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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Successful therapeutic management of canine Isosporosis in puppies</title><author><name sortKey="Garanayak, Nishiswapna" sort="Garanayak, Nishiswapna" uniqKey="Garanayak N" first="Nishiswapna" last="Garanayak">Nishiswapna Garanayak</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Gupta, A R" sort="Gupta, A R" uniqKey="Gupta A" first="A. R." last="Gupta">A. R. Gupta</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Patra, R C" sort="Patra, R C" uniqKey="Patra R" first="R. C." last="Patra">R. C. Patra</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28316386</idno><idno type="pmc">5339170</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339170</idno><idno type="RBID">PMC:5339170</idno><idno type="doi">10.1007/s12639-015-0747-0</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000286</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000286</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Successful therapeutic management of canine Isosporosis in puppies</title><author><name sortKey="Garanayak, Nishiswapna" sort="Garanayak, Nishiswapna" uniqKey="Garanayak N" first="Nishiswapna" last="Garanayak">Nishiswapna Garanayak</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Gupta, A R" sort="Gupta, A R" uniqKey="Gupta A" first="A. R." last="Gupta">A. R. Gupta</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author><author><name sortKey="Patra, R C" sort="Patra, R C" uniqKey="Patra R" first="R. C." last="Patra">R. C. Patra</name><affiliation><nlm:aff id="Aff1"></nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology</title><idno type="ISSN">0971-7196</idno><idno type="eISSN">0975-0703</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="Par1">Four labrador male puppies were confirmed for the <italic>Isospora</italic> spp infection by direct smear and flotation method following complains of anorexia, haematemesis and haematochezia. The puppies were treated with trimethoprime and sulphamethoxazole @ 40 mg/kg body weight in combination with metronidazole @ 10 mg/kg body weight twice daily for 5 days which was supported with fluid therapy, aniemetics and plasma expanders. All the animals showed completed clinical recovery along with clearing of faecal oocyst.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Altreuther, G" uniqKey="Altreuther G">G Altreuther</name></author><author><name sortKey="Gasda, N" uniqKey="Gasda N">N Gasda</name></author><author><name sortKey="Schroeder, I" uniqKey="Schroeder I">I Schroeder</name></author><author><name sortKey="Joachim, A" uniqKey="Joachim A">A Joachim</name></author><author><name sortKey="Settje, T" uniqKey="Settje T">T Settje</name></author><author><name sortKey="Schimmel, A" uniqKey="Schimmel A">A Schimmel</name></author><author><name sortKey="Hutchens, D" uniqKey="Hutchens D">D Hutchens</name></author><author><name sortKey="Krieger, Kj" uniqKey="Krieger K">KJ Krieger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Baek, Bk" uniqKey="Baek B">BK Baek</name></author><author><name sortKey="Kim, Cs" uniqKey="Kim C">CS 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Parasit Dis</journal-id><journal-id journal-id-type="iso-abbrev">J Parasit Dis</journal-id><journal-title-group><journal-title>Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology</journal-title></journal-title-group><issn pub-type="ppub">0971-7196</issn><issn pub-type="epub">0975-0703</issn><publisher><publisher-name>Springer India</publisher-name><publisher-loc>New Delhi</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28316386</article-id><article-id pub-id-type="pmc">5339170</article-id><article-id pub-id-type="publisher-id">747</article-id><article-id pub-id-type="doi">10.1007/s12639-015-0747-0</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Successful therapeutic management of canine Isosporosis in puppies</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Garanayak</surname><given-names>Nishiswapna</given-names></name><address><email>littlegaranayak@gmail.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Gupta</surname><given-names>A. R.</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Patra</surname><given-names>R. C.</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.412372.1</institution-id><institution>Orissa University of Agriculture and Technology,</institution></institution-wrap>Bhubaneswar, Odisha India</aff></contrib-group><pub-date pub-type="epub"><day>27</day><month>1</month><year>2016</year></pub-date><pub-date pub-type="ppub"><month>3</month><year>2017</year></pub-date><volume>41</volume><issue>1</issue><fpage>48</fpage><lpage>50</lpage><history><date date-type="received"><day>2</day><month>8</month><year>2015</year></date><date date-type="accepted"><day>28</day><month>12</month><year>2015</year></date></history><permissions><copyright-statement>© Indian Society for Parasitology 2016</copyright-statement><license><license-p>This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.</license-p></license></permissions><abstract id="Abs1"><p id="Par1">Four labrador male puppies were confirmed for the <italic>Isospora</italic> spp infection by direct smear and flotation method following complains of anorexia, haematemesis and haematochezia. The puppies were treated with trimethoprime and sulphamethoxazole @ 40 mg/kg body weight in combination with metronidazole @ 10 mg/kg body weight twice daily for 5 days which was supported with fluid therapy, aniemetics and plasma expanders. All the animals showed completed clinical recovery along with clearing of faecal oocyst.</p></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Puppies</kwd><kwd>Isospora</kwd><kwd>Diarrhoea</kwd><kwd>Flotation method</kwd><kwd>Oocyst</kwd><kwd>Sulphamethoxazole and trimethoprime</kwd></kwd-group><funding-group><award-group><funding-source><institution>College of Veterinary Sc & AH, OUAT</institution></funding-source></award-group></funding-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© Indian Society for Parasitology 2017</meta-value></custom-meta></custom-meta-group></article-meta></front><body><sec id="Sec1"><title>Introduction</title><p id="Par2">Diarrhoea among the puppies is a major health hazard encountered which can affect the normal development of the animal along with immunologically compromising it for various diseases and vaccination failure (Daugschies et al. <xref ref-type="bibr" rid="CR8">2000</xref>). Bacterial and viral diseases are the major culprits for diarrhoea among the puppies along with some parasitic origin. Attending proper protection by scheduled vaccination and deworming, the diarrhoea incidences of infectious origin can be reduced. Among the parasitic entities responsible for puppy diarrhoea coccidial organism <italic>Isospora</italic> spp. plays a vital role. Isospora associated diarrhoea has been reported prior (Baek et al. <xref ref-type="bibr" rid="CR2">1993</xref>) but the clinical manifestations may be due to secondary bacterial and viral infections of the compromised gut environment (Lindsay et al. <xref ref-type="bibr" rid="CR25">1997</xref>; Lappin <xref ref-type="bibr" rid="CR20">2010</xref>; Altreuther et al. <xref ref-type="bibr" rid="CR1">2011</xref>).</p><p id="Par3">The protozoan organism Isospora belongs to the kingdom—Protista, phylum—Apicomplexa, class—Sporozoea, Subclass—Coccidia, family—Eimeriidae and genus—Isospora (Levine <xref ref-type="bibr" rid="CR22">1977</xref>).</p><p id="Par4">A large number of species diversity among the genus Isospora can be found along with a wide range of host organisms which includes human, primates, pig, canines and felines etc. (Levine <xref ref-type="bibr" rid="CR23">1988</xref>; Lindsay et al. <xref ref-type="bibr" rid="CR25">1997</xref>).</p><p id="Par5"><italic>I. canis</italic> and <italic>I. ohioensis</italic> complex which includes 2 additional spp. <italic>I. burrowsi</italic>, <italic>I. neorivolta</italic> are the major miscreants for canine coccidiosis. Identification of the Isospora organisms is based on the dimensions and number of sporozoites and sporocysts present in the excreted oocyst from the host animal (Dubey <xref ref-type="bibr" rid="CR10">1978</xref>; Lindsay et al. <xref ref-type="bibr" rid="CR27">1997</xref>).</p><p id="Par6">Young canines mostly get infected by ingestion of sporulated oocyst (Lindsay et al. <xref ref-type="bibr" rid="CR25">1997</xref>; Daugschies et al. <xref ref-type="bibr" rid="CR8">2000</xref>; Buehl et al. <xref ref-type="bibr" rid="CR5">2006</xref>; Dubey et al. <xref ref-type="bibr" rid="CR13">2009</xref>). Immune compromised puppies and stressed animals are under the enhanced risk of infection (Lappin <xref ref-type="bibr" rid="CR20">2010</xref>). <italic>I. canis</italic> establishes itself in the lamina propria of the posterior small intestine (Lepp and Todd <xref ref-type="bibr" rid="CR21">1974</xref>) resulting enteritis and mucosal damage due to schizogony and gamogony (Mitchell et al. <xref ref-type="bibr" rid="CR26">2007</xref>; Lappin <xref ref-type="bibr" rid="CR20">2010</xref>). The <italic>I. ohioensis</italic> complex infects the enterocytes in the lamina propria of small intestine, cecum, and colon of dogs resulting in villous atrophy, necrosis of apical enterocytes, and cryptitis (Dubey <xref ref-type="bibr" rid="CR10">1978</xref>; Dubey and Mahrt <xref ref-type="bibr" rid="CR11">1978</xref>; Trayser and Todd <xref ref-type="bibr" rid="CR30">1978</xref>).</p><p id="Par7">The clinical implications include watery to haemorrhagic diarrhoea along with vomition, tenesmus and inappetance. Death due to excessive dehydration has been advocated by Daugschies et al. (<xref ref-type="bibr" rid="CR8">2000</xref>) and Lappin (<xref ref-type="bibr" rid="CR20">2010</xref>).</p><p id="Par8">Diagnosis of oocyst in the faecal matter by direct smear, Sheather sugar flotation method and sedimentation method with increasing order of sensitivity has been reported (Faust et al. <xref ref-type="bibr" rid="CR15">1961</xref>; Current <xref ref-type="bibr" rid="CR7">1990</xref>).</p><p id="Par9">The present study deals with <italic>Isospora</italic> associated diarrhoea in four puppies and its successful management with sulphamethoxazole and trimethoprime combinations.</p></sec><sec id="Sec2"><title>Materials and methods</title><p id="Par10">Four labrador male puppies of 2–3 month age were presented to the Teaching Veterinary clinical complex (TVCC) of College of Veterinary Science and AH, Bhubaneswar with history of anorexia, haematemesis, haematochezia for last 3 days with an average body temperature ranging from 101.8 to 102.2 °F. The puppies were vaccinated against distemper, hepatitis, parvo, parainfluenza, leptospira and corona virus following deworming with pyrantel pamoate @ 11 mg/kg body weight. Prior treatment regime of the puppies was done with Amikacin @ 10 mg/kg body weight without any clinical recovery. Faecal sample examination through direct smear method for presence of sporulated and non-sporulated oocyst of <italic>Isospora</italic> spp. was carried out which was later confirmed by flotation method (Soulsby <xref ref-type="bibr" rid="CR28">1986</xref>). Haematological findings of the infected animals showed haemoglobin (Hb) level as 8.6 ± 0.8 g/dl and the differential count was within the normal range.</p><p id="Par11">The puppies were administered with trimethoprime and sulphamethoxazole @ 40 mg/kg body weight in combination with metronidazole @ 10 mg/kg body weight twice daily for 5 days. As supportive therapy plasma expander @ 5 ml/kg body weight for 3 days along with Ringer’s Lactate @ 30 ml/kg body weight twice daily for 5 days were given. Dextrose was administerd to the puppies to provide the energy @ 0.5 mg/kg body wt. Antiemetic metoclopramide @ 0.4 mg/kg body weight and haemocoagulase etamsylate @ 250 mg twice daily was given for 2 days.</p></sec><sec id="Sec3"><title>Result</title><p id="Par12">The direct faecal smear examination showed presence of <italic>Isospora</italic> oocyst which was confirmed by flotation method (Fig. <xref rid="Fig1" ref-type="fig">1</xref>) but Identification of the <italic>Isospora</italic> spp. was not confirmed. Basing on the internal anatomy of the oocyst it was concluded that both <italic>I. Canis</italic> and <italic>I. Ohioensis</italic> complex were present. History also confirmed the presence of mouse (<italic>Mus musculus</italic>) in the kennel premises which can act as the paratenic host of the infection as reported by Frenkel and Dubey (<xref ref-type="bibr" rid="CR17">1972</xref>), Dubey (<xref ref-type="bibr" rid="CR9">1977</xref>, <xref ref-type="bibr" rid="CR10">1978</xref>).<fig id="Fig1"><label>Fig. 1</label><caption><p>Oocyst of <italic>Isospora</italic> spp. from faecal smear (100×)</p></caption><graphic xlink:href="12639_2015_747_Fig1_HTML" id="MO1"></graphic></fig></p><p id="Par13">The clinical recovery was observed from day one of treatment with absence of blood in vomitus and stool. The consistency of stool became normal after 2–6 days depending up to the clinical severity. However vomition tendency remained up to 8 days in 2 pups who started taking food with no clinical signs after 10 days. The faecal samples of all the puppies were free from oocysts as an indication of clinical recovery. The haemoglobin (Hb) level fell back to normal range (11 ± 0.5 g/dl) within a span of 7 days.</p></sec><sec id="Sec4"><title>Discussion</title><p id="Par14">Isospora infection in puppies is the serious health concern due to its ability to spread through litter materials of kennel (Daugschies et al. <xref ref-type="bibr" rid="CR8">2000</xref>; Buehl et al. <xref ref-type="bibr" rid="CR5">2006</xref>). The infectivity of sporulated <italic>Isospora</italic> spp. oocysts can remain up to months along with the ability to resist the basic hygienic measures (Barutzki et al. <xref ref-type="bibr" rid="CR3">1981</xref>; Buehl et al. <xref ref-type="bibr" rid="CR5">2006</xref>). The infection leads to malabsorption in puppies rendering reduced vigour (Brandborg et al. <xref ref-type="bibr" rid="CR4">1970</xref>; Henry et al. <xref ref-type="bibr" rid="CR19">1974</xref>; Seah et al. <xref ref-type="bibr" rid="CR27">1975</xref>).</p><p id="Par15">Identification of the <italic>Isospora</italic> spp. by structural morphology through flotation method and its superiority over the direct smear method has already been advocated for Isosporosis determination (Faust et al. <xref ref-type="bibr" rid="CR15">1961</xref>; Current <xref ref-type="bibr" rid="CR7">1990</xref>). However identification of the organism is not confirmatory based on oocyst structure which leads to the nomenclature of <italic>I. ohioensis</italic>-<italic>like</italic> or <italic>I. ohioensis</italic> complex (Dubey et al. <xref ref-type="bibr" rid="CR12">1978</xref>).</p><p id="Par16">The recovery of the puppies by administration of trimethoprime and sulphamethoxazole along with supportive therapies and metronidazole resulted in complete clinical recovery with elimination of faecal oocyst. Similarly use of Sulfadimethoxine alone and in combination with ormetoprim has been proved effective in canines and felines (Wilkinson <xref ref-type="bibr" rid="CR33">1977</xref>; Dunbar and Foreyt <xref ref-type="bibr" rid="CR14">1985</xref>; Lindsay and Blagburn <xref ref-type="bibr" rid="CR24">1995</xref>). Administrations of emodepside plus toltrazuril suspension in combination with oral Amprolium have proven effectiveness against canine infection (Altreuther et al. <xref ref-type="bibr" rid="CR1">2011</xref>). Anti-giardial drugs like metronidazole, tinidazole, quinacrine, and furazolidone have very limited effect but metronidazole has been reported successful in some cases (Trier et al. <xref ref-type="bibr" rid="CR31">1974</xref>; Syrkis et al. <xref ref-type="bibr" rid="CR29">1975</xref>; Butler and deBoer <xref ref-type="bibr" rid="CR6">1981</xref>; Hallak et al. <xref ref-type="bibr" rid="CR18">1982</xref>; Forthal and Guest <xref ref-type="bibr" rid="CR16">1984</xref>; Weiss et al. <xref ref-type="bibr" rid="CR32">1988</xref>). The major aim of the treatment includes reduction of clinical signs along with reduction in faecal oocysts for interrupting the life cycle (Daugschies et al. <xref ref-type="bibr" rid="CR8">2000</xref>; Buehl et al. <xref ref-type="bibr" rid="CR5">2006</xref>). Supportive therapies like fluid administration are done depending on the severity of clinical signs which can enhance the recovery of the animals (Altreuther et al. <xref ref-type="bibr" rid="CR1">2011</xref>).</p><p id="Par17">It was concluded that the canine Isosporosis can be clinically managed by use of trimethoprime and sulphamethoxazole along with supportive therapies and metronidazole. 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