title: Retrospective analyses of dogs found serologically positive for Ehrlichia canis in Cebu, Philippines from 2003 to 2014.
abstract: OBJECTIVE
  The study aimed to document the clinical and hematological observations of dogs found serologically positive for Ehrlichia canis and to identify parameters or factors that are associated with the disease with focus on the anemic and thrombocytopenic state of the infected dogs.
  
  
  METHODS
  From 7 participating veterinary establishments, a total of 913 cases from 2003 to 2014 were initially assessed using inclusion criteria, including E. canis diagnosis by the attending veterinarian and the presence of ticks or history of infestation, thrombocytopenia, and/or anemia. From these, 438 cases that were found serologically positive for E. canis using commercial test kits were selected. Profile, clinical observations and hematological test results were obtained from the selected cases. Computations for statistical associations between the anemic and thrombocytopenic state of the infected dogs and their profile, observed clinical signs and other hematological values were performed.
  
  
  RESULTS
  Most of the dogs were purebred (60.0%) and female (51.1%) and were within the age range of 1-5 years (38.4%). The mean packed cell volume (PCV), red blood cell (RBC) count, and platelet count were lower than the normal values while the absolute count of basophils were higher than normal values. Creatinine and blood urea nitrogen (BUN) appear to be elevated. The most common clinical signs observed were inappetence (41.3%), lethargy/depression (35.6%), vomiting (32.4%), fever (18.5%), paleness (8.2%), and epistaxis (6.6%). Analyses showed that there were no significant differences on the hematological values and clinical signs between thrombocytopenic and non-thrombocytopenic seropositive dogs. Moreover, very weak correlations between platelet count and RBC count, absolute lymphocyte count, and neutrophil count were found. On the other hand, only paleness (p=0.008) and epistaxis (p=0.004) were found to be significantly different between anemic and non-anemic patients. This coincided with the linear regression results where PCV (p=0.000, R=0.787, R(2)=0.619) was moderately correlated with the RBC count. In addition, eosinophil count was found weakly correlated.
  
  
  CONCLUSIONS
  E. canis infection in dogs may produce varied clinical signs that may be influenced by the thrombocytopenic and anemic states of affected animals. Complete blood counts remain important in the diagnosis of the disease, especially the platelet and RBC counts. Creatinine, BUN and alanine aminotransferase can be of value in the diagnosis of the infection. Several cases were lost to follow-up and appeared to be a challenge for handling veterinarians to monitor compliance of owners and progress of infected patients.
authors.affiliation: Biology and Environmental Studies Program, Sciences Cluster, University of the Philippines Cebu, Lahug, Cebu City, Philippines; Southwestern University, Villa Aznar, Urgello St., Cebu City 6000, Philippines; GPY Veterinare Animale - Group of Veterinary Clinics, Cebu City 6000, Philippines.
authors.forename: Adrian P
authors.initials: AP
authors.lastname: Ybañez
authors.affiliation: Biology and Environmental Studies Program, Sciences Cluster, University of the Philippines Cebu, Lahug, Cebu City, Philippines.
authors.forename: Rochelle Haidee D
authors.initials: RH
authors.lastname: Ybañez
authors.affiliation: Southwestern University, Villa Aznar, Urgello St., Cebu City 6000, Philippines.
authors.forename: Rex R
authors.initials: RR
authors.lastname: Villavelez
authors.affiliation: Southwestern University, Villa Aznar, Urgello St., Cebu City 6000, Philippines.
authors.forename: Honey Pearl F
authors.initials: HP
authors.lastname: Malingin
authors.affiliation: Biology and Environmental Studies Program, Sciences Cluster, University of the Philippines Cebu, Lahug, Cebu City, Philippines.
authors.forename: Dana Natasha M
authors.initials: DN
authors.lastname: Barrameda
authors.affiliation: Biology and Environmental Studies Program, Sciences Cluster, University of the Philippines Cebu, Lahug, Cebu City, Philippines.
authors.forename: Sharmaine V
authors.initials: SV
authors.lastname: Naquila
authors.affiliation: Biology and Environmental Studies Program, Sciences Cluster, University of the Philippines Cebu, Lahug, Cebu City, Philippines.
authors.forename: Shiella Mae B
authors.initials: SM
authors.lastname: Olimpos
keywords: Cebu; Ehrlichia canis; Philippines; clinical signs; dog; hematology