Clinico-Pathological Diagnosis and Management of Concomitant Theileriosis and Anaplasmosis in a Calf.
Vector borne hemoprotozoan and rickettsial diseases are of significant economic importance to livestock industry being responsible for deadly diseases in cattle as well as production loss due to severe anemia and debility (Singh et al., 2003). Bovine tropical theileriosis is a tick borne hemoprotozoan infection caused by Theileria annulata, which produces lympho proliferative disease clinically characterized by fever, swelling of lymph nodes and severe anemia (Sivakumar et al., 2014). Anaplasmosis has been clinically characterized by fever, severe anemia, jaundice, brownish urine, loss of appetite, dullness or depression, rapid deterioration of body condition, pale mucus membrane and labored breathing (Awadet al., 2011). Both Theileria spp. and Anaplasma spp. are responsible for causing anemia in bovines. Concurrent infection with Theileria spp. and Anaplasma spp.are rarely reported in bovines with partial success in therapeutic management (Bhatt et al., 2009; Kumar, 2013). The present case report emphasizes successful therapeutic management of Deoni calf ailing with severe anemia due to mixed infection of Theileria annulata and Anaplasma marginale using combination of whole blood transfusion and therapeutics for piroplasms.
History and Clinical Signs
A four month old male Deoni calf weighing 75 kg was presented with history of anorexia, fever, licking of soil (geophagia) and weakness since three days. Distant clinical examination revealed rough/coarse hair coat and inability to walk due to severe weakness. Assessment of vital clinical parameters revealed high fever (104.5[degrees]F), tachycardia (132/min) and papery white conjunctival mucous membranes (Fig. 1). Palpation revealed swollen pre-scapular lymph nodes and tick infestations. About 2 ml of jugular vein blood sample was collected in EDTA vacutainer and hematological analysis was performed on automated hemoanalyzer.
Hematological analysis revealed severe anemia (erythrocyte count: 1.30 x [10.sup.9]/L, hemoglobin: 2.0 gm/dl, hematocrit: 5.72%), granulocytic leukocytosis (leucocyte count: 15.20 x [10.sup.9]/L, granulocyte count: 7.71 x [10.sup.9]/L) and platelet count (249 x [10.sup.9]/L) (Table 1). The blood smear examination (Giemsa staining) revealed presence of numerous intra-erythrocytic crescent or signet ring shaped stages of Theileria annulata and small basophilic dot shaped Anaplasma marginale organisms at margins of erythrocytes (Fig. 2). The history, clinical signs and hematological findings confirmed case for concurrent Theileriosis and Anaplasmosis.
Therapeutic Management Initially based on preliminary data of hematology and clinical signs, calf was treated symptomatically with Inj. Meloxicam and Paracetamol (Melonex plus (a)) @ 4 ml IM, Inj. Vitamin B complex (Tribivet (a)) @ 3 ml IM and Inj. Chlorpheniramine maleate (Anistamin (a)) @ 20 mg IM. Taking into consideration severe weakness, pallor of mucosae and severe anemia, it was decided to perform blood transfusion.
Compatible whole blood from healthy and disease free donor was obtained from college cattle breeding farm of same breed after confirming compatibility through major and minor cross matching. Immediately after collection, 350 ml of whole blood was transfused to calf through jugular catheterization. The calf was monitored over a period of transfusion for heart rate, respiration rate and sign of anaphylaxis. Few hours later the affected calf showed positive response to blood transfusion in the form of urination, unassisted standing and walking for some distance. After confirmatory diagnosis on the basis of blood smear examination, the calf was treated with single dose of Inj. Buparvaquone (Inj. Zubion (a)) @ 2.5 mg/kg IM for theileriosis. From second day and onwards the calf was treated for Anaplasmosis and anemia with Inj. Oxytetracycline @ 10 mg/kg in 500 ml Dextrose slow IV, Inj. Vitamin B complex @ 3 ml IM, Hematinics (Liq. RBC Rakta (b)) @ 25 ml orally for five days.
From second day and onwards, the affected calf showed gradual clinical improvement with increased alertness, subsidence of fever (102.3[degrees]F), resumption of feed and water intake and calf was able to stand and walk. Hematological analysis after completion of treatment (i.e. on sixth day post transfusion, Table 1) revealed increase in haemoglobin concentration (3.20 gm/dl) and hematocrit (10.39 percent) along with clinical improvement in body temperature, heart rate, color of mucus membrane, feed and water intake and general alertness. Based on improvement in health status, clinical and hematological parameters, the calf was discharged with advice to continue Inj. Vitamin B complex @ 5 ml IM for next five days and haematinics for ten days to hasten the recovery. Follow up after twenty days showed uneventful recovery in calf.
Bovine Theileriosis and Anaplasmosis are important protozoan and rickettsial diseases of crossbred cattle. Since, crossbred cattle are more prone to these diseases, oftenly it leads to heavy economic losses due to decrease in production and high mortality. The concomitant infection of Theileria and Anaplasma has been previously reported by Sisodia and Mandial (1986) and Meenakshisundaram et al. (2014). Hematological changes such as reduction in erythrocyte count, hemoglobin, hematocrit and elevated total leukocyte count as a result of stimulation of lymphoid organs and system due to parasite and its toxins are in agreement with findings of Bhatt et al. (2009) and Ashuma et al. (2013).
Generally by thumb rule, blood transfusion is recommended in cattle when packed cell volume is less than 10 percent but in case of acute onset anemia, transfusion should be undertaken before PCV falls below 15 percent (Kristensen and Feldman, 1995; Divers, 2005). Hemoprotozoan as well as rickettsial infections targeting and damaging red blood cells might cause severe anemia as discussed above in the ailing calf, which necessitates immediate blood transfusion to save the animal.
In our case, taking all above facts into consideration, the immediate blood transfusion was performed in order to save the life of severely anemic calf followed by definitive diagnosis and treatment. Line of treatment for these concomitant diseases generally includes single dose of specific anti-protozoan (anti-theilerial) drug like Buparvaquone and five doses of broad-spectrum drug like Oxytetracycline. Restoration of red blood cell count through blood transfusion not only assists in stabilization of patient before administering specific drugs for Theileriosis and Anaplasmosias well as hasten the recovery process and survival rate.
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R.K. Jadhav (1), S.G. Chavhan (2) and A.U. Bhikane (3)
Department of Veterinary Clinical Medicine, Ethics and Jurisprudence
College of Veterinary and Animal Sciences
Maharashtra Animal and Fishery Sciences University (MAFSU)
Dist. Latur - 413517 (Maharashtra)
(1.) Assistant Professor
(2.) Assistant Professor and Corresponding author. E-mail: email@example.com
(3.) Professor and Head
(a) - Brand of Intas Animal Health, Ahmedabad
(b) - Brand of Vetoquinol India Ltd., Mumbai
Table 1: Hematological findings before and after treatment (6th day) Sr. Parameter Before After Reference Value No. Treatment Treatment 1. TLC (x[10.sup.9]/L) 15.20 4.00 4-12 2. Lymphocyte count 6.49 2.54 2.5-7.5 (x[10.sup.9]/L) 3. Monocyte count 1.00 0.08 0-0.84 (x[10.sup.9]/L) 4. Granulocyte count 7.71 1.38 0.6-6.7 (x[10.sup.9]/L) 5. RBC count 1.30 2.40 5-10 (x[10.sup.12]/L) 6. Hemoglobin (g/dL) 2.0 3.20 8-15 7. Hematocrit (%) 5.72 10.39 24-46 8. MCV (fl) 44.00 43.00 40-60 9. MCH (pg) 15.50 13.50 11-17 10. MCHC (g/dL) 35.30 31.10 30-36 11. Platelet count 249.00 486.00 100-800 (x[10.sup.9]/L)
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|Title Annotation:||Short Communication|
|Author:||Jadhav, R.K.; Chavhan, S.G.; Bhikane, A.U.|
|Article Type:||Disease/Disorder overview|
|Date:||Jul 1, 2018|
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