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THEILERIOSIS ANAPLASMOSIS BABESIOSIS CATTLE.PDF

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					     DIAGNOSIS AND TREATMENT
                     of



      THEILERIOSIS
(EAST COAST FEVER AND TROPICAL THEILERIOSIS)



    ANAPLASMOSIS
              (GALLSICKNESS)



         BABESIOSIS
                (REDWATER)
                     in



             CATTLE
With thanks for photomicrography to the Department of Veterinary
    Microbiology and Parasitology, University College Dublin.
      DIAGNOSIS AND TREATMENT
       OF TICK-BORNE DISEASES
Cattle farmers and veterinarians encounter tick-borne
diseases, the threat of tick-borne diseases or the
consequences of tick-borne diseases every day. Theileriosis,
anaplasmosis and babesiosis develop quickly and they can
kill with little warning. They occur as single cases or as
major outbreaks, as acute disease or as grumbling infections.
Some symptoms are easy to recognise, others are not. They
can occur as mixed infections and they are often
complicated by pneumonia, enteritis and many other
diseases. Diagnosis and treatment is notoriously difficult.
Despite vast expenditure on molecular "diagnostics" for tick-
borne diseases, they are of little value to the veterinary
practitioner. Practitioners must rely on their own clinical
diagnostic skills and experience.

Effective drugs are available to cure all these diseases – those
transmitted by ticks and the main complicating conditions.
Cure rates, as with all diseases, increase the earlier the
diseases are treated. Complicated cases are more difficult to
manage because each disease must be diagnosed and
treated appropriately. Time is important with fulminating
diseases like theileriosis, anaplasmosis and babesiosis, but
usually there is not much time. "If I could have treated it
yesterday, I would have cured it".




        This booklet aims to help you to


      TREAT TICK-BORNE DISEASES

              YESTERDAY
   Parvexon™                       Parvexon Plus™

  Buparvex              TM
                                   ADACYCLINE™

    ZOLIMID™                       TETROXY LA™


                               1
              THERE ARE FOUR SIMPLE RULES

                     DIAGNOSE EARLY

                  DIAGNOSE ACCURATELY

                      TREAT PROMPTLY

                     TREAT CORRECTLY

DIAGNOSE EARLY: The earlier a diagnosis is made, the
sooner treatment can begin. Farmers know the main signs of
tick-borne diseases – fever, swollen lymph nodes, anaemia
and a sudden drop in milk yield. If they see these signs, they
should call the veterinarian immediately. Dairy farmers and
smallholder farmers in particular should be encouraged to
examine their animals daily and perhaps take their
temperature once or twice a week. A thermometer used by
a farmer is an excellent aid to early diagnosis.

DIAGNOSE ACCURATELY: The treatments for tick-borne
diseases are very specific. It is essential to know which
disease is present to ensure that the correct drug is used.
Mixed infections of two tick-borne diseases are common.
Take lymph-node and blood smears to confirm the diagnosis,
and examine them as soon as possible. The primary
diagnosis may be complicated by other diseases, such as
pneumonia or enteritis. Each disease must be diagnosed
correctly.

TREAT PROMPTLY: Tick-borne diseases develop rapidly.
They must be treated as soon as the first symptoms are
observed, and a correct diagnosis has been made.

TREAT CORRECTLY: Each tick-borne disease and any
complicating conditions must be treated appropriately, using
the correct drug at the right dosage, and completing the
course of treatment. Under-dosage risks treatment failure,
over-dosage wastes drugs. If possible, weigh the animal
before treatment or use a weigh-band. Give supportive
treatment and good nursing, particularly to anaemic animals.
If the clinical response to treatment is poor, check the
diagnosis – do not simply give another dose of the same
treatment. Many cattle die of undiagnosed secondary
conditions following correct diagnosis and treatment of the
primary condition.


   FARMERS AND VETERINARIANS WORKING TOGETHER

   TREAT MORE CATTLE YESTERDAY
  CURE MORE CATTLE AT LESS COST
                              2
                      EAST COAST FEVER
                                   Causative organism : Theileria parva.
                          Vector : brown ear tick, Rhipicephalus appendiculatus

 SUMMARY
 Key signs:      Fever, enlarged lymph nodes, laboured respiration, drooling

 Treatment:      Buparvex (buparvaquone), Parvexon (parvaquone)
                 Parvexon Plus (parvaquone + frusemide) for cases with pulmonary signs

 Key points:     Take lymph-node and blood smears to confirm diagnosis
                 Treat promptly – ECF is rapidly fulminating and lymphodestructive
                 Diagnose and treat intercurrent infections, particularly anaplasmosis
                 Complete course of treatment to avoid relapses



Clinical signs of ECF                                          should be taken to prepare very thin lymph and blood
Enlarged superficial lymph nodes, fever up to 42°,             smears to maximise spreading of the cells and the
laboured respiration / pulmonary oedema, drooling              visibility of the parasites.
from the nostrils, “bottle-jaw” oedema, petechial
haemorrhages on mucous membranes, dullness,                    Lymph node smears from clinical cases of ECF always
dramatic drop in milk yield. If also anaemic,                  show lymphoid hyperplasia. Hyperplasia can have
suspect concurrent anaplasmosis and possibly                   other causes including the effect of feeding ticks, even
babesiosis. The closely related condition Corridor             uninfected ones, because as they feed, they inject
disease (CD) is caused by ticks that have picked up            saliva which causes irritation. So, do not confirm a
their infection by feeding on buffalo. The clinical            case of ECF simply because there are many
symptoms of CD are very like those of ECF, but they            lymphoblastoid cells in the smear. Continue searching
may be more acute and the eyes are often clouded               for Theileria schizonts – it may be an early case of ECF,
due to invasion by white blood cells, sometimes                but if it is not, consider other diagnoses before treating
leading to blindness.                                          unnecessarily for ECF. Usually, a smear from an
                                                               enlarged lymph node caused simply by feeding ticks
Confirmation of diagnosis of ECF                               will contain more macrophages than one infected with
Lymph node smear – essential to confirm diagnosis,             ECF. It is also likely to be more oedematous, so it will
particularly in doubtful cases. The prescapular lymph          feel softer than in early ECF. Late ECF nodes are often
node is the easiest to sample, using an 18G                    oedematous too, but it should be easy to find
hypodermic needle, but the parotid node may be                 schizonts in them.
preferred if the head can be restrained adequately.
The earliest positive diagnosis can usually be made
from the parotid node, below and in front of the ear,
because this drains the predilection site of the brown
ear tick. Schizonts usually appear in the prescapular
nodes two or three days later than in the parotid node
on that side of the body. Examine slides for the
presence of schizonts in lymphoblastoid cells, and
obvious lymphoid cell hyperplasia. Macroschizonts
may be rare and small in early cases of ECF and at all
stages of Corridor disease, despite the presence of
lymphoid hyperplasia. Presence of microschizonts
indicates an advanced case. Be aware that some
strains produce few macroschizonts, even in advanced
cases. ECF may be caused by only a single infected
tick. The lymph nodes on the side on which the
infecting tick attached may have schizonts at least two
days before the contra-lateral lymph nodes so it is best       Lymph node smear. Lymphoid hyperplasia, with Theileria
                                                               macroschizonts in some cells
to take smears from both sides of the body. Care

                                                           3
Blood smear –for presence of Theileria piroplasms,
and for Anaplasma and Babesia, in the
erythrocytes. Large numbers of Theileria
piroplasms indicate an advanced ECF case. Small
numbers may indicate either an early case or an
acute case. In Corridor Disease piroplasms may be
very scarce or absent, even in advanced cases.
Moderate numbers of piroplasms in the blood
smear but no schizonts and little or no hyperplasia
in the lymph node smear suggest an immune carrier
or an infection with a non-pathogenic species of
Theileria.

Treatment of ECF
ECF is a rapidly fulminating, lymphodestructive and
                                                               Drug-damaged schizonts in a lymph-node smear taken a day after
immuno-depressive disease. Prompt treatment of ECF             treatment with buparvaquone.
and specific treatment of intercurrent infections is
essential.

• Buparvex (buparvaquone) 1ml / 20 Kg by                       Comments
  intramuscular injection. Repeat if clinically
  indicated after 48 – 72 hours.                               • In all but the mildest cases of ECF, complete cure
                                                                 requires the drug to be present for at least four
• Parvexon (parvaquone) 1ml / 15 Kg by intramuscular             days. It is essential to complete the course of
  injection. Repeat after 48 hours and thereafter as             treatment, even if clinical signs resolve in a day or
  clinically indicated.                                          two. Cured animals become asymptomatic
                                                                 carriers of ECF.
• Parvexon Plus (parvaquone + frusemide/furosemide)
  for advanced cases with pulmonary signs. 1ml / 15 Kg
                                                               • Advanced cases of ECF with pulmonary signs usually
  by intramuscular injection, repeat after 48 hours,
                                                                 show clear clinical improvement within one or two
  complete treatment with Buparvex or Parvexon.
                                                                 days of first treatment with Parvexon Plus. Once
                                                                 resolved, pulmonary signs do not usually recur so
For further information, read the package insert.
                                                                 the course of treatment may be completed using
                                                                 Parvexon or Buparvex to give the minimum of four
Intercurrent and concurrent conditions must be                   days drug cover.
treated specifically because they may be acute in
animals immuno-depressed by ECF. The carrier state             • Temperature may be within normal ranges, or sub-
of anaplasmosis may be activated into clinical                   normal, in advanced cases. An animal with obvious
anaplasmosis in an animal suffering from ECF. In                 clinical signs of ECF but no fever is likely to die
areas endemic for anaplasmosis it may be advisable to            within 24 hours if it is not treated immediately. Of
treat all cases of ECF additionally with tetracycline or         course, if organ damage is irreversible, it may die
imidocarb even if the animal is not anaemic. Low                 despite treatment.
Anaplasma parasitaemia that would be insignificant in
an uncomplicated case can cause severe anaemia and             • Appetite and body condition may be little
liver dysfunction that can be fatal in combination with          affected even in fairly advanced acute cases of
ECF.                                                             ECF, but in less acute cases appetite is usually
                                                                 poor and loss of body condition may be rapid.
                                                                 Affected animals usually continue to drink. In
Response to treatment of ECF
                                                                 milking cows, a drop in yield is among the first
Except in the most severe or terminal cases, all                 signs of ECF.
clinical symptoms (apart from enlarged lymph nodes)
should resolve or show clear signs of improvement              • “Chronic” cases of ECF may also be encountered.
within two days of treatment. If improvement is not              They are particularly difficult to diagnose. They
seen, the diagnosis should be reconsidered.                      respond relatively slowly to treatment because so
Schizonts and piroplasms should show clear signs of              many organ systems are damaged. The usual
degeneration within two days of treatment. Their                 clinical signs of ECF may not be obvious. The
numbers should then decline quickly. If significant              exhausted lymph nodes may not be very
numbers of undamaged parasites remain, or if their               enlarged, parasite numbers in smears are often
numbers increase, additional treatment should be                 low and lymph smears may not be very
given immediately even if clinical signs of ECF have             hyperplastic.
resolved. Lymphoid hyperplasia may not reduce until
several days or weeks after clinical and parasitological       • The presence or absence of brown ear ticks on a
cure of ECF.                                                     sick animal is not a very useful aid in the

                                                           4
   diagnosis of ECF because the incubation period is                         renewed clinical phase. This may be rapidly fatal
   longer than the feeding period of the tick. The                           because lympho-destruction and therefore immuno-
   tick that transmits ECF will have dropped off                             depression is likely to progress during the period of
   before clinical signs of ECF appear. Of course, if                        clinical remission.
   there are lots of ticks on the animal, a dipping
   failure is indicated and ECF should certainly be                       • ECF is a lympho-destructive disease so
   considered.                                                              intercurrent infections should be expected.
                                                                            If they are severe, they must be treated
• Hay and cut fodder are common sources of ticks.                           specifically. In the immuno-depressed animal,
  Ticks can survive in hay for more than a year and                         intercurrent infections can progress more rapidly
  still transmit ECF. Ticks in cut-and-carry fodder are a                   and become more severe than in animals not
  common source of ECF in zero-grazed smallholder                           affected by ECF. If an animal fails to improve
  cattle.                                                                   after treatment for ECF, check the diagnosis – for
                                                                            ECF and for intercurrent infections, and give the
                                                                            appropriate treatment.

                                                                          • Examination of lymph node smears is essential to
                                                                            confirm a diagnosis of ECF, but it is equally
                                                                            important to examine blood smears to detect even
                                                                            very low parasitaemias of Anaplasma and Babesia.
                                                                            Blood smears must be taken before the animal is
                                                                            treated for ECF because parvaquone and
                                                                            buparvaquone cause Theileria piroplasms to
                                                                            condense and look like Anaplasma organisms.
                                                                            After the animal has been treated, it is almost
                                                                            impossible to distinguish between drug-damaged
                                                                            theilerial piroplasms and Anaplasma.

A typical blood smear, prepared on the farm, showing high Theileria
piroplasm parasitaemia.


• Cattle that are cured of ECF are immune to re-
  infection with the same strain but they may be
  susceptible to other strains. Cattle that recover from
  ECF are still susceptible to Corridor disease. Bought-
  in cattle and hay may bring ticks infected with new
  strains of ECF. Recovered cattle are carriers, so they
  can bring new strains that can infect the ticks on the
  buyer’s farm.




                                                                          A correctly stained lymph node smear taken during the pre-patent
                                                                          stage of ECF showing lymphoid hyperplasia but no Theileria
                                                                          schizonts. In a poorly stained smear from a more advanced case of
                                                                          ECF, lymphoid cell nuclei would stain blue rather than purple, and
                                                                          schizonts would remain unstained.



                                                                          • It is easy and interesting to examine a well-prepared
                                                                            slide under the microscope. Examining a poor slide
                                                                            is a nightmare. Well prepared lymph and blood
Blood smear taken one day after treatment of ECF with                       smears, using clean slides, properly fixed and
buparvaquone. The Theileria piroplasms are dead, and they
resemble Anaplasma. Compare this with the smears from early and             stained, are essential for the correct diagnosis of
advanced cases of anaplasmosis on pages 7 and 8.                            tick-borne diseases. They must be examined under
                                                                            a well-maintained and properly adjusted (but not
• Different strains of ECF can cause various patterns of                    necessarily expensive) microscope, using an oil-
  disease. With most strains the disease is rapidly                         immersion objective. Diagnoses may be missed, or
  progressive but with some a period of remission may                       incorrect positive diagnoses made, if preparation,
  occur after an initial clinical episode, followed by a                    staining or examination of slides is sub-standard.

                                                                      5
• Smears should be dried quickly, away from flies                   The spleen is usually enlarged and its pulp is jam-
  and dust, then fixed and stained using fresh, water-              like, but when lymphoid depletion is severe, the
  free alcohol and fresh stain. It is almost                        spleen may be shrunken and pale. Cigarette-burn
  impossible to recognise schizonts in poorly                       ulcers are usually present in the abomasum, with
  prepared or thick lymph smears, and every bad                     oedema of the folds in the omasum, but these signs
  blood smear appears to be infected with                           are not confined to cases of ECF. Changes in the
  Anaplasma ! In weakly stained slides, the                         intestine are very variable, but zebra striping with
  parasites are the elements that are least likely to               black pigment, particularly in the colon and rectum,
  take up stain. Apart from not staining for long                   is common in more protracted cases.
  enough, weak staining can be due to ‘stale’ stain,
  stain of the wrong pH, or poor fixing, usually                    Petechial and ecchymotic haemorrhaging on the
  because the fixing alcohol contains water.                        myocardium and various mucous membranes is
                                                                    common, but not diagnostic, and other changes to the
• Corneal opacity, due to white cell infiltration, is a             heart are variable, as would be expected in a disease
  common sign of ECF particularly in more protracted                that takes so many forms. Surface haemorrhages and
  cases, but it usually resolves as animals recover. It is          white lymphoid infarcts may be seen on the kidneys,
  more common and more severe in Corridor disease,                  particularly in more protracted cases, but in chronic
  and may cause permanent blindness.                                cases they are likely to have resolved, leaving scars.
                                                                    The kidney cortex is often congested.
• Post mortem signs: Post mortem signs of ECF are
  notoriously variable, even within a single outbreak and in        The liver may be enlarged; if it is icteric and fragile-
  uncomplicated cases. Signs in an animal that has been             like gingerbread with an enlarged gall bladder, and
  treated unsuccessfully for ECF, particularly if there was a       particularly if the carcase is anaemic, concurrent
  complicating infection, may be further confused. “Slow”           anaplasmosis should be suspected. Anaemia without
  or “chronic” cases may show almost no ECF pathology.              icterus may indicate concurrent babesiosis.
                                                                    Significant anaemia is not characteristic of
• Froth-filled airways, associated with pulmonary                   uncomplicated ECF or Corridor disease except when
  changes, are a common but not invariable sign of fatal            there has been extensive bleeding into the gut from
  ECF. Fresh carcases, before they are moved, may                   severe ulceration.
  show characteristic columns of froth emerging from
  the nostrils. These signs are less likely to be seen in
  peracute and protracted cases. Pulmonary interstitial
  oedema, emphysema and enlarged lymph nodes,
  particularly of superficial nodes and those associated
  with the alimentary canal, are the most common signs.
  In protracted or unsuccessfully treated cases, lymph
  node enlargement may be less and characteristic black
  pigmentation may be present within the nodes. Muscle
  and fat appear normal, except in cases in which there
  is clear loss of condition.




                                                                6
ANAPLASMOSIS OR GALLSICKNESS
                            Causative organism : Anaplasma marginale
  Vectors : Blue ticks (Boophilus spp.) and other ticks, biting flies, used needles and instruments


 SUMMARY
 Key signs:       Anaemia, icterus, constipation, lethargy

 Treatment:       Tetroxy LA (oxytetracycline), Zolimid (imidocarb), Adacycline (oxytetracycline)

 Key points:      In acute disease, anaemia may be severe on first presentation
                  Parasitaemia is usually more than 40% but may be less than 10%
                  Sub-acute disease is difficult to diagnose
                  Good blood smear is essential for diagnosis
                  Common complicating infection in ECF


Clinical signs of anaplasmosis
Acute anaplasmosis causes severe anaemia (PCV may be
10% or less) and jaundice (hence the name “gallsickness”)
with fever up to 41.5°. Mucous membranes are pale and
icteric, often with petechial haemorrhages. Constipation
with bile-stained faeces is common, but calves may have
diarrhoea. Urine may be dark but not the deep red that is
characteristic of babesiosis (redwater). Affected animals
are lethargic, but occasionally aggressive. Milk yield falls
progressively over several days.

Sub-acute or “chronic” anaplasmosis is difficult to
diagnose because anaemic changes are less clear.
Anaemia may be moderate (PCV 15-20%) and icterus
not obvious. Body condition deteriorates steadily and
the animal may remain in very poor condition for many              Blood smear from an early clinical case of anaplasmosis, before
days or weeks. Anaplasmosis concurrent with East                   anaemic changes have occurred. Compare this with the blood
                                                                   smear from a case of ECF after treatment with buparvaquone, on
Coast fever (ECF) develops rapidly because the animal is
                                                                   page 5
immuno-depressed but parasitaemia may be very low
(less than 5%). The diagnostic clue is anaemia because
anaemia is not characteristic of uncomplicated ECF.                erythrocytes are a useful diagnostic clue. In acute cases
                                                                   not yet showing clear regenerative signs, many of the
Confirmation of diagnosis of anaplasmosis                          erythrocytes may be noticeably smaller than in a normal
Confirmation must be made from examination of a                    blood smear. In chronic cases, parasitaemia is usually
blood smear for the presence of Anaplasma “marginal                below 10% and may be below 1%, signs of anaemia
bodies” in erythrocytes. The textbook picture with 70%             and regeneration are much less than in an acute case
Anaplasma parasitaemia in an otherwise normal blood                and macrophages containing erythrocytes are rare.
smear is rarely encountered in practice.                           Temperature may be sub-normal in very advanced cases.

If the animal is showing clinical signs, the blood smear is        Treatment of anaplasmosis
almost certain to show anaemic changes. In acute cases
parasitaemia may be anything between 1% and 90%                    The pathology of anaplasmosis is due almost entirely to
with clear signs of anaemia and regeneration, such as              destruction of infected and uninfected erythrocytes.
anisocytosis (erythrocytes of widely varying size, some            Haemoglobin is broken down principally in the liver,
smaller than usual), and polychromasia (blue staining of           hence the main signs of anaemia and jaundice.
erythrocytes, particularly the largest ones). Varying              Anaplasma does not produce toxins. Treatment,
degrees of basophilic stippling (blue-black particles in           therefore, should aim primarily to control the causes
erythrocytes) makes positive identification of Anaplasma           and effects of anaemia and jaundice. Killing the
organisms difficult, particularly if parasitaemia is low.          Anaplasma, the cause of the disease, obviously is
Macrophages packed with infected and uninfected                    important but supportive treatment is essential too.

                                                               7
                                                                      Comments

                                                                      • Anaplasmosis occurs throughout Eastern Africa.
                                                                        Calves are more resistant to anaplasmosis than older
                                                                        cattle, partly because they respond better to
                                                                        anaemia. They usually undergo a mild episode and
                                                                        become immune carriers but they may die if they are
                                                                        stressed or subjected to high levels of challenge.
                                                                        Anaplasmosis sometimes occurs as a major outbreak
                                                                        among older cattle, particularly if there is a dipping
                                                                        failure on a farm that practices strict tick control.
                                                                        This is because the animals may not have
                                                                        encountered anaplasmosis as calves, so they are not
                                                                        immune. More often, there are single or sporadic
                                                                        cases, presumably in cattle that did not become
Blood smear from an advanced case of anaplasmosis with anaemia.
                                                                        infected as calves.

Specific treatment: Oxytetracycline long-acting                       • Despite the characteristic anaemia and jaundice,
injection, (Adacycline or Tetroxy LA) 1ml / 10 Kg                       anaplasmosis may be difficult to diagnose on clinical
(20mg / Kg) by intramuscular injection at 48-72 hours                   symptoms alone, particularly in chronic cases or
intervals, as clinically indicated (usually two injections              when sporadic cases occur. The signs may also be
are necessary for an acute case) or short-acting                        confused with plant poisoning. In acute cases,
tetracycline injections delivering 10mg / Kg daily for at               anaemia develops very rapidly and jaundice may not
least three days. Alternatively, imidocarb dipropionate                 appear immediately. An animal with PCV as low as
(Zolimid) 1ml / 40 Kg (3mg / Kg) by intramuscular                       15% may appear completely normal on casual
injection. A second similar injection may be necessary                  observation or until it is stressed for example by
after 48 -72 hours. Chronic cases should receive only a                 herding over long distances, when it will lag behind
single injection of either Tetroxy LA or Zolimid in the                 the main herd. A day later, PCV may be below 10%
first instance. Additional injections may be given,                     and it will be very obviously sick.
depending on the response to the first one.
                                                                      • Examination of a well-prepared thin blood smear is
For further information, read the package insert.                       advisable to confirm a diagnosis of anaplasmosis.
                                                                        However, haematological changes make
Supportive treatment : It is essential to stress the                    confirmation of the diagnosis difficult. The size of
treated animal as little as possible. It should be given                the Anaplasma marginal bodies is variable, but
free access to drinking water and food, in a dry shaded                 generally between 0.2 and 0.5 microns in diameter.
place. It should not be made to walk more than                          For comparison, the diameter of a bovine red cell is
necessary, but prolonged recumbency should be                           about six microns. The largest anaplasms tend to be
avoided. Supportive treatment with haematinics and                      seen in the most anaemic animals. As the name
metabolic stimulants should be considered. Blood                        suggests, they tend to be located near the margin of
transfusion could be considered for particularly                        the erythrocyte, which helps to distinguish them
valuable animals.                                                       from nuclear debris in the immature erythrocytes,
                                                                        which is distributed more evenly. Normocyte nuclei
Response to treatment of anaplasmosis                                   and Howel Jolly bodies are larger and should not be
Treatment with either tetracycline or imidocarb usually                 confused with Anaplasma. These distinctions,
halts the rise in parasitaemia within 24 hours and                      however, may be difficult to make unless the smear
parasitaemia then falls to low levels over several days.                is a well-prepared and well-stained monolayer, and
However, a continuing regenerative anaemia may                          the microscope is correctly adjusted.
persist for a day or two after treatment, hence the need
to avoid stressing the animal. It should then stabilise                  On a poorly prepared slide almost every erythrocyte
and show clear signs of improvement over the next few                    may appear to be infected with Anaplasma,
days. Temperature should return to normal levels within                  particularly if the smear was not dried quickly and
two days of treatment. Signs of jaundice may take                        the outline of the cells is not smooth. Dirt and
several weeks to resolve completely.                                     particles of stain can be identified by their generally
                                                                         rougher outline than anaplasms, their more uniform
In general, acute cases of anaplasmosis either recover                   distribution over and between the erythrocytes and
rapidly or the animal dies or remains in a persistently                  their adherence to the outside of the erythrocytes.
poor condition despite continued treatment. Renewed                      Focussing the objective and the condenser may show
signs of anaplasmosis may occur after two or three                       their greater refractivity. However, there is no
weeks. Further treatment may be necessary but in most                    substitute for a well-prepared slide!
cases recovery occurs without treatment. Chronic cases
rarely show a dramatic response to treatment and they                 • Rapid drying of a blood smear is important. The
may never resume normal productivity.                                   slower the smear dries, the more distortion will be

                                                                  8
   seen in the red cells, making parasite identification         simple mechanical transporters of infected blood
   more difficult. Slow drying also gives flies more             from one animal to another. Hypodermic needles,
   opportunity to feed on the smear. Fly feeding is              surgical instruments, etc., that are used on more than
   characterised by clear round areas, about 2mm                 one animal can transfer the infection. In controlled
   across, on the smear. A thin smear that is dried              studies, cattle have been infected with only 10
   quickly does not give flies time to feed on it.               infected red blood cells. Thus, a syringe that has
                                                                 been used for intravenous injection, and even a used
• Even if treatment results in reduced fever and a               needle, may infect several animals sequentially.
  decline in parasitaemia, PCV may continue to fall
  for a day or two, usually at a slower rate than
  before treatment. It will then begin a progressive           • Post mortem signs.
  recovery. However, the rise in haemoglobin
  concentration lags somewhat. This is because new               The carcase is anaemic and icteric in most cases of
  erythrocytes are considerably larger than mature               anaplasmosis. In acute and chronic cases icterus
  ones, but they contain the same amount of                      may be less apparent or entirely absent although in
  haemoglobin. Restoration of respiratory capacity,              some chronic cases it is spectacularly obvious.
  therefore, is slightly delayed beyond what the rising          Acute cases that die despite treatment are likely to
  PCV might suggest, hence the continued need to                 be anaemic and icteric, the carcase dehydrated and
  avoid stressing the animal until PCV has risen                 the fat gelatinous.
  substantially.
                                                                 The urine may be dark, but haemoglobinuria is not
• A re-appearance of symptoms of anaplasmosis and                seen because intravascular erythrolysis is not a
  a rise in parasitaemia is often seen about two or              feature of anaplasmosis. Erythrocytes, both infected
  three weeks after clinical cure of anaplasmosis. This          and uninfected, are removed from the blood by
  may be severe enough to need further treatment, but            phagocytosis and breakdown of haemoglobin occurs
  in most cases it is not. Cattle should not be re-              mainly in the liver. This gives rise to the typical
  treated before this “relapse”, in an attempt to                jaundice signs of anaplasmosis or gallsickness –
  prevent it because this usually only delays the                enlarged liver, liver parenchyma orange and friable,
  relapse. Then, when the relapse does occur, it may             gall bladder enlarged and filled with thickened
  be more severe than if the “preventive” treatment              (grumous) bile which may be gritty, and bile-stained
  was not given.                                                 lower gut and gut contents with signs of
                                                                 constipation.
• All strains of anaplasmosis seem to be
  immunologically similar and recovered animals                  Various other signs may be seen, but they are not
  become immune carriers. An animal that has                     consistent. They include petechial and echymotic
  recovered from anaplasmosis, therefore, is unlikely            haemorrhages on the mucous membranes and on
  to develop the disease again even if it is moved to            the epi- and endo-cardium, flabby myocardium,
  another area. The extremely important exception to             renal haemorrhages, particularly of the cortex, and
  this is the animal with East Coast fever (see the              gelatinous fat. The spleen may be grossly enlarged,
  section on ECF). This is because ECF causes severe             but not always. Acute and chronic cases may show
  immunodepression, so the carrier state can be                  few of these signs, although acute cases are usually
  activated into severe clinical anaplasmosis.                   anaemic and poor carcase condition typifies chronic
                                                                 cases. Blood smears prepared post mortem are
• There is a continuing debate on the ways in which              rarely good enough to confirm any but the heaviest
  anaplasmosis can be transmitted. Blue ticks, and               parasitaemia of anaplasmosis because distortions of
  perhaps other species of tick, are certainly involved.         the erythrocytes produces artefacts that closely
  Biting flies have also been implicated. They act as            resemble anaplasms.




                                                           9
         BABESIOSIS                                         OR       REDWATER
                  Causative organism : Babesia bigemina (rarely in E. Africa, B. bovis)
                                 Vector : Blue ticks - Boophilus spp.


 SUMMARY
 Key signs:       Anaemia, dark or red urine, laboured respiration, lethargy

 Treatment:       Zolimid (imidocarb), or diminazene

 Key points:      In acute disease, anaemia may be severe on first presentation
                  Sub-acute disease is difficult to diagnose
                  Haemoglobinuria may be transient
                  Good blood smear is essential for diagnosis
                  Primary cause of death is anaemia – careful nursing is essential


Clinical signs of babesiosis                                     probably be present in at least one individual.
Acute babesiosis due to Babesia bigemina causes high             However, such multiple case outbreaks are relatively
fever and severe anaemia that can develop very                   rare, particularly in small herds, because most animals
quickly. Destruction of red blood cells is partly by             develop at least some immunity to babesiosis during
lysis, which releases haemoglobin into the plasma                calfhood.
and subsequently into the urine (causing “redwater”),
and partly by phagocytosis of both infected and                  Fortunately not all cases of babesiosis are acute. The
uninfected red cells. Temperature may be up to 42°.              disease may develop more slowly in some animals,
Affected animals can appear clinically normal despite            because of partial immunity acquired in calfhood.
severe anaemia, until they are stressed by exercise.             These cases can be difficult to diagnose because there
Respiration becomes laboured and the heartbeat rapid             are so few clear or specific signs. However, some of
as the animal strives to provide enough oxygen to the            them will progress into severe disease over several days,
tissues. The jugular pulse may be easily visible and             often without obvious fever, and rarely showing
the heartbeat can even be audible from a distance as             redwater.
the heart fights to pump the watery anaemic blood
around the body. Mucous membranes are almost                     Babesiosis in Eastern Africa is almost always caused by
completely white. Preparation of a good blood smear              Babesia bigemina, transmitted by Boophilus
can be difficult because there are so few red cells              decoloratus, the common blue tick of East Africa.
present and because the viscosity of the blood is so             Occasional cases caused by Babesia bovis (transmitted
low. Packed cell volume (PCV) may be less than 10%               by Boophilus microplus), have been reported from
when the animal is first examined, and it can be as              southern and coastal areas of Tanzania, and it is
low as 7%.                                                       common in Southern Africa. It also occurs from Sudan
                                                                 northwards and in West Africa, where it is transmitted
The symptom of “redwater” (haemoglobinuria) is not               by Boophilus annulatus, a tick that is not found in
invariably present, and it may be transient. It is               Eastern Africa. Babesia bovis causes anaemia and fever,
associated with the time of maximum red cell                     similar to Babesia bigemina in some respects, but it is
destruction. This is usually as the PCV falls from around        characterised in many cases by nervous signs caused by
20% to 10%, which may happen in little more than 12              infected red blood cells blocking brain capillaries.
hours. When PCV is below 10%, relatively few red cells           Severe nervous signs and death can occur in animals
are being destroyed, so redwater may not be present.             showing little or no fever or anaemia, and parasitaemia
The acutely sick animal, therefore, may not have                 in the blood of less than 1%, so it can be confused with
redwater and temperature may have fallen below                   heartwater. Even when it is hard to find any parasites in
normal levels. Diagnosis of an acute case of babesiosis          a blood smear, brain capillaries can be blocked with red
often depends on recognising the acute anaemia                   blood cells, almost all of them infected with Babesia
accompanied by severe respiratory and cardiac distress,          bovis parasites (see photo on page 13).
in the absence of icterus (which might signify
anaplasmosis).                                                   Confirmation of diagnosis of babesiosis
                                                                 Taking and examining a blood smear for the presence of
Diagnosis is simplified if several cases occur                   parasites and abnormal haematology is essential. In
simultaneously because each of the principal signs will          general, the presence of any Babesia parasites in a

                                                            10
blood smear confirms the diagnosis because Babesia                        Specific treatment : Imidocarb dipropionate (e.g.
parasites are almost never seen in blood smears from                      Zolimid and Imizol) is a very effective babesiacide at a
carrier animals. Parasitaemia in acute clinical cases                     dose of 1.2mg / Kg (1ml / 100Kg bodyweight) in cases
caused by Babesia bigemina is usually at least 10% and                    caused by Babesia bigemina. A single injection is
it can reach 90%. In late cases with severe anaemia,                      usually effective, and all parasites are cleared from the
the parasitaemia may be lower and the parasites may be                    blood within a day or two. Imidocarb is also effective
degenerate, as the immune response develops. There                        for the treatment of anaplasmosis (and Babesia bovis) at
are likely to be signs of regeneration of red cells and                   3ml / 100Kg, and this dose rate should be considered in
anisocytosis, and macrophages may be packed with                          case of mixed infections. Diminazene (various brand
parasitised and uninfected red cells. Babesia bigemina                    names, such as Berenil) is an alternative drug for the
infects very young red cells as well as more mature                       treatment of babesiosis, but it has almost no action on
ones, and this can intensify and prolong the anaemia in                   anaplasmosis.
the regeneration phase even after most of the parasites
have been eliminated.                                                     Supportive treatment : Treated animals should be kept
                                                                          shaded and given adequate water and food, and they
                                                                          should not be moved unnecessarily. Blood transfusion or
                                                                          fluid therapy can be considered for particularly valuable
                                                                          animals if they are very anaemic or dehydrated. A diuretic
                                                                          such as frusemide should be considered in case of renal
                                                                          failure. The value of treatment with corticosteroids to
                                                                          reduce the destruction of red blood cells is questionable
                                                                          even if immune-mediated haemolytic anaemia is
                                                                          suspected, partly because steroids are unlikely to help this
                                                                          condition, and they may inhibit the immune response to
                                                                          babesiosis.
Blood smear from a case of redwater caused by Babesia bigemina.
Photo kindly provided by Dr. Theo de Waal, Dept. Vet. Microbiology
                                                                          Response to treatment of babesiosis
and Parasitology, University College Dublin                               Examination of a blood smear only a day after treatment
                                                                          with imidocarb usually shows that all the parasites have
Babesia bigemina is a large parasite that is easily                       been killed and mostly eliminated, and temperature is
recognisable in all but the worst prepared and badly                      likely to be normal. If the animal survives the first day
stained blood smears. Many of the parasites are paired,                   or two after treatment (some very anaemic animals will
occupying almost half of the red blood cell, and                          not) rapid signs of recovery, both clinical and
multiple infections that appear to completely fill the cell               haematological, should then be seen. PCV may
are common at high parasitaemias. Babesia bovis is                        continue to fall for up to two days despite obvious
noticeably smaller, paired parasites lie at a greater angle               regenerative changes in blood smears, but it should then
to each other and multiple infections of red blood cells                  rise progressively with resolution of the worst signs of
are less common.                                                          anaemia, provided that good supportive care is given.
                                                                          The recovering animal may remain weak for a few days,
Examination of blood smears is also important to assist                   but when PCV reaches about 15% it should appear
the diagnosis of concurrent tick-borne diseases,                          clinically near normal then quickly recover completely.
particularly anaplasmosis and East Coast fever. The                       Animals that do not recover in this way may have
incubation periods of babesiosis and ECF are similar –                    suffered irreversible renal or liver damage and they may
around two or three weeks, so a single dipping failure                    never make a complete recovery; the chronic ill-thrift
can result in both diseases appearing at the same time.                   sometimes associated with anaplasmosis is rare in
The incubation period of anaplasmosis is longer – at                      babesiosis.
least four weeks and sometimes more than six, but
mixed anaplasmosis and babesiosis is fairly common.                       Comments
This may be because the stress of a new infection with
babesiosis can precipitate a carrier case into clinical                   • Babesiosis occurs throughout Africa. Calves are
anaplasmosis.                                                               said to be less susceptible than older cattle, but
                                                                            cases in calves are common, often in combination
Treatment of babesiosis                                                     with ECF. Most calves get infected at an early age,
It is essential to treat acute clinical babesiosis                          recover without treatment and become
immediately, because the anaemia develops                                   asymptomatic carriers that are then immune to
extremely quickly. Killing the parasites with a                             clinical babesiosis. They are probably re-infected
specific drug will remove the main cause of the                             periodically because a few of the blue ticks that
anaemia, but red cells will continue to be destroyed                        transmit the infection are likely to be present on
for a few days after treatment so it may be several                         even the best-managed farms, and this will boost
days before the anaemia is reversed. Very anaemic                           their immunity. The chances of an animal reaching
animals may die within 24-48 hours despite                                  adulthood without becoming infected by Babesia
treatment, but if they survive this first period,                           and developing immunity is small unless tick
recovery can be rapid.                                                      control is very effective. However, if infection is

                                                                     11
   avoided, the animal remains completely susceptible.            • Diminazene does not always eliminate babesiosis
   So, if a dipping failure occurs on a farm like this, or          infections completely, so would it be safer to treat
   if the cattle stray onto tick-infested land, a severe            babesiosis with diminazene instead of imidocarb so
   outbreak of babesiosis can result. Conversely, major             that their immunity is not compromised? Again,
   outbreaks of babesiosis are uncommon among                       there is no simple answer. Animals whose infection
   poorly dipped cattle.                                            was not eliminated are likely to remain immune, but
                                                                    there is no easy way to tell which ones these are.
• Treatment with imidocarb completely eliminates                    Diminazene gives only a very short period of
  Babesia infections (but not anaplasmosis).                        prophylactic protection, so diminazene-treated
  Diminazene eliminates Babesia from some animals,                  animals from which the infection is eliminated may
  but not all. In the absence of infection, immunity to             become susceptible again earlier than those treated
  babesiosis will decline progressively and                         with imidocarb. This doesn’t matter if they become
  susceptibility to re-infection and clinical babesiosis            infected again very quickly, but this cannot be
  will increase. The timing of this is very uncertain               guaranteed. The choice between treatment with
  and it varies between individual cattle and according             imidocarb or diminazene should be based primarily
  to how strong the immunity was at the time of                     on the ability of these drugs to cure the initial
  treatment. Usually it seems to take between three                 clinical condition, not on what might happen later.
  and six months for immunity to fade completely.                   Remember that imidocarb also cures anaplasmosis
  This doesn’t matter if the animal continues to be                 and diminazene cures trypanosomiasis. The choice
  exposed to infected blue ticks because it will be re-             of which treatment to use, and what action to take
  infected and become an immune carrier again. But                  after treatment, should consider all of these factors.
  if it remains uninfected, it will eventually become
  completely susceptible.                                         • Post mortem signs

• Imidocarb not only cures babesiosis and eliminates                 Post mortem signs of babesiosis (caused by Babesia
  the infection, it also has a prophylactic effect against           bigemina) are mostly related directly to the anaemia
  re-infection with Babesia bigemina for at least four               that is characteristic of the disease. They include
  weeks and in some cases for more than six weeks.                   pallor of the musculature, enlarged spleen and
  (Prophylactic protection against Babesia bovis is                  congested liver, and watery blood. If the disease was
  about half as long as for Babesia bigemina). So, for               acute, the bladder may contain red urine, there may
  the first few weeks after treatment with imidocarb                 be pulmonary oedema and the kidneys are often
  cattle are completely refractory to re-infection by                haemorrhagic. There are likely to be echymotic
  Babesia, then they become progressively more                       haemorrhages on the epicardium and endocardium,
  susceptible as the last traces of the drug disappear.              reflecting the severe stress on the heart. Acute cases
  Imidocarb cures but does not eliminate Anaplasma                   that die despite treatment are likely to show signs of
  infections, and it has no true prophylactic effect                 extreme anaemia, including plasma clots in the main
  against anaplasmosis. The issue of immune status                   blood vessels and in the heart.
  after treatment of anaplasmosis with imidocarb,
  therefore, is far less important than with babesiosis.             Less acute and chronic cases show emaciation and
                                                                     dehydration, degeneration of fat and other signs of a
• What are the implications of all of this? How can                  progressive loss of bodily condition. The urine is
  imidocarb-treated cattle be managed so that they                   likely to appear normal, because the destruction of
  maintain their immunity to babesiosis? Should                      red blood cells will have largely subsided. For the
  they be deliberately exposed to re-infection, and if               same reason, the liver and kidneys may be fairly
  so, how? There are no easy answers. On most                        normal but the spleen is likely to remain enlarged.
  farms, some blue ticks (the ones that transmit                     The carcase may be moderately icteric, but not as
  babesiosis) survive, no matter how intensive the                   severely as in anaplasmosis, and although the gall
  dipping programme. So, imidocarb-treated animals                   bladder may be enlarged, the bile is usually normal
  usually become infected again at some time as the                  in appearance, unlike the thickened bile
  prophylactic effect of their imidocarb treatment                   characteristic of anaplasmosis.
  wanes, but before their immunity is lost. If this
  happens, there is no problem – they become                         Check the diagnosis for bracken poisoning, which
  immune carriers again. This seems to be what                       shares the signs of haemoglobinuria and sudden
  usually happens, otherwise treated cattle would                    death. Examination of a blood smear should
  suffer from repeated episodes of babesiosis, every                 confirm the diagnosis !
  few months, and usually they do not. So, the best
  advice seems to be to continue to dip or spray                     Note that mixed infections of babesiosis and
  cattle as usual after they are treated with                        anaplasmosis are fairly common, but diagnosing
  imidocarb. Another outbreak of babesiosis is                       anaplasmosis from a post mortem blood smear may
  possible if there is another dipping failure, so look              be difficult because distortion of the red blood cells
  our for the signs of babesiosis, but be aware that                 results in artefacts that are very hard to distinguish
  East Coast fever and anaplasmosis may also occur,                  from Anaplasma parasites. Mixed babesiosis and
  so look out for them too.                                          East Coast fever is also common. It should be

                                                             12
suspected if the lymph nodes are grossly enlarged or
if the airways are filled with froth. Stained smears
taken from lymph nodes or spleen, and blood
smears, should confirm this diagnosis. Note that
thin smears, not dabs or impressions, should be
made from lymph nodes and spleen post mortem.
They should be prepared like blood smears to spread
the lymphoid cells to display any Theileria schizonts
that may be present.

Post mortem signs of babesiosis caused by Babesia
bovis are often much more difficult to recognise
because the anaemia may be mild and the
parasitaemia very low, and because death is often
caused by the blockage of brain capillaries by
parasitised red blood cells, not primarily by anaemia.
There may, therefore, be very few diagnostic signs. If
this disease is suspected, a smear made from the brain        “Squash and spread” preparation of brain tissue from a case of
                                                              redwater caused by Babesia bovis. The capillaries are filled with red
usually confirms it. A small piece of brain tissue (a         blood cells containing deeply-stained Babesia parasites.
few cubic millimetres) should be squashed between
two slides, which are then slid apart to stretch the
capillaries. When stained and examined under the
microscope, the capillaries will be seen to be full of
dark dots (the parasites), even in partly putrefied
carcases. Remember to take care when taking a brain
smear from an animal that died showing nervous signs
– these could be caused by rabies.




                                                         13
            TROPICAL THEILERIOSIS
                                Causative organism : Theileria annulata.
                        Main vectors : Hyalomma anatolicum and H. dendriticum,


 SUMMARY
 Key signs:       Fever, anaemia, icterus, enlarged lymph nodes, laboured respiration, drooling

 Treatment:       Buparvex (buparvaquone), Parvexon (parvaquone)
                  Parvexon Plus (parvaquone + frusemide) for cases with pulmonary signs

 Key points:      Take lymph-node and blood smears to confirm diagnosis
                  Treat promptly – theileriosis is rapidly fulminating and lymphodestructive
                  Diagnose and treat intercurrent infections
                  Complete the course of treatment to avoid relapses



Clinical signs of tropical theileriosis                          Lymph node smears from a clinical case of tropical
Fever up to 42°, severe anaemia and sometimes icterus,           theileriosis always show lymphoid hyperplasia but
enlarged superficial lymph nodes, laboured breathing             lymphoid hyperplasia can have several other causes,
and coughing, drooling and excessive lachrymation are            including the effect of feeding ticks, even uninfected
the most obvious signs of clinical theileriosis. Milking         ones. As they feed, ticks inject saliva, causing irritation.
cows show a sudden and severe drop in yield, petechial           So, do not confirm a case of theileriosis simply because
haemorrhages are usually present on mucous                       there are many lymphoblastoid cells in the smear.
membranes, and affected animals are obviously                    Continue searching for Theileria schizonts – it may be
depressed. The eyeballs may be prominently protrusive,           an early case of theileriosis, but if it is not, consider
apparently due to excessive retro-orbital pressure, which        other diagnoses before treating unnecessarily for
may even force the eyeballs out of their sockets.                theileriosis. Usually, a smear from an enlarged lymph
                                                                 node caused simply by ticks feeding will contain more
Confirmation of diagnosis of theileriosis                        macrophages than one infected with theileriosis. The
Lymph node smear. Clinical diagnosis of tropical                 lymph node is also likely to be more oedematous, so it
theileriosis is easy if all or most of these signs are           will feel softer than in early theileriosis. Of course, late
present, but usually they are not. Early or chronic              theileriosis nodes are also likely to be oedematous, but
cases are likely to show only some of these signs, and           schizonts should be easy to find.
none of them may be particularly pronounced. In
doubtful cases, it is essential to take lymph node and           Blood smear. Blood can most easily be taken from a
blood smears to check for the presence of Theileria              superficial ear vein. Examine the smear for the
parasites. Lymph node smears should be examined                  presence of Theileria piroplasms in erythrocytes, and
for the presence of schizonts in enlarged lymphoid               also for Anaplasma and Babesia. Large numbers of
cells. Macroschizonts may be rare and small in early             Theileria piroplasms indicate an advanced case, low
cases despite the presence of marked lymphoid                    numbers may indicate an early case or an acute case.
hyperplasia. The presence of microschizonts indicates            Moderate numbers of piroplasms in the blood smear but
an advanced case; if schizonts are seen in lymphoid              no schizonts and little or no hyperplasia in the lymph
cells in blood smears, this too indicates an advanced            node smear suggest an immune carrier or an infection
case.                                                            with a non-pathogenic species of Theileria. The
                                                                 piroplasms of Babesia bovis are not much bigger than
The prescapular lymph node is the easiest to sample,             those of Theileria and they can be confused.
using an 18G hypodermic needle. A single tick can
transmit theileriosis and schizonts can be found in              Treatment of theileriosis
nodes on the side of the body on which the tick fed up           Tropical theileriosis is a rapidly fulminating,
to two days before the contra-lateral nodes. In cases            lymphodestructive and immuno-depressive disease
with mild symptoms, therefore, it is advisable to sample         characterised by severe anaemia. Prompt treatment of
nodes from both sides of the body. Care should be                theileriosis and specific treatment of intercurrent
taken to prepare very thin lymph node smears to ensure           infections is essential. In most respects, the disease and
maximal spreading of the cells, which greatly improves           its treatment is similar to ECF except that management
the visibility of the parasites.                                 of the anaemia is a primary concern.

                                                            14
• Buparvex (buparvaquone) 1ml / 20 Kg by                          • Appetite and body condition may be little affected
  intramuscular injection. Repeat if clinically                     even in fairly advanced acute cases of theileriosis,
  indicated after 48 – 72 hours.                                    but in less acute cases appetite is usually poor and
                                                                    loss of body condition may be rapid. In milking
• Parvexon (parvaquone) 1ml / 15 Kg by intramuscular
                                                                    cows, a drop in yield is among the first signs of
  injection. Repeat after 48 hours and thereafter as
                                                                    theileriosis.
  clinically indicated.
• Parvexon Plus (parvaquone + frusemide/furosemide)               • “Chronic” cases of tropical theileriosis may also be
  for advanced cases with pulmonary signs. 1ml / 15 Kg              encountered. They are particularly difficult to
  by intramuscular injection, repeat after 48 hours,                diagnose. They may respond relatively slowly to
  complete treatment with Buparvex or Parvexon.                     treatment because so many organ systems are
                                                                    damaged. The usual clinical symptoms of
If anaemia is severe, supportive treatment should be                theileriosis may not be obvious and anaemia may be
considered and the animal should be stressed as little as           moderate. The exhausted lymph nodes may not be
possible. Intercurrent and concurrent conditions must               much enlarged, parasite numbers in lymph and
be treated specifically because they may be acute in                blood smears are usually low and lymph smears may
animals immuno-depressed by theileriosis.                           not be very hyperplastic.

For further information, read the package insert.                 • The presence or absence of ticks on a sick animal is
                                                                    not a very useful aid in the diagnosis of theileriosis
Response to treatment of theileriosis                               because the incubation period is longer than the
Except in advanced or terminal cases, most clinical                 feeding period of the tick. The tick that transmits
symptoms (apart from severe anaemia and enlarged                    theileriosis will have dropped off before clinical
lymph nodes) should resolve or show clear signs of                  signs of theileriosis appear. Remember that the
improvement within two days of treatment. If                        saliva from uninfected ticks can cause lymphoid
improvement is not seen, the diagnosis should be                    hyperplasia in lymph nodes. A diagnosis of
reconsidered. Schizonts and piroplasms in lymph and                 theileriosis should be made only if theilerial
blood smears should show clear signs of degeneration                schizonts are seen too.
within two days of treatment. Their numbers should
then decline. If significant numbers of undamaged                 • Cattle that are cured of tropical theileriosis are strongly
parasites remain, or if their numbers increase,                     resistant to re-infection. Recovered animals are
additional treatment should be given immediately even               carriers, so they can be a source of infection for ticks
if most of the clinical signs of theileriosis have                  on the farm. This should be considered in the
resolved. Anaemia may progress for a day or two                     management of a farm after an outbreak of theileriosis.
after treatment, but it should then begin to resolve,
and PCV should increase rapidly over the following                • Most cases of theileriosis are progressive but in some
few days. Lymphoid hyperplasia may not reduce until                 a period of remission may occur after an initial
several days or weeks after clinical and parasitological            clinical episode, followed by a renewed clinical
cure of theileriosis.                                               phase. This may be rapidly fatal because lympho-
                                                                    destruction and therefore immuno-depression, and
Comments                                                            anaemia, are likely to progress during the period of
                                                                    clinical remission.
• In all but the mildest cases of theileriosis,
  parasitological cure requires the drug to be present            • Because theileriosis is a lympho-destructive disease,
  for at least four days. It is essential to complete the           intercurrent infections should be expected. If they
  course of treatment, even if clinical signs resolve in a          are severe they must be treated specifically. In the
  day or two. Cured animals become immune                           immuno-depressed animal, intercurrent infections are
  asymptomatic carriers of the infection.                           likely to progress more rapidly and become more
• Advanced cases of theileriosis with pulmonary signs               severe than in animals not affected by theileriosis.
  usually show clinical improvement within one or                   Damage to the lungs and intestines caused by
  two days of first treatment with Parvexon Plus. Once              theileriosis often results in pneumonia and enteritis.
                                                                    If an animal fails to show clear signs of improvement
  resolved, pulmonary signs do not usually recur so
                                                                    after treatment for theileriosis, check the diagnosis –
  the course of treatment may be completed using
                                                                    for theileriosis and for intercurrent infections, then
  Parvexon or Buparvex (which do not contain
                                                                    give the appropriate treatment.
  frusemide) to give four days drug cover.
• Temperature may be sub-normal in very advanced                  • Examination of lymph node smears is essential to
  cases. An animal with obvious clinical signs of                   confirm a diagnosis of theileriosis, but it is equally
  tropical theileriosis but no fever is likely to die               important to examine blood smears for theilerial
  within 24 hours if it is not treated immediately.                 piroplasms. The blood smear should also be
  Of course, if the animal is very anaemic or organ                 checked for the presence of Babesia and Anaplasma,
  damage is irreversible, the animal may die within                 both of which cause anaemia. For the detection of
  hours despite treatment.                                          Anaplasma the blood smear must be taken before

                                                             15
   the animal is treated for theileriosis because                      recognise theilerial schizonts in poorly prepared or
   parvaquone and buparvaquone cause Theileria                         thick lymph smears, and practically every poor or dirty
   piroplasms to condense and look like Anaplasma                      blood smear appears to be heavily infected with
   organisms. After the animal has been treated, it is                 Anaplasma ! In weakly stained slides, the parasites are
   almost impossible to distinguish between damaged                    the elements that are least likely to take up stain. Apart
   Theileria piroplasms and Anaplasma.                                 from staining for too short a period, weak staining can
   Theileria annulata and T. parva parasites look very                 be due to ‘stale’ stain, the wrong pH, or poor fixing,
   similar, in lymph node and blood smears. See photos                 usually because the fixing alcohol contains water.
   on pages 3-5.
                                                                    • Post mortem signs: Post mortem signs of tropical
• Clinical anaplasmosis may not be very common in                     theileriosis are notoriously variable, even within a
  areas endemic for tropical theileriosis caused by                   single outbreak and in uncomplicated cases. Signs
  Theileria annulata but asymptomatic carriers of                     in an animal that has been treated unsuccessfully for
  Anaplasma may be present. The carrier state of                      theileriosis, particularly if there was a complicating
  anaplasmosis can be precipitated into clinical                      infection, may be further confused. “Slow” or
  anaplasmosis in an animal that is immuno-depressed                  “chronic” cases may show almost no clear
  by theileriosis. Even a very low parasitaemia of                    diagnostic signs.
  Anaplasma can cause severe anaemia in
  combination with theileriosis.                                    • In addition to the effects of anaemia and icterus, the
                                                                      presence of pulmonary oedema, emphysema and
• Low parasitaemic cases of anaplasmosis in                           enlarged lymph nodes, particularly of superficial
  combination with tropical theileriosis can easily go                nodes and those associated with the alimentary canal,
  un-noticed. An animal may be treated successfully                   are the most common signs. Froth-filled airways may
  for theileriosis but die of anaplasmosis if specific                be associated with pulmonary changes. Muscle and
  treatment (with tetracycline or imidocarb) is not                   fat may appear normal, except in cases in which there
  given. If animals die of persistent anaemia following               is clear loss of condition. In protracted cases, node
  treatment for theileriosis, particularly if the carcase is          enlargement may be less and characteristic black
  icteric, consider a diagnosis of concurrent                         pigmentation may be present within the lymph nodes.
  anaplasmosis or babesiosis. If post mortem                          Grossly protruberant eyeballs, an occasional sign in
  examination reveals a ginger-coloured liver,                        acute cases, are rarely seen in chronic cases.
  anaplasmosis is a likely cause. Persistent anaemia
  without icterus could indicate concurrent babesiosis.             • The spleen is usually enlarged and its pulp is jam-like,
                                                                      but when lymphoid depletion is severe, the spleen may
• It is easy and interesting to examine a well-prepared               be shrunken and pale. Cigarette-burn ulcers are usually
  slide under the microscope. Examining a poor slide                  present in the abomasum, with oedema of the folds in
  is a nightmare. Well-prepared lymph and blood                       the omasum, but these signs are not confined to cases of
  smears, using clean slides, properly fixed and                      theileriosis. Changes in the intestine are very variable,
  stained, are essential for the correct diagnosis of                 but zebra striping with black pigment, particularly in the
  tick-borne diseases. They must be examined under                    colon and rectum, is common in more protracted cases.
  a well maintained and properly adjusted (although
  not necessarily expensive) microscope, using an oil-              • Petechial and echymotic haemorrhaging on the
  immersion objective. Diagnoses may be missed, or                    myocardium and various mucous membranes is
  incorrect positive diagnoses may be made, if                        common, but not diagnostic, and other changes to the
  preparation, staining or examination of slides is sub-              heart are variable, as would be expected in a disease
  standard.                                                           that takes so many forms. Surface haemorrhages and
                                                                      white lymphoid infarcts may be seen on the kidneys,
• Smears should be dried quickly, away from flies and                 particularly in more protracted cases, but in chronic
  dust, then fixed and stained using fresh, water-free                cases they are likely to have resolved, leaving scars.
  alcohol and fresh stain. It is almost impossible to                 The kidney cortex is often congested.



Acknowledgement. This booklet has been produced in the hope that it will be interesting, and of help, to veterinary practitioners,
cattle owners and others concerned with the diagnosis and treatment of tick-borne diseases. It is based on many years of research
with imidocarb, parvaquone and buparvaquone, from their discovery to the development of products in which they are the active
ingredients, starting with Imizol, Clexon, and Butalex, more recently Zolimid, Parvexon, Parvexon Plus and Buparvex.

I want to thank all the farmers, veterinary practitioners, research workers and many others with whom I have worked and discussed
tick-borne diseases over the years for all their help, support, advice and friendship. So much of what is written here came from
them. They, and no doubt whoever may read this booklet, will not agree with everything that I have written, and they will probably
tell me so. That is the way it has always been, and it is why I have enjoyed working with them so much.

Nick McHardy,
Dublin, 2012.

                                                               16
                                                         ADACYCLINE™
                                                    Oxytetracycline 20% LA Injection
COMPOSITION
Each ml contains Oxytetracycline 200mg

DESCRIPTION
Adacycline is a wide spectrum bacteriostatic antibiotic. It acts on gram-positive and gram-negative micro-organisms. It is particularly sensitive to streptococci,
clostridia, E.coli, shigellae, brucellae, salmonellae, leptospirae. In addition, it is effective against some mycoplasmas, rickettsiae, chlamydiae, some protozoa
and large viruses.
After administration of therapeutic dose of Adacycline, a high level of Oxytetracycline in blood is achieved within half an hour to 4 hours.

INDICATIONS
Treatment of diseases caused by Oxytetracycline-susceptible organisms in cattle, sheep and goats. Diseases including pneumonia and shipping fever complex
associated with Pasteurella spp and Haemophilus spp, infectious bovine kerato-conjunctivitis (pinkeye) caused by Moraxella bovis, foot rot and diphtheria
caused by Fusobacterium necrophorum, bacterial enteritis (scours) caused by Escherichia coli, wooden tongue caused by Actinobacillus lignierisii, leptospirosis
caused by Leptospira pomoma; wound infections and acute metritis caused by strains of staphylocci and streptococci organism sensitive to Oxytetracycline.

For cattle: Bronchopneumonia and other respiratory infections, infections of the gastrointestinal primarily caused by viruses.

For sheep and goats: Infections of respiratory, urogenital, gastrointestinal tract and hooves, mastitis, infected wounds.

DOSAGE AND ADMINSTRATION
Administer Adacycline 20% LA by deep intramuscular injection. The dose is 20 mg/kg bodyweight (1ml/10kg bodyweight). The product is recommended for
a single administration.
Maximum recommended dose at one site:

Cattle                20 ml
Sheep and Goats        5 ml
Pigs                  10 ml

CONTRA-INDICATIONS WARNINGS, ETC.
Adacycline injection is not intended for cats, dogs and horses. It should not be given to animals in late pregnancy, animals with severe damages of liver and
kidneys and to animals oversensitive to oxytetracycline.
Sometimes a temporary swelling on the injection site occurs.
A maximum of 20 ml may be injected at any one site for cattle, and 5 ml maximum for sheep and goats. If the total volume exceeds the above mentioned
quantity, it should be divided and injected to more sites.
The drug must not be diluted.

WITHDRAWAL PERIODS
From last treatment, within 21 days for meat and edible tissues and within 7 days for milk.



STORE IN A COOL, DRY PLACE, AWAY FROM DIRECT SUNLIGHT

50ml glass vial
100ml glass vial



Assia Animal Health Ltd.
P.O. Box 30620-00100,
Nairobi, Kenya
                                                    TETROXY LA™
PRESENTATION
A long acting oxytetracycline solution for injection.
Each ml contains Oxytetracycline 200 mg (as Oxytetracycline Dihydrate).
This product does not contain an antimicrobial preservative.
Also contains Povidone and N-methyl-pyrrolidone as co-solvents and Sodium formaldehyde sulfoxylate 0.27% as an antioxidant.

USES
For the treatment and control of diseases in cattle, caused by or associated with organisms sensitive to oxytetracycline.

These include:      Pasteurella spp.         Anaplasma marginale
                    Salmonella spp.          Cowdria ruminantium
                    Escherichia coli
                    Listeria spp.

DOSAGE AND ADMINISTRATION
By deep intramuscular injection
1 ml per 10 Kg bodyweight, equivalent to 20 mg oxytetracycline per Kg bodyweight. Maximum volume at one injection site, 10 ml.

CONTRA-INDICATIONS WARNINGS, ETC.
Do not dilute or bring into contact with calcium solutions.
The use of Tetroxy LA during the period of tooth development, including late pregnancy, may lead to tooth discolouration.
Avoid contact with the eyes.
Wash hands after use.

WITHDRAWAL PERIODS
Cattle for human consumption should not be slaughtered within 28 days of treatment. Milk intended for human consumption or the manufacture of cheese
or yogurt should not be drawn from treated animals within 7 days after treatment.

PHARMACEUTICAL PRECAUTIONS
Avoid the introduction of contamination during use.
Should any apparent growth occur, the product should be discarded.
After broaching, the product should be used within 28 days.

FOR ANIMAL TREATMENT ONLY
KEEP OUT OF THE REACH OF CHILDREN
STORE BETWEEN 2° and 25° C
PROTECT FROM LIGHT

100 ml glass vial
250 ml glass vial


Bimeda Chemicals Export
(A division of Cross Vetpharm Group Ltd.),
Broomhill Road, TalIaght,
Dublin 24, Ireland.
                                                               ZOLIMID
                                                                      INJECTION

                                                        (IMIDOCARB DIPROPIONATE)


PRESENTATION
A sterile aqueous solution for injection containing imidocarb dipropionate, 12% w/v.
INDICATIONS
Treatment of babesiosis in cattle, sheep, horses and dogs.
Treatment of anaplasmosis in cattle.
Treatment of ehrlichiosis in dogs.
Dosage and Administration
Zolimid may be administered by subcutaneous or intramuscular injection. Intramuscular injection is recommended for cattle, sheep and horses, preferably
into the muscles of the neck. Subcutaneous injection is recommended for dogs, preferably into the loose skin at the back of the neck.

                      Babesiosis              Anaplasmosis           Ehrlichiosis
Cattle                1 ml / 100 Kg bwt       1 ml / 40 Kg bwt       -
Sheep                 1 ml / 100 Kg bwt       -                      -
Horses                1 ml / 50 Kg bwt        -                      -
Dogs                  1 ml / 40 Kg bwt        -                      1 ml / 20 Kg bwt
It is important that accurate dosages are injected and that suitably sized syringes are used. 1ml / 100 Kg = 0.1 ml / 10 Kg, 1 ml / 50 Kg = 0.2 ml / 10 Kg, 1
ml / 40 Kg = 0.25 ml / 10 Kg
Babesiosis
At the recommended doses a single injection of Zolimid treats and usually eliminates infections with ‘large’ babesias including B. bigemina, B. major and B.
divergens of cattle, B. motasi of sheep, B. canis of dogs and B. caballi of horses. ‘Small’ babesias are less readily eliminated and clinical disease may recur.
A second injection of Zolimid may be needed, usually 7–14 days after the first, to give complete control of B. bovis of cattle and B. ovis of sheep. B. equi
(now called Theileria equi) of horses may be particularly difficult to eliminate, even by two injections one or two days apart. Zolimid has little therapeutic
effect on B. gibsoni, the ‘small’ babesia of dogs, and it does not eliminate this infection.
A single injection of Zolimid at twice the dose recommended for treatment prevents clinical babesiosis of cattle, sheep and dogs (except B. gibsoni) for up to
six weeks. The period of protection is shorter against ‘small’ babesias than against ‘large’ species and it is also reduced when the level of challenge is severe.
Anaplasmosis
At the recommended dose, Zolimid is effective for the treatment of bovine anaplasmosis (Anaplasma marginale infection). A second injection may be
needed, usually 7-14 days after the first. A. marginale infection is not eliminated by treatment with Zolimid. Treatment with Zolimid does not protect
against infection with bovine anaplasmosis but treatment in the incubation period can prevent the development of clinical anaplasmosis.
Ehrlichiosis
Zolimid is effective for the treatment of ehrlichiosis (tropical pan-leucopoenia, Ehrlichia canis infection) in dogs. A second injection should be given 14
days after the first. E. canis infection may not be eliminated by treatment with Zolimid.
Additional information
Mixed infections of babesiosis and anaplasmosis are common in cattle; mixed infections of babesiosis and ehrlichiosis are common in dogs. Mixed
infections should be treated with Zolimid at the dose appropriate to the less susceptible infection.
Anaplasmosis and babesiosis frequently occur as complications of bovine theileriosis (Theileria annulata and T. parva infections) and babesiosis may be a
complication of theileriosis (T. hirci infection) in sheep. Clinical anaplasmosis may be precipitated from the asymptomatic carrier state by theileriosis as a
result of profound immunodepression, either during the acute phase of theileriosis or later. Very low anaplasmosis parasitaemia can cause severe anaemia
when concurrent with theileriosis, making differential diagnosis difficult. Anaplasmosis should be considered as a possible cause of apparent failure of
specific treatment for theileriosis. Anaplasmosis occurring as a complication of bovine theileriosis should be treated with Zolimid as soon as the diagnosis
is confirmed. Zolimid has little effect on anaplasmosis in sheep.
Contra-indications and warnings
Do not inject Zolimid intravenously.
Cholinergic (parasympathomimetic) side effects may be produced by treatment with Zolimid, particularly in horses and dogs. These effects are usually
transient and they rarely persist for more than 30 minutes. The commonest of these signs include muscle fasciculation, laboured breathing, increased heart
rate and uncontrolled urination and defecation. If these signs persist or are excessive, they may be alleviated by treatment with atropine sulphate. Pre-
treatment with atropine sulphate may be appropriate in horses.
Injection of Zolimid may cause pain, particularly in dogs. Oedematous swelling is occasionally caused at the site of injection. The injection site should be
massaged thoroughly after administration.
Withholding periods
Cattle    Meat 28 days            Milk 5 days
Sheep     Meat 28 days            Milk should not be used for human consumption for the remainder of the lactation

FOR ANIMAL TREATMENT ONLY
KEEP OUT OF THE REACH OF CHILDREN
STORE BETWEEN 2° and 25° C
PROTECT FROM LIGHT

50 ml glass vial


Bimeda Chemicals Export
(A division of Cross Vetpharm Group Ltd.),
Broomhill Road, TalIaght,
Dublin 24, Ireland.
                                                         PARVEXON PLUS
                                                          INJECTION ™
                                                  FOR ECF WITH PULMONARY OEDEMA

                                                       (PARVAQUONE + FRUSEMIDE)

DESCRIPTION: A potent injection treatment for theileriosis (East Coast Fever, ECF), particularly for advanced cases with pulmonary oedema; containing in
each ml, parvaquone 150mg and frusemide 55mg. Parvaquone is theilericidal, acting on schizonts and piroplasms; Frusemide is a diuretic, which resolves
pulmonary oedema.

DOSAGE AND ADMINSTRATION: Inject by the intramuscular route into the neck muscles at the rate of 1ml/15kg (10.0 mg Parvaquone,
3.6 mg Frusemide per kg).
Repeat after 48 hours.
In cases of exceptionally severe infections with pulmonary oedema, further treatment at half the dosage rate may be required at 24 hour intervals.

Calves:                                       1ml per 15kg bodyweight

Young-stock and adults:                       Bodyweight                        Dose
                                              100kg                             7ml
                                              150kg                             10ml
                                              200kg                             14ml
                                              250kg                             17ml
                                              300kg                             20ml

Alternatively, when pulmonary symptoms have been resolved by Parvexon Plus, treatment to achieve parasitic cure may be completed with Parvexon, which
contains only parvaquone, at a dose rate of 1ml/15kg every 48 hours.

Do not use by the intravenous or subcutaneous routes. Normal aseptic precautions should be observed.

CONTRA-INDICATIONS AND WARNINGS: East Coast Fever (ECF) is an immuno-depressive disease and potentially fatal concurrent infections are
common. In particular, anaplasmosis may be activated from the carrier state and the principal lesions of ECF, such as oedema of the lungs and the
alimentary canal, predispose to bacterial pneumonia and enteritis. The symptoms of these conditions may be masked by those of ECF. Special care should
be taken to diagnose any complicating conditions and to treat them promptly and specifically.

Adverse reaction to parvaquone is extremely rare. Frusemide is chemically similar to the sulphonamides so Parvexon Plus should not be used in animals
with sulphonamide sensitivity.

Local swelling may occur at the injection site but this is usually transient.

Milk withholding period – 14 days
Meat withholding period – 28 days

FOR ANIMAL TREATMENT ONLY.
KEEP OUT OF REACH OF CHILDREN.
STORE BELOW 25ºC.
PROTECT FROM LIGHT

50ml glass vial
100ml glass vial


Bimeda Chemicals Export
(A division of Cross Vetpharm Group Ltd.),
Broomhill Road, Tallaght,
Dublin 24, Ireland.
                                                              Parvexon™
                                                                 Injection
                                                                    (PARVAQUONE)


DESCRIPTION:
A potent theilericide containing in each ml Parvaquone 150mg; it is effective in the treatment of the piroplasm and schizont stages of Theileria. The
product may be used both in animals showing clinical signs; and also infected animals which have not yet displayed clinical signs.

DOSAGE AND ADMINISTRATION:
Inject by the intramuscular route into the neck muscles. Repeat after 48 hours. In exceptionally severe infections further treatment at the recommended
dosage rate may be required at 48 hour intervals.

Calves:                   1ml per 15Kg (10mg per Kg)

Adults:                   Bodyweight                  Dose
                          100 Kgs                     17 ml
                          150 Kgs                     10 ml
                          200 Kgs                     14 ml
                          250 Kgs                     17 ml
                          300 Kgs                     20 ml

Do not use the intravenous or subcutaneous routes. Normal asceptic precautions should be observed.

CONTRA INDICATIONS & WARNINGS:
1.           Very often the presence of Theileriosis in an animal will mask other tick-borne infections which are also present such as anaplasmosis,
             cowdriosis or babesiosis. These latent infections may become patent, due to the immuno-suppressive effect of the theilerial infection.
             Appropriate treatment should be given. In particular anaplasmosis and cowdriosis can be effectively treated using Tetroxy L.A. Injection at
             the rate of 1ml/10Kg.

2.           Occasionally local swelling may occur at the injection site - this is generally of a transient nature.

3.           Milk with-holding period - 14 days
             Meat with-holding period - 28 days



FOR ANIMAL TREATMENT ONLY
KEEP OUT OF THE REACH OF CHILDREN
STORE BETWEEN 2° and 25° C
PROTECT FROM LIGHT


100ml glass vial
50ml glass vial




Bimeda Chemicals Export
(A division of Cross Vetpharm Group Ltd.),
Broomhill Road, TalIaght,
Dublin 24, Ireland.
                                                       Buparvex                                         TM

                                                                   (BUPARVAQUONE)
Presentation: Buparvex is a clear red solution for intramuscular injection. Each 1ml contains 50mg buparvaquone.
Indications: Buparvex is indicated for the treatment of all forms of theileriosis of cattIe.
North Africa, Middle East, Southern Europe, India and Asia - Mediterranean or Tropical theileriosis caused by Theileria annulata.
Eastern Africa - East Coast fever (ECF) caused by Theileria parva. T. parva also causes Corridor Disease of cattle in areas populated by the African buffalo
(Syncerus caffer). Buparvex is used to treat clinical cases of theileriosis. It may also be used during the incubation period to prevent clinical disease in
animals that are known to be infected but not yet showing clinical signs. Buparvaquone kills theilerial schizonts (in lymphoid celIs) and piroplasms (in red
blood celIs) and it suppresses pre-schizont stages during the incubation period of the disease. It kills the parasites through its action on their mitochondrial
electron transport (respiratory) system. Usually it does not completely eliminate the infection so cured animals continue to carry a sub-clinical infection.
Dosage and Administration: 1ml of Buparvex per 20Kg bodyweight (2.5mg buparvaquone per Kg) injected intramuscularly is usually sufficient to cure
moderate cases of theileriosis. More advanced cases may require one or more additional, similar, injections. These should be given with an interval of two or
three days between injections, as clinically indicated. Injections should be given into the neck muscles because the drug mobilises best from this site.
If Buparvex is used to suppress theileriosis during its incubation period, a single dose of 1ml per 20Kg bodyweight, injected into the neck muscles, is
usually sufficient to prevent the development of clinical signs.
Warnings and Precautions: Buparvex must be administered only by the intramuscular route. It must not be injected intravenously. Buparvex is poorly
mobilised after subcutaneous injection and its curative effect is greatly reduced.
Adverse effects: Localised swelling may occur at injection sites but it resolves in a few days. Buparvaquone is very safe so over-dosage is unlikely to cause
significant adverse effects. Withholding Periods: Milk for human consumption should not be taken from animals treated with Buparvex until at least 48
hours after treatment. Milk from animals treated with Buparvex is safe for consumption by calves. Animals should not be slaughtered for human
consumption until at least 42 days after treatment with Buparvex.
FURTHER INFORMATION ABOUT BUPARVEX AND THE TREATMENT OF THEILERIOSIS: Buparvaquone is effective only against theileriosis and a few
closely related diseases. It has no other clinically significant effect. The clinical signs of theileriosis include high fever, swollen superficial lymph nodes,
nasal discharge, coughing and other signs of pulmonary oedema, and petechial haemorrhages on mucous membranes. Grossly protruberant eyebalis are a
feature of T. annulata infections in some areas; this sign is not typical of T. parva infections. Often, the first sign of theileriosis in lactating cows is a sudden
drop in milk yield. Anaemia is a common sign of theileriosis caused by T. annulata, particularly in advanced cases. Anaemia is not typical of uncomplicated
theileriosis caused by T. parva. Clinical diagnosis of theileriosis should be confirmed by examining a stained blood smear for intraerythrocytic piroplasms,
and a lymph node biopsy smear for the presence of schizonts within enIarged lymphoid celIs (lymphoblasts). The presence of schizonts in a hyperplastic
lymph node smear is the most certain indication of clinical theileriosis. Large numbers of piroplasms in blood smears indicate advanced theileriosis.
Absence of piroplasms from the blood smear despite the presence of other signs may indicate an early clinical case or an acute case of theileriosis. Small
numbers of piroplasms alone should not be regarded as a positive diagnosis of theileriosis because they may be of one of the non-pathogenic theilerias that
infect cattle, or a low-grade parasitaemia typical of an asymptomatic immune carrier.
Theileriosis is a lympho-destructive disease. In severe cases more than 90% of lymphoid cells may be destroyed. This results in profound immuno-
depression. Intercurrent pneumonia and enteritis are common and they must be treated specifically. Immuno-competence is usually restored after a few
days in cases cured by Buparvex. Theileriosis can activate the carrier state of anaplasmosis into severe clinical disease. Concurrent theileriosis and
anaplasmosis is characterised by profound anaemia, often with only a low parasitaemia of Anaplasma organisms. In E. Africa up to 50% of cases of
theileriosis may be complicated by concurrent anaplasmosis. Uncomplicated cases of theileriosis usually respond quickly to treatment with Buparvex.
Temperature falls to normal within one or two days. Pulmonary oedema, anaemia (in cases of Tropical theileriosis) and lethargy usually show improvement
within two days. Moderate cases of theileriosis are usually cured by a single injection of Buparvex. More severe cases may require additional injections.
Additional injections of Buparvex should be given as clinically indicated. If recovery is unexpectedly slow the diagnosis should be checked, particularly for
intercurrent conditions. Persistent anaemia may indicate concurrent anaplasmosis or babesiosis. Clinical signs and potentially fatal theileriosis may reappear
after apparent clinical cure. Treated animals, therefore, should be kept under observation for relapses for at least three weeks. They should be re-treated
promptly if clinical signs reappear. Cases showing pulmonary signs should be treated additionally with a diuretic such as frusemide. Concurrent
anaplasmosis can be treated with products containing imidocarb or tetracycline, babesiosis with products containing imidocarb or diminazene.
Care of treated animals. Animals treated for theileriosis should be given adequate drinking water and food, and subjected to a minimum of stress.
Supportive treatment should be considered, particularly for anaemic animals. Theileriosis is a non-contagious disease, transmitted by ticks. To reduce the
risk of transmission of disease, affected animals may be hand-treated to kill ticks, but they should not be subjected to the stress of dipping until they have
recovered from theileriosis. Cured animals are strongly immune to re-infection with the same strain of theileriosis, but they may have only partial protection
against other strains. Cured animals do not usually develop theileriosis again unIess they are stressed or if the level of disease challenge is very high. Cattle
that are cured of East Coast fever are not immune to Corridor disease.
Other immunisations. Theileriosis causes severe but usually temporary damage to the immune system. It is recommended that routine vaccinations are
delayed until the animal has recovered completely from an episode of theileriosis.
Other theilerioses. Various other Theileria parasites infect cattle, including T. taurotragi, T. orientalis, T. buffeli and T. mutans. Their clinical significance is
uncertain, but there are reports of their successful treatment with buparvaquone. Malignant theileriosis of sheep and goats, caused by T. hirci, has also been
treated successfully. There are published reports of the treatment of T. equi (formerly Babesia equi) infection of horses and of Babesia gibsoni and other
"small" babesias of dogs, using buparvaquone.

50ml glass vial

FOR ANIMAL TREATMENT ONLY
KEEP OUT OF THE REACH OF CHILDREN
STORE BETWEEN 2° and 25° C
PROTECT FROM LIGHT

Bimeda Chemicals Export
a Division of Cross Vetpharm Group Ltd
Broomhill Road, TalIaght,
Dublin 24, Ireland.

				
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