Jasper's Canine Tick-Borne Disease Information Page

in loving memory of

U-CDX Aurum's Vintage Dubl Trouble

UDX TDX JH WC CGC

"Jasper"

Who taught us that sometimes you CAN beat the odds.

Introduction & Disclaimer

For most dog owners who have become informed about tick-borne disease in dogs, it was not something done out of choice. It was a matter of necessity thrust on us because our dogs were dying and our veterinarians lacked the information needed to find diagnoses and appropriate treatment plans. Out of desperation we reached out and sought answers, however and wherever we could find them.

If you are reading this, it is likely you are in the same position. Know that you are not alone and others have walked this same path before you. Know that there is help available, but you must search and reach for it. Know that you are your dog's best hope right now -- no one else in this world is going to fight as hard for your dog's life as you will. You will need a partner as you fight to restore your dog's health -- that partner should be your veterinarian. You are going to need either a veterinarian with experience in successfully treating tick-borne disease, OR you are going to need an open-minded veterinarian willing to admit when they don't have answers, willing to listen, willing to seriously consider the information that you can bring them, willing to make contact and accept advice from more experienced vets to get the information needed to help your dog. If your current vet does not meet these criteria, you may need to find a new one. This is not the time to worry about hurting your veterinarian's feelings by seeking help elsewhere; your most important obligation right now is to your DOG.

I am not a veterinarian! I am a dog trainer; although for 16 years, prior to trading the world of academia for the world of dogs, I worked as a research scientist at University of Houston. I hold a PhD in Geology from Stanford University, geochemistry and mineralogy being my specialties. One thing my education and professional work taught me was how to research a topic, find accurate material on the subject, and how to understand what I was reading -- skills that became of utmost importance when one day my dog was sick and dying and the veterinary profession could offer no help in diagnosis or treatment.

The contents of this site reflect the accumulated knowledge I have acquired in my journey to diagnose my dogs and get them well again. It was not a journey taken alone, although at times it felt that way. I am deeply indebted to a few people who provided important clues to the puzzle I sought to solve: veterinary technician & friend Lisa Ducher who first suggested my dog might have Ehrlichia; Dr. Jane Biggerstaff for sharing her knowledge of tick-borne disease especially Neorickettsia (Ehrlichia) risticii; Terri Lee for having the determination to keep searching for a vet who could help Chester and for finally finding Dr. B.; and last but never least, Dr. Kelly McIntyre for hanging in there and working with me even when skeptical about it all.

PLEASE NOTE -- Due to the prevalence of tick-borne disease (TBD) in dogs and the large number of e-mail inquiries I receive as a result of this web page, I regret that I am unable to return e-mail queries. Just about everything I know about TBD in dogs is contained in this page. I am not a veterinarian and am not qualified by law to dispense veterinary advice. If you can not find the answers to your questions here, then either those answers do not exist or I surely won't have them for you -- instead try having your veterinarian contact one of the experts such as Dr. Kakoma at University of Illinois or Dr. Holland at Protatek Labs. Their contact info is given below. Sincerely, Anne McGuire



What tick-borne (& related) diseases can infect dogs in the United States?

There are numerous vector-borne diseases that can infect dogs in the United States. While ticks are one of the most common vectors, some of these diseases may also be spread via mosquito or flea bite. One group of rickettsial organisms (Neorickettsia) are spread via ingestion. All of these organisms produce similar illness in dogs. All are intracellular -- they get into and survive inside the dog's blood cells. Most are bacteria, but several are protozoa. Dogs may be multiply-infected; having more than one of these organisms. A single tick bite may transmit multiple species. Infection does not confer lasting immunity, dogs can easily become re-infected.

genus Ehrlichia Babesia Rickettsia Borrelia Neorickettsia species known to infect dogs E. canis

E. platys

E. chaffeensis

E. ewingii

Anaplasma phagocytophila

(formerly E. equi) B. canis

B. gibsoni plus one or more as yet unnamed species of "small" Babesia R. rickettsii B. burgdorferi N. helminthoeca

N. (Ehrlichia) risticii causes this disease: ehrlichiosis babesiosis Rocky Mountain Spotted Fever Lyme Disease N. helminthoeca ... -- Salmon poisoning N. risticii -- causes Potomac Horse Fever; in dogs illness is similar to ehrlichiosis

In addition, Leishmania , Bartonella sp., and Hepatozoon canis are now known to infect dogs in the USA. These are vector-borne organisms, and may produce symptoms similar to the above tick-borne organisms.



Effects of tick-borne disease on the canine immune system

The tick-borne diseases are caused by intracellular organisms, that is organisms that reside inside of cells in the animals they infect. Most are hemoparasites, inhabiting blood cells. Several can inhabit several different kinds of cells including those other than blood cells.

For whatever reason, perhaps their ability hide within the hosts cells, these organisms have profound effects on the immune systems of their host. They seem to cause immune system dysfunction, and often appear to suppress the hosts immune system at the same time they are triggering autoimmune reactions. Immune system depression manifests as lack of antibodies and vulnerability of the infected animal to secondary infections.

Autoimmune reactions are the hallmark of tick-borne disease. There may be autoimmune destruction of blood cells or blood cell progenitors in the bone marrow. Joints are inflamed and swollen and fluid tapped from affected joints has all the characteristics of autoimmune poly arthritis. Affected dogs may suffer from autoimmune disorders such as inflammatory bowel syndrome, myositis, and uveitis. Many affected dogs are reported to suffer from skin "allergies", another indication of immune system dysfunction.



What are the early symptoms?

Rickettsial infections go through three stages: acute, sub-clinical, and chronic.

The acute stage occurs within a few weeks of infection. Dogs may appear to be suffering from “flu,” exhibiting low energy, lack of appetite, fever, swollen lymph nodes, and even nasal discharge. Other manifestations may include, but are not limited to:

low platelet count

slight anemia

swollen lymph nodes

photosensitive eyes

discharge from the eyes

cough

lameness, joint pain and swelling

recurrent diarrhea

vomiting bile

unexplained weight loss and/or loss of muscle mass

increased water consumption

Neurological symptoms may also be seen, including (but not limited to) seizures.

Blood work may reveal elevated liver enzymes and low total blood protein levels. Low platelets are a hallmark of ehrlichiosis, however extremely high red cell, white cell, or platelet counts have also been reported. Hemolytic anemia is a hallmark of babesiosis, but may occur with other tick-borne diseases. Not all dogs with ehrlichiosis will have low platelets; not all dogs with babesiosis will have anemia. Infected dogs with any of these diseases may have normal CBC values.

Dogs with babesiosis may be vulnerable to hypoglycemia. Any dog diagnosed with babesiosis, should have blood sugar levels checked as hypoglycemia concurrent with babesiosis worsens the prognosis for recovery (Keller et al., 2004).

Most infected dogs will have more than one, but not all of these signs of infection. During the acute phase the symptoms may be severe or may be so mild as to go unnoticed.



Can a dog be infected, but have no symptoms?

Yes. Acute stage symptoms may be so mild that symptoms are not recognizable. Following the acute stage of infection, untreated dogs may enter a sub-clinical stage . In this stage the dog is asymptomatic and appears healthy. The sub-clinical stage can last for weeks or years. If a dog has a strong immune system, it may be able to keep the organisms in check, thus maintaining a sub-clinical state for quite a long time. Eventually the dog may experience stress that weakens the immune system enough that the infection becomes active again, and the dog enters a chronic stage of infection.



What are the chronic stage symptoms?

In chronic stage infections, the organism may penetrate brain and central nervous system tissues, internal organs (liver, spleen, kidneys), reproductive organs (uterus or testes) and bone marrow. A tremendous number of symptoms are possible, making accurate diagnosis difficult. Symptoms and signs are serious and may be life-threatening including:

Chronic Stage Symptoms severe anemia

low platelets (thrombocytopenia)

low white cells

bone marrow failure

muscle wasting / weight loss

kidney failure

liver failure

enlarged spleen and/or liver

cardiac damage

autoimmune disorders

abnormal thyroid function

seizures & other neurological disorders

meningitis-like illness

uveitis

severe non-regenerative anemia and thrombocytopenia (i.e. low platelets), seizures, muscle wasting, kidney failure, enlargement of the spleen, cardiac abnormalities, and bone marrow hypoplasia. Neurological symptoms have been documented for almost all rickettsia species. Many of these infections can trigger a wide array of autoimmune processes in the body: autoimmune facial paralysis, immune-mediated polyarthritis, inflammatory bowel syndromes, chronic ear and skin infections and “allergies”. Thyroid hormone and thyroid auto-antibody levels may be abnormal. There is anecdotal evidence to suggest these infections may be responsible for a variety of reproductive disorders including sterility, abnormal heat cycles, and resorbtion of litters. There is no scientific proof as yet, however a number of dog owners and veterinarians who have direct experience with rickettsial infections suspect that they may have the potential to trigger the development of lymphosarcoma. Ehrlichia canis has been associated with meningitis and uveitis in dogs (Panciera at al., 2001, Massa et al., 2002), and Leishmania has been associated with uveitis (Pena at al., 2000).

Tick-borne infections are commonly misdiagnosed. Symptoms may be very similar to blastomycosis and Valley Fever. Tick-borne infections may be misdiagnosed as lupus, lymphosarcoma, leukemia, autoimmune hemolytic anemia, epilepsy, myositis, brucellosis, inflammatory bowel disease, encephalitis and “autoimmune disease.”



What you should know about tests for tick-borne diseases

There are two major types of tests available for tick-borne diseases: direct tests such as PCR testing look for direct evidence of the presence of the organism itself, whereas indirect tests such IFA titer, ELISA and Western blot tests look for the presence of antibodies against a particular organism.

Indirect Testing Methods

Indirect antibody tests are most commonly used as they are more easily available from commercial testing laboratories and are less expensive. These tests analyze for the presence of antibodies against specific organisms. High levels of antibodies are believed to indicate active infection. The problem is how to interpret negative or low level positive results. A negative result is generally interpreted to mean the dog is not infected, although it could also mean the dog's body simply has mounted no immune defense against the infecting organism. Low levels of antibodies may indicate a poor immune response against an active infection, or past exposure to the organism but no active infection.

Since antibodies may persist in the bloodstream for months or years following an infection, the presence of antibodies is not unequivocal evidence of active infection. The tick-borne organisms are notorious for causing immunosuppression and there is anecdotal evidence that infected dogs may have low or zero antibody levels. Low antibody levels or negative antibody test results are not conclusive evidence for lack of infection.

One probable reason for negative test results for dogs whose symptoms strongly suggest tick-borne disease is that the dog was not tested for the right species. Antibody tests are very specific for the exact species of tick-borne organism. Only a few species create "cross-over" problems, where antibodies from one species cause a false positive reading when testing for a different species. Typical test "panels" only test for a few species of the many tick-borne organisms that may infect dogs.

IFA (indirect fluorescence assay) titers are the most reliable type of titer test to run for tick-borne diseases. IFA tests analyze for the presence of antibodies. Results are reported as a ratio, indicating how far the sample could be diluted and still have a positive reading for the presence of antibodies. The higher the ratio, the greater the abundance of antibody in the dog's blood. Tests are specific for the exact species. IFA tests are available for almost all species of tick-borne organisms that infect dogs, and are available from a great many commercial laboratories. As with all testing, it is important to use a reputable laboratory that uses careful lab procedures and quality control.

Veterinarians now have available to them a simple in-house test kit that tests for Borrelia burgdorferi (Lyme Disease), Ehrlichia canis, and canine heartworm, all in the same test kit. These test use the ELISA antibody testing method. They are fast and inexpensive, but not 100% reliable for Borrelia and Ehrlichia. (the heartworm part of the test appears to be reliable) The test is called the SNAP 3Dx. A positive reading on the SNAP test for Lyme Disease or E. canis should be considered accurate. A negative reading does not necessarily mean the dog is free of those infections. E. canis is the only Ehrlichia species tested for on this test, and dogs can be infected by many other Ehrlichia species.

The SNAP 3Dx test can not distinguish between Borrelia antibodies caused by natural infection versus those produced by the Lyme Disease vaccine. For that determination a Western Blot test must be run. Many vets will recommend running a Western Blot test to confirm a diagnosis of Lyme Disease detected on the in-house SNAP 3Dx test.

Direct Testing Methods

Blood smear slides can be examined by microscope to look for visible evidence of tick-borne organisms. Ehrlichia and Babesia can sometimes be detected in this manner. The problem is even at the height of active infection, the actual numbers of organisms in the infected animal are low. Sometimes several slides need to be examined in order to find just one organism. The absence of organisms on a blood smear is not proof for lack of infection. Visual blood smear inspections should be done by a technician with experience in detection of these intracellular parasites.

Blood smear slides should be made from blood transferred directly from the patient to the slide via a clean syringe, and NOT exposed to any anti-coagulants or other chemicals sometimes added to preserve whole blood samples.

PCR testing is a method that can detect the presence of DNA from a specific species of infecting organism. One advantage of PCR testing is that it can be done on tissues other than blood samples, enabling one to test for organisms that have left the blood stream and may be sequestered in other body tissues. I have had PCR testing for tick-borne organisms has been done on canine blood, bone marrow, spleen, and testicular samples. The PCR method extracts DNA from the sample, adds it to a "primer" that binds DNA that matches specific DNA sequences for the exact species of organism being tested for. This is then amplified to detectable levels and tested to verify the match to the species of interest. The method can detect extremely small quantities of DNA.

PCR testing is very specific to the exact species. PCR tests are available for most but not all species of tick-borne organisms known to infect dogs. At the time of this writing, PCR tests are not widely available from commercial laboratories. A number of research laboratories have developed PCR tests for tick-borne organisms and will run samples submitted from private veterinary clinics. PCR testing requires extremely precise lab procedure and careful equality control; use only a reputable lab with a well-established track record of running these tests.

PCR tests can produce false positive test results. Only a tiny bit of contamination of the sample can yield a false positive, hence the need for high quality lab work. PCR can not distinguish between DNA from a dead organism versus a living one, therefore dogs who have been recently treated and still have dead organisms in their bodies, may get positive test results even when treatment was successful. Follow-up PCR testing done after treatment should be delayed until 6-8 weeks following the end of treatment.

PCR testing can yield false negative results also. The tests are so species-specific, one must test for exactly the right organism. There must be some organisms present in the sample sent for testing. If the infecting organism has left the blood stream and is sequestered in bone marrow, spleen or other tissue, then a blood sample may PCR test negative even though the organism is still present in the dog's body.



Can a dog be exposed, but not infected?

In my personal experience: NO.

There is some controversy concerning whether one should treat or not treat dogs that test positive for tick-borne disease but appear asymptomatic. It has been my experience that if a dog has a positive titer for one of these diseases, no matter how low a level, that dog is infected. Symptoms may be so varied, so diverse, or so subtle that often owners are not aware that their dog IS symptomatic. Many dogs that appear perfectly normal but test positive, after treatment is started will perk up and display a notably higher energy level, and improved state of health indicating that they were in fact affected. Sometimes a symptom is serious and glaring, but the owner and veterinarian are unaware that this is a symptom of tick-borne disease.

Treatment

For most tick-borne diseases, doxycycline is the treatment of choice. My personal experience, and that of owners and vets I have communicated with who have successfully treated tick-borne disease, is that the dose needs to be high and the duration long.

I have used a dose of 5 mg per pound dog body weight, twice a day, for a minimum of 8 weeks. This is not a prescription or a recommendation; this is simply information about the dose I have used in the past. Please consult with your veterinarian to determine if doxycycline is appropriate for your dog and what dose to use.

Doxcycyline dosage

by dog body weight, as I have used it for treatment of tick-borne disease Dog's body weight gets this dose

TWICE a day Daily TOTAL intake of doxy 20 lb 100 mg 200 mg 40 lb 200 mg 400 mg 60 lb 300 mg 600 mg 80 lb 400 mg 800 mg

I give the doxcycyline at mealtime, giving the doxycycline first and then immediately feeding the dog its regular meal. One of the common adverse effects of high doses of doxycycline is esophageal irritation; one wants to get the doxycycline into the dog's stomach as quickly as possible. Giving with food helps greatly in reducing esophageal and stomach irritation. Sensitive dogs may be helped by taking Pepcid AC 30-60 minutes before taking their doxycycline. Try to keep the dog upright, sitting or standing or moving around, for 30 minutes after taking their doxycycline. To minimize esophageal irritation, give doxycycline tablets or capsules intact , never open the capsules or split tablets. High levels of calcium and magnesium taken at the same time, may lower the effectiveness of doxycycline; it should not be given with calcium-rich and/or magnesium-rich supplements (no Tums!), but is OK with normal foods including moderate amounts of dairy foods. Bismuth may also interfere with doxycycline up-take, so don't give Peptobismol within 2 hours of giving doxycycline!

[Hint for giving pills to dogs -- try wrapping them in Velveeta! Dogs love the taste but can't get the gooey Velveeta off the pill so they swallow the whole thing! A small amount of Velveeta or other cheese given with doxycycline will not inhibit its effectiveness.]

In extreme cases where dogs are too ill to take doxycycline by mouth or too sensitive to it, it can be given by IV. This must be under the supervision of a veterinarian and is not without risk. Lower amounts can be given than by mouth, yet can achieve a higher blood concentration of the antibiotic; but the dose must be administered very slowly to avoid causing cardiac arrest.

Babesia may or may not respond slightly to doxycycline treatment, but doxycycline will not cure it. Imizol (imidocarb dipropionate) is currently the drug of choice in the USA for treatment of Babesia infection. Imizol is given by injection. Injections are given 2 weeks apart, and at least 2 are required.

Imizol may be effective against some Ehrlichia species. Sometimes Imizol and doxycycline are used concurrently for treatment of ehrlichiosis.

Doxycycline is often the first line of attack against Lyme Disease, but there are other antibiotics that may work as well or better. Rocephin is sometimes used for dogs with Lyme Disease, and is particularly useful when there are neurological complications. (It is very expensive.) Borrelia burgdorferi can form cysts which are impervious to doxycycline but are killed by metronidazole (Flagyl). Some human Lyme Disease patients have benefited from concurrent treatment with both doxycycline and metronidazole; there is little published research to know if this is beneficial for canine Lyme Disease patients. Amoxicillin and chloramphenicol have both been used for treatment of Lyme Disease in dogs, but generally are regarded as not as effective as doxycycline. Chloramphenicol has an unfortunately adverse effect of causing permanent (fatal) bone marrow failure in some dogs (and humans) who take it; it is generally to be avoided unless there are no other options.

Prednisone -- to use or not to use?

Much has been written on other web sites admonishing against the use of prednisone for dogs with tick-borne disease. One needs to consider such advice with caution. Owners may attribute the death of their dog to use of prednisone, but in reality they can not know if that dog would have died regardless of whether prednisone was used or not.

In general, it is advisable to avoid use of steroids concurrently with antibiotics. Steroids may suppress the immune system, reducing its ability to work with antibiotics to kill the offending bacteria. This may be especially true when treating with doxycycline which requires the dog's immune system play an active role in killing the targeted bacteria. Many tick-borne infections are quite immunosuppressive, thus further immunosuppression by steroid use would not seem to be sensible.

On the other hand, many tick-borne diseases trigger a wide array of autoimmune problems in infected dogs. Once triggered, theses autoimmune processes do not simply stop when the infecting organism is killed by antibiotic therapy. Often it is necessary to use immunosuppressive therapy (steroids or other drugs) to address immune-mediated symptoms and return the immune system to normal function. For at least one of my dogs (see Jasper's Story below), use of high-dose immunosuppression may have saved his life.

Certainly, use of steroids for dogs with tick-borne disease should be a carefully considered decision. Dogs with tick-borne disease should be carefully and frequently monitored while on steroids. Common sense would suggest that steroids may be most safely used for these dogs in conjunction with antibiotics selected to target the infecting organism(s).

Diet Considerations

Attention to diet can aid in a dog's recovery from tick-borne disease. Patients recovering from severe anemia require nutritional building blocks for producing new red blood cells: high quality protein, iron, folic acid, B-complex vitamins, vitamin C. Tick-borne disease can cause muscle wasting, so patients can benefit from high quality, highly digestible, protein sources in the diet. Before increasing your dog's dietary protein, your veterinarian should evaluate the dog's kidney function using both blood work and urinalysis. If kidney function is compromised, it may be preferable to stay with a low protein, but high quality protein, diet until the kidneys are recovered.

Dogs on high antibiotic doses may benefit greatly from addition of probiotics to their daily diet. These help restore normal gut bacterial fauna damaged by the antibiotics, and promote better digestion and absorption of food.

Do NOT give a dog with tick-borne disease any foods or nutritional supplements that may be immune system stimulants: garlic, excessive doses of vitamins E and C, or herbals that stimulate immune function. These dogs are already vulnerable to autoimmune problems, ie. an over-stimulated immune system. Their immune system needs to calm and regain normal control functions; it does NOT need further stimulation. Garlic in large quantities also may cause anemia or low platelets in some dogs.

Onions, raw or cooked, can cause anemia in dogs. Dogs should never be fed onions.

Prednisone has a number of serious side effects on the body. It can cause problems with calcium absorption, can cause protein leakage from the kidneys, can cause muscle wasting. High quality, highly digestible, protein in the diet can help counter these effects, if the dog's kidney function can handle it. Extra calcium may help. Calcium requires vitamins C and D for optimum uptake.

Doxycycline's effectiveness may be diminished if given with supplements or foods that are excessively high in calcium or magnesium. The effect is not as significant as with tetracycline, but for optimum doxycycline up-take and effectiveness, any calcium or magnesium-rich foods or supplements should be given 2 hours before or 2 hours after doxycycline is given. Peptobismol also should not be given within 2 hours of giving doxycycline as if can diminish up-take of doxycycline. Small amounts of calcium-bearing foods such as cheese should not be a problem. In fact Velveeta makes a very good "disguise" for giving pills to dogs, and a small amount used to give doxycycline should not be a problem.

Since giving food along with the high doxycycline dose can greatly minimize digestive irritation from the doxycycline, if your sick dog is unwilling to eat you may have to tempt their appetite with whatever it takes to get them eating a little. At the end of this article is a link to the recipe for Satin Balls. These are a fairly nutritionally complete, fresh food that many dogs will eat, and that can be molded into small balls and force fed if necessary. Satin Balls are also good for disguising pills!

Why NOT to use the Lyme Disease vaccine

Use of vaccinations against Lyme Disease is controversial. They are short-lived (one year or less). Their efficacy is debatable. There are reports of Lyme vaccine reactions causing immune-mediated symptoms that for all practical purposes are identical to Lyme Disease itself. At a time when the veterinary community and dog owners are increasingly aware of the health risks of over-vaccination, many are concerned about the use of the Lyme Disease vaccines. A number of veterinary school vaccination protocols call for not using the Lyme Vaccine, or only using it on dogs that live in highly endemic areas. At the same time, Lyme Disease is increasingly recognized as a serious, potentially fatal, disease whose prevention is desirable.

Dog owners should study the issue and come to their own decision. Do not blindly accept any recommendation to use (or not use) this vaccine without educating yourself about its use.

ONE reason not to use the Lyme Disease vaccine: It does not offer protection against any other tick-borne disease. There are numerous documented instances of dogs being co-infected with multiple tick-borne diseases. It would be foolish to use the vaccine and think it was safe to let one's dog get tick bites!

To this author, a more common sense approach would be to focus on tick prevention

as a means of disease prevention(!), and spare the dog the immune system stress of a vaccine of questionable efficacy and short-lived duration of protection.

JASPER'S STORY -- click here Jasper's Bloodwork & Medication Record



REFERENCES

Keller N, Jacobson LS, Nel M, de Clerq M, Thompson PN, Schoeman JP (2004) Prevalence and risk factors of hypoglycemia in virulent canine babesiosis. J Vet Inter Med, 18, 265-270.

Massa KL, Gilger BC, Miller TL, Davidson MG (2002) Causes of uveitis in dogs: 102 cases (1989-2000). Vet. ophthamalogy, 5, p. 93.

Panciera RJ, Ewing SA, Confer AW (2001) Ocular histopathology of Ehrlichial infections in the dog. Vet. Pathol., 38, 43-46.

INFORMATION RESOURCES

Laboratories That Do Testing for Tick-Borne Disease in Dogs:

Protatek Reference Laboratory

574 East Alamo Street, Suite 90

Chandler, AZ 85225

Telephone: 480.545.8499

Fax: 480.545.8409

Email: reference@protatek.com

Vet schools at Cornell, Ohio State, North Carolina State, Michigan State, and UC Davis also have research programs on tick-borne disease in dogs and most offer testing services.

Tick-Borne Disease Information Resources:

Pam Barbe's Canine Tick Disease FAQ page

Gil Ash's Tick Disease FAQ

LymeNet

TICK-L e-mail list devoted to discussion of tick-borne disease in dogs

Imizol -- Schering-Plough label information

Imizol -- FDA Freedom of Information publication #NADA-141-071

Canine Monocytic Ehrlichiosis (CME) by T. Waner and S. Harrus (PDF)

Therapeutic Effect of Doxycycline in Experimental Subclinical Canine Monocytic Ehrlichiosis: Evaluation of a 6-Week Course by S. Harrus et al. (1998)

Ehrlichiosis, A Silent and Deadly Killer by Jan Hendricks & Bob Wilson

Bartonellosis: Veterinary and Human Implications by Dr. Edward Breitschwerdt

Doxycycline Use by Pregnant and Lactating Women USDA publication. Summary of the very little information (as of 2001) on doxycycline use during pregnancy.

General Information Resources On-Line:

Satin Balls Recipe

Blood Cells and The CBC by Dr. Ed Uthman.

Good article to help you understand the CBC and what all the numbers mean.

PubMed

Searchable database of medical literature references (human and veterinary)

Center for Disease Control (CDC) home page

FDA CVM Adverse Drug Report database

The Merck Veterinary Manual

Copyright 2004 by Anne V. McGuire. No part of this site, including but not limited to text, photos, and graphics, may be used without explicit permission of the owner of this site.

Page last updated June 9, 2013.

PLEASE NOTE -- Due to the prevelance of tick-borne disease (TBD) in dogs and the large number of e-mail inquiries I receive as a result of this web page, I regret that I am unable to return e-mail queries. Just about everything I know about TBD in dogs is contained in this page. I am not a veterinarian and am not qualified by law to dispense veterinary advice. If you can not find the answers to your questions here, then either those answers do not exist or I surely won't have them for you -- instead try having your veterinarian contact one of the experts such as Dr. Holland at Protatek Labs. Their contact info is given above. Sincerely, Anne McGuire

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