Abstract
This retrospective study describes 4 cases of canine babesiosis with histologically confirmed acute pancreatitis. In addition, 16 dogs with babesiosis are reported with serum amylase (>3500 U/l) and/or lipase (>650 U/l) activity elevations of a magnitude that would support a diagnosis of probable acute pancreatitis, although extra-pancreatic sources of the enzymes could not be excluded in these cases. Median time of pancreatitis diagnosis was 2.5 days post-admission, with primarily young (median age 3 years), sexually intact dogs affected. The development of pancreatitis was unrelated to the degree of anaemia at time of admission. In addition to pancreatitis, 80% of cases suffered from other babesial complications, namely icterus (13), acute respiratory distress syndrome (6), immune-mediated haemolytic anaemia (6), renal failure (3), haemoconcentration (2) and cerebral syndrome (2). Acute respiratory distress syndrome, renal failure and cerebral syndrome were associated with a poor prognosis, with 4 of the 5 dogs included in the overall 26% mortality rate having at least 1 of these complications. Haemolytic anaemia with ischaemia-reperfusion injury to the pancreas is proposed as a possible primary pathophysiological mechanism in babesial pancreatitis. Hypotensive shock, immune-mediated haemolytic anaemia, haemoconcentration and possibly altered lipid metabolism in babesiosis may also be involved. The previously postulated pro-inflammatory cytokine milieu of complicated babesiosis may underlie the progression, if not the primary initiation, of pancreatic pathology. Acute pancreatitis may represent the previously reported 'gut' form of babesiosis.
Highlights
Canine babesiosis is a tick-borne disease caused by the haemoprotozoan parasite Babesia canis[53]
All dogs with naturally occurring babesiosis that were admitted to the Onderstepoort Veterinary Academic Hospital (OVAH) between January 1996 and February 1999, and had serum amylase (AMS) and/or lipase (LIP) activities determined, were evaluated
Serum AMS and/or LIP activities were determined for 76 dogs with babesiosis admitted to the OVAH over a 38-month period
Summary
Canine babesiosis is a tick-borne disease caused by the haemoprotozoan parasite Babesia canis[53]. Different isolates of B. canis are capable of inducing differing disease syndromes[46]. Babesiosis in South Africa is caused by B. canis rossi . 46,53 Haemolytic anaemia due to both intravascular and extravascular haemolysis is the hallmark of babesiosis[32]. The disease can be divided clinically into uncomplicated babesiosis, where clinical signs are attributable to the anaemic state alone, and complicated babesiosis, where additional factors are thought to play a role in disease expression[25]. Well-recognised complications of B. canis infection include acute renal failure, cerebral syndrome, icterus and hepatopathy, immune-mediated haemolytic anaemia (IMHA), pulmonary oedema BDepartment of Pathology, Faculty of Veterinary Science, University of Pretoria.
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