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Pulmonary hypertension associated with Ehrlichia canis infection in a dog
  1. C. Locatelli, DVM, PhD1,
  2. D. Stefanello, DVM, PhD1,
  3. G. Riscazzi, DVM1,
  4. S. Borgonovo, DVM, PhD1 and
  5. S. Comazzi, DVM, PhD2
  1. 1Dipartimento di Scienze Cliniche Veterinarie,
  2. 2Dipartimento di Patologia Animale, Igiene e Sanita' Pubblica Veterinaria, Facoltà di Medicina Veterinaria, Università degli Studi di Milano, Via Celoria 10, 20131 Milan, Italy
  1. E-mail for correspondence:

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CANINE monocytic ehrlichiosis (CME) is an important canine disease with a worldwide distribution. The clinical presentation can be acute, subclinical or chronic, and there may be a multitude of clinical manifestations (Neer 1998, Neer and others 2002, Cohn 2003, Harrus and Waner 2011). This report describes a case of severe pulmonary hypertension (PH) in a dog infected with Ehrlichia canis, which completely resolved after treatment.

A seven-year-old, neutered female Yorkshire terrier, weighing 5.5 kg, was presented to the Cardiology Service of the Veterinary Teaching Hospital of Milan with a one-month history of syncope and a one-week history of anorexia and abdominal distension. The dog was housed indoors, its vaccination programme was up to date and it received monthly heartworm-prevention treatment during the warm season. Every August, the dog spent a month in a tick-endemic area (the island of Sardinia, Italy).

On physical examination, the dog showed generalised weakness, dyspnoea, pale mucous membranes, prolonged capillary refill time, jugular distension and pulse, a weak femoral pulse, generalised moderate lymph node enlargement, right systolic heart murmur (grade 3/6), abnormal lung sounds and marked abdominal distension. Body temperature was 38.6°C. These findings were consistent with right-sided congestive heart failure (RCHF) and poor peripheral perfusion.

Complete blood count (CBC) and biochemistry showed a mild normocytic normochromic anaemia, leucocytosis with marked lymphocytosis, moderate thrombocytopenia, severe hyperproteinaemia, hyperglobulinaemia, hypoalbuminaemia and increased plasma C-reactive protein (Table 1). Serum protein electrophoresis showed a narrow peak in the gammaglobulin region suggesting an oligo- or monoclonal gammopathy. Cytological evaluation of aspirates from peripheral lymph nodes showed a prevalent population of small lymphoid cells with signs of reactive lymphoid hyperplasia. Cytological examination of a bone marrow aspirate showed mild hypoplasia of erythroid and megakaryocytic lineages and an increased percentage of small lymphocytes (about 20 per cent of total …

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