Hector – Page 2 – Second Chance AIHA Dogs

Keymaster

Clara,

Thank you for finding the lab results. There is an important distinction between the two species: Babesia gibsoni and Babesia Canis. First is the difference in size when viewed under a microscope, thus Babesia canis is referred to as “large” Babesia whereas Babesia gibsoni is referred to as “small” Babesia. The difference appears to be related to where the strains originated from(and thus the difference in the virility of the strain.) So how this disease plays out in dogs is different depending on the strain.

I know I already posted the link to an article that discusses this, but I want to pull out some important information to read about this strain for everyone else so they can follow along.

Note that while you are located in Minnesota, the following information about the location of Babesia gibsoni puts you right next door to Wisconsin, where this strain has been reported since 1999. Ticks don’t necessarily honor state lines, and with warmer weather worldwide, it is pretty likely that ticks have migrated across state lines since 1999 so that they carry Babesia gibsoni in your state as well. In addition you will note that these cases have appeared in American Pit Bull and American Staffordshire terriers.

http://veterinarynews.dvm360.com/canine-babesiosis-continues-create-challenges-practitioners

“In 1999, Babesia gibsoni infection was reported in nine dogs from North Carolina. Since that time, infections have been reported in dogs from Oklahoma, Alabama, Georgia, Indiana, Missouri, Wisconsin, Michigan and Florida. Almost all of the reported cases have occurred in American Pit Bull terriers or American Staffordshire terriers.”

“This small Babesia organism appears to be identical to the original pathogen from Okinawa, Japan, that is endemic in Northern Africa, the Middle East and Southern Asia. The parasite appears to be a rapidly emerging pathogen in the United States that is currently endemic in the Pit Bull population in diverse areas of the country east of the Mississippi River.”

“Researchers at Oklahoma State University experimentally infected dogs with blood from two naturally infected Pit Bulls from Oklahoma. One of the source dogs had been treated twice with imidocarb but still had detectable organisms in the blood. Parasitemia was detected in all dogs within one to five weeks after inoculation and peaked at four to six weeks before declining. The degree of parasitemia was 1.9-6 percent, except in the splenectomized dog which reached 16.4 percent before euthanasia. All dogs developed regenerative anemia and marked thrombocytopenia within one to three weeks post innoculation. Clinical signs included lethargy, fever and pallor, but were mild or inapparent in some dogs. Parasitemia persisted for three to four weeks and then became undetectable as the dogs apparently entered a carrier state.”

“Initial reports of the Babesia gibsoni organism isolated from dogs in the Midwest and Southeast United States seem to indicate that it is not as pathogenic as the California isolate. Although acute infection is associated with severe anemia and thrombocytopenia, many dogs survive the acute phase and become chronic carriers. A recent study reported that 55 percent of American Pit Bull dogs tested in Alabama were subclinically infected. Dogs with subclinical infections had lower hematocrits and platelet counts and increased mean platelet volume compared to dogs that were negative. The tendency to relapse or exhibit signs of vasculitis, protein-losing nephropathy or hepatic failure that is seen in dogs infected with the California isolate has not been reported in dogs chronically infected with the Southeast/Midwest United States isolate.”

So there you have it. There is a chronic carrier state and most likely Hector is one of these dogs. What to do? Well, your best resource is Dr. Holland. This is all she does every day, all year round. If she knows a successful treatment protocol she will tell you. You may find other owners on the internet that have found a successful treatment protocol. Many vets apply clinical experience to treating dogs with intractable conditions.

As you have read above, those dogs that were used in research and infected with this, and had their spleens removed, were far less able to clear the Babesia gibsoni. If you can determine if the spleen is otherwise healthy besides being enlarged, it may be in your best interest to leave it be. This is a decision that you and your vet need to make together, my opinion matters little in this.

I think you have done a fabulous job at maintaining him in a stable state. You are welcome to stay here on this forum for friendship and support!

my best, patrice

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Patrice

Keymaster

Clara,
Yes of course I understand your confusion. Please read the articles I am linking to.

There is definitely a relationship to the Babesia gibsoni entering the red blood cells and the reaction by the immune system to attack its own red blood cells. This is autoimmune hemolytic anemia, “intolerance of self.” Nearly every dog with Babesia gibsoni goes through an acute stage of some level of hemolytic anemia. The spleen is also active in this immune process, targeting RBC that contain this tick disease and destroying them in an attempt to get to the tick disease. That is why I say the spleen is the organ of control for Babesia.

This is referred to as IMHA, immune mediated hemolytic anemia. Different than Primary hemolytic anemia, This Secondary hemolytic anemia is caused by some condition. This can be variable but in Hector’s case it is directly related to the infection with Babesia gibsoni. Treating the tick disease is the appropriate way to stop the hemolytic anemia. If the IMHA is severe and there is a very low PCV, then the dog may also need treatment with transfusions and even the application of prednisone and cyclosporine in an attempt to halt the active immune mediated hemolysis.

The real goal, however, is to eradicate the disease. But to save a dog’s life, this other approach may also be taken. If the dog goes into a carrier state, does this mean they are essentially clear of the disease and will not be affected by it anymore? I don’t know that for sure. Dr. Holland would know more about that. But it is clear that Hector’s immune system stepped up and actually did fight the disease in the spleen. Otherwise he may not have survived the original acute stage of the disease.

Anemia really is only a sign, not a disease. The cause of the anemia must be identified and treated if possible. Tick disease is an insidious direct cause of autoimmune hemolytic anemia. The goal of this disease (any tick disease) is to find a place in the body to reproduce and the RBC is the perfect location.

Lyme Disease is also a tick borne disease, but it tends to seek out body tissues rather than RBC and it causes orthopedic disease, neurological symptoms, nephritis of the kidneys etc.

Each tick disease has a different set of symptoms and in fact many dogs can be co-infected with several diseases at once. This can lead to great difficulty in diagnosis and treatment. What if a dog is infected not only with Babesia but also with Ehrlichia? The only effective treatment for Ehrlichia is doxycycline, which doesn’t do much to clear Babesia and vice versa for the treatments used with Babesia.

The diagnostics for these diseases are well known, the treatments are less standard. There is a disagreement among experts whether the high dose, long treatment doxycycline protocol that many, including Tick-L, recommend is actually necessary and effective. However, on Tick-L the saying goes, “treat hard and long to avoid tickling the disease.” Get it the first time to avoid relapses. Dogs that relapse have a harder time and do very poorly.

So having a known carrier state with Babesia gibsoni does lead one to believe that there could be a relapse. I am no expert in this that is why I hope you are able to get more information from vets who are experts. I want to know what they say.

We have discussed this hundreds of times on Tick-L over the years and Gil’s information on the link I sent you is the highlight of those conversations. What we have all agreed over time is that there is just not enough research on dogs and tick disease. Period. And the sad thing for me about this is that many dog owners are not even aware of the dangers of tick disease. I stay active in the canine tick disease world just so I can specifically catch those dogs that are experiencing IMHA. I know how serious it is and I know most of the diagnostic test results that point to this. I know what the treatments are.

The tough part in the end is convincing owners to test their dogs and getting past vets that don’t think tick disease is an issue. You are one of the lucky ones who not only tested for it, your vet actually treated it properly.

does this help? do you have more questions?
my best
patrice

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