# Babesia



## MSK (Aug 13, 2008)

Subject: Babesia... Sat 31 May 2008 - 11:17 
Babesia FAQ


About Dr. Birkenheuer:

Dr. Adam Birkenheuer is considered one of the countries leading authorities on Babesia gibsoni.

Dr. Birkenheuer is a graduate of the University of Florida College of Veterinary Medicine and has completed a residency in small animal internal medicine at North Carolina State University College of Veterinary Medicine.

Dr. Birkenheuer is currently working in the Tick Borne Disease Laboratory at the NCSU-CVM. He has been studying Babesia gibsoni since 1995, when he was the first veterinarian to diagnose Babesia gibsoni infection in an American Pit Bull Terrier.

His research has focused on the clinical disease manifestations in naturally infected dogs, epidemiology, diagnosis and treatment of Babesia gibsoni. He is currently conducting a research trial investigating a possible cure for this disease. Moreover, Dr. Birkenheuer is the proud owner of an ADBA registered American Pit Bull Terrier and true lover of the breed.

What is Babesia?

Babesia are protozoal organism that infect red blood cells. It is a close cousin to Malaria. There are at least two different species of Babesia that can infect dogs, Babesia canis and Babesia gibsoni.

What are the signs of a Babesia infection?

Babesia infections cause a dog's red blood cell count to drop (anemia). Red blood cells are necessary to transport oxygen to all of the tissues in your dog's body. Anemia will result in pale mucous membranes (i.e. gums), weakness, lack of appetite, and lack of energy. This destruction of red blood cells can lead to jaundice which is the buildup of a yellow pigment in the whites of the eyes, skin, mucous membranes, and whites of the eyes. This may also cause a dog to have urine that is discolored red, brown, or dark yellow. Some dogs will lose weight or have enlarged lymphnodes.

Some dogs will NEVER show any signs of illness. You cannot tell that a dog is not infected because it looks and acts healthy. This is similar to saying that a person is definitely not infected with HIV because they are not sick.

How do I know if my dog has Babesia?

There are several ways to confirm that a dog is infected with Babesia. Unfortunately, there is no easy way to confirm that a dog is definitely not infected with Babesia.

Microscopy:

The first way to diagnose Babesia infection is to see the organism in a blood smear under the microscope. A positive microscopic examination by an experienced person provides extremely strong evidence (I try not to say never or always) that a dog is infected with Babesia. Unfortunately, microscopic diagnosis is unable to definitively determine which species is infecting the dog, and microscopy alone can lead to false negative results. The bottom line: A positive microscopic exam means your dog has Babesia, but a negative microscopic exam does not rule a Babesia infection out.

Antibody Titers:

The second test is frequently referred to as the "titer test." The "titer test" detects antibodies in your dog's blood that react against Babesia. The titer test does not actually physically detect the organism, it only detects antibodies produced by your dog's immune system. This means that a positive titer is only circumstantial evidence that your dog is infected with Babesia. Antibodies will frequently cross-react with the wrong species and sometimes even with other organisms, leading to false positive results. Many dogs are misdiagnosed as having Babesia canis based on antibody titers. Sometimes, the titer tests from some Babesia gibsoni infected dogs have come back completely negative to both Babesia canis and Babesia gibsoni. The bottom line: A positive titer means that the dog might have Babesia, and a negative titer means that the dog might have Babesia. High titers seem to correlate well with infection, but can't be used to reliably determine whether it's Babesia canis or Babesia gibsoni.

Polymerase Chain Reaction:

The last test is referred to as the "DNA test" or "PCR test." This test actually detects a small piece of Babesia DNA from your dog's blood. It is more sensitive than the microscopic exam, but false negative results are still possible when only low numbers of the organism are present. It is also the only way to definitively determine what species of Babesia is causing an infection. The bottom line: A positive DNA means that the dog is definitely infected with Babesia. A negative DNA test can not completely rule out Babesia infection, but is better than microscopy alone. Short of cutting out a dog's spleen and suppressing it's immune system (This option does not seem very popular), in my opinion, 2-3 consecutive negative DNA tests are the best thing that can be done to rule out Babesia infection.

Which species of Babesia is infecting APBT's?

Of the hundreds of APBT's that I have tested and diagnosed with Babesia, 99.9% of the cases of Babesia in APBT's that I have diagnosed have been Babesia gibsoni. Many of these cases have been previously "diagnosed" with Babesia canis based on the titers and microscopic exams. Without DNA testing, you can not be sure what species of Babesia is infecting a dog.

Can Babesia gibsoni be treated?

Yes, but at the current time there is no cure. There are many drugs that can and should be used to treat a dog that is infected with Babesia gibsoni. These include ImizolÒ, BerenilÒ, AralenÒ, Doxycycline, and Clindamycin. In my experience the vast majority of dog's that receive one or more of these treatments survive, and it has only been dogs that received no treatment that have died. The dogs that survive will often have miraculous recoveries and "get back to normal" according to their owners. Unfortunately, over 99.9% of these recovered dogs that have been treated with the above-mentioned drugs remain infected. This means that they can be a source of infection for other dogs. I am currently conducting a clinical trial evaluating a new therapy, that we hope will eliminate Babesia gibsoni infections from dogs.

My veterinarian does not want to test my dogs for Babesia gibsoni. How come?

It has only been recently discovered that Babesia gibsoni is present in the United States, so most veterinarians were taught in school that this disease does not exist here. Be persistent in having your dog's tested/treated, espescially if they have any of the signs of Babesia.

How did Babesia gibsoni get into the United States?

Babesia gibsoni comes from Southeast Asia. It is likely that people bringing sub-clinically infected dogs from Southeast Asia imported Babesia gibsoni to the US.

One of my dogs was diagnosed with Babesia. What about the rest of my dogs?

Unfortunately, studies have shown that kennels where one dog has been diagnosed with Babesia gibsoni, 10-20% of the other dogs in the kennel are also infected. With some infected dogs that have never been sick or shown any signs.

How is Babesia gibsoni transmitted?

In Southeast Asia, ticks transmit Babesia gibsoni. However, the species of ticks that transmit Babesia gibsoni in Asia have not been found in the US. The route of transmission in the US is unknown. Possible routes of transmission in the US, other than ticks, include blood to blood transfer (kennel accidents, needles, biting flies?, fleas?) and perinatal transmission (bitches to puppies, probably through the placenta).

Can Babesia be sexually transmitted?

No one knows. Studies on the sexual transmission of Babesia in dogs have not been performed. Blood transmission between the stud and the bitch can occur during mating, so it is theoretically possible that transmission can occur. No cases have been "documented", but since no one has ever actually looked, that's not too surprising.

How can I keep my kennel free of Babesia?

This is not the answer that people want to hear, but unfortunately I think this is what needs to be done. First of all, every dog in the kennel needs to be tested. Ideally, by 2-3 consecutive DNA tests. Positive dogs should be culled or quarantined until a cure is found. New dogs should be quarantined and test negative before they are moved into the general population. Lastly, any interactions such as breeding with dogs from other kennels should require negative Babesia tests. These tests should be repeated whenever a dog has contact with other dogs such as breeding. Since this may be difficult for active stud dogs, artificial insemination using blood free semen that was collected immediately after negative testing would be ideal.

Can my Babesia infected dog be used as a stud dog or brood bitch?

Infected bitches are likely to pass the infection to at least some of their pups, so it is recommended that they are not used for breeding. No one knows what the percentage of puppies from an infected bitch will be infected. One of the major difficulties is that dogs that seem to have been infected by their dam, do not seem to show any clinical signs which make it very difficult pick out the infected puppies without testing them all. Since it is theoretically possible that an infected stud can transmit the infection to the bitch during mating, artificial insemination using a semen sample that is free of red blood cells would be the safest way to stud an infected dog.

Can I get Babesia from my dog?

It is highly unlikely that you can get Babesia from your dog. Common sense and good hygiene should be used. The species of Babesia that infects humans is Babesia microti. Generally speaking, Babesia infections do not cross-species. Babesia organisms appear to have developed specific host-parasite relationships. As they should with all infectious disease, immuno-compromised individuals and people without spleens should take extra care.


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