A Case of Hemolytic Anaemia Causing Disseminated Intra-Vascular Coagulapathy
A case of hemolytic anemia associated with intra-vascular coagulopathy was investigated with a view to determine the specific etiology and treat the same.
Materials & Methods
A 2 year old male, brown, cocker spaniel with heavy tick infestation presented with dullness, pyrexia and petechial haemmorhages. During the course of treatment blood / serum samples were collected periodically. Blood smears stained with Giemsa were examined for detection of haemoprotozoan / rickettsial organisms. The blood / serum samples were investigated for haematological and biochemical profiles.
Investigations revealed thrombocytopenia, hypochromia, normoblasts, haemoglobin (9.6g/dl) and hyperglobulinemia. The patient was treated with Doxycycline and Vitamin K3. Case exhibited bleeding gums and pyrexia 2 days later. Imidocarb dipropionate was administered. (Note-no parasite was seen on the blood smear). The case improved clinically. Two days later, the patient presented again with epistaxis, vomiting and melena. The haemoglobin had dropped to 5.3g/dl and the PCV was 15.4%. Diminazene aceturate (Berenil, Intervet) was administered at this time. The patient was given whole blood transfusion and put on Enrofloxacin and Metronidazole. 48 hours later, haemoglobin -PCV increased, but the thrombocytopenia persisted. Hence Betamethasone was given. Anemia and thrombocytopenia worsened following which a second transfusion was given. (Aerobic culture reports-negative). Smear after 48 hours revealed the presence of Babesia species. Case improved with leucocytosis. Diminazene (Berenil) and tetracyclines were administered. Following recovery, supportive treatment was given for three weeks.
The etiological agent in this case of hemolytic anemia, thrombocytopenia and disseminated intra-vascular coagulopathy was found to be Babesia species. The case responded successfully to a combination of 2 injections of Diminazene aceturate (Berenil), Imidocarb dipropionate and Tetracyclines. The case importantly needed 2 whole blood transfusions from 2 different donors and lot of supportive care to recover.