title: Refractory hypoglycaemia in a dog infected with Trypanosoma congolense.
abstract: A 20 kg German shepherd dog was presented to a French veterinary teaching hospital for seizures and hyperthermia. The dog had returned 1 month previously from a six-month stay in Senegal and sub-Saharan Africa. Biochemistry and haematology showed severe hypoglycaemia (0.12 g/L), anaemia and thrombocytopenia. Despite administration of large amounts of glucose (30 mL of 30% glucose IV and 10 mL of 70% sucrose by gavage tube hourly), 26 consecutive blood glucose measurements were below 0.25 g/L (except one). Routine cytological examination of blood smears revealed numerous free extracytoplasmic protozoa consistent with Trypanosoma congolense. PCR confirmed a Trypanosoma congolense forest-type infection. Treatment consisted of six injections of pentamidine at 48-hour intervals. Trypanosomes had disappeared from the blood smears four days following the first injection. Clinical improvement was correlated with the normalization of laboratory values. The infection relapsed twice and the dog was treated again; clinical signs and parasites disappeared and the dog was considered cured; however, 6 years after this incident, serological examination by ELISA T. congolense was positive. The status of this dog (infected or non-infected) remains unclear. Hypoglycaemia was the most notable clinical feature in this case. It was spectacular in its severity and in its refractory nature; glucose administration seemed only to feed the trypanosomes, indicating that treatment of hypoglycaemia may in fact have been detrimental.
authors.affiliation: Emergency and Critical Care Unit, ONIRIS, School of Veterinary Medicine, La Chantrerie, CS 40706, 44307 Nantes Cedex 03, France.
authors.forename: Jack-Yves
authors.initials: JY
authors.lastname: Deschamps
authors.affiliation: Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), UMR Intertryp, 34398 Montpellier, France - Faculty of Veterinary Medicine, Kasetsart University, Chatuchak, Bangkok, 10900 Thailand.
authors.forename: Marc
authors.initials: M
authors.lastname: Desquesnes
authors.affiliation: Emergency and Critical Care Unit, ONIRIS, School of Veterinary Medicine, La Chantrerie, CS 40706, 44307 Nantes Cedex 03, France.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Dorso
authors.affiliation: Institut de Recherche pour le Développement (IRD), UMR Intertryp, LRCT Campus International de Baillarguet, 34000 Montpellier, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Ravel
authors.affiliation: Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), UMR Intertryp, 34398 Montpellier, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Bossard
authors.affiliation: Emergency and Critical Care Unit, ONIRIS, School of Veterinary Medicine, La Chantrerie, CS 40706, 44307 Nantes Cedex 03, France.
authors.forename: Morgane
authors.initials: M
authors.lastname: Charbonneau
authors.affiliation: Emergency and Critical Care Unit, ONIRIS, School of Veterinary Medicine, La Chantrerie, CS 40706, 44307 Nantes Cedex 03, France.
authors.forename: Annabelle
authors.initials: A
authors.lastname: Garand
authors.affiliation: Emergency and Critical Care Unit, ONIRIS, School of Veterinary Medicine, La Chantrerie, CS 40706, 44307 Nantes Cedex 03, France.
authors.forename: Françoise A
authors.initials: FA
authors.lastname: Roux
mesh_terms: D017954:Africa South of the Sahara; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D004283:Dog Diseases / Q000097:blood / Q000469:parasitology*; D004285:Dogs; D005260:Female; D005334:Fever / Q000209:etiology / Q000662:veterinary; D005947:Glucose / Q000009:adverse effects / Q000627:therapeutic use; D007003:Hypoglycemia / Q000188:drug therapy / Q000209:etiology / Q000662:veterinary*; D018512:Parasitemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary*; D010419:Pentamidine / Q000627:therapeutic use; D012008:Recurrence; D012640:Seizures / Q000209:etiology / Q000662:veterinary; D012675:Senegal; D014195:Travel; D014348:Trypanosoma congolense / Q000302:isolation & purification*; D014353:Trypanosomiasis, African / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary*
chemical_list: D000981:Antiprotozoal Agents; D010419:Pentamidine; D005947:Glucose