Of 120 suspected dogs, 17 (14.16%) were positive for
E. canis by microscopic examination (Fig 1) and 16S rRNA PCR assay
(Bhagwan et al., 2024). While analyzing breed-wise variation of CME in dogs, the majority of cases were reported in non-descript breeds, followed by Labrador retriever and German shepherd, Bully (Fig 2a). The sex-wise occurrence of CME revealed almost equal detection rates in male and female dogs (Fig 2b). The majority of CME cases were diagnosed in dogs over a year old. (Fig 2c).
The clinical profiles of dogs detected with
E. canis are shown in Table 1 and Fig 3. Pyrexia (82.35%), anorexia (70.58%), congested mucous membrane (41.17%), pale mucous membrane (58.82%) and lethargy (41.17%) were the most prevalent clinical symptoms linked to CME. Ticks (
Rhipicephalus sanguineus) were present on 76.47% of dogs that detected positive for
E. canis.
The hematological profiles of CME affected dogs (n=17) are provided in Table 2. The Hb levels in the most of dogs affected with CME were below the normal reference range. The TEC was within normal limits (n=9), followed by values below the lower limit (n=8). PCV was less than normal limit of the reference range in most cases (n=15). MCV (n=15), MCHC (n=9) and MCH (n=12) were below the lower limit of the normal reference range in most cases. The TLC was within normal limits in the most of the cases (n=10); however, the lymphocyte count was within normal limits in nine cases, followed by lymphocytosis. Neutrophils were within normal limits in the majority of CME affected dogs (n=15). Eosinophil count, basophil count and monocyte were detected within normal limits in most cases. Thrombocytopenia was reported in all CME positive cases. Overall blood profile found microcytic hypochromic to normochromic anemia, thrombocytopenia, normal to elevated TLC with absolute neutrophilia and normal to elevated lymphocyte count.
Table 3 depicts the serum biochemical profiles of dogs with CME. Total protein levels in affected dogs were within normal limits in many cases (n=10). There was hypoalbuminemia in all cases and the A:G ratio was found below the lower limit in most cases (n=16). GGT activity was above the upper limit in all cases. Urea level in serum was within the normal range (n=15), whereas serum creatinine level was above the upper limit in all cases. The total bilirubin level in affected dogs was within normal limits in the majority of cases (n=15). Serum direct bilirubin was within normal limits (n=15), whereas indirect bilirubin was within normal limits in all cases.
Of the 17 positive samples, two randomly selected PCR products were sequenced. The obtained nucleotide sequences were submitted to the NCBI and accession numbers PX736498 and PX736499 were obtained. After phylogenetic analysis, both sequences from the present study clustered with
E. canis sequences reported from different parts of the world (Fig 4). This confirmed the molecular identification of our sequence as
E. canis. The sequences from the present study (PX736498 and PX736499) formed a separate cluster that was closely related to PX591180 from South Africa, with sequence identities of 94.18% and 86.43%, respectively. PX736498 and PX736499 had a high nucleotide identity (84.80%) with previously published
E. canis sequences from India, Taiwan, Iraq, Brazil, Turkey, Japan, China and the USA.
In the present study, the most common clinical findings with CME were fever, anorexia, pale to congested mucous membrane, lethargy, lymphadenopathy and epistaxis,
etc. Diverse clinical signs recorded in dogs with CME have been reported in previous studies (
Harrus and Waner, 2011;
Mylonakis et al., 2019), which indicate multi-organ dysfunctions due to underlying pathological changes such as vasculitis
(Mylonakis et al., 2019). Haemorrhages manifested as epistaxis, dermal petechiae and ecchymoses, haematuria and melena in cases of CME during the present study had also been observed earlier
(Rungsipipat et al., 2009; Bai et al., 2017; Chakraborty et al., 2024). The increased bleeding tendencies could be attributed to thrombocytopenia and the deposition of immune complexes on the vascular wall
(Rungsipipat et al., 2009).
The present study reported more predisposition of non-descript breed (20%), followed by German shepherd (10.34%) and Labrador retriever (9.67%) for CME. In a previous study from Hisar, Haryana, non-descript dogs were more susceptible to the haemoprotozoan infections like
E. canis (Bhagwan et al., 2024). Out of the known breeds, German Shepherds were found to be most frequently reported with
E. canis as reported from other parts of India (
Bhardwaj, 2013;
Bhadesiya and Raval, 2015). When comparing CME in different age groups, the maximum number of cases was reported in dogs above one year of age, as reported earlier
(Kottadamane et al., 2017; Singh et al., 2021). However, in a few studies, younger dogs (below 1 year) were more susceptible to CME
(Rungsipipat et al., 2009; Chandrasekar et al., 2002). The present study reported an almost equal detection rate of CME in male and female dogs as reported earlier (
Revathi et al., 2025;
Rungsipipat et al., 2009).
Haematological profile revealed a lower level of Hb and total erythrocyte count in CME-affected dogs which are in agreement with published reports
(Srikala et al., 2012; Singh et al., 2021; Chakraborty et al., 2024). These alterations could be due to the higher affinity of
E. canis towards the vascular endothelial cells, leading to vasculitis, which is manifested as multiple petechial or ecchymotic haemorrhages
(Sainz et al., 2015; Mohanapriya et al., 2021). In the majority of CME-affected dogs, the levels of PCV (n=15), MCV (n=15) and MCH (n=12) were found below the lower limit. This suggests the microcytic hypochromic to normochromic anemia which is in contrast to the usual finding of normocytic normochromic anaemia
(Nakaghi et al., 2008; Silva et al., 2012). The destruction of canine RBC may also be due to an immunological mechanism, resulting in haemoglobinuria and anaemia
(Taylor et al., 2015).
Thrombocyte count was found to be drastically reduced, which is the characteristic feature of CME (
Woody and Hoskins, 1991;
Mylonakis et al., 2017). The reports of thrombocytopenia during ehrlichiosis had been consistently reported earlier
(Waner et al., 2001; Nakaghi et al., 2008; Chakraborty et al., 2024). Thrombocytopenia, mainly due to large-scale destruction of the cells in the spleen that begins a few days after the infection
(Smith et al., 1975), alongside bone marrow hypoplasia, are also amongst the primary causes of pancytopenia and thrombocytopenia (
Waner, 2008). Increased splenic sequestration, platelet consumption and decreased platelet lifespan may be the possible factors for thrombocytopenia
(Harrus et al., 1999). Reduced synthesis of coagulation proteins in the liver due to necrosis may also cause increased platelet aggregation, further aggravating the thrombocytopenia
(Mylonakis et al., 2019).
The TLC was found within normal limits in the majority of the cases (n=10) as reported earlier
(Rungsipipat et al., 2009). Leukocytosis in the present study is in agreement with a study conducted from Maharastra, India
(Parmar et al., 2013). However, in a study from Israel, significant leucopenia was documented in dogs affected with
E. canis (Waner et al., 2008). Lymphocyte count was within normal limits in more than 50% of cases (n=9), followed by absolute lymphocytosis, which is in agreement with published literature
(Parmar et al., 2013). The possible reasons for lymphocytosis may be due to chronic immune stimulation, lymphaenopathy and lymphoid hyperplasia (
Tamai and Staji, 2025). Neutrophil count was found within normal limits in the majority of the cases (n=15); however, previous studies had reported neutrophilia in dogs affected with
E. canis (Rungsipipat et al., 2009; Parmar et al., 2013).
Total protein level in serum of CME-affected dogs was within normal limits in the majority of the cases (n=10), followed by hypoprotenemia (n=7). CME affected dogs were reported with hypoalbuminemia in all the cases with A:G ratio below the lower limit in majority of dogs (n=16). Hypoproteinemia and hyperglobulinemia associated with ehrlichiosis in dogs were in agreement with previous study reports
(Rungsipipat et al., 2009; Srikala et al., 2012; Bai et al., 2017), while a study had recorded a significant increase in total protein levels in dogs with ehrlichiosis (
Bhardwaj, 2013). The probable causes for hypoproteinemia and hypoalbuminemia are loss of plasma proteins from the vascular endothelial pores due to vasculitis (
Woody and Hoskins, 1991) or due to reduced protein synthesis as a result of concurrent liver diseases (
Reardon and Pierce, 1981) or glomerulonephritis (
Mylonakis et al., 2010). Liver function tests (ALT, AST and ALP) in affected dogs were within normal limits in the majority of the cases. However, studies from previous studies reported elevated levels of ALT, AST and ALP. However elevated level of GGT has been consistently reported in present and previous studies (
Bhardwaj 2013;
Srikala 2012). These findings of measured GGT could be attributed to
E. canis-induced inflammation of the sinusoidal endothelium and infiltration of perivascular mononuclear cells in liver
(Mylonakis et al., 2010; Nair et al., 2016).
Serum urea was found within normal limits (n=15) in the majority of CME affected dog, while serum creatinine level was found above the upper limit in all the cases, as reported earlier (
Srivastava and Srivastava, 2011). The results were in agreement with studies reporting renal damage due to concurrent immune-mediated glomerulonephritis caused by
E. canis antigen against the basement membrane of the glomerulus
(Silva et al., 2016).
The phylogenetic analysis based on 16S rRNA sequence confirmed the genetic identity of the PCR product as
E. canis. Similar methods for species identification have been used previously
(Parthiban et al., 2024; Kopparthi et al., 2025). Phylogenetic analysis revealed that the
E. canis from the present study were closely related and were phylogenetically similar to sequences from South Africa, India, Taiwan, Iraq, Brazil, Turkey, Japan, China and the USA, with high genetic identity (Supplementary Fig 1), implying a regionally conserved nature of the 16s rRNA sequence
E. canis (
Nguyen et al., 2025;
Venugopal et al., 2026).