UKC Forums - Dr Hallada, Questions and Answers

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Posted by Mike Knuckols on 01-20-2017 06:42 AM:

I hear about so many dogs getting Erlichia . What exactly is it and can you vaccinate to prevent

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Posted by ahallada on 01-21-2017 04:38 AM:

quote:
Originally posted by Mike Knuckols
I hear about so many dogs getting Erlichia . What exactly is it and can you vaccinate to prevent

It's a tick transmitted infection that leads to many problems listed below in dogs. There is not effective vaccination. Tick prevention is the best way to prevent the disease in your dogs. If you aren't using Simparica for flea and tick prevention then now would be a good time to start. Coupled with Permethrin spray, it's about as good as it gets.

Ehrlichiosis in Dogs
Drs. Foster & Smith Educational Staff
Canine ehrlichiosis is a disease of dogs and wild canids (e.g.; wolves) and is found worldwide. Canine ehrlichiosis is also
known by other names such as 'tracker dog disease,' 'tropical canine pancytopenia,' 'canine hemorrhagic fever,' and 'canine
typhus.' It affected a large number of military dogs in the war in Vietnam.
What causes ehrlichiosis?
Ehrlichiosis in dogs is most commonly caused by Ehrlichia canis, E. chaffeensis, E. ewingii, and possibly E. ruminantium.
There are multiple strains of Ehrlichia, affecting different species of animals. Some also affect people. Some organisms that
were formerly classified as Ehrlichia have now been reclassfied as Anaplasma. The Ehrlichia organisms are what we call
rickettsia, which on the evolutionary scale are between bacteria and viruses.
How is Ehrlichia transmitted?
Ehrlichia are transmitted by ticks including the Brown Dog Tick, Rhipicephalus sanguineus and the Lone Star Tick
Amblyomma americanum. The immature form of the tick feeds on an animal infected with Ehrlichia. When these immature
ticks or a mature form of the tick feeds on another animal, the Ehrlichia is passed on to that animal. The Ehrlichia can remain
alive in the developing tick for up to 5 months. This means a tick could become infected in the fall, and infect a dog the
following spring.
Because the disease is transmitted by these ticks, it can occur wherever Brown Dog and Lone Star Ticks are found. Almost
every state in the United States has reported a case of ehrlichiosis.
What are the symptoms of ehrlichiosis?
Ehrlichiosis can have three phases. Signs of the acute phase of the disease usually develop 1-3 weeks after the bite of the
infected tick. The acute phase of the disease generally lasts 2-4 weeks. The Ehrlichia enter white blood cells and reproduce
inside of them. In addition to the blood, these cells are found in the lymph nodes, spleen, liver, and bone marrow. Platelets,
the small cell fragments that help blood to clot, are often destroyed, as well. As a result of the infection, the lymph nodes,
liver, and spleen are often enlarged. Anemia, fever, depression, lethargy, loss of appetite, shortness of breath, joint pain and
stiffness, and bruises are often seen. Many dogs will be able to fight off the infection. If not, they enter the subclinical phase.
In the subclinical phase the animal may appear normal or show only slight anemia. During this phase the Ehrlichia live inside
the spleen. This phase can last for months or years. Ultimately, the dog either eliminates the Ehrlichia from the body or the
infection may progress to the chronic phase.
The chronic phase can be either mild or severe. Weight loss, anemia, neurological signs, bleeding, inflammation of the eye,
edema (fluid accumulation) in the hind legs, and fever may be seen. Blood tests show that one or all of the different blood cell
types are decreased. One cell type, the lymphocyte may increase and be abnormal in appearance. This can sometimes be
confused with certain types of leukemia. If a dog becomes chronically infected, the disease can keep coming back, especially
during periods of stress. In some cases, arthritis or a kidney disease called 'glomerluonephritis' may develop.
A decrease in the number of platelets (platelets help the blood clot) in the blood is the most common laboratory finding in all
phases of the disease. Changes in the protein levels in the blood are common. The most common protein, albumin, is
decreased and other types of protein called 'globulins' are increased.
Since one tick could be infected with and transmit more than one disease (e.g.; haemobartonellosis or babesiosis), it is not all
that uncommon to see a dog infected with more than one of these diseases at a time, which generally causes more severe
symptoms.
How is ehrlichiosis diagnosed?
The diagnosis is based on the typical clinical signs and results of special blood tests.
Two blood tests that detect the dog's antibodies (proteins produced to fight off the infection) to Ehrlichia are available. One is
called the indirect immunofluorescent antibody (IFA) test, and the other is known as an ELISA test. A veterinarian cannot
rely solely on these tests to make a diagnosis. The antibodies may not be detected in the early phase of the disease, since it
takes some time for the body to make them. Also, if a dog is extremely ill, he may not be able to produce enough antibodies
to be accurately detected. A positive test demonstrates that the dog has been exposed to Ehrlichia, but not that he necessarily
is currently infected. In the acute stage of the disease, the antibody level will rise significantly. Often two tests will be done 2
weeks apart and the results compared. Dogs with an active infection will show a significant rise in the amount of antibody
present.
The antibodies can last for one or more years after the infection, but they do not make the dog immune to ehrlichiosis - the
dog could get reinfected.
A newer diagnostic test called the PCR tests for the presence of the organism itself, not antibodies to it. Unfortunately, it does
not distinguish between live an dead organisms. For this reason, it is generally recommended to perform the PCR along with
Ehrlichiosis in Dogs - Page 1 of 2
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one of the antibody tests to make a diagnosis.
Sometimes, the organism can be seen inside cells on a blood smear. To find them, a small drop of blood is spread over a
microscope slide, stained and examined under the microscope. The organism can only be found in the bloodstream for a few
days during the acute phase of the disease. So this method of diagnosis could miss some cases of the disease.
How is ehrlichiosis treated?
The antibiotics, tetracycline or doxycycline are used. Treatment is usually for 3-4 weeks, even though the dog's symptoms
generally improve after several days of therapy. Some dogs will need blood transfusions or intravenous fluids depending on
the severity of the disease. Generally, the prognosis during the acute phase is good, if the animal is properly treated. Dogs
who go on to the chronic phase have a poorer prognosis. German Shepherds and Doberman Pinschers tend to have a more
severe chronic form of the disease.
The drug, imidocarb dipropionate, is sometimes used in conjunction with the antibiotics. It is given as an injection, but may
not be available in all areas.
Some of the damage caused by Ehrlichia may be due to the dog's own immune response to the organism. For this reason, if
immune-mediated arthritis or decrease in platelets occurs, corticosteroids (e.g., prednisolone) may be given.
How can I prevent ehrlichiosis in my pet?
Tick control is the main way to prevent ehrlichiosis. Products which repel and kill ticks such as those containing permethrins
are excellent choices. Tick collars containing the active ingredient amitraz (Preventic collars) are also used, sometimes in
conjunction with permethrin products in those areas with high tick infestations. If a large number of cases of ehrlichiosis are
diagnosed in an area, some veterinarians recommend placing dogs on low doses of tetracycline or doxycycline during the tick
season.
There is no vaccine for ehrlichiosis.
Can people get ehrlichiosis?
Yes. The common symptoms in people include fever, chills, headache, and muscle aches. Other less common symptoms
include nausea, loss of appetite, weight loss, abdominal pain, cough, diarrhea and change in mental status.
People do NOT get infected directly from a dog, but through a tick bite. Also, the Ehrlichia species most often implicated in
human infections is E. chaffeensis.

Doc

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Posted by ahallada on 01-21-2017 04:45 AM:

Re: Doc

quote:
Originally posted by blue blue
I have a year old that was a very hard going dog alone didn't come back very accurate. Over a period of a few weeks he started not hunting good and just falling treed slick and half hearted treeing. Took him to vet and Ehrlichia. Treated 30 days with doxycycline and gave the two imizol shots. Finished treatment this week and took him hunting last night and same thing. What would you suggest to try next?

Ehrlichiosis can be a tough bug to treat. I'd work with a specialist at this point who has experience in treating tick born diseases. I've been working with Idexx Labs when diagnosing tick born illnesses and they use a new PCR testing method that is more accurate than older methods. I'd perform a comprehensive tick panel using PCR methodology at Idexx labs. They have one that has both the 4DX test along with the full PCR Tick Panel. It will check for about 12 different tick born illnesses that most vets don't check for. From those results your vet can work with one of the internal medicine specialists at Idexx on coming up with a plan of attack.

Test Code # 2871 Comprehensive Tick PCR Panel with 4DX

Immunology and Serology

A. PHAGOCYTOPHILUM/PLATYS

EHRLICHIA CANIS/EWINGII

HEARTWORM

LYME

Referred

ANAPLASMA SPP by RealPCR

BABESIA SPP by RealPCR

CAND. M. HAEMATOPARVUM

CANINE BARTONELLA RealPCR

EHRLICHIA SPP by RealPCR

FOLD DIFFERENCE ABOVE CUTOFF

HEPATOZOON SPP by RealPCR

LEISHMANIA INTERPRETATION

LEISHMANIA QUANTITY

LEISHMANIA SSP QUANT

MYCOPLASMA HAEMOCANIS

NEORICKETTSIA RIST by RealPCR

RICKETTSIA SPP by RealPCR

Most comprehensive tick panel on the market!

Doc

Posted by GA DAWG on 01-21-2017 05:32 PM:

Are the pills the only option to raise thyroid back up? What the crap is causing all this tyroid stuff?

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Posted by chris-rush on 01-25-2017 04:10 AM:

Worm Medicine

Dr., thank you for all the great advice. I have sent you a PM with a question.

Posted by ahallada on 01-25-2017 05:16 AM:

quote:
Originally posted by GA DAWG
Are the pills the only option to raise thyroid back up? What the crap is causing all this tyroid stuff?

There are other options through compounding the drug into liquid if that is what you mean. Easier and cheaper to just use the pills.

Not sure what is behind all of the thyroid hype here lately. I suspect there is a good amount of misdiagnosis though of dogs that have Euthyroid Sick Syndrome and not true Hypothyroidism. Almost every person I've talked to had their dogs tested at their veterinarian's hospital and many of them had history of tick borne illness or have a tick born illness at the time their thyroid levels were checked. You can't do an accurate assessment of the thyroid without sending out to either Idexx Labs or Dr. Jean Dodds lab. You need to assess the Free T4 levels by either Equilibrium Dialysis or the newer Free T4 test that Dr. Dodds is now recommending. In house laboratories don't have that capability.

I think every coonhound that is assessed for thyroid issues should be tested for tick diseases. An in house 4DX test will help diagnose Ehrlichia, Anaplasma, Lyme and Heartworm and is reasonably priced. It takes about 10 minutes to run this test and it is worth it.

Doc

Posted by Kler Kry on 01-27-2017 06:03 PM:

Doc Ahallada

My Rex dog is recovering from fungal infection, blasto, and is still on 200 mg of fluconazole for 2 more weeks. I hear all these stories of dogs relapsing do you have any suggestions? He still doesn't have an appetite and is thin.

Posted by Kler Kry on 01-27-2017 06:03 PM:

Doc Ahallada

Posted by ahallada on 01-27-2017 10:46 PM:

Re: Doc Ahallada

quote:
Originally posted by Kler Kry
My Rex dog is recovering from fungal infection, blasto, and is still on 200 mg of fluconazole for 2 more weeks. I hear all these stories of dogs relapsing do you have any suggestions? He still doesn't have an appetite and is thin.

Yep you need to follow up with your veterinarian. They will do some follow up tests to see how the treatment is going and see if he needs a different type of medication if this is not working. You are not far from the Vet School in Madison so it wouldn't be a bad idea to work with them as well.
Doc

Posted by R Jerry Leviner on 01-28-2017 02:38 AM:

Thyroid level question?

What is the acceptable thyroid level in a dog? Is 1.2 level too low?

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Posted by ahallada on 01-28-2017 06:14 AM:

Re: Thyroid level question?

quote:
Originally posted by R Jerry Leviner
What is the acceptable thyroid level in a dog? Is 1.2 level too low?

Depends on the breed and the method of testing. Some breeds run lower than other breeds and some methods of testing thyroid have different levels of normal than others. I recommend using the Free T4 by ED for initial testing to diagnose low thyroid levels in dogs combined with a resting T4 and Cholesterol.

Clear as mud?

Doc

Posted by R Jerry Leviner on 01-28-2017 10:32 PM:

Question for Doc

Is 1.2 too low for a Treeing Walker Coon hound?

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Posted by DAVE H on 01-28-2017 11:06 PM:

Doc first I would like to thank you for taking the time to educate and help us, your generosity is appreciated.
With a small puppy say eight to ten weeks how long from the time it contacted the Parvo virus till it showed symptoms is there any sort of time for this or is it case by case?
Thank you again for all your help!!

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Posted by ahallada on 01-29-2017 02:04 AM:

Re: Question for Doc

quote:
Originally posted by R Jerry Leviner
Is 1.2 too low for a Treeing Walker Coon hound?

Please read what I posted above about thyroid levels in dogs. It depends on the test that was run. Was this an in hospital test for Resting T4 levels or was this sent out to a reference lab for Free T4 ? Is the dog showing any clinical signs of hypothyroidism? Is the Cholesterol level elevated? Is the dog sick or not feeling well? Is he already on L-Thyroxine?

Doc

Posted by R Jerry Leviner on 01-29-2017 10:05 PM:

In Office test!

It was an in office test and no to the other questions! Just thought it would be good to have it checked while at the vet. Vet said she saw no signs of a thyroid issue. But the test showed 1.2!

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Posted by ahallada on 01-30-2017 07:33 PM:

Re: In Office test!

quote:
Originally posted by R Jerry Leviner
It was an in office test and no to the other questions! Just thought it would be good to have it checked while at the vet. Vet said she saw no signs of a thyroid issue. But the test showed 1.2!

If there are no clinical signs and your dog is acting good, I wouldn't be too concerned at this point. If you want to do a more thorough workup in the future, then send in for the thyroid panel with TSH, Resting T4 and Free T4 by ED. Also get a cholesterol level from a blood panel.

Doc

Posted by JHannack on 02-07-2017 02:51 AM:

Puppy Food

I feed Pro Plan Sport Salmon 30/20, says for all life stages. Would you recommend feeding to pups or use a puppy formula? I've heard too much protein isn't good but the puppy food is at 28 protein so not a lot of difference.
Thanks for your advise in advance.

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Posted by Blackjack ohio on 02-10-2017 08:33 PM:

Upset/sensitive stomach

Would like your opinion Dr. I have a pup that's little over a year old now that has a sensitive tummy, our local vet said to give him tums but then a friends vet said that it will make it worse and to use pepcid(?) Instead. I would like your input on this please.
Thanks

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Posted by Jackson87 on 02-16-2017 08:29 PM:

Btt

Posted by Rex Ridge on 02-23-2017 04:24 AM:

Btt

Posted by joey on 03-04-2017 09:25 PM:

Doc, I read through most of these post but couldn't find your answer. Exactly what tick spray would you recommend before cutting a dog loose. I have them on monthly preventive but I know that isn't completely efficient. Do you have any idea how effective it is after they are wet? Its getting that time and here in Arkansas they can get real bad!

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Posted by joey on 03-04-2017 09:26 PM:

Posted by Preacher Tom on 03-04-2017 10:32 PM:

Joey, he advised me to use the Simparica pill and spray the dog with permethrin before hunting.

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Posted by joey on 03-04-2017 11:14 PM:

quote:
Originally posted by Preacher Tom
Joey, he advised me to use the Simparica pill and spray the dog with permethrin before hunting.

Which spray are you using?

Posted by Preacher Tom on 03-04-2017 11:21 PM:

Bought the concentrate at the farm store and dilute it in a spray bottle. Don't remember brand but it was in the section for horses.

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