When to Treat Ehrlichia in Dogs? Recovery and Prognosis
My Dog Was Diagnosed With Tick-Borne Diseases
“I have a female Bichon Frisès named Milky. She is 9 years old. Two months ago, she tested positive for anaplasmosis and Ehrlichia, and an ultrasound showed she was pregnant with one puppy. The vets told us we should have an abortion for Milky since the baby would most likely not survive the anaplasmosis. But I begged them to let the single puppy try to survive and prayed hard.
The vets gave Milky vitamins and doxycycline, and we went back to the hospital every 3 days for Milky’s CBC blood panels. On July 9, I woke up from sleep and found Milky like she was about to give birth. We rushed her to the hospital, but she gave birth in the car (normal delivery). When we got to the hospital, the puppy was alive, and we were so glad. The night shift doctor said we should take Milky and the puppy home.
A few hours later, the puppy wasn’t breathing, so we rushed him back again to the hospital, but he was dead. I’m going to file a complaint against the hospital, but I would not like to go back there. Hence, I’m seeking your advice as to what to do with Milky in order for her to overcome her anaplasmosis and Ehrlichia. Thank you.”—Louie
Proceed With Treatment
Yes, you are correct that the best course at this time is to continue with the treatment if your dog has any clinical symptoms or laboratory changes consistent with one of these infections. The treatment would consist of giving a full course of doxycycline. Sometimes, anaplasmosis clears up in as little as a few weeks, but ehrlichiosis usually needs to be treated for a whole month.
There are other antibiotics that are effective, like minocycline (1) and other non-terramycin type antibiotics for dogs that are allergic, but unless your dog has problems with the doxycycline, then that is the treatment that should be used.
I am unsure from your question how long Milky has been on doxycycline. If you are no longer going to that first veterinary clinic, you should have your dogs medical records sent to another clinic so that you can continue with her therapy there.
Signs of Tick-Borne Illnesses
All dogs with clinical symptoms from these tick-borne infections need to be treated. In the early stages of the disease (the acute phase), the following symptoms may be seen:
- Weight loss and not eating (This is one of the first things that families and owners notice in my region, where Ehrlichia infections are relatively common.)
- Vomiting and diarrhea
- Depression
- Lameness
- Stumbling or seizures
- Coughing
- Fever
- Swollen lymph nodes
Chronic Symptoms
If not treated for those signs, some dogs die, some become subclinical and do not have any symptoms but still have an infection, and others have chronic symptoms, including:
- Swollen joints and lameness
- Kidney damage (This is usually noticed because the dog is drinking a lot more and urinating in the house.)
- Eye symptoms (The eyes may just be inflamed [uveitis], or there may be bleeding into the eyes [hyphema] that leads to blindness.)
- Bleeding (This can happen anywhere, as dogs no longer have enough platelets, so even a minor cut will bleed more than normally.)
- Neurological symptoms like stumbling, wobbling, or seizures
Can Ehrlichiosis Be Asymptomatic?
What to do with dogs that have no clinical symptoms but still test positive is still an open question. The dogs need to have their blood checked to see if they have abnormalities like a low number of platelets, any changes to the kidney, or anemia.
If abnormal, they should be treated like dogs with clinical signs, but if all the values are normal, one treatment option is “watch and wait” or benign neglect.
Since I am unaware of her CBC results, I cannot tell you if she should be treated. If you decide not to treat her, watch her for any of those clinical signs I listed above and take her back to your regular vet every year so that you can have her CBC checked, her blood tested to evaluate kidney function, and her urine checked to evaluate any changes.
A Note About the Puppy
As far as the puppy that died, there was probably nothing that could have been done to save it. The veterinarian may have looked at the swollen joints or mucus membranes when the pup was born and estimated, based on the pallor and poor condition, that there was internal bleeding because of low platelets. It may have been apparent that the puppy was not going to make it.
They may have also noticed swollen joints or other problems that indicated the puppy was infected and not likely to survive. I am not sure why they did not explain that to you at the time.
Does Ehrlichiosis Ever Go Away in Dogs?
The antibiotic treatment works most of the time to clear the parasites from the blood, but, as you pointed out, the SNAP test may still test positive for years to come. For that reason, you will want to watch her for any clinical signs and keep her on a good tick control medication so that she cannot become reinfected. Please let us know if you have any other questions about Milky’s treatment.
Sources
- Jenkins S, Ketzis JK, Dundas J, Scorpio D. Efficacy of Minocycline in Naturally Occurring Nonacute Ehrlichia canis Infection in Dogs. J Vet Intern Med. 2018 Jan;32(1):217-221. https://pubmed.ncbi.nlm.nih.gov/29197122/
This article is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from your veterinarian. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.
© 2024 Mark dos Anjos, DVM
