Rapid loss of condition and dark urine are the most common signs first noticed. There is fever, anaemia, jaundice, brown urine from excreted liver pigments in anaplasmosis, red or black urine from haemoglobinuria in babesiosis, and often deaths. Nervous signs commonly occur with
Babesia bovis resulting from parasitised red blood cells blocking capillaries in the brain.
Necropsy findings include thin watery blood, jaundice (yellowing of normally white tissues), enlarged spleen with a cut surface resembling raspberry jam, enlarged and yellow-brown liver, and the gall bladder is distended with thick black bile. Urine in the bladder is dark.
Laboratory confirmation in live animals requires unclotted blood in ethylenediamine tetraacetic acid (EDTA) tubes submitted chilled for haematology and parasitology, and thin and thick air dried blood smears for parasitology. Dead animals additionally require impression smears from organs including the kidney, liver, spleen and brain (cerebral cortex) for parasitology. Sections of brain, kidney, liver, heart and spleen may also be submitted chilled for parasitology and in buffered formalin for histology.
Differential diagnoses include anthrax (where there is sudden death and an enlarged spleen), haemonchosis (where there is profound anaemia), and lead poisoning (where there are nervous signs and death).