Perspectives on the pathogenesis and treatment of canine monocytic ehrlichiosis (Ehrlichia canis)

Development and validation of a TaqMan® probe- based real-time PCR assay for detection of Ehrlichia canis

Ehrlichiosis is a potentially fatal zoonotic tick-borne disease, caused by a pleomorphic Gram-negative bacterium. It occurs worldwide and affects humans, domestic and wild animals. Dogs infected with Ehrlichia canis develop canine monocytic ehrlichiosis (CME), a significant infectious disease of canines. TaqMan® based real-time PCR assays to detect Ehrlichia spp. affecting dogs were developed and a real-time PCR assay specific for E. canis validated. The efficiency of the assay was 93% and the 95% limit of detection was 33 E. canis plasmid copies/µl of blood (95% confidence interval: 23 - 58). The assay was specific for E. canis when tested against other haemoparasites. Consistent repeatability was observed, with an inter-run standard deviation (SD) range between 0.33 and 1.29 and an intra-run SD range between 0.04 and 1.14. Field samples were tested in parallel by both the E. canis real-time PCR assay and a reverse line blot hybridization assay. The results were in agreement for the two assays, with an exception of two out of 121 samples. Bayesian latent class analysis was used to calculate a diagnostic sensitivity of the E. canis real-time PCR assay of 90% and a specificity of 92%. This assay is a sensitive and reliable molecular detection method for E. canis and will be a useful tool for early diagnosis and timely treatment for this haemoparasite.

Immunophenotypical and pathological changes in dogs experimentally infected with Ehrlichia canis

Canine monocytic ehrlichiosis (CME) is one of the most important tick-borne diseases worldwide, with multisystemic presentations. Immune dysregulation has been proposed as the primary mechanism involved in its pathogenesis and in tissue injury in dogs with CME. Experimental infection of German Shepherd dogs in the present study demonstrated that CME caused marked pathological changes in their lymph nodes and spleen, and also gave rise to mononuclear infiltration in organs and tissues. Immunophenotyping of cells in lymph nodes, spleen and injured tissues highlighted differences in lymphocyte subsets, local expression of immunoglobulin subclasses and MHCII molecules between infected and control dogs. These findings suggest that the immunophenotypic and immunopathological changes in dogs with acute experimental CME are related to Th1 bias and compartmentalized immune response.

Serological Survey of Canine Vector-Borne Infections in North-Center Spain

Various factors are currently causing an increase in vector-borne parasitic diseases at a global scale; among them, some stand out, such as climatic disturbances derived from global change, the increase in movements of reservoir animals, or changes in land made by human activity. In the European continent, there have been an increasing number of epidemiological studies focused on the detection of these diseases, especially in dogs. In Spain, there are few epidemiological studies focused on the evaluation of the biotic and abiotic factors that may influence the distribution, such as climatic zones, orography, or presence of water reservoirs. The aim of this study was to analyze the prevalence and distribution of several canine vector-borne diseases caused by Dirofilaria immitis, Leishmania infantum, Anaplasma platys, and Ehrlichia canis in the autonomous community of Castilla y León, the largest region of the Iberian Peninsula, providing a geospatial approach based on a geographic information system (GIS) analysis. Blood from a total of 1,475 domestic dogs from the nine provinces of Castilla y León were analyzed. Also, a GIS analysis of the sample locations was carried out, taking into account the most important predictor variables. The prevalence in dogs infected by D. immitis was 7.19%, and the seroprevalence by L. infantum was 4.61 and 1.56% for A. platys and E. canis. Most of the infected animals were located in areas with stagnant water, irrigated agriculture, or riverbanks, always close to forest and woodland vegetation. These results indicate that dogs living in Castilla y León should take prophylactic measures to avoid infections.

Current Distribution of Selected Vector-Borne Diseases in Dogs in Spain

Currently, climate change, modifications of landscapes and habitats due to human activities, as well as an increase in the movement of reservoirs and new species of competent vectors, have contributed to the spread of canine vector-borne diseases. These are mostly emerging and neglected diseases, some of them with zoonotic potential. Therefore, the objective of this study was to assess the prevalence and distribution of four major canine vector-borne diseases (Dirofilaria immitis, Leishmania infantum, Anaplasma spp., and Ehrlichia canis) in Spain. Between September 2018 and February 2020, blood was sampled from 4643 client-owned dogs from 111 veterinary clinics from the 17 autonomous communities of Spain. All samples were tested for the detection of D. immitis antigens, and for antibodies against L. infantum, Anaplasma spp. and E. canis. Of the studied dogs, 22.14% were positive for one or several diseases while the prevalence was 6.25% (CI: 5.59–6.98) for D. immitis, and the seroprevalences were 10.36% (CI: 9.52–11.27) for L. infantum, 5.06% (CI: 4.47–5.73) for Anaplasma spp., and 4.26% (CI: 3.72–4.88) for E. canis. Co-infections by two and three vector-borne diseases were reported in 13% and 2% of the infected dogs, respectively. The studied vector-borne diseases are widely distributed throughout the Spanish geography, being observed and expanding northward in the case of D. immitis and L. infantum. The results point to an insufficiency of preventive measures to avoid the infection, and the need of the implementation of awareness campaigns among veterinarians and owners. Furthermore, a close collaboration between veterinarians, physicians and health authorities would be necessary for such zoonotic vector-borne diseases.

Evaluation of heart rate variability and behavior of electrocardiographic parameters in dogs affected by chronic Monocytic Ehrlichiosis

Canine Monocytic Ehrlichiosis (CME) is a systemic disease prevalent in the entire world caused by the obligate intracellular bacteria Ehrlichia canis. The occurrence of myocarditis with a high prevalence of arrhythmias in dogs affected by this disease in the cytopenic phase has already been proven. This study aims to evaluate the concentrations of CK MB, cTnI and NT-proBNP in dogs affected by Ehrlichia canis in the chronic phase since the intense stimulation of the immune system can lead to myocarditis; to evaluate if the condition can lead to arrhythmic events and, if so, define their frequency and classification through conventional and ambulatory electrocardiogram tests (Holter method) for a period of 24 hours; to analyze heart rate variability in the time domain and whether the condition can lead to autonomic imbalance; and to determine the survival rate of affected dogs, identifying possible risk factors for mortality at this stage of the disease. For this purposes, we evaluated clinical, hematological and biochemical data, as well as the concentrations of cardiac biomarkers Creatine Kinase-MB (CK MB), Cardiac Troponin I (cTnI) and N-terminal pro-peptide natriuretic type B (NT-proBNP). We also analyzed conventional and ambulatory electrocardiography (24-hour Holter) and heart rate variability (HRV) in 20 dogs afflicted by cytopenic CME in the chronic phase of the disease (G1) and compared the results with a control group comprised of ten healthy dogs (G2). G1 was monitored during the treatment for 28 days, during which eight (8) of the 20 infected dogs died (40%). Anorexia, vomiting, fatigue, hypoalbuminemia, heart murmurs and increased concentrations of alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were common clinical signs. The mean concentrations of cTnI and CKMB were significant (0.24 ng / mL ± 0.5, 229 ± 205 IU / mL) in comparison to the control group (0.042 ± 0.07 ng / mL, 126 ± 46.12 IU / mL). No significant differences were observed between NT-proBNP concentrations in G1 (135.46 ± 29.7) and G2 (138.28 ± 19.77). Nine of the twenty dogs (45%) presented a high frequency of arrhythmias during 24-hour recording, ranging from first and second-degree atrioventricular block, ventricular and supraventricular ectopic events and sinus tachycardia. No sinus pause was observed. One dog had 120 episodes of unsustained ventricular tachycardia and two episodes of sustained ventricular tachycardia. The short-term and long-term HRV data, represented by SDNN (ms), SDANN (ms) and pnn50 (%) were also significant lower (83 ± 65, 56.05 ± 37.3 and 14.56 ± 20, respectively) in comparison to the healthy animals (268 ± 74.6, 168.3 ± 39.14 and 55.87 ± 12.8, respectively). These results suggest that cytopenic CME is characterized by an arrhythmogenic component and intense stimulation of the sympathetic autonomic nervous system in the heart, reflecting an imbalance in the activity of the ANS.