 10:1177-1191 All sick pups were treated 12 hourly with oral Dumler JS, Barbet AF, Bekker CP, Dasch GA, Palmer Doxycycline (5mg/ Kg), Clindamycin (15mg/ Kg) and GH, Ray SC, Rikihisa Y, Rurangirwa FR. (2001).Metronidazol (20mg / Kg) without intravenous fluid, and Reorganization of genera in the families'