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Babesia induced Multiorgan failure in a Dog with special focus on Chronic Kidney Disease
- 1. Therapeutic Management of Babesia induced Chronic Kidney Disease in Dog Presented By : 4th Year BVSc & AH, 1. Zotluangpuii(2019-v-63). 2. Mohit Gupta(2019-v-64) 3. V.L.Rinchhana(2019-v-65) 4. PremAggarwal(2019-v-66) 5. Angel Malsawmtluangi (2019-v-67) 6. Debbie Lalhruaitluangi (2019-v-70) Group 10 VCP II Case Presentation
- 2. Introduction Chronic kidney disease (CKD) is defined by presence of functional or structural impairment in 1 or both kidneys for more than approximately 3 months. Familial Acquired Congenital 1 in 10 Dogs 1 in 3 Cats
- 7. Anamnesis Case No: 799 Date: 08/12/22 Owner Name: Lalrohlua Address: Durtlang Phone No: 9383062949 Species: Canine Breed: Pitbull Sex: Male Colour: Black Age: 1 Year Body Weight: 13.5 Kg No food intake since yesterday (07/12) Vomited once yesterday (yellowish). Reddish brown diarrhoeaa from yesterday. Vaccinated with ARV & Dewormed last year. No history of ticks infestation, presence of fleas. Observations HR: 94 bpm RT:99.8 ºF MM: Congested CRT: 1 Sec STT: 4 Secs Body Weight: 13.5 kgs Signalment
- 8. Tentative Diagnosis Treatment Tests Advised ➢ Gastroenteritis & Canine Distemper ➢ Radiographic Examination ➢ Hematology & Serum Biochemistry Profile Inj. RL @ 250ml i/v Inj. DNS @ 250ml i/v Inj. Ondansetron @ 0.5mg/kg i/v STAT Inj. Pantop 40mg @1mg/kg i/v Inj. Intazef Tazo @25mg/kg i/v Inj. Tribivet 30 mL @ 1 mL slow i/v
- 9. Radiographic Examination ▪ Thorax – VHS – 11 ( slight cardiomegaly) lung lobes show radio-dense, multiple foci. ▪ Abdomen – filled with fluid (ground glass appearance) ▪ Splenomegaly and Hepatomegaly detected
- 10. Urea - 216.6mgs% Creatinine - 5.7 mgs Total Protein - 6.0 % gm/dL Albumin - 3.0 gm % Globulin - 3.0 mgs % Total Bilirubin - 0.5 mgs Direct - 0.2 mgs Indirect - 0.3 mgs SGPT - 26 IU/L SGOT - 21.0 IU/L ALP – 161.0 IU/L 15-40 mgs % 0.8-1.4 mgs 5.4-7.5 % gm/dL 3.5-5 gm % 3.0 mgs % 0.2-1 mgs % 0-0.2 mgs 0.2-0.8 mgs 0.0-42 IU/L 0.0-43 IU/L 1-114 IU/L Serum Biochemistry Results: Patient’s Results Normal Range WBC - 21.1 K/µL Grans – 18.1 K/µL HGB – 7.9 g/dL PLT – 83 K/µL HCT – 22.9 % MCHC – 34.5 g/dL 0.6-17 3.3-12 12.0-18 175-500 37-55 30-10 Normal Range Patient’s Results Hematology Results: The dog teste positive for Babesia gibsoni ,afterwhich triple drug therapy was initiate for 28 days, alongwith it threatment for 4th stage kidney failure or CKDwas started from this day onward.
- 11. Clindamycin @ 25 mg/kg PO BID Metronidazole @ 10 mg/kg PO BID Doxycycline @ 5 mg/kg PO, OD 28 Days Triple Therapy
- 12. Treatment for CKD Tab. Envas (Enalapril) @ 0.25 mg/kg B.W., PO, BID Tab Lasilactone @ 2 mg/kg B.W., PO, q24h Inj. Sodium Bicarbonate (5%) 8-12 mg/kg, PO. q8h Tab. Renoflex 1 Tab/20Kg B.W., PO. BID Tab. Rubenal ½ Tab BID FOR 8-12 Kg B.W. Syp. PetsApp 0.5 mL /Kg B.W. Syp. Digene 2 tsp. BID, before foo Renal Diet As per manufacturer
- 13. No Vomiting, Defecated once, Blackish stool, Anorexia, Normal water intake Purulent nasal Discharge, twitching, arrhythmia, chewing gum seizure No vomiting, anorexia, no Defecation, urinate twice, normal water intake Little amount of foo intake, no Defecation, no vomiting, urine output increase Little amount of foo intake, no vomiting, no Defecation, increase urine output, cold extremities 9.12.2022 10.12.22 11.12.22 12.12.22 13.12.22 MM- Pale, STT- 3 sec, CRT- 1 sec, HR- 90bpm, RT-102.1 F MM- Pale Pink, STT- 4 sec, CRT- 2 sec, HR- 85bpm, RT-100.5 F RT-101.3F, HR- 107bpm, STT-3sec, CRT-2sec, MM- pale RT-100.5F, HR- 110bpm, STT- 5sec, CRT- 2sec, MM- pale pink RT-97.8F@10:35am ,100F @11:50am, HR- 90bpm, MM- pale pink, CRT- 2sec, STT- 4sec Ondan Stopped Treatment for CKD CST CST CST Date Management Parameters Observation
- 14. Body weight decreased(12.10kg), little food intake, normal water intake, normal urination. Normal food intake, normal urination, normal defecation, normal water intake, no vomition and no diarrhea Normal food and water intake, normal defecation, no vomition, increased urination No vomition, no diarrhea, normal food and water intake, increased urination. Normal food intake, normal urination and defecation. 14.12.2022 15.12.22 16.12.22 17.12.22 19.12.22 MM- Pale pink, STT- 5 sec, CRT- 2 sec, HR- 93bpm, RT-98F F MM- Pale Pink, STT- 5 sec, CRT- 2 sec, HR- 98bpm, RT-100.1 F RT-100.2F, HR- 107bpm, STT- 3sec, CRT-2sec, MM- pale pink RT-99.7F, HR- 98bpm, STT- 2sec, CRT- 2sec, MM- pink RT-99.9F, HR- 90bpm, MM-pink, CRT- 2sec, STT- 2sec CST CST CST CST Tab. Wysolone @1/2 tab. PO BID for 5 days Date Management Parameters Observation
- 16. After 17 days of treatment for Babesia induced CKD, the animal is in normal health and well being and further complications had not been yet reported. Prognosis