The treatment for canine babesiosis depends primarily upon the species of piroplasm causing the clinical disease. The drug of choice for the large piroplasms (Babesia canis) is imidocarb dipropionate (5.0 to 6.6 mg/kg intramuscularly, given once, then repeated in two to three weeks), which is effective against Babesia canis but not B. gibsoni. Imidocarb also has some effect against Ehrlichia canis, thus, it may be useful for co-infections.
Diminazene aceturate has been used for many years to treat B. gibsoni infection but this has been superseded in recent years by the anti-malarial atovaquone in combination with azithromycin which as shown promise for the treatment of B. gibsoni.
Other drugs reportedly effective against both B. canis and B. gibsoni include phenamidine isethionate, pentamidine isethionate and diminazine aceturate. The last is given as a single intramuscular injection at a dosage of 5 mg/kg. Trypan blue (1% solution) is used in Southern Africa to treat complicated infection with B. rossi.
Supportive therapy such as judicious intravenous fluids and blood transfusions should be employed when necessary.
In many cases treatment does not completely eliminate the infection. The host immune response may clear the infection after months to years, so animals become longterm chronic carriers of the organism and potential reservoirs of infection. Subclinically infected animals may have recurrence of disease with stress, immunosuppressive therapy or concurrent disease. In addition, dogs that have recovered from babesiosis should never be used as donors for blood transfusions because the recipients may develop the disease.
Dogs living in non-endemic areas should generally not be taken into endemic areas as these dogs usually develop a more severe disease. Owners wishing to travel with their pets to endemic areas should seek veterinary advice and take great care to prevent tick bites and potential disease transmission.
Vaccination against Babesia infection has been researched for long time and vaccines are registered in some European countries. Cross-immunity experiments have shown that the antigenic differences between the subspecies or even strains of the B. canis complex have important implications on the development of a vaccine as there is no complete cross-protection between the single pathogens. As a consequence the degree of protection may vary in vaccinated dogs. Further studies are required to elucidate this situation. In every case the prevention of canine babesiosis includes the prevention of tick bites.