Canine babesiosis and ehrlichiosis are widespread endemic tick-borne diseases that are widely distributed and being more prevalent in tropical areas including India. However, acute mixed infection of B. Canis vogeli and E. canis in dogs were rarely reported. The presence study reported simultaneous infection of B. Canis vogeli and E. canis with history of vomition and anorexia since one week. Similar clinical findings like lack of appetite, a pale mucus membrane but high fever was detected in Ehrlichia, Anaplasma and Babesia spp. in 3-month-old puppy in the Philippines (Yabnez et al. 2018), inappetence, dullness pyrexia and lymph node enlargement due to B. canis and E. canis in sub-clinical effected dog (Kalaivanan et al. 2017). Generally, the acute phase of canine monocytic ehrlichiosis is characterized by fever, anorexia, lymphadenomegaly, epistaxis and petechia (Neer and Harrus 2006). Clinical sign like hypothermia was seen in dogs having profoundly pancytopenia infected with canine monocytic ehrlichiosis (Mylonakis et al. 2010). Haematological analysis revealed severe anemia, decrease neutrophil level and thrombocytopenic abnormalities. Similar hematological changes have also been observed previously in canine babesiosis (Kettner et al. 2003; Scheepers et al. 2011), and canine ehrlichiosis (Kelly 2000; Shipov et al. 2008). The most common laboratory findings found in canine babesiosis and ehrlichiosis are anaemia and thrombocytopenia (Assarasakorn and Niwetpathomwat, 2007; Schetters et al. 2009). Hypoglycemia, hyperbilirubinemia, hypoproteinemia, hypoalbuminemia and increased plasma levels of AST, ALT, ALP, BUN, were in agreement to earlier findings (Mylonakis et al. 2010; De Caprariis et al. 2011; Al Izzi et al. 2013). Elevated levels of BUN could possibly be due to the altered renal function and glomerular filtration (Saravanan et al. 2014). Hyperbilirubinaemia in the present case may be due to intra-and extravascular hemolysis by Babebesia sp. (Al Izzi et al. 2013). Microscopic examination revealed merozoites of B. canis inside as well as outside the RBC is which is in agreement to the earlier findings available in the literature (Laha et al. 2015; Kalaivanan et et al. 2017). In some cases, single RBC, multiple invasion of more than one organism up to 16 may be found in single RBC (Laha et al. 2015). Morulae of E. canis were also detected in the cytoplasm of mononuclear cells as reported by earlier authors also (Lakkawar et al. 2003, Baneth et al. 2015). Although, both B. canis vogeli and E. canis were visualized by thin blood smear method. Molecular investigation confirmed B. canis vogeli and E. canis infection by PCR amplification method.
The present case was reported in the month of November, which is associated with winter season and having lowest percentage of prevalence of tick infestation as compared to summer and rainy season as reported by authors (Sahu et al. 2013). Inspite of cold weather, and low atmospheric temperature, the present case of co-infection by B. canis vogeli and E. canis was reported in winter season which might be favourable for development of mechanical vectors. Concurrent infection of two or more than two haemoprotozoan infections in dogs is fatal and can make the prognosis grave. In the present study, animal died on the same day. Hence, Public and private health officials, especially veterinarians should be aware of the increased potential risks caused for vector-borne diseases in dogs. Further, the present study may contribute in confirmatory diagnosis that might help in specific treatment of the animal and make the prognosis safe.