Small Ani. Medicine- Tick Bourne Dzs 1

drraythe's version from 2016-04-29 14:14

intro/ chart

Question Answer
which polysystemic rickettsial disease can affect ppl?A. phagocytophilum (she mentioned E. chaffeensis also can)
A. phagocytophilum has what host(s)?Human, cat, and dog
A. phagocytophilum has cell tropism for what cell?Granulocytes
vector for A. phagocytophilum?Ixodes spp.
primary clinical syndromes for A. phagocytophilum?fever, polyarthritis
A. platys has what host(s)?dog
A. platys cell tropism?platelets
A. platys primary vector?R. sanguineus
A. platys primary clinical syndromes?Fever, TCP (thrombocytopenia) , uveitis
E canis has what host(s)?dog, cat
cell tropism for E canis?monocytes
primary vector for E canis?R. sanguineus
primary clinical syndromes for E canis?Fever, variety
E. chaffeensis host(s)?dog (she mentioned ppl too)
cell tropism for E. chaffeensis?monocytes
primary vectors for E. chaffeensis?A. americanum, D. variabilis, Ixodes
primary clinical syndromes for E. chaffeensis?subclinical
E. ewingii host(s)?dog
E. ewingii cell tropism?granulocytes
E. ewingii vector?A. americanum
E. ewingii clinical syndromes?Polyarthritis, fever, meningitis
N.risticii host(s)?dog
N.risticii cell tropism?monocytes
primary vector for N.risticii?dont know
primary clinical syndomes of N.risticii?similar to E. canis
what are the monocyte ones?E. canis, E. chaffeensis, N.risticii
what are the granulocyte ones?A.phagocytophilum, E. ewingii
what are the platelet ones?A. platys
which two are the ones that can affect cats?A.phagocytophilum, E. canis
If you see the clinical sign of shifting leg lameness/polyarthritis, what do you think?probably a TICK BOURNE DZ

Granulocytic ehrlichiosis

Question Answer
causative agent of Granulocytic ehrlichiosis?Anaplasma phagocytophilum
Anaplasma phagocytophilum used to be aka?Formerly E. equi, phagocytophilia
granulocytic ehrilchiosis/A. phagocytophilum affects what kinda hosts?Variety of animals, Including canine and humans
where is granulocytic ehrlichiosis prevalance (geographically)?Northeastern USA, CA, WI, MN (also Europe, Asia, Africa)
granulocytic ehrlichiosis (caused by?) usually has co-infections with what?(caused by A. phagocytophylum) often has Co-infections with Borrelia bergdorferi
Is GE usually acute or subacute?Primarily acute disease, Subclinical infections possible
what are the clinical signs of an acute case of granulocytic ehrlichiosis?Polyarthritis, fever, lethargy, inappatance...but variable
how might you be able to dx A. phagocytophilum with cytology? which cells?you MIGHT be able to see a morula in the granulocytes
what are some Ab tests you can use, how effective are they?they MIGHT work, try IFA, ELISA, SNAP 4Dx
what should you know if the SNAP for anaplasma phagocytophylum comes back positive?can be cross reaction with A. platys
Can you use PCR to dx granulocytic ehrlichiosis?yes, it may or may not work tho

monocytic ehrlichiosis

Question Answer
monocytic ehrlichiosis can be caused by what three organisms?E. canis, E. chaffeensis, Neorickettsia risticii var. atypicalis
Neorickettsia risticii var. atypicalis is similar to what other organism? what are the natural reservoirs? what are the vectors?similar to E canis. Bats and swallows are natural resevoirs. Snail and insect trematodes vectors
What is this? what does it tell you? The blue spec near the nuc is a morula...the morula is in a MONOCYTE, so this is most likely E. canis
E. chaffeensis causes what dz? in who? what is the reservoir host?causes Human mononuclear ehrlichiosis, and is carried by White-tailed deer, voles, coyotes, opossums
what kinda dz stages can E. canis have? (long, short....?)Mild to severe clinical diseases that can be Acute, subclinical and chronic
what are the places E. canis likes to get (geographically)Southern US and Massachusetts
once E canis infects a monocyte, what happens? what things are damaged?Marginate and migrate into endothelial tissues--> vasculitis--> vasculitis, depending on where it is, can cause liver, spleen, bone marrow, LN’s, lung, kidney & CNS problems.
organs most affeceted by E canis?liver, spleen, bone marrow, LN’s, lung, kidney & CNS
In the ACUTE E. canis disease, signs begin how long after infection? How long is the duration of the dz?signs begin 1-3 weeks after infection, and then continue for a 2-4 week duration
prognosis of being infected with E canis?most immunocompetant animals survive
how is the subclinical E canis infection characterized? how easy is it to clear it?can last Months to years. Can be cleared by some animals, but difficult because the organism is basically "in hiding"
how is the chronic E canis infection charaterized?slow, constant and chronic affects of dz. there is low grade Ag production leading to Ab production--> immune complexes--> can lead to immune mediated dzs
which is more horrible to have- acute E canis infxn of chronic?Chronic is actually more deadly because the chronic low grade Ag production leads to Abs leads to Ab complexes (like glom. nephritis)--> bad news (can be fatal)
what are the acute clinical signs of E canis infection?Fever, Oculonasal discharge, Anorexia, Dyspnea, +/-Evidence of ticks, Lymphadenopathy, Epistaxis/petechia, Weight loss
what are the SUNCLINICAL signs of an E canis infection?NONE! Might just find ticks on the animal.
the short answer for chronic E canis infxn (monocytic ehrlichiosis) clinical signs is...basically anything it wants
chronic E canis clinical signs which are non-specific?depression, weight loss, might have ticks on them, pale MM, abdominal pain
CV system clinical signs of a chronic E canis infection?Pale MM, Epistaxis/petechia, Retinal hemorrhage, Lymphadenopathy, Azotemia/ARF/CKD, Splenomegaly, Arrythmias, DIC, Gammopathies
renal system clinical signs of a chronic E canis infection?Azotemia/ARF/CKD, Proteinuric, PU/PD
resp system cinical signs of a chronic E canis infection?ARDS, Dyspnea, Increased respiratory sounds, Interstitial to alveolar radiographic pattern
abdominal/musculoskele clinical signs of a chronic E canis infection?Abdominal pain, Splenomegaly, Hepatomegaly (kidney on a diff card) [muscoloskele= Arthropathies, Myopathies]
CNS/eye signs/OVERALL BODY signs of chronic E canis infection?Retinal hemorrhage, Neurologic signs, MOF (mult organ failure)
what does the CBC of a dog infected with E canis look like?(VARIABLE). can show Thrombocytopenia ( Vasculitis and immune-mediated mechanisms), Leukopenia followed by a leukocytosis--> Monocytosis, Lymphocytosis---> Then the BM is infiltrated and you will see Pancytopenia and anemia (either regen or non regen)
what is the protein/protein fractions like in the bloodwork of an e canis dog?there is Hyperglobulinemia (poly or monoclonal gammopathies) and Hypoalbuminemia. You will also see Proteinuria
diagnostic tests you can use to dx E canis?PCR will be positive, serology will be variable and you cannot rely on finding morulae in a monocyte either
8 neurologic manifestations of E canisdepression, pain, ataxia, vestibular, cerebellar, paresis, Nystagmus, Seizures
opthamologic manifestations of E canis (5)Tortuous retinal vessels, Perivascular retinal infiltrates, Retinal hemorrhage, Anterior uveitis, Exudative retinal detachment
what is the "go to" dx test for E canis? what are some other tests?snap 4DX is the go-to (Ab test). you could also use Immunofluorescent assays, Serology (paired titers, watch for cross-reactivity), Western immunoblot (all 3 are Ab tests)..and PCR
what is the dilemma about Ab tests for E canis?They are NOT diagnostic-- only tell you if maybe they were exposed. There can be cross reactivity, false positives, false negatives
what can cross react with an Ab test for E canis?E. canis, ewingii, chaffeensis, N. helminthoeca, C. ruminantium
why might there be false positives for an Ab test for E canis? what can you try to do?due to cross reactivity with other organisms. You can recheck, and try using paired samples for serology (see if there is change going on)
why might there be false negatives for Ab tests for E canis? might be a diff specie which isnt showing on test, seroconversion might not have happened yet (time where Abs become detected)
you can make a presumptive diagnosis of E canis off of what 2 things, and what should you do?You see a clinical animal and there is positive serology. Initiate tx!
what can you use in conjunction with serology to dx E canis?PCR (Organism specific DNA)
some supportive care you can provide E canis sufferers is...fluids and possibility a transfusion.
what is the abx therapy you provide for E canis dogs?Doxycycline for 21-28 days. Recheck snap and CBC
how can you use PRC as a tool in gauging the treatment of the dog?do PCR 2 weeks after treatment cessation. IF POS: Continue tx for 4 more weeks. IF NEG: Recheck PCR in 8 weeks
which two clinical signs are you looking at to determine if there has been resolution signs?look at if there is still Thrombocytopenia and Hypergammaglobulinemia
prog of acute monocytic ehrlichiosis?good with tx
prog of chronic monocytic ehrlichiosis?variable to guarded
why might you see an E canis dog with an aneurysm?E canis causes vasculitis!!
it's extremely common that in E canis, the dog can die because the dz just KILLS the..KIDNEYS! (remember corrigan being worried about her dogs kidneys)
3 main places in the she summarized with pictures that seem to be hit the worse with E canis/monocytic ehrlichia?KIDNEY, BONE MARROW, BLOOD VESSELS
Monocytic ehrlichiosis can commonly be co-infected with... (4)(ticks can be carrying more than one dz, one bite can cause more than one dz) bartonella, anaplasma, borrelia, babesia


Question Answer
where does babesia like to live? (cell tropism)RBC!
what kind of causative agent is babesia?intracellular protozoan
4 most common spp of babesia?Babesia canis, B.gibsoni, B.felis, B.leo most common (Many subspecies)
which babesia is this? larger babesia is B. canis (irregular piroplasms, larger)
which babesia is this? smaller babeisa is B. gibsoni (smaller, ring shaped, more numerous)
what are the vectors which xmit babesia?Ixodid ticks (Haemophysalis spp), Rhipicephalus sanguineus(brown dog tick), Dermacentor reticulatus
what are all the ways an animal can be infected with babesia?tick bite, Transmission also via transfusion (dog bites- higher incidence in pitbulls) or transplacental route
4 presentations of babesiosis?Peracute, acute, subclinical, chronic
along with non-specific clinical signs of fever, anorexia, lethargy, rough hair coat-- what are more clinical signs of babesiosis? (what two main systems affected?)(note: signs vary based on sp of babesia) BLOOD: anemia, icterus, +/- agglutination, all this can lead to Hemoglobinuria, hepatosplenomegaly. LIVER: Icterus, hepatosplenomegaly
how can you tell hemoglobinuria from blood in the urine? why does hemoglobinuria suck so much?if you centrifuge urine, and it stays red, then you know its hemoglobinuria because if it were RBCs they'd have pelleted to the bottom. We dont like Hgburia because it is damaging to the kidneys (gloms)
what other dz might a babesia dog look like they are presenting with?IMHA (so if you see a pitbull with "IMHA" then you should treat for IMHA AND for babesia)
which clinical signs of babesiosis are uncommon in cats?Fever & icterus uncommon in cats
what are some complications that have to do with the blood that babesia can cause?Severe hemolytic anemia/hemolytic crisis. Can lead to Hypotensive shock. 2* IMHA can develop, as well as DIC.
how might babeisa cause complications with the kidney?metabolic acidosis, renal dz (HGuria bad for glom)
B. Canis affects which dog breed more severely?Greyhounds (esp racing greyhounds, in cramped conditions under stress) (we use greyhounds for blood donors a lot!! CHECK FOR BABESIA FIRST!!)
B. gibsoni affects which dog breed more severely?pit bulls
how can you dx babesia with cytology?can see intraerythrocytic trophozoites on a blood smear. But can be hard to find- so can use Giemsa, Romanowsky, Field's, and modified Wright's stains to help see them better
what non-cytology dx tests can you use? Any downsides to the tests? how can you determine species of the babesia?IFA and serology available (but can be cross reactivity between species) so...use PCR to determine babesia AND species
which babeisa is this? B. felis
babesia can lead to splenomegaly-- do you want to splenectomize?NO, not unless totally necessary. The reason the spleen is big is because it is helping by filtering out all the babesia infested RBCs. Take away the spleen-- more babesia in circulation
what is tx/protocol to tx B. canis?Imidicarb dipropionate SQ once, and then repeated in 2-3 weeks
what is tx/protocol to tx B. Gibsoni?Atovaquone PO q8 (every 8hrs) (with a fatty meal), and azithromycin PO q24 in combination for 10 days
what happens to the animals which survive babesiosis?remain subclinically infected and can suffer a relapses & act as a disease reservoir