Hector

Clara,
I am really really sorry to read this. You have had quite a time with Hector. I do have some good information for you to research. You should be commended for all you have done up to this point. You must love Hector very much.

What is important to understand is the the spleen in considered to be the organ that is most active in fighting Babeseosis. Without a spleen, humans and dogs alike are virtually defenseless against this tick disease. So in fact, a relatively healthy human or dog exposed to this should, by all accounts, be able to fend off the disease and recover. The US recommends that humans that have had a splenectomy do not travel abroad for this reason so it stands to reason that dogs should not either. My dog Chance had a splenectomy and my vet warned me of this danger of his inability to fight this tick disease.

What can alter this ability to fight it off? Well, other illness can reduce the ability to muster the immune system properly to fight, say perhaps co-infection with another tick disease at the same time. The fact that his spleen was enlarged is a good clue that it has been working hard to fight this for a very long time. And subsequently, his marrow is having a hard time making blood right now too. This is a very specific cause for this non-regenerative anemia.

The attending vet may feel like they are tasked to fight two things, the autoimmune anemia and/or the tick disease and it is hard to figure out what to do in this case. It is definitely not straightforward. But the reality is if a dog is not making blood there is only so long that you can allow this to continue. And if they decide to forgo the immunosuppressive treatments in order to allow the immune system to fight the tick disease, there is a risk of death from anemia before you have successfully completed the treatment for the tick disease. So it may be appropriate for an expert to treat for both conditions simultaneously.

Your vet has missed one particularly highly recommended treatment for Babeseosis, Imidocarb Dipropionate (Imizol). In fact, I would, if this were me, try this next. It is quite expensive and requires two shots to be effective.
http://www.merck-animal-health-usa.com/products/130_163327/productdetails_130_163631.aspx

But first I want you to read one website page very very carefully and follow all the links provided on this page carefully. Gil Ash developed this website over many years while on a tick disease email list called Tick-L. I have also been on this list a long time. It is moderated by a scientist and there is a vet who helps from time to time with discussions. Gil started collecting this information we talked about and gathered from many sources. She is a consummate researcher and her information is the best on tick disease.
https://sites.google.com/site/tickbornediseaseindogs/babesiosis

The most important information for you on this page may be that a dog with Babesiosis can remain sub-clinically infected and may have relapses.

Whether or not to remove the spleen is extremely complicated. It is not healthy to have a diseased and necrotic spleen, but is it still protecting Hector to a certain extent from the Babesiosis? I think in this case you need an expert opinion from a veterinarian hematologist. I recommend you request a consultation with Dr. Jean Dodds of Hempet.org. Her on-line consultation form is easy to use and the cost in inexpensive. She will review all your paperwork, your detailed history and will give you an expert opinion on the continued treatment.
https://labordatenbank.com/cake/hemopet/onlineorders/hemopet_add

Getting Hector to better health is the critical matter. The healthier he is the better he is able to fight this disease, as he may be a carrier for life. His life should be one of low stress and generally reduced exposure to disease. Dr. Dodds can discuss this with you.

If you have questions, please ask away.
my best
patrice

It is a big complex to describe, and I am a bit tired at this point, but the lowish PCV most likely has two connections.

One is that Babesiosis is a disease of red blood cells. It is possible that this disease, as like many other tick diseases, does not restrict infection to just the RBC in circulation. All body tissues are fair game after all this time. Thus, the reason they say that dogs can be carriers. You will see this mentioned specifically with Pit Bulls. So the bone marrow, which is considered an organ, is susceptible to infection as well.

In addition there is a condition called Anemia of Chronic Disease. Trying to shorten this for easy understanding, the body when confronted with invaders like bacteria, viruses or even parasites may attempt to alter the environment in the body to make it less hospitable to these invaders. What research is beginning to reveal is that the body most likely modifies and moderates the amount of iron available to the body in order to restrict it to bacteria etc that also need iron for survival. So the thought goes, reduce iron and the bacteria etc fail to thrive.

However this also shorts the bone marrow from receiving the proper amount of iron to make new red blood cells. So you may find a moderate chronic anemia as a symptom of chronic disease. A PCV of 34% is fine. Chance, once his spleen was removed never topped over about 36-38%. That is acceptable.

I think in addition to Dr. Dodds, who will provide you with more information on the blood aspects of this condition, you probably should become familiar with Dr. Holland at Protatek Labs, she is the Dr. Dodds of the tick world and has been known to take phone calls from owners who have questions about testing and treatments.
https://sites.google.com/site/tickbornediseaseindogs/testlaboratories

Here is a part of that page I posted the link to that discusses Dr. Holland’s opinion of how to view titers and continued testing.
“Continuing, low positive titer for B. canis

EG was actively involved in greyhound adoption for many years. Many of the dogs her group placed were positive for B. canis and of the 600 they titered, more dogs than not had titers as low as 1:80, possibly indicating exposure only. E tells me the ideal thing to do with low positive dogs showing no symptoms is to run a number of PCRs to see if any of the blood serum samples has the B. canis organism in it. Otherwise, continue doing regular bloodwork and the occasional titer to see if there are any changes.

In 1996, E spoke with Dr. Cynthia Holland of ProtaTek about one of her own greyhounds, Molly, who was asymptomatic but continued to have a low titer for B. canis. She asked Dr. Holland the question she had heard from many others: What do I do now?” Read the answer here:
https://sites.google.com/site/tickbornediseaseindogs/b-canis-what-now

By the way it is important to know whether Hector was infected with Babesia canis or Babesia gibsoni, Do you know what your test results showed?

my best
patrice