Intas Polivet 21 (1): 129-132 Short Communication

Strategic Management of a Sahiwal cow calf

with Co-infection of Babesia and Theileria
Dushyant Kumar Sharma, Ujjwal Kumar De1, R. Raguvaran and Jitendra Singh Gandhar
Division of Medicine
ICAR-Indian Veterinary Research Institute (IVRI)
Izatnagar
Bareilly - 243122 (Uttar Pradesh)

Abstract
A male calf was presented with history of anorexia, fever, weakness, brown urine, recumbency and loss of suckling reflex.
The clinical examination revealed anemia, jaundice, infestation of ticks and enlarged superficial lymph nodes and peripheral
blood smear was found positive for both Babesia bigemina and Theilaria sp. Further, cytology of lymph node fluid exhibited
presence of prominent koch’s blue body of Theileria spp. Hemogram and serum biochemistry revealed lower level of
hemoglobin, packed cell volume and total erythrocyte count and elevated total leukocyte count (TLC), concentrations of
alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), blood urea nitrogen (BUN) and
creatinine. The calf was strategically treated with Diminazine aceturate @ 7 mg/ kg b. wt. and Buparavaquone @ 2.5 mg/ kg
b. wt. by deep intramuscular route. Further, Meloxicam, Vitamin B complex and Inorganic phosphorous were administered as
per standard dose once daily for five day as supportive therapy. After therapy calf shows uneventful recovery from illness
and started suckling the dam and blood smear was found negative for any hemoprotozoal infection.
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Keywords: Babesiosis; calf; co-infection; theileriosis

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Introduction symptoms are often non-specific and overlapping in

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Tick-borne hemoprotozoan parasitic diseases have
major economic importance in terms of production
losses, reduction in growth performance, morbidity
and mortality in dairy animals. The high prevalence
of hemoprotozoal diseases in ruminants has been
recorded in tropical as well as sub-tropical countries
(L’Hostis and Seegers 2002; Altay et al., 2008).
Owing to hot and humid climatic conditions, the
incidence of tick-borne haemoprotozoans has
gradually risen over the last few years. In addition,
the occurrence of hemoprotozoal infections
increases by stressful conditions such as low
nutritional levels, unsafe housing conditions and
acaricidal resistance (Singh et al., 2000).
Among the blood parasite diseases, babesiosis and
theileriosis cause high morbidity and mortality in
exotic and crossbreed stock in endemic areas
(Forsyth et al., 1997; Omer et al., 2003; Altay et al.,
2008). Both the diseases affect the health and
productivity of dairy animals in tropical and
subtropical countries (Uilenberg, 1995). Babesiosis
is typically presented with hemoglobinuria and fever,
while theileriosis causes progressive lympho
proliferative disease. Clinically, both the diseases
are manifested with fever, anemia, icterus,dyspnoea,
enlarged superficial lymph nodes, abortion and
reduced milk yield. Clinically, it is very difficult to
distinguish both diseases since the clinical
1. Corresponding author. E-mail: ujjwalde@gmail.com
nature. In this report, a concomitant infection of
Theileria sp. and Babesia sp. in a five-month old
Sahiwal calf and its effective therapeutic
management have been described.
History
A five month old Sahiwal male cow calf was
presented in pre-monsoon season with history of
inappetance, persistent fever, brown colour urine
(Fig. 1), recumbency, absence of suckling reflex,
weakness. The detail clinical examination revealed
infestation of ticks on the body, high rectal
temperature (104.2oF), tachycardia (heart rate; 78/
min), tachypnoea (respiration rate; 52/ min) and
whitish conjunctival and buccal mucosa, the
yellowish sclera (Fig. 2) and enlarged superficial
pre-scapular lymph nodes (Fig. 3). Based on history
and clinical examination, the case was initially
suspected for hemoprotozoan infection.
Sample collection, laboratory analysis and
diagnosis
The blood sample (approximately 5.0 mL) was
collected from jugular venipuncture in a vial with
anti-coagulant for hemogram and serum collection
vial with clot activator for serum biochemical analysis.
Serum was separated through centrifugation at 3000
rpm for ten minutes and stored at -20 C for further
biochemical analysis. A separate thin blood smear
was also made from tip of ear and air-dried. Fine-
needle aspiration cytology was performed from the

129
 Co-infection of babesia and theileria
Fig.1: Dark yellow color urine depicting hemoglobinuria
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Fig. 3: Enlarged pre-scapular lymph nodes
pre-scapular lymph node after applying 1%
Cetrimide solution over enlarged lymph node with
the help of 20 G needle. Both the smears were fixed,
stained with Giemsa stain and examined in oil
emersion lens under microscope. Thin blood smear
revealed presence of separate large pyriform and
signet ring shaped microorganisms that were
suggestive of both Babesia bigemina (large form)
and Theilaria spp. Lymph node smear revealed
presence of giant schizonts of theilaria organism
called as Koch Blue Bodies (KBB) in lymphocytes
(Fig. 4). Based on history, blood and lymph node
smear examination, the presented case was
diagnosed as co-infection of Babesia bigemina and
Theilaria spp. Simultaneously, the whole blood was
analyzed complete blood count by manual method,
whereas, serum biochemistry was performed to
measure the concentrations of total protein, albumin,
Alanine aminotransferase (ALT), Aspartate
aminotransferase (AST), Alkaline phosphatase
(ALP), Blood urea nitrogen (BUN) and creatinine by
spectro photometric method.
Hematological examination revealed lower
concentration of hemoglobin (Hb, 5.0 g/dL),
hematocrit (16.0%), total erythrocyte count (2.21 x
106/ml) whereas leucocytosis (14800/µl) with high
relative lymphocytosis (86%) was observed before
a - Brand of Intas Animal Health, Ahmedabad
130
Fig. 2: Dark yellow color of sclera depicting jaundice
Fig. 4: Blood smear depicting intraerythrocytic (Red
arrow-Babesta bigemina; red arrow head. Theilarla spp).
(A,B); Lymph node smear depicting intralympocytic giant
Shizonts of Thelesia spp. (black arrow) (C,D).
(oil emersion lens-100X)
treatment. Biochemical examination revealed high
concentration of ALT (92 IU/L), AST (105 IU/L), ALP
(288 IU/L), BUN (86 gm/dl), serum creatinine (1.42
gm/dl), serum globulin (3.9 gm/dl) whereas
hypoproteinemia (6.6 g/dl) with hypoalbuminemia
(2.7 gm/dl) was observed before therapy. After five
days of treatment, improvement was observed in
hemoglobin, hematocrit, TEC whereas ALT, AST,
ALP, BUN, and creatinine concentration was
remarkably reduced to the normal level of the
species. The values of hemogram and serum
biochemical profile are depicted in Table 1.
Therapeutic Management
Initially the treatment was instituted with Meloxicam
(Melonexa) @ 0.25 mg/ kg b. wt., IM to reduce fever.
After confirmatory diagnosis from the examinations
of blood smear and lymph node cytology, the calf
was treated with combination of Diminazine
aceturate (Nilberrya) @ 7 mg/ kg b. wt. IM in divided
dose for treatment of babesiosis. The supportive
therapy was consisted of Chlorpheniramine maleate
(Anistamina) @ 3.0 ml IM, Vitamin B complex @ 5.0
ml IM (Tribivet a ) and Inorganic Phosphorous
(Novizaca) @ 10.0 ml IM. On second day, clinical
examination revealed the rectal temperature of
 Sharma et al.

Table 1: Changes of hemogram and serum Sarcoferolb (Malt Based Vitamins, Iron, Copper and
biochemical values in a sahiwal calf co-infected Calcium) orally for 20 days as hematinics to hasten
with Babesia sp and Theileria sp. during the complete recovery.
the course of treatment
Discussion
Sr. Parameters Pre- Post- Among the tick borne diseases, babesiosis and
No. treatment treatment theileriosis are the major threat to dairy animals
(0th day) (5th day) owing to its impact on growth and production losses
1 Hemoglobin (g/dL) 5.0 6.0 in livestock sector. Losses have been reported in
terms of treatment costs, reduced milk yield, mortality,
2 Hematocrit (%) 16.0 18.0
poor live weight gain in chronic or sub-clinical cases,
3 TEC (×106 /ml) 2.21 2.38 increased inter-calving period and delayed puberty
4 MCV (fl) 72.39 75.63 (Gharbi et al., 2006). It has been reported that young
ones are more susceptible than adult animals for
5 MCH (pg) 22.62 25.21 hemoprotozoal diseases due to inadequate innate
6 MCHC (%) 31.25 33.33 immunity (Abdela and Bekele, 2016). Although
7 TLC (/µl) 14800 11000 prophylactic vaccine for theileriosis (Rakshavac-Tc)
is available in India, but no vaccine is available for
8 Neutrophils (%) 22 29 babesia infection. Moreover, prophylactic vaccine is
9 Lymphocytes (%) 86 68 not used routinely for theileriosis in India. Hence,
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10 Eosinophils (%) 2 2
strategic treatment is the only option to save the
animals with multiple hemoprotozoan infections.
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12 Monocytes (%) 0 1
The peripheral blood smear examination is the gold
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13 Basophils (%) 0 0 standard for diagnosis of the hemoprotozoal

14 ALT (IU/L) 92 26 diseases like babesiosis and theileriosis but in
concurrent infection, one parasite may be masked
15 AST (IU/L) 105 32
by other and probability of finding giant schizonts of
16 ALP (IU/L) 288 210 Theileria sp. is very less in blood smear. Therefore,
17 Total protein (g/dL) 6.6 6.8 cytology of lymph node may be suitable diagnostic
tool for theileriosis to identify the KKB-Giant Schizonts
18 Albumin (g/dL) 2.7 3.1
in lymphocytes (Baghel et al., 2016). The low level
19 Globulins (g/dL) 3.9 3.7 of hemoglobin, hematocrit and TEC of infected calf
20 A/G ratio 0.69 0.83 are attributed to hemolysis, immune complex
formation, increased erythrocyte fragility or immune
21 BUN (g/dL) 86 48 mediated destruction of erythrocytes (Omer et al.,
22 Creatinine (g/dL) 1.42 1.04 2002, Shino et al., 2004). Increase in total leukocyte
count with lymphocytosis and enlargement of lymph
TLC, total leukocyte count; ALT, alanine transaminase; nodes may be due to defense mechanism against
AST, aspartate transaminase; ALP, alkaline phosphatase; invading piroplasm leading to lymphoid proliferation
BUN, blood urea nitrogen
(Mehta et al., 1988). Biochemical analysis revealed
101.8F, pale sclera but animal was able to sit instead higher activity of liver-specific enzymes such as ALT,
of lateral recumbency and intensity of urine color AST and it might be due to hepatocellular damage
was reduced. The calf was treated with single dose (Col and Uslu 2007; Khan et al., 2011). The higher
of Buparvaquone (Zubiona) @ 2.5 mg/ kg b. wt., by level of BUN and serum creatinine concentrations
intramuscular route. Further, 25% Dextrose @100.0 may be due to hemolysis, reduced feed intake and
ml IV and Vitamin B complex (Tribiveta) @ 5.0 ml IM, dehydration of calf (Khan et al., 2011).
Inorganic Phosphorous (Novizac a) @ 10.0 ml IM,
Chlorpheniramine maleate @ 3 ml IM were The calf with co-infection of Babesia sp. and
administered. After five days of treatment, the calf Theileria sp. was successfully treated by
showed remarkable improvement and suckled the combination therapy consisting of Diminazene
dam. The owner was advised to feed 10-15 gm of diaceturate and Buparvaquone along with
supportive therapy. It has been reported that
b - Brand of Alembic Pvt. Ltd., Mumbai Diminazene diaceturate and Buparvaquone are very
c - Brand of Indian Immunologicals Ltd., Hyderabad effective for treatment of babesiosis and theileriosis

131
 Co-infection of babesia and theileria
in bovine, respectively (Verma and Sing, 2016;
Tuvshintulga et al., 2017). The Diminazene
diaceturate, an aromatic diamidine, exhibits
ntiprotozoal activity by disrupting DNA synthesis and
aerobic glycolysis of the parasite whereas,
buparvaquone, a antiprotozoal drug,  selectively
blocks protozoan mitochondrial electron
transport leading to inhibition of pyrimidine and ATP
synthesis (Baneth, 2018). In the current report,
Diminazene diaceturate and Buparvaquone were
not used simultaneously because these drugs
produce potential side effect such as hypotension
which may cause death of animal. Hence,
Diminazene diaceturate was administered in divided
doses to treat babesiosis on the first day and on the
second day, the same was followed for the
administration of Buparvaquone to avoid side effect
of drug.
Conclusion
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It is concluded from the present case report that
peripheral blood smear and lymph node biopsy
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examination may be the most economical, fast and
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adopted method for diagnosis of hemoprotozoal
diseases. Clinical assessment of affected animal is
the utmost important for administration of diminazene
aceturate and buparvaquone having some potential
toxic affects to cure the animal and may not be used
simultaneously to treat the patient. Finally, it may be
recommended that existing prophylactic vaccine may
be useful to prevent theileriosis for high yielding dairy
animals with superior germ plasm of elite herd.
However, tick control will be the mainstay to prevent
the irrespective type of hemoprotozoal infection in
bovine.
Conflicts of interest
The authors declare that they have no competing
interests.
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Received on: 30.01.2020
Accepted on: 06.04.2020