Clinicopathological abnormalities, treatment, and outcome in in a 45-day-old puppy with acute Babesia canis infection.

The knowledge regarding Babesia canis infections in puppies is limited to 3 dogs aged 43-46 days. A 45-day-old, male intact German Shepherd dog was presented due to lethargy, inappetence, and gait disorders. An acute Babesia canis infection was diagnosed by PCR. Marked thrombocytopenia, anemia, and hyperbilirubinemia were noted. A subcutaneous injection of imidocarb dipropionate (ID, 2.0 mg/kg bodyweight) was applied. The puppy's general condition significantly improved, but vomitus was noted. A negative PCR and mild hematological abnormalities were seen 14 days later. A second subcutaneous injection of ID (4.2 mg/kg bodyweight) was applied. Babesia canis infections should be considered in puppies with fever, marked thrombocytopenia, and marked anemia in the immunological gap. Next to vectorial transmission, transplacental Babesia canis infections are reported but considered unlikely in the presented puppy. The puppy responded well to a lower-ranged dose of ID, but side effects were noted (vomiting). In adult dogs, treatment of acute Babesia canis infections using ID dosed 6.6 mg/kg bodyweight is recommended. No safety regulations are published by the manufacturer regarding the use of ID in puppies, but vomitus is reported as a potential side effect after the use in adult dogs. A second ID injection (4.2 mg/kg bodyweight) was applied to avoid a potential disease relapse. The case report highlights the significance of the immunological gap in puppies with Babesia canis infections and the need for ectoparasite prophylaxis in puppies, if vector contact is possible.