A complicated case of concurrent canine babesiosis and canine ehrlichiosis

Canine babesiosis and canine ehrlichiosis are the major tick-borne diseases throughout the world. The concurrent infection between canine babesiosis and canine ehrlichiosis can occur in endemic regions. This report showed the clinical pathology and treatment outcome of concurrent infection in a dog admitted to a veterinary hospital. Based on the history, physical examination, and laboratory finding, the dog was diagnosed with neurological disorders induced by babesiosis and ehrlichiosis concurrent infection. The dog presented with moderate normocytic normochromic anemia, severe thrombocytopenia and moderately increased alkaline phosphatase. The symptoms were more complicated with high fever, seizure, and cardiopulmonary arrest. The condition was specifically treated with doxycycline and diminazene aceturate, but the dog died 2 days after admission. In conclusion, concurrent infection of canine babesiosis and canine ehrlichiosis can cause complicated clinical neurological compromise and result in mortality in dogs.     

A retrospective study of the therapeutic efficacy of doxycycline on concurrent canine ehrlichiosis and babesiosis in a veterinary hospital population

Doxycycline has a well known broad spectrum activity against bacteria and rickettsia, as well as Ehrlichia spp. However, the use of doxycycline for the treatment of concurrent ehrlichiosis and babesiosis has rarely been evaluated, especially in veterinary hospital populations. A retrospective study of 70 canine ehrlichiosis and 12 canine babesiosis concurrent infections from Out Patient Department patients at Chulalongkorn Small Animal Teaching Hospital, admitted during 2001–2003, were studied. The results showed a complete curative effect of doxycycline on both canine ehrlichiosis and canine babesiosis concurrent infections. The red blood cell indices after treatment were significantly higher in canine ehrlichiosis (P < 0.05). The platelet cell counts after treatment were significantly higher in concurrent canine ehrlichiosis and babesiosis infections (P < 0.05). Doxycycline can be recommended as the drug of choice for both canine ehrlichiosis and canine babesiosis and concurrent infections of both conditions in veterinary hospitals.     

Surveillance of leptospirosis after flooding at Loei Province, Thailand by year 2002

In this surveillance, suspected leptospirosis patients in Loei Hospital, Loei Province were studied by conventional methods of cultivation and microscopic agglutination test (MAT) during July-October, 2002. It was found that 63% of 64 admitted patients and 35% of 34 outpatients were found positive by leptospire cultivation. Antibodies determined by MAT were positive in 78% of 63 admitted patients. Particularly, the five most common agglutinating antibodies were reactive with serovars bratislava (57%), autumnalis (48%), new (38%), australis (37%) and bangkok (29%). The MAT results of 15 OPD patients were 67% positive with the following five serovars, including bratislava (47%), new (20%), bangkok (7%), ranarum (7%) and australis (7%). Accordingly, preventive strategies against leptospirosis outbreaks after flooding in Thailand should be undertaken, including the prompt treatment of the disease in this endemic area.     

Five-Session Dual-Transcranial Direct Current Stimulation With Task-Specific Training Does Not Improve Gait and Lower Limb Performance Over Training Alone in Subacute Stroke: A Pilot Randomized Controlled Trial

ObjectiveTo determine the effect of five-session dual-transcranial direct current stimulation (dual-tDCS) combined with task-specific training on gait and lower limb motor performance in individuals with subacute stroke.Materials and MethodsTwenty-five participants who had a stroke in the subacute phase with mild motor impairment were recruited, randomized, and allocated into two groups. The active group (n = 13) received dual-tDCS with anodal over the lesioned hemisphere M1 and cathodal over the nonlesioned hemisphere, at 2 mA for 20 min before training for five consecutive days, while the sham group (n = 12) received sham mode before training. Gait speed as a primary outcome, temporospatial gait variables, lower-limb functional tasks (sit-to-stand and walking mobility), and muscle strength as secondary outcomes were collected at preintervention and postintervention (day 5), one-week follow-up, and one-month follow-up.ResultsThe primary outcome and most of the secondary outcomes were improved in both groups, with no significant difference between the two groups, and most of the results indicated small to moderate effect sizes of active tDCS compared to sham tDCS.ConclusionThe combined intervention showed no benefit over training alone in improving gait variables and lower-limb performance. However, some performances were saturated at some point, as moderate to high function participants were recruited in the present study. Future studies should consider recruiting participants with more varied motor impairment levels and may need to determine the optimal stimulation protocols and parameters to improve gait and lower-limb performance.     

A retrospective study of blood transfusion in dogs from a veterinary hospital in Bangkok, Thailand

Blood transfusion is the established therapeutic method for anemic human patients and has recently become more practical in veterinary medicine. The objectives of this study were to demonstrate the etiology of anemia, the effectiveness of blood transfusion, and the incidence of transfusion reaction after treatment in dogs. The data of the transfusion veterinary service at the Chulalongkorn Veterinary Teaching Hospital (CVTH) were collected from January 2005 to February 2006. The presentation, causes of anemia, hematology, and transfusion reaction of 41 dogs were summarized as frequency and percentage. The hematology data were continuously analyzed as mean, median, and range. The mean of packed cell volume before and after treatment of all dogs was 11.3 and 26.5%, respectively. The anemic causes of 41 dogs were categorized into three groups including blood loss (43.90%), ineffective erythropoiesis (34.15%), and hemolysis (21.95%). The hematology of three categorized groups was not significantly different. Acute nonhemolytic transfusion reactions were observed in 4.18% of the dogs after transfusion, and they rapidly recovered after treatment. Although transfusion treatment in dogs shows good short-term efficacy, for complete therapeutic results, long-term data need to be gathered.     

A retrospective study of clinical hematology and biochemistry of canine hepatozoonosis on hospital populations in Bangkok, Thailand

Canine hepatozoonosis is an endemic tick-borne disease of Thailand, but the clinical data for the disease are rarely reported. The objective of this study was intended to characterize the clinical hematology and biochemistry of admitted canine hepatozoonosis cases of the Chulalongkorn Small Animal Teaching Hospital, Bangkok from January 2001 to December 2003. A total of 342 dogs were examined in this study. Most of the dogs presented with hypocytic hypochromic anemia. Leukocyte and platelet counts were variable and nonspecific in these cases. Additionally, serum biochemistry including blood urea nitrogen, creatinine, liver enzymes, total protein, albumin, and glucose of infected dogs were within normal ranges. This study indicated that hypocytic hypochromic anemia was a consistent hematological value feature of canine hepatozoonosis, but clinical biochemical findings were not consistent in this endemic-hospital population of canine hepatozoonosis.     

A retrospective study of clinical use of recombinant human erythropoietin for treatment of anemia in dogs with renal failure in Bangkok,Thailand

The administration of recombinant human erythropoietin (r-HuEPO) for treatment of anemia in dogs with renal failure is practical in most of veterinary hospitals, but there is a variation in clinical use among them. However, the determination of r-HuEPO in dogs has never been addressed in Thailand. Therefore, the objective of the present study was to evaluate the clinical efficacy of r-HuEPO to recover the hematology in dogs that had developed chronic renal failure-induced anemia at the Chulalongkorn Small Animal Teaching Hospital, Thailand. The medical records of the anemic dogs admitted to the hospital were reviewed only in case of treatment with r-HuEPO during the period from January to November 2006. The hematologic and serum biochemical data pre and post-treatment with r-HuEPO were assessed. The results were found that means of packed cell volume (PCV), red blood cell count, and hemoglobin concentration were significantly different from the values at week 0 after only 1 week of r-HuEPO treatment until week 8 of treatment. Erythrocyte indices indicated normocytic and normochromic. Other parameters were insignificant during treatment. In conclusion, treatment with r-HuEPO stimulated erythrocyte production in dogs with naturally developing anemia of chronic renal failure during 8-week treatment period. PCV reached the target range within 6 weeks of treatment. Exogenous r-HuEPO had no effect on leukocyte, platelet counts, and serum biochemistry in these uremic dogs.     

Effect of single-session dual-tDCS before physical therapy on lower-limb performance in sub-acute stroke patients: A randomized sham-controlled crossover study

Anodal stimulation increases cortical excitably, whereas cathodal stimulation decreases cortical excitability. Dual transcranial direct current stimulation (tDCS; anodal over the lesioned hemisphere, cathodal over the non-lesioned hemisphere) was found to enhance motor learning. The corresponding tDCS-induced changes were reported to reduce the inhibition exerted by the unaffected hemisphere on the affected hemisphere and restore the normal balance of the interhemispheric inhibition. Most studies were devoted to the possible modification of upper-limb motor function after tDCS; however, almost no study has demonstrated its effects on lower-limb function and gait, which are also commonly disordered in stroke patients with motor deficits. In this randomized sham-controlled crossover study, we included 19 patients with sub-acute stroke. Participants were randomly allocated to receive real or sham dual-tDCS followed by conventional physical therapy with an intervention interval of at least 1 week. Dual-tDCS was applied over the lower-limb M1 at 2-mA intensity for 20 min. Lower-limb performance was assessed by the Timed Up and Go (TUG) and Five-Times-Sit-To-Stand (FTSTS) tests and muscle strength was assessed by peak knee torque of extension. We found a significant increase in time to perform the FTSST for the real group, with improvements significantly greater than for the sham group; the TUG score was significantly increased but not higher than for the sham group. An after-effect on FTSTS was found at approximately 1 week after the real intervention. Muscle strength was unchanged in both limbs for both real and sham groups. Our results suggest that a single session of dual-tDCS before conventional physical therapy could improve sit-to-stand performance, which appeared to be improved over conventional physical therapy alone. However, strength performance was not increased after the combination treatment.