Successful Management of Presumed Reactivation of Neospora caninum Following Immunosuppression for Immune Thrombocytopenia in an Adult Doberman.

Abstract

A 5-year old, vaccinated, untravelled and neutered female Doberman with occasional exposure to raw food presented for investigation of severe thrombocytopenia and anaemia. Extensive investigations led to a diagnosis of non-associative immune thrombocytopenia, with secondary bleeds resulting in anaemia. Management with repeated packed red blood cell transfusions, vincristine (0.02 mg/kg single intravenous injection), prednisolone (50 mg/m/day) and mycophenolate (10 mg/kg twice daily) allowed normalisation of haematology parameters. Scheduled reassessment 10 days after discharge revealed lethargy, ataxia, wide-based stance and marked generalised muscle wastage. Platelet count remained normal, but biochemistry was supportive of muscle damage. Neospora caninum antibodies were elevated (indirect fluorescence antibodies > 1600). Rapid tapering of prednisolone alongside clindamycin (20 mg/kg twice daily) allowed a complete recovery. Mycophenolate was slowly tapered and discontinued after 12 weeks, as was antibiotic therapy. This case describes the successful management of a dog with presumed neuromuscular neosporosis, suspected secondary to reactivation of the parasite from immunosuppression, and absence of long-term complications.