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These factors complicate diagnosis, treatment and can adversely influence prognosis if the practitioner fails to suspect, document, and treat each concurrent infection. The spectrum of pathogens co-infecting dogs may change over time in a given practice location due to the rapid expansion of arthropods and their associated vectored agents, and international transit among pets and wild animals. This applies, for example, to<jats:italic>Dirofilaria immitis<\/jats:italic>and<jats:italic>Leishmania infantum<\/jats:italic>, the distributions of which have expanded from northern to southern Italy, and vice versa, respectively. Indeed, mixed infections by<jats:italic>D. immitis<\/jats:italic>and<jats:italic>L. infantum<\/jats:italic>have only been reported once in Italy, probably due to the fact that competent vectors for these infections do not usually occur in the same geographical areas. Thus, information that would help practitioners to identify clinical presentations in dogs co-infected by<jats:italic>D. immitis<\/jats:italic>and<jats:italic>L. infantum<\/jats:italic>and other CVBD-causing pathogens is scant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>This manuscript describes the clinical history and physical examination of findings for 7 CVBD co-infected dogs that were examined because of a spectrum of clinical signs. Five dogs were co-infected with<jats:italic>L. infantum<\/jats:italic>and<jats:italic>Ehrlichia canis<\/jats:italic>, one dog with<jats:italic>L. infantum<\/jats:italic>,<jats:italic>E. canis<\/jats:italic>and<jats:italic>D. immitis<\/jats:italic>and the remaining dog with<jats:italic>L. infantum<\/jats:italic>and<jats:italic>D. immitis<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The clinical signs and haematological abnormalities associated with the diagnostic evaluation and treatment of these dogs is discussed. Also, the usefulness of bone marrow specimens for the molecular diagnosis of CVBDs and for the enhanced monitoring of treatment response is emphasized.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1756-3305-6-97","type":"journal-article","created":{"date-parts":[[2013,4,15]],"date-time":"2013-04-15T08:14:07Z","timestamp":1366013647000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":91,"title":["Are vector-borne pathogen co-infections complicating the clinical presentation in dogs?"],"prefix":"10.1186","volume":"6","author":[{"given":"Anna Sara","family":"De Tommasi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Otranto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filipe","family":"Dantas-Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioia","family":"Capelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward B","family":"Breitschwerdt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donato","family":"de Caprariis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2013,4,15]]},"reference":[{"key":"895_CR1","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.pt.2009.01.003","volume":"25","author":"D Otranto","year":"2009","unstructured":"Otranto D, Dantas-Torres F, Breitschwerdt EB: Managing canine vector-borne diseases of zoonotic concern: part one. 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