Received: 1 January 2024 | Accepted: 23 April 2024 DOI: 10.1111/eve.14009_1


C A S E R E POR T


Fatal acute clinical babesiosis in an adult gelding pony living in an endemic area


Lisa- Marie Hermans 1 | Antonin Tortereau 2 | Barbara Riccio 3 | Isabelle Desjardins 1


1 Clinéquine, VetAgro Sup , University of Lyon , Marcy l ' Etoile , France 2 VetAgro Sup , University of Lyon , Marcy l ' Etoile , France 3 Equine Practitioner , Turin , Italy


Correspondence: Lisa- Marie Hermans Email: lisa-marie.hermans@hotmail.com


SUMMARY


Equine piroplasmosis is a haemoprotozoal disease caused by Theileria equi and Babesia caballi . Clinical presentations vary in severity according to infectious load, host immunity and endemicity. In endemic regions, equine piroplasmosis rarely presents in an acute or peracute form. This case report de- scribes the case of a 10- year- old pony gelding presented for fever and acute inspiratory dyspnoea. The pony had a history of fever, tachypnoea, depression and dysorexia. Systemic an- timicrobials and corticosteroids had been administered for 3 days, without improvement. Worsening of the tachypnoea and development of sternal oedema prompted referral. On ad- mission, clinical signs of hypovolemic shock were observed, as well as coagulation disorders with haematoma formation after venipuncture. A complete blood count showed mild anaemia, mild neutrophilia and thrombocytopenia. Blood smear exami- nation confirmed mild anaemia and thrombocytopenia and identified intra- erythrocytic inclusions


resembling Babesia


caballi merozoites. Several organ lesions and/or dysfunctions were confirmed by biochemical analyses, including renal fail- ure, muscle, cardiac and pancreatic involvement. Pulmonary lesions and mild pleural effusion were detected on thoracic ultrasound. A presumptive diagnosis of acute babesiosis was made. Supportive therapy was initiated with continuous crys- talloid fluid infusion, intranasal oxygen, and plasma transfu- sion, but no total blood transfusion. Imidocarb dipropionate was not administered due to potentially fatal adverse reactions


in a horse in shock. Vital parameters deteriorated, anaemia worsened and a foamy haemorrhagic bilateral nasal discharge, suggestive of acute pulmonary oedema, was observed. The gelding was euthanised due to a poor prognosis and financial constraints. Post- mortem examination confirmed multi- organ dysfunction and disseminated intravascular coagulation syn- dromes secondary to acute babesiosis.


K E YWORDS horse , coagulopathy , haemolysis , piroplasmosis , SIRS


Key points


• Even in horses living in endemic areas, acute to pera- cute clinical presentations of


piroplasmosis with sec-


ondary systemic inflammatory response syndrome and multiple organ dysfunction syndrome can occur and al- though uncommon, may potentially be fatal. Systemic corticosteroid- induced immunosuppression during severe blood parasitaemia may contribute to disease worsening.


• The evaluation of a blood smear can be a rapid and reliable tool in the context of clinical piroplasmosis.


• Treatment with imidocarb in animals in a state of shock remains controversial. Whole blood transfusion may be considered in very acute cases of haemolytic anaemia and thrombocytopenia due to equine piroplasmosis.


This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2024 The Author(s). Equine Veterinary Education published by John Wiley & Sons Ltd on behalf of EVJ Ltd.


566 | aaep.org/wiley-redirect Equine Vet Educ. 2024;36:566.


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