Emergency management of severe anemia due to presumptive Babesia vogeli in a Puppy: Whole blood transfusion and doxycycline monotherapy

Abstract

Aim: To document the successful clinical management of life-threatening hemolytic anemia caused by a presumptive Babesia vogeli infection in a puppy and to describe the clinical and hematological response to emergency whole-blood transfusion combined with doxycycline monotherapy. Case Presentation: A two-month-old male puppy was presented to the Small Animal Outpatient Medicine Unit with severe lethargy, recumbency and icterus. Clinical examination revealed heavy tick infestation and a life-threatening Packed Cell Volume (PCV) of 10%. Peripheral blood smears confirmed the presence of large forms of intra-erythrocytic piroplasms morphologically consistent with Babesia spp. (presumptive B. vogeli). The patient was stabilized with an emergency whole-blood transfusion (45 mL) and initiated on doxycycline therapy (5 mg/kg IV for five days, followed by 10 mg/kg orally for 21 days). Within 24 hours, clinical improvement was noted, and by Day 4, the PCV had increased to 28%. Discussion: While B. vogeli is typically considered to have mild to moderate pathogenicity in adult dogs, this case underscores its potential to cause high pathogenicity in puppies. The rapid stabilization provided by the blood transfusion was critical, as it allowed the pup to survive the severe hypoxic crisis. Doxycycline monotherapy appeared to be a viable therapeutic strategy in this case, potentially suppressing the parasite burden while avoiding the safety risks associated with imidocarb in very young or debilitated puppies. Conclusion: Prompt diagnosis and timely blood transfusion are life-saving interventions in puppies with severe babesiosis. This case suggests that early intervention combined with doxycycline and supportive care can lead to successful clinical outcomes in acute, life-threatening suspected B. vogeli infections.