Clinical management of a Labrador retriever dog concurrently infected with Leptospira interrogans, Babesia gibsoni and Dirofilaria repens

Concurrent infection of Leptospira interrogans, Babesia gibsoni, and Dirofilaria repens in a properly vaccinated and dewormed Labrador retriever dog and its successful clinical management are described. The dog was presented with a history of anorexia, vomiting, lethargy, brownish yellow urine, frequent shivering, and weakness. Clinical and laboratory investigations revealed pyrexia, spleenomegaly, icterus, lymphadenopathy, dehydration, hemoglobinuria, anemia, neutrophilia, thrombocytopenia, and hyperbilirubinemia. Concurrent infection of Leptospira interrogans var pyrogenes and autumnalis, Babesia gibsoni and Dirofilaria repens, was confirmed by dark field microscopy of urine sample and blood smear examination, respectively. The animal was stabilized and undergone a combination therapy using Metronidazole (20 mg/kg bid i/v) and Clindamycin (12 mg/kg bid i/v) for 7 days, Doxycycline (5 mg/kg bid po) for 21 days, single dose of Ivermectin was given at 100 μg/kg orally on day 7. Supportive therapy using plasma volume expander, polyionic electrolytes, antiemetics, hepatotonics, vitamin supplements, and hematinics was provided during the course of treatment. The animal made a dramatic recovery by 3 months of care. The case point towards the need of selection of appropriate clinical materials for differential diagnosis, the control of mosquito borne diseases based on ecological characteristics of vector, and the need of incorporating emerging virulent serovars of leptospira in vaccines.