Subclinical Babesia

[GreytHurleyDawg]

Hello!

 

I am posting in the hopes that others have gone through something similar. During a routine workup to determine if our greyhounds were qualified to be blood donors at the emergency hospital, my dog and my friend's dog were found to be carriers of Babesia. I was told by the blood donor coordinator that treatment was a difficult process and not performed prophylactically. My Petra, although lazy in the mornings, is not unhealthy at all so we let it go. Of course, if she ever exhibits symptoms, we will investigate and treat.

My friend was told by her vet (who now has the titer results) to treat and then test by pcr two months later to determine if the infection is cleared. We do not know what the titer result is. What we do know is that this is driving us nuts since we are lab techs and lab tests are what.we do! Has anyone gone through this and what would the recommendation be? Is there a particular lab that is rated well for testing? Is there such a thing as infection without obvious symptoms? Is it wise to wait fir symptoms to appear or better to treat if the titer is above a cutoff value? I would imagine that this is quite common since one article claimed that 46% of all Florida racing greyhounds are carriers.

Lastly, if you have treated, has the pcr test come back negative or do they remain a carrier and then exhibit and live with less symptoms?

This is clearly not something to jump into and maybe we can help the next person faced with this dilemma to decide on a course of action. I am hoping my friend's dog is just a carrier like mine!

Edited March 28, 2013 by GreytHurleyDawg

[robinw]

Phoenix was treated for babesia, so all I cal do is relate my experience.

 

His titres were weren't that terrible, but he was symptomatic, plus the little critters were visible in his blood. Treatment was two injections of Imidocarb. We were lucky as he didn't have any bad side effects post treatment but I know of other dogs who have.

 

I would have the titres redone at North Carolina State.

 

Here is a good art idle which may answer some of your questions.

 

http://www.vet.ohio-state.edu/assets/pdf/hospital/bloodBank/wellness/research/TestingforTickBorneDiseases.pdf

[Batmom]

Where was the titer done? Assuming it was low, I would either do nothing or send for a PCR at NCSU. If the PCR is positive, treat. If it's negative, don't treat. If it's negative and you want extra peace of mind for the future, repeat the PCR in a couple months.

 

A positive titer doesn't mean the dog is carrying the disease. It means only that the dog was exposed and his/her immune system made some antibodies against it.

[oldrunners]

This happened to one of my bridge boys, maybe ten years ago. He had his yearly check for blood donation, after having donated for the previous year, and came up positive. I took him to my vet at the time, who said not to treat, since he was never symptomatic. He never did develop any symptoms, but was unable to donate anymore. He was a Kansas boy, who came to me by way of Florida.

[kudzu]

One of mine came up positive for babesia. He was symptomatic but symptoms were mild & somewhat general, except for his escalating lymphocytosis. We debated the risks & merits of treatment. For a variety of reasons we decided to treat. He had his two injections of Imidocarb. Had slight swelling at injection site after first injection but it resolved quickly & no other adverse reactions. At his second injection he let out a GSOD that terrified owners & pets all the way out in the waiting area. One of the vets had to go out & reassure folks things were OK. I was standing at the time & can attest to the fact that he started screaming BEFORE they got withing 6 inches of him with the needle. My guess is that the first injection really had hurt. Anyway, other than the premature scream he had no obvious probs with the second injection, not even the slight swelling.

 

He had no resolution of his symptoms. He was later diagnosed with chronic lymphocytic leukemia which was a known possibility when we chose to treat for babesia. We never reran the babesia testing.

[GreytHurleyDawg]

Thanks for all the quick responses! We are still waiting for the titer information. The vet she goes to is my vet too. We are going there upon getting high recommendations from other longtime greyhound owners but we are both new clients. He seems to make extra suggestions frequently so she want all her facts checked before calling him back. He mentioned that a patient of his developed complications due to Babesia infection so I understand that he might encourage treatment. Petra got her results over a year ago when I was at her vet. That group of vets is very laidback, to the point that they would never push for any procedure unless we were ok with it, I think. I also wonder what the er hospital's vets think.

 

Thank you for your easy clarification, Batmom, and I am so sorry to hear about the circumstances with your hound, Kudzu. That is rough.

 

Batmom (or anyone else!), is the pcr going to be too sensitive? I read somewhere that the only method of determining subclinical infection is through pcr. This I interpreted to mean that carrier status is better determined by pcr but we already know he had a positive titer so where does carrier status end and infection begin in a dog that is lethargic because he is a retired greyhound with some shyness issues? He has good Hematological and other values. I guess it is always an individual case and difficult to generalize!

Edited March 28, 2013 by GreytHurleyDawg

[kudzu]

My dog's initial tick panel was done at Protatek. It didn't include babesia. Follow up testing specifically for babesia was sent out to NC State. We really did give long, careful consideration over whether to treat or not. My vet was 50/50 on it & said it was my call. She said, "I wouldn't treat if I thought it was harm him." We knew of the possible complications/dangers of treatment. We didn't treat just because he was babesia positive.

 

Treating babesia isn't an easy call. The call on whether to treat or not for possible Lyme disease was much easier. All you can do is gather as much info as possible & make your best choice based on that. There is often no obvious sign indicating you should treat or not treat. Good luck.

 

ETA: IIRC, PCR doesn't indicate the dog has babesiosis. It only gives a, hopefully, more accurate idea of titer status. It can be helpful in making a decision on whether a dog has babesiosis but not definitive. Finding babesia organisms in a blood smear seemed the only certain way but then a dog could have babesiosis & it still not show in the sample. It was quite frustrating.

 

PS My dog went on to live another 3.5 years with his leukemia, making it to 13.5 yo. He was still doing M&G at age 13. I'd call that good.

Edited March 28, 2013 by kudzu

[Batmom]

 

ETA: IIRC, PCR doesn't indicate the dog has babesiosis. It only gives a, hopefully, more accurate idea of titer status. It can be helpful in making a decision on whether a dog has babesiosis but not definitive. Finding babesia organisms in a blood smear seemed the only certain way but then a dog could have babesiosis & it still not show in the sample. It was quite frustrating.

 

 

 

A positive PCR DOES show the dog has babesiosis, and that is definitive.

 

A negative PCR doesn't PROVE that he doesn't have it. However, two negative PCRs would be pretty good evidence that he doesn't have it.

[kudzu]

Batmom, maybe I am misunderstanding the term babesiosis. I thought it was used to describe an active disease process whereas having a positive PCR for babesia means there are at least traces of babesia in the system but those are not necessarily causing disease. And I'm still probably not explaining myself correctly so let me just ask:

 

What is your definition of babesiosis?

[Batmom]

Ah, I see what you're saying. Technically, you're correct -- it would be possible for the dog to have babesia organisms in the system and not seem ill. But, in the case of babesia, if there's any trace of it in the system you'd want to treat. The only exception would be if you thought the organisms were likely dead (for example, you recently treated with imizol).

 

PCR looks for DNA so it can pick up recently deceased organisms that haven't yet been cleared from the blood.

[kudzu]

OK so maybe babesiosis is meant to indicate infection with babesia regardless of whether it appears to be causing disease. Makes more sense that way & I think regardless of whether I'm technically correct I may still have been using the term incorrectly. Thanks for the explanation. (There's a reason I'm in accounting.)

[Guest twogreytkids]

My 10 1/2 year old female tested positive for babesia six years ago and she underwent the two injections.

 

I just had her into the vet over the weekend because she was just not acting like her old self. An ultrasound revealed that she has an enlarged spleen. The vet suspects that the babesia was not totally "cured" six years ago and we have retested her. We are currently waiting for the results.

 

Meanwhile, we have started her treatment again. The critical time is the first four hours for a negative reaction. The vet kept her to observe her for the four hours and said that she had no reaction at all. The reason why we started the treatment without waiting for the results is that the vet said that my girl could be gone by the time that the results come back. I was not about to take any chances.

 

My vet handles all the GPA/Daytona Beach greyhounds and she has saved the lives of more than one.

 

Marcy

[gracegirl]

Grace had a positive babesia titer just after I got her. She was new to me so I was having a hard time determining if she was symptomatic or just a lazy grey with stomach/bowel issues. I didn't know enough to run a PCR to look for organisms so I treated her. She did just fine, aside from her lingering fear of any vets office after that.

 

If I had known then what I know now, I would have run another test before treating.

[Guest Quirkderk]

I am the friend GreytHurleyDawg is talking about. This is my first post, first grey (Quirkey), first hello Greytalk!

 

Today I received a copy of the work-up done by the blood donation program.

 

Babesia canis titer: positive at 1:640 (done by Antech Diagnostics)

Hematocrit 50%

Hemoglobin 17.2 g/dL

RBCs 6.7

 

He did have fibrin clumps and micro clots in his sample because he decided to just stop blood flow mid-draw so I think that could be why his numbers are a little on the low side, but I'm not 100%. He has absolutely no clinical signs of infection now, but I think I want to perform the PCR first before giving treatment the green light since it makes sense to me to make sure the organism is actually there before subjecting him to treatment.

[GreytHurleyDawg]

I agree with you, Katie (aka Quirkderk!). I think the severity of treatment warrants proof of the organism/ infection. He is perfectly healthy to all outward appearances so I think the week or so that it takes to confirm is not going to do any harm. Essentially, I am being even riskier by waiting to see if Petra gets symptoms but I assume her titer was quite low so no alarms were raised by the lab or the blood donor coordinator or my vets.

 

 

Oh yes, and WELCOME!!!!!!!!

 

You'll probably never be the same!!

[kudzu]

Welcome, Quirkderk. I agree with getting the PCR first as long as the dog is asymptomatic. Hope all turns out well.

[Guest Quirkderk]

Wow! I have been extremely tardy on posting an update to this topic.

 

So the PCR for Babesia came back negative (hooray!) and Quirk seems to be doing just fine now. I'm so glad that I didn't put him through that treatment.