title: Acute pancreatitis: a newly recognised potential complication of canine babesiosis.
abstract: This retrospective study describes 4 cases of canine babesiosis with histologically confirmed acute pancreatitis. In addition, 16 dogs with babesiosis are reported with serum amylase (>3500 U/l) and/or lipase (>650 U/l) activity elevations of a magnitude that would support a diagnosis of probable acute pancreatitis, although extra-pancreatic sources of the enzymes could not be excluded in these cases. Median time of pancreatitis diagnosis was 2.5 days post-admission, with primarily young (median age 3 years), sexually intact dogs affected. The development of pancreatitis was unrelated to the degree of anaemia at time of admission. In addition to pancreatitis, 80% of cases suffered from other babesial complications, namely icterus (13), acute respiratory distress syndrome (6), immune-mediated haemolytic anaemia (6), renal failure (3), haemoconcentration (2) and cerebral syndrome (2). Acute respiratory distress syndrome, renal failure and cerebral syndrome were associated with a poor prognosis, with 4 of the 5 dogs included in the overall 26% mortality rate having at least 1 of these complications. Haemolytic anaemia with ischaemia-reperfusion injury to the pancreas is proposed as a possible primary pathophysiological mechanism in babesial pancreatitis. Hypotensive shock, immune-mediated haemolytic anaemia, haemoconcentration and possibly altered lipid metabolism in babesiosis may also be involved. The previously postulated pro-inflammatory cytokine milieu of complicated babesiosis may underlie the progression, if not the primary initiation, of pancreatic pathology. Acute pancreatitis may represent the previously reported 'gut' form of babesiosis.
authors.affiliation: Department of Companion Animal Medicine, University of Pretoria, Onderstepoort, South Africa.
authors.forename: A J
authors.initials: AJ
authors.lastname: Möhr
authors.forename: R G
authors.initials: RG
authors.lastname: Lobetti
authors.forename: J J
authors.initials: JJ
authors.lastname: van der Lugt
mesh_terms: D000681:Amylases / Q000097:blood; D000818:Animals; D001404:Babesiosis / Q000150:complications / Q000662:veterinary*; D004283:Dog Diseases / Q000175:diagnosis / Q000209:etiology*; D004285:Dogs; D005260:Female; D008049:Lipase / Q000097:blood; D008297:Male; D010179:Pancreas / Q000473:pathology / Q000503:physiopathology*; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000209:etiology / Q000662:veterinary*; D012189:Retrospective Studies
chemical_list: D008049:Lipase; D000681:Amylases