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Ehrlichiosis ile Doğal Enfekte Köpeklerde Serum C-Reaktive Protein, Prokalsitonin ve Seruloplazmin konsantrasyonları

Year 2023, , 174 - 181, 30.06.2023
https://doi.org/10.30607/kvj.1238703

Abstract

Bu çalışma, Ehrlichiosis ile doğal enfekte köpeklerde inflamatuar sürecin potansiyel biyokimyasal belirteçlerinden olan C-reaktif protein (CRP), Prokalsitonin (PCT) ve seruloplazmin (Cp) konsantrasyonlarını değerlendirmeyi amaçladı. Çalışmaya, klinik olarak sağlıklı 8 (Sağlıklı grup) ve Ehrlichia spp. ile mono enfekte 12 (Ehrlichia grubu) olmak üzere toplam 20 köpek dahil edildi. Ehrlichia grubundaki köpekler, klinik olarak aktif enfeksiyon belirtileri gösteren köpekler arasından seçildi ve hastalıkları, ticari test kitleri ile teşhis edildi. Serum CRP ve PCT seviyeleri köpek spesifik ticari ELISA test kitleri ile analiz edildi ve Cp konsantrasyonu kolorimetrik yöntemle belirlendi. Ehrlichia grubundaki CRP konsantrasyonu, sağlıklı grupla karşılaştırıldığında anlamlı olarak daha yüksekti. Serum PCT ve Cp konsantrasyonlarında gruplar arasında anlamlı fark yoktu. Sonuç olarak, serum CRP konsantrasyonundaki artış, Ehrlichiosis'li köpeklerde inflamatuar süreçlerin saptanmasında kullanılabilir. Ek olarak bu çalışma, PCT ve Cp konsantrasyonlarının Ehrlichiosis'li köpeklerde inflamatuar durumu belirlemek için klinik olarak yararlı belirteçler olmadığını göstermiştir.

References

  • Abiramalatha T, Santhanam S, Mammen JJ, Rebekah G, Shabeer MP, Choudhury J, Nair SC. Utility of neutrophil volume conductivity scatter (VCS) parameter changes as sepsis screen in neonates. J Perinatol. 2016; 36(9):733-738.
  • Aktas M, Özübek S. Genetic diversity of Ehrlichia canis in dogs from Turkey inferred by TRP36 sequence analysis and phylogeny. Comp Immunol Microbiol Infec Dis. 2019; 64:20-24.
  • Ansari-Mood M, Khoshnegah J, Mohri M, Rajaei S. Seroprevalence and risk factors of Ehrlichia canis ınfection among companion dogs of Mashhad, North East of Iran, 2009–2010. J Arthropod Borne Dis. 2015; 9:184-194.
  • Asawakarn S, Sirisawadi S, Kunnasut N, Kamkong P, Taweethavonsawat P. Serum protein profiles and C-reactive protein in natural canine filariasis. Vet World. 2021; 14(4):860.
  • Asawapattanakul T, Pintapagung T, Piratae S, Juntautsa S, Chancharoen P. Erythrocyte sedimentation rate, C-reactive protein, and interleukin-6 as inflammatory biomarkers in dogs naturally infected with Ehrlichia canis. Vet World. 2021; 14(9):2325-2331.
  • Ayan A, Orunc Kilinc O, Erdogan S, Akyildiz G, Bia MM, Lee D. High prevalence of Ehrlichia canis in dogs in Van, Turkey. Appl Ecol Env Res. 2020; 18:1953-1960.
  • Bassetti M, Russo A, Righi E, Dolso E, Merelli M, D'Aurizio F, Sartor A, Curcio F. Role of procalcitonin in bacteremic patients and its potential use in predicting infection etiology. Expert Rev Anti Infect Ther. 2019; 17:99-105.
  • Battaglia F, Meucci V, Tognetti R, Bonelli F, Sgorbini M, Lubas G, retti C, Intorre L. Procalcitonin Detection in Veterinary Species: Investigation of Commercial ELISA Kits. Animals. 2020; 10:1511.
  • Bhadesiya CM, Raval SK. Hematobiochemical changes in ehrlichiosis in dogs of Anand region, Gujarat. Vet World. 2015; 8:713-717.
  • Cerón JJ, Martínez-Subiela S. An automated spectrophotometric method for measuring canine ceruloplasmin in serum. Vet Res. 2004; 35:671-679.
  • Cho JG, Oh YI, Song KH, Seo KW. Evaluation and comparison of serum procalcitonin and heparin-binding protein levels as biomarkers of bacterial infection in cats. J Feline Med Surg. 2021; 23(4):370-374.
  • Chomel B. Tick-borne infections in dogs-an emerging infectious threat. Vet Parasitol. 2011; 179:294-301.
  • Cray C, Zaias J, Altman NH. Acute phase response in animals: a review. Comp Med. 2009; 59:517-526.
  • de Castro MB, Machado RZ, de Aquino LP, Alessi AC, Costa MT. Experimental acute canine monocytic Ehrlichiosis: clinicopathological and immunopathological findings. Vet Parasitol. 2004; 119:73-86.
  • Duzlu O, Inci A, Yildirim A, Onder Z, Ciloglu A. The investigation of some tick-borne protozoon and rickettsial infections in dogs by Real Time PCR and the molecular characterisations of the detected isolates. Ankara Univ Vet Fak Derg. 2014; 61 275-282.
  • Easley F, Holowaychuk MK, Lashnits EW, Nordone SK, Marr H, Birkenheuer AJ. Serum procalcitonin concentrations in dogs with induced endotoxemia. J Vet Intern Med. 2020; 34:653-658.
  • Fonseca JP, Bruhn FRP, Ribeiro MJM, Hirsch C, Rocha CMBM, Guedes E, Guimarães AM. Haematological Parameters and Seroprevalence of Ehrlichia canis and Babesia vogeli in Dogs. Ciênc Anim Bras. 2017; 18:1-9.
  • Goggs R, Milloway M, Troia R, Giunti M. Plasma procalcitonin concentrations are increased in dogs with sepsis. Vet Rec Open. 2018; 5(1):e000255. Harrus S, Waner T: Diagnosis of canine monocytotropic Ehrlichiosis (Ehrlichia canis): an overview. Vet J 2011, 187:292-296. Jaheen AH, Kubesy AA, Rakha GM, Salem SI, El-Sherif MA. Diagnostic value of procalcitonin, C-reactive protein, and leukocyte count in canine Ehrlichiosis and canine demodicosis. Comp Clin Pathol. 2022; 1-8.
  • Karnezi D, Ceron JJ, Theodorou K, Leontides L, Siarkou VI, Martinez S, varijonaviciute A, Harrus S, Koutinas CK, Pardali D, Mylonakis ME. Acute phase protein and antioxidant responses in dogs with experimental acute monocytic Ehrlichiosis treated with rifampicin. Vet Microbiol. 2016; 184:59-63.
  • Liu HH, Guo JB, Geng Y, Su L. Procalcitonin: present and future. Ir J Med Sci. 2015; 184:597- 605.
  • Maggi RG, Krämer F. A review on the occurrence of companion vector-borne diseases in pet animals in Latin America. Parasit Vectors. 2019;12:145.
  • Matur E, Dokuzeylül B, Özcan M, Çetinkaya H, Arslan M, Or E, Erhan S, Çötelioğlu Ü. Can procalcitonin be used as a clinical biomarker during bacterial, viral and parasitic infections in dogs?. Jpn J Vet Res. 2021; 69:5-17.
  • Meisner M. Update on procalcitonin measurements. Ann Lab Med. 2014; 34:263-273.
  • Moonarmart W, Sungpradit S, Rawangchue T, Suphaphiphat K, Suksusieng S, Jirapattharasate C. Clinical history and haematological findings among canines with monocytic Ehrlichiosis. Southeast Asian J Trop Med Public Health. 2014; 45:157-166.
  • Munhoz TD, Faria JLM, Vargas-Hérnandez G, Fagliari JJ, Santana ÁE, Machado RZ, Tinucci-Costa M. Experimental Ehrlichia canis infection changes acute-phase proteins. Rev Bras Parasitol Vet. 2012; 21(3):206-212.
  • Murata H, Shimada N, Yoshioka M. Current research on acute phase proteins in veterinary diagnosis: an overview. Vet J. 2004; 168:28-40.
  • Mylonakis ME, Ceron JJ, Leontides L, Siarkou VI, Martinez S, Tvarijonaviciute A, Koutinas AF, Harrus S. Serum acute phase proteins as clinical phase indicators and outcome predictors in naturally occurring canine monocytic Ehrlichiosis. J Vet Intern Med. 2011; 25:811-817.
  • Mylonakis ME, Harrus S, Breitschwerdt EB. An update on the treatment of canine monocytic Ehrlichiosis (Ehrlichia canis). Vet J. 2019; 246:45-53.
  • Nakamura M, Kono R, Nomura S, Utsunomiya H. Procalcitonin: mysterious protein in sepsis. J Basic Clin Med. 2013; 2(1):7-11.
  • Nakamura M, Takahashi M, Ohno K, Koshino A, Nakashima K, Setoguchi A, Fujino Y, Tsujimoto H. C-reactive protein concentration in dogs with various diseases. J Vet Med Sci. 2008; 70(2):127-131.
  • Pardo-Marin L, Ceron JJ, Tecles F, Baneth G, Martínez-Subiela S. Comparison of acute phase proteins in different clinical classification systems for canine leishmaniosis. Vet Immunol Immunopathol. 2020; 219:109958.
  • Reitman AJ, Pisk RM, Gates JV, Ozeran JD. Serial procalcitonin levels to detect bacteremia in febrile neutropenia. Clin pediatr. 2012; 51(12):1175-1183.
  • Rikihisa Y, Yamamoto S, Kwak I, Iqbal Z, Kociba G, Mott J, Chichanasiriwithaya W. C-reactive protein and alpha 1-acid glycoprotein levels in dogs infected with Ehrlichia canis. J Clin M icrobiol. 1994; 32(4):912-917.
  • Schmidt EMS, Eckersall PD. Acute phase proteins as markers of infectious diseases in small animals. Acta Veterinaria. 2015; 65:149-161.
  • Schuetz P, Briel M, Christ-Crain M, Stolz D, Bouadma L, Wolff M, Luyt CE, Chastre J, Tubach F, Kristoffersen KB, Wei L, Burkhardt O, Welte T, Schroeder S, Nobre V, Tamm M, Bhatnagar N, Bucher HC, Mueller B. Procalcitonin to guide initiation and duration of antibiotic treatment in acute respiratory infections: an individual patient data meta-analysis. Clin Infect Dis. 2012; 55(5):651-662.
  • Schuetz P, Daniels LB, Kulkarni P, Anker SD, Mueller B. Procalcitonin: A new biomarker for the cardiologist. Int J Cardiol. 2016; 223:390-397.
  • Seo M, Lee H, Song R, Park C, Park J. Evaluating of serum procalcitonin as a biomarker in patients with inflammatory disease. Korean Soc Vet Clin Med. 2015; 32:56-57.
  • Shimada T, Ishida, Y, Shimizu M, Nomura M, Kawato K, Iguchi K, Jinbo T. Monitoring C-reactive protein in beagle dogs experimentally inoculated with Ehrlichia canis. Vet Res Commun. 2002; 26(3):171-177.
  • Singh J, Srivastava M, Gupta K, Sudan V, Srivastava A, Sharma B. Alteration in Serum Concentration of Canine C-Reactive Protein (CRP) Associated with Canine Monocytic Ehrlichiosis (CME) and its Amelioration by Conventional Treatment. J Anim Res. 2021; 11(4):611-617.
  • Sitar ME, Ipek BO, Karadeniz A. Procalcitonin in the diagnosis of sepsis and correlations with upcoming novel diagnostic markers. Int J Med Biochem. 2019; 2(3):132-140.
  • Sunderman FW, Numato S. Measurement of human serum ceruloplasmin by its p-phenylene diamine oxidase activity. Clin Chem. 1970; 16:903-910.
  • Waritani T, Cutler D, Chang J. Development of canine C-reactive protein assays. Acta Vet Scand. 2020; 62:50. Yılmaz Z, Ilcol YO, Ulus IH. Endotoxin increases plasma leptin and ghrelin levels in dogs. Crit Care Med. 2008; 36:828-833.

Serum C-Reactive Protein, Procalcitonin and Ceruloplasmin Concentrations in Dogs with Naturally İnfected Ehrlichiosis

Year 2023, , 174 - 181, 30.06.2023
https://doi.org/10.30607/kvj.1238703

Abstract

This study aimed to evaluate the concentrations of C-reactive protein (CRP), Procalcitonin (PCT), and ceruloplasmin (Cp), which are potential biochemical markers of the inflammatory process in dogs naturally infected with Ehrlichiosis. A total of 20 dogs, 8 clinically healthy (Healthy group) and 12 mono-infected with Ehrlichia spp. (Ehrlichia group) were included in the study. Dogs in the Ehrlichia group were selected from those showing clinical signs of active infection, and their diseases were diagnosed with commercial test kits. Serum CRP and PCT levels were analysed by commercially available test kits, and Cp concentration was determined by colourimetric methods. The CRP concentration in the Ehrlichia group was significantly higher compared to the healthy group. There was no significant difference between the groups in serum PCT and Cp concentrations. As a result, the increase in serum CRP concentration can be used for detecting inflammatory processes in dogs with Ehrlichiosis. In addition, this study showed that PCT and Cp concentrations are not clinically useful markers for determining inflammatory status in dogs with Ehrlichiosis.

References

  • Abiramalatha T, Santhanam S, Mammen JJ, Rebekah G, Shabeer MP, Choudhury J, Nair SC. Utility of neutrophil volume conductivity scatter (VCS) parameter changes as sepsis screen in neonates. J Perinatol. 2016; 36(9):733-738.
  • Aktas M, Özübek S. Genetic diversity of Ehrlichia canis in dogs from Turkey inferred by TRP36 sequence analysis and phylogeny. Comp Immunol Microbiol Infec Dis. 2019; 64:20-24.
  • Ansari-Mood M, Khoshnegah J, Mohri M, Rajaei S. Seroprevalence and risk factors of Ehrlichia canis ınfection among companion dogs of Mashhad, North East of Iran, 2009–2010. J Arthropod Borne Dis. 2015; 9:184-194.
  • Asawakarn S, Sirisawadi S, Kunnasut N, Kamkong P, Taweethavonsawat P. Serum protein profiles and C-reactive protein in natural canine filariasis. Vet World. 2021; 14(4):860.
  • Asawapattanakul T, Pintapagung T, Piratae S, Juntautsa S, Chancharoen P. Erythrocyte sedimentation rate, C-reactive protein, and interleukin-6 as inflammatory biomarkers in dogs naturally infected with Ehrlichia canis. Vet World. 2021; 14(9):2325-2331.
  • Ayan A, Orunc Kilinc O, Erdogan S, Akyildiz G, Bia MM, Lee D. High prevalence of Ehrlichia canis in dogs in Van, Turkey. Appl Ecol Env Res. 2020; 18:1953-1960.
  • Bassetti M, Russo A, Righi E, Dolso E, Merelli M, D'Aurizio F, Sartor A, Curcio F. Role of procalcitonin in bacteremic patients and its potential use in predicting infection etiology. Expert Rev Anti Infect Ther. 2019; 17:99-105.
  • Battaglia F, Meucci V, Tognetti R, Bonelli F, Sgorbini M, Lubas G, retti C, Intorre L. Procalcitonin Detection in Veterinary Species: Investigation of Commercial ELISA Kits. Animals. 2020; 10:1511.
  • Bhadesiya CM, Raval SK. Hematobiochemical changes in ehrlichiosis in dogs of Anand region, Gujarat. Vet World. 2015; 8:713-717.
  • Cerón JJ, Martínez-Subiela S. An automated spectrophotometric method for measuring canine ceruloplasmin in serum. Vet Res. 2004; 35:671-679.
  • Cho JG, Oh YI, Song KH, Seo KW. Evaluation and comparison of serum procalcitonin and heparin-binding protein levels as biomarkers of bacterial infection in cats. J Feline Med Surg. 2021; 23(4):370-374.
  • Chomel B. Tick-borne infections in dogs-an emerging infectious threat. Vet Parasitol. 2011; 179:294-301.
  • Cray C, Zaias J, Altman NH. Acute phase response in animals: a review. Comp Med. 2009; 59:517-526.
  • de Castro MB, Machado RZ, de Aquino LP, Alessi AC, Costa MT. Experimental acute canine monocytic Ehrlichiosis: clinicopathological and immunopathological findings. Vet Parasitol. 2004; 119:73-86.
  • Duzlu O, Inci A, Yildirim A, Onder Z, Ciloglu A. The investigation of some tick-borne protozoon and rickettsial infections in dogs by Real Time PCR and the molecular characterisations of the detected isolates. Ankara Univ Vet Fak Derg. 2014; 61 275-282.
  • Easley F, Holowaychuk MK, Lashnits EW, Nordone SK, Marr H, Birkenheuer AJ. Serum procalcitonin concentrations in dogs with induced endotoxemia. J Vet Intern Med. 2020; 34:653-658.
  • Fonseca JP, Bruhn FRP, Ribeiro MJM, Hirsch C, Rocha CMBM, Guedes E, Guimarães AM. Haematological Parameters and Seroprevalence of Ehrlichia canis and Babesia vogeli in Dogs. Ciênc Anim Bras. 2017; 18:1-9.
  • Goggs R, Milloway M, Troia R, Giunti M. Plasma procalcitonin concentrations are increased in dogs with sepsis. Vet Rec Open. 2018; 5(1):e000255. Harrus S, Waner T: Diagnosis of canine monocytotropic Ehrlichiosis (Ehrlichia canis): an overview. Vet J 2011, 187:292-296. Jaheen AH, Kubesy AA, Rakha GM, Salem SI, El-Sherif MA. Diagnostic value of procalcitonin, C-reactive protein, and leukocyte count in canine Ehrlichiosis and canine demodicosis. Comp Clin Pathol. 2022; 1-8.
  • Karnezi D, Ceron JJ, Theodorou K, Leontides L, Siarkou VI, Martinez S, varijonaviciute A, Harrus S, Koutinas CK, Pardali D, Mylonakis ME. Acute phase protein and antioxidant responses in dogs with experimental acute monocytic Ehrlichiosis treated with rifampicin. Vet Microbiol. 2016; 184:59-63.
  • Liu HH, Guo JB, Geng Y, Su L. Procalcitonin: present and future. Ir J Med Sci. 2015; 184:597- 605.
  • Maggi RG, Krämer F. A review on the occurrence of companion vector-borne diseases in pet animals in Latin America. Parasit Vectors. 2019;12:145.
  • Matur E, Dokuzeylül B, Özcan M, Çetinkaya H, Arslan M, Or E, Erhan S, Çötelioğlu Ü. Can procalcitonin be used as a clinical biomarker during bacterial, viral and parasitic infections in dogs?. Jpn J Vet Res. 2021; 69:5-17.
  • Meisner M. Update on procalcitonin measurements. Ann Lab Med. 2014; 34:263-273.
  • Moonarmart W, Sungpradit S, Rawangchue T, Suphaphiphat K, Suksusieng S, Jirapattharasate C. Clinical history and haematological findings among canines with monocytic Ehrlichiosis. Southeast Asian J Trop Med Public Health. 2014; 45:157-166.
  • Munhoz TD, Faria JLM, Vargas-Hérnandez G, Fagliari JJ, Santana ÁE, Machado RZ, Tinucci-Costa M. Experimental Ehrlichia canis infection changes acute-phase proteins. Rev Bras Parasitol Vet. 2012; 21(3):206-212.
  • Murata H, Shimada N, Yoshioka M. Current research on acute phase proteins in veterinary diagnosis: an overview. Vet J. 2004; 168:28-40.
  • Mylonakis ME, Ceron JJ, Leontides L, Siarkou VI, Martinez S, Tvarijonaviciute A, Koutinas AF, Harrus S. Serum acute phase proteins as clinical phase indicators and outcome predictors in naturally occurring canine monocytic Ehrlichiosis. J Vet Intern Med. 2011; 25:811-817.
  • Mylonakis ME, Harrus S, Breitschwerdt EB. An update on the treatment of canine monocytic Ehrlichiosis (Ehrlichia canis). Vet J. 2019; 246:45-53.
  • Nakamura M, Kono R, Nomura S, Utsunomiya H. Procalcitonin: mysterious protein in sepsis. J Basic Clin Med. 2013; 2(1):7-11.
  • Nakamura M, Takahashi M, Ohno K, Koshino A, Nakashima K, Setoguchi A, Fujino Y, Tsujimoto H. C-reactive protein concentration in dogs with various diseases. J Vet Med Sci. 2008; 70(2):127-131.
  • Pardo-Marin L, Ceron JJ, Tecles F, Baneth G, Martínez-Subiela S. Comparison of acute phase proteins in different clinical classification systems for canine leishmaniosis. Vet Immunol Immunopathol. 2020; 219:109958.
  • Reitman AJ, Pisk RM, Gates JV, Ozeran JD. Serial procalcitonin levels to detect bacteremia in febrile neutropenia. Clin pediatr. 2012; 51(12):1175-1183.
  • Rikihisa Y, Yamamoto S, Kwak I, Iqbal Z, Kociba G, Mott J, Chichanasiriwithaya W. C-reactive protein and alpha 1-acid glycoprotein levels in dogs infected with Ehrlichia canis. J Clin M icrobiol. 1994; 32(4):912-917.
  • Schmidt EMS, Eckersall PD. Acute phase proteins as markers of infectious diseases in small animals. Acta Veterinaria. 2015; 65:149-161.
  • Schuetz P, Briel M, Christ-Crain M, Stolz D, Bouadma L, Wolff M, Luyt CE, Chastre J, Tubach F, Kristoffersen KB, Wei L, Burkhardt O, Welte T, Schroeder S, Nobre V, Tamm M, Bhatnagar N, Bucher HC, Mueller B. Procalcitonin to guide initiation and duration of antibiotic treatment in acute respiratory infections: an individual patient data meta-analysis. Clin Infect Dis. 2012; 55(5):651-662.
  • Schuetz P, Daniels LB, Kulkarni P, Anker SD, Mueller B. Procalcitonin: A new biomarker for the cardiologist. Int J Cardiol. 2016; 223:390-397.
  • Seo M, Lee H, Song R, Park C, Park J. Evaluating of serum procalcitonin as a biomarker in patients with inflammatory disease. Korean Soc Vet Clin Med. 2015; 32:56-57.
  • Shimada T, Ishida, Y, Shimizu M, Nomura M, Kawato K, Iguchi K, Jinbo T. Monitoring C-reactive protein in beagle dogs experimentally inoculated with Ehrlichia canis. Vet Res Commun. 2002; 26(3):171-177.
  • Singh J, Srivastava M, Gupta K, Sudan V, Srivastava A, Sharma B. Alteration in Serum Concentration of Canine C-Reactive Protein (CRP) Associated with Canine Monocytic Ehrlichiosis (CME) and its Amelioration by Conventional Treatment. J Anim Res. 2021; 11(4):611-617.
  • Sitar ME, Ipek BO, Karadeniz A. Procalcitonin in the diagnosis of sepsis and correlations with upcoming novel diagnostic markers. Int J Med Biochem. 2019; 2(3):132-140.
  • Sunderman FW, Numato S. Measurement of human serum ceruloplasmin by its p-phenylene diamine oxidase activity. Clin Chem. 1970; 16:903-910.
  • Waritani T, Cutler D, Chang J. Development of canine C-reactive protein assays. Acta Vet Scand. 2020; 62:50. Yılmaz Z, Ilcol YO, Ulus IH. Endotoxin increases plasma leptin and ghrelin levels in dogs. Crit Care Med. 2008; 36:828-833.
There are 42 citations in total.

Details

Primary Language English
Subjects Veterinary Sciences
Journal Section RESEARCH ARTICLE
Authors

Gülten Emek Tuna 0000-0002-9729-8813

Gamze Sevri Ekren Aşıcı 0000-0002-9625-7956

Pınar Alkım Ulutaş 0000-0002-2447-3027

Early Pub Date May 29, 2023
Publication Date June 30, 2023
Acceptance Date May 17, 2023
Published in Issue Year 2023

Cite

APA Tuna, G. E., Ekren Aşıcı, G. S., & Ulutaş, P. A. (2023). Serum C-Reactive Protein, Procalcitonin and Ceruloplasmin Concentrations in Dogs with Naturally İnfected Ehrlichiosis. Kocatepe Veterinary Journal, 16(2), 174-181. https://doi.org/10.30607/kvj.1238703
AMA Tuna GE, Ekren Aşıcı GS, Ulutaş PA. Serum C-Reactive Protein, Procalcitonin and Ceruloplasmin Concentrations in Dogs with Naturally İnfected Ehrlichiosis. kvj. June 2023;16(2):174-181. doi:10.30607/kvj.1238703
Chicago Tuna, Gülten Emek, Gamze Sevri Ekren Aşıcı, and Pınar Alkım Ulutaş. “Serum C-Reactive Protein, Procalcitonin and Ceruloplasmin Concentrations in Dogs With Naturally İnfected Ehrlichiosis”. Kocatepe Veterinary Journal 16, no. 2 (June 2023): 174-81. https://doi.org/10.30607/kvj.1238703.
EndNote Tuna GE, Ekren Aşıcı GS, Ulutaş PA (June 1, 2023) Serum C-Reactive Protein, Procalcitonin and Ceruloplasmin Concentrations in Dogs with Naturally İnfected Ehrlichiosis. Kocatepe Veterinary Journal 16 2 174–181.
IEEE G. E. Tuna, G. S. Ekren Aşıcı, and P. A. Ulutaş, “Serum C-Reactive Protein, Procalcitonin and Ceruloplasmin Concentrations in Dogs with Naturally İnfected Ehrlichiosis”, kvj, vol. 16, no. 2, pp. 174–181, 2023, doi: 10.30607/kvj.1238703.
ISNAD Tuna, Gülten Emek et al. “Serum C-Reactive Protein, Procalcitonin and Ceruloplasmin Concentrations in Dogs With Naturally İnfected Ehrlichiosis”. Kocatepe Veterinary Journal 16/2 (June 2023), 174-181. https://doi.org/10.30607/kvj.1238703.
JAMA Tuna GE, Ekren Aşıcı GS, Ulutaş PA. Serum C-Reactive Protein, Procalcitonin and Ceruloplasmin Concentrations in Dogs with Naturally İnfected Ehrlichiosis. kvj. 2023;16:174–181.
MLA Tuna, Gülten Emek et al. “Serum C-Reactive Protein, Procalcitonin and Ceruloplasmin Concentrations in Dogs With Naturally İnfected Ehrlichiosis”. Kocatepe Veterinary Journal, vol. 16, no. 2, 2023, pp. 174-81, doi:10.30607/kvj.1238703.
Vancouver Tuna GE, Ekren Aşıcı GS, Ulutaş PA. Serum C-Reactive Protein, Procalcitonin and Ceruloplasmin Concentrations in Dogs with Naturally İnfected Ehrlichiosis. kvj. 2023;16(2):174-81.

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