Haemato-Biochemical Changes and Therapeutic Outcomes in Cerebral Babesiosis in Dogs

Canine cerebral babesiosis is a rare, but life threatening neurological manifestation of Babesia gibsoni infection with scant documentation in India. The aim of the present study was to evaluate the clinical, haemato-biochemical changes with response to treatment in dogs with cerebral babesiosis (n=11). Cerebral babesiosis was initially suspected based on the presence of characteristic neurological signs and subsequently confirmed by microscopic examination of stained peripheral blood smears, and molecular confirmation by species-specific PCR targeting the 18S rRNA gene of Babesia gibsoni, which yielded the expected 670-bp amplicon. Eleven dogs diagnosed with cerebral babesiosis were treated with diminazene aceturate, doxycycline, enrofloxacin, metronidazole, and supportive medications. Clinical, haematological and serum biochemical parameters were assessed on days 0, 3, 7, 14 and 28 post-treatment. Neurological signs included ataxia, hind limb stiffness, paddling, opisthotonus, seizures, head pressing, stupor, circling, nystagmus, blindness and paraplegia, which mostly improved slowly after treatment. Haematological evaluation showed anaemia, leukocytosis and marked changes in the lymphocyte, eosinophil and monocyte profiles in the early phase. Haemoglobin and erythrocyte parameters improved progressively after therapy and leukocyte abnormalities progressively approached the values recorded in apparently healthy dogs. Serum biochemical analysis showed significant changes in albumin, ALT, ALP, total bilirubin, direct bilirubin and BUN. High concentrations of ALT, ALP, bilirubin and BUN were observed at the beginning of the study and gradually decreased with treatment, while albumin concentration increased in the direction of the normal range. There were no significant differences in globulin, A/G ratio, creatinine, indirect bilirubin, glucose and magnesium. Results suggest cerebral babesiosis is associated with a poor prognosis despite intensive therapy, and combination chemotherapy with appropriate supportive care improved clinico-pathological and haemato-biochemical parameters and recovery of surviving dogs. Early diagnosis and treatment are thus still important to improve clinical outcomes.