Hypoglycaemia in virulent canine babesiosis: Prevalence and risk factors

Abstract

A study was conducted to determine the prevalence of and potential risk factors for hypoglycaemia in canine babesiosis due to Babesia canis rossi. Plasma glucose concentration was measured at presentation in 250 dogs with babesiosis, of which 111 were admitted to hospital. The overall prevalence of hypoglycaemia (< 3.3 mmol/l) was 9% (23/250). Twenty-two hypoglycaemic dogs required admission, making the prevalence of hypoglycaemia in admitted cases 19.8%. Sixteen dogs had severe hypoglycaemia (¡Ü 2.2 mmol/l) of which 5 had a blood glucose < 1 mmol/l. Hyperglycaemia (> 5.6 mmol/l) was present in 38 (38/250; 5.2%) dogs of which 21 (21/250; 8.4%) were admitted and severe hyperglycaemia (> 15 mmol/l) did not occur. Risk factors for hypoglycaemia identified by univariable analysis were: Collapsed state (P < 0.00001), severe anaemia (P = 0.0002), icterus (P = 0.003), age below 6 months (P = 0.02) and vomition (P = 0.03). After logistic regression analysis, collapsed state (OR = 17.8, 95% CI: 1.9 to 171, P = 0.01) and young age (OR = 2.8, 95% CI: 0.8 to 9.7, P = 0.1) remained significantly associated with hypoglycaemia. Toy breeds and pregnant bitches were not at higher risk for hypoglycaemia than other dogs. Hypoglycaemia was only associated with overt neurological signs in two dogs. Blood glucose concentration should ideally be measured in all dogs requiring treatment for babesiosis, but is mandatory in collapsed dogs, puppies and dogs with severe anaemia, vomition or icterus. Many cases have probably been misdiagnosed, as cerebral babesiosis in the past and hypoglycaemia should be suspected in any case with coma or other neurological signs; however, this should in no circumstances be the only reason to suspect hypoglycaemia.