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TickborneDisease:Prevalence,Prevention,andTreatment

PeerReviewed

Contents
IntroductiontoTickborneDisease...........................................................................................................................1
RegionalPrevalenceofTickborneDisease...............................................................................................................2
KeepYourDogSafefromTickborneDisease...........................................................................................................2
SpeciesofTicksThatCarryInfectiousPathogens.....................................................................................................3
IfMyDogTestsPositive,DoesThisNecessitateTreatment?...................................................................................3
Ehrlichiosis.................................................................................................................................................................4
RockyMountainSpottedFever.................................................................................................................................4
LymeDisease.............................................................................................................................................................5
Anaplasmosis.............................................................................................................................................................5
Babesiosis..................................................................................................................................................................6
Hepatozoonosis.........................................................................................................................................................6
Bartonellosis..............................................................................................................................................................7
Prevention.................................................................................................................................................................7

IntroductiontoTickborneDisease
Tickbornediseaseoccurswhenticksinfectedwithapathogenbiteadogandtransmitthepathogen
intothedogsbody.Manyofthesepathogensarezoonotic,meaningtheycanalsoinfecthumans.
Diseaseisnotspreadbetweendogsandhumansdirectlybecausethesepathogensmustcomplete
theirlifecyclephasewithintheticktobecomeinfectious.Therefore,whilehumansandothernon
caninefamilymemberscanalsobecomeinfected,adirecttickbiteisrequiredtotransmitdisease.The
mostcommontickbornediseasesareAnaplasmosis,Babesiosis,Ehrlichiosis,Hepatozoonosis,Lyme
disease,andRockyMountainspottedfever.Thefeedingtimerequiredtoallowdiseasetransmission
fromaticktoadogorpersonvariesbetweenticksanddiseaseagents.EhrlichiosisandRocky
MountainSpottedFevercausingbacteriacanbetransmittedwithin36hoursoftickattachment,while
LymeDiseasecausingbacterialtransmissioncanrequire2448hoursoffeedingbeforeahostis
infected.
RegionalPrevalenceofTickborneDisease
Distributionoftickbornediseaseisassociatedwiththespeciesoftickendemictoagivenregion.
Distributionoftickspecies,prevalenceoftickswithinaregionandtheprevalenceofinfectious
pathogenstheycarryisnotstableandfluctuatesonaseasonalbasisdependingonweather,rainfall
andclimate.Forthisreasonmonitoringoftickbornediseaseisadynamic,ongoingprocess.

ThisinteractivemapshowsthenumberofreportedpositivecasesofEhrlichiosis,Lymedisease,
Anaplasmosisandheartwormdiseaseindogs.MapsareavailableforallregionsoftheUnitedStates
andCanada.Becausesomanydogsgountestedfortickbornediseases,theactualnumberofdogs
infectedbyticksislikelymanytimeshigherthanreportedfigures.

KnowtheFactsReducetheRisk

Learnabouttheticksanddiseasesinyourarea.
Useeffectivepreventionconsultyourlocalveterinarian.Beawarethattickpreventativesdo
notpreventdiseasetransmission;theyreduceriskbyreducingthetickburdenonthedog.
Alwaysusecanineapprovedpreventativesonly.
Mostcommonclinicalsigns:localinflammation,lethargy,lackofappetite,shiftingleg
lameness,fever,andspontaneousbruising.
Ifyourdogspendstimeoutdoors,checkthemdailyforticks.Paycloseattentiontothehead,
ears,shoulders,andupperlegareas.
Neversprayhumantickrepellentonyourdogasthesechemicalsaretoxicifingested.
Talktoyourveterinarianaboutannualtestingfortickbornedisease.Testingisfastand
effective.
Ifyourdogdisplayssignsoftickbornedisease,theymayinitiallytestnegative.Thisisbecause
teststhatmeasureforthepresenceofantibodiesagainstthepathogentaketimetoreach
measurablelevelsintheblood.Yourveterinarianmaytesttwiceusinganinitialacutesample
followedbyaconvalescentsampleabouttwoweekslater.Alternately,thePolymeraseChain
Reaction(PCR)diagnostictestsfortheactualpathogens.

SpeciesofTicksThatCarryInfectiousPathogens
AmericanDogTick(Dermacentorvariabilis)
DeerTickorBlackleggedTick(Ixodesscapularis)
BrownDogTick(Rhipicephalussanguineus)
GulfCoastTick(Amblyommamaculatum)
LoneStarTick(Amblyommaamericanum)
RockyMountainWoodTick(Dermacentorandersoni)
SpinoseEarTick(Otobiusmegnini)
WesternBlackleggedTick(Ixodespacificus)

Browndogticksliveandcaninfestinsideandaroundhomesandkennelswheredogsarepresent,
includingincolderregionsofNorthAmericasuchasCanadaandAlaska.

LoneStarticks,blackleggedticksandWesternblackleggedticksaremostcommonlyfoundinthe
understoryorleaflitterassociatedwithnaturalwoodedareasfrequentedbywildlife.Theedgehabitat
oftenfoundsurroundingahomeoryardprovidesamplehabitattosupporttheseticks.

Americandogticks,RockyMountainwoodticks,andGulfCoastticksaremorecommonlyfoundintall,
grassymeadows;openwoods,particularlyalongtrails;andopenfieldsinagriculturalareas.

SpinoseearticksarefoundinaridareaswestoftheMississippi,particularlyinthesouthcentraland
southwesternUnitedStates.

IfMyDogTestsPositive,DoesThisNecessitateTreatment?

Veterinarians are able to effectively treat most tickborne infections; however, the
decision of whether to treat an asymptomatic dog remains a point of controversy. Dr.
Adam Birkenheuer, DVM, PhD, DACVIM, an Internal Medicine and Infectious Disease
specialistatNorthCarolinaStateUniversityCollegeofVeterinaryMedicinerecommends
treatment after a positive test, followed by a complete blood cell count, serum
biochemistryandurinalysisin6monthintervalsfor1year.AccordingtoDr.Birkenheuer
"There are currently no evidencebased recommendations on whether or not to treat
yourpetifheorsheisfoundtobeexposedtoaticktransmittedinfectionlikeEhrlichia
or Borrelia. Some doctors may recommend treatment while others may not. The most
importantthingistocontinuetomonitoryourpetforsignsofillnesswithexaminations
andlaboratorytesting.Irecommendthisyearlyfortherestofthepet'slife."

Ehrlichiosis
Ehrlichiosis[pronouncederlickeeosis]iscausedbyEhrlichiaspeciesofbacteria(Ehrlichiacanis,
Ehrlichiaewingii,Ehrlichiachaffeensis)andmorerecentlydescribed,PanolaMountainEhrlichia.
Ehrlichiacanisistransmittedbythebrowndogtick;EhrlichiaewingiiandEhrlichiachaffeensisare
transmittedbythelonestartick.ThehighestconcentrationofEhrlichiacaniscasesisreportedin
southwesternandGulfCoastregionsoftheUnitedStates.ThedistributionandnumberofEhrlichia
ewingiiandEhrlichiachaffeensiscasesareontheriseandcanbefoundinstatesasfarnorthas
MassachusettsandasfarwestascentralOklahomaandKansas.

SymptomsofEhrlichiosis
Ehrlichiaspeciesinfectwhitebloodcellsandplatelets,causingsymptomsassociatedwithinflammation
andproblemswithbloodclotting.Commonsymptomscanincludeanyofthefollowing:
Depressionand/orlackofenergy
Lossofappetite
Runnyeyesandnose/discharge
Spontaneousnosebleeds
Bruisingongumsandbelly
Lameness/jointpain
Spontaneousandshiftingleglameness,reluctancetomove

RockyMountainSpottedFever
RockyMountainspottedfever(RMSF)iscausedbyRickettsiarickettsiabacteria.RMSFistransmitted
bytheAmericandogtickandthelonestartick.Indogs,RockyMountainspottedfeverappears
suddenlywithsevereillnesslastingabouttwoweeks.Ifnottreatedearlyenough,RockyMountain
spottedfevercanresultindeath.RockyMountainspottedfeverisalsoazoonoticdisease,which
meansitcaninfectpeopleaswellaspets.WhileRockyMountainspottedfeverismostprevalentinthe
RockyMountainStates,itisalsoprevalentintheSoutheastandcanbefoundthroughouttheUnited
StatesandCanada.

SymptomsofcanineRockyMountainspottedfever(canbemoderatetosevere)
Acutefever
Depressionand/orlackofenergy
Arthritislikestiffnesswhenwalking
Neurologicalabnormalities


LymeDisease
LymediseaseiscausedbyBorreliaburgdorferi,abacterium.Lymediseaseistransmittedbythedeer
tickandthewesternblackleggedtick.LymediseasehasbeenfoundthroughouttheUnitedStatesand
Canada,butinfectionsaremostfrequentlydiagnosedinthenortheastern,midAtlanticandnorth
centralstates,aswellasinCalifornia.

SymptomsofLymedisease
Spontaneousandshiftingleglamenessthatlasts34days,recurrentlamenessdueto
inflammationofthejoints
Reluctancetomove,fatigue
Lossofappetiteanddepression

Moreseriouscomplicationsincludedamagetothekidney,andrarelyheartornervoussystemdisease
symptomsmaycomeandgoandcanmimicotherhealthconditions.Casesvaryfrommildtosevere
withseverecasessometimesresultinginkidneyfailureanddeath.

Anaplasmosis
Canineanaplasmosis[pronouncedanuhplazmohsis]iscausedbyAnaplasmaspeciesofbacteria,
specificallyAnaplasmaphagocytophilumandAnaplasmaplatys.Bothformsofcanineanaplasmosisare
foundthroughoutmostoftheUnitedStatesandCanada.Areaswherecanineanaplasmosisaremore
commonincludethenortheastern,midAtlanticandnorthcentralstates,aswellasCalifornia.
Anaplasmaplatys,specifically,ismorecommoninGulfCoastandsouthwesternstates

Anaplasmaphagocytophilumistransmittedbythedeertickandthewesternblackleggedtick.These
arethesameticksthattransmitLymedisease,whichincreasestheriskofcoinfectionwithmultiple
tickbornediseases.BothAnaplasmaplatysandphagocytophilumarealsozoonotic,whichmeansthey
caninfectpeopleaswellaspets.Anaplasmaplatysistransmittedbythebrowndogtick.

SymptomsofAnaplasmaphagocytophilum
Anaplasmaphagocytophiluminfectswhitebloodcells,causingsymptomsassociatedwith
inflammation.Symptomsareoftenvagueandnonspecific.
Lossofappetite
Lethargy
Lameness,reluctancetomove
Neckpain
Neurologicsignsinsomecases

SymptomsofAnaplasmaplatys
Anaplasmaplatysinfectsplatelets,causingsymptomsassociatedwithfailureofbloodclotting:
Bruisingonthegumsandbelly
Spontaneousnosebleeds
Babesiosis
Babesiosis[pronouncedbabeezeeohsis]iscausedbyBabesiaspeciesofbacteria:Babesiagibsoni
andBabesiavogeli.Babesiavogeliorganismsaretransmittedbythebrowndogtick,butotherspecies
likeBabesiagibsonicanalsobetransmittedfromdogtodogifaninfecteddogbitesanother(fighting,
etc.)orbyabloodtransfusion.BabesiosisisfoundthroughouttheUnitedStatesandCanada.

Symptomsofbabesiosis
Babesiosisaffectsredbloodcells,andasadogsimmunesystemtriestoeliminatetheinfectedblood
cells,anemia,pallorandgeneralweaknessmayresult.
Lackofactivity/lethargy
Generalizedweakness
Vomiting
Lossofappetite
Weightloss

Hepatozoonosis
CaninehepatozoonosisiscausedbyinfectionwithHepatozoonspeciesofparasites:Hepatozoon
americanumistransmittedbytheGulfCoasttick,andHepatozooncanisistransmittedbythebrown
dogtick.Casesofcaninehepatozoonosishavebeenreportedintheeasternandmiddlesouthern
regionsoftheUnitedStates.Unlikeothervectorbornediseasesthataretransmittedbytickbite,both
formsofcaninehepatozoonosisaretransmittedwhenadogingestsaninfectedtick.

SymptomsofHepatozooncanis
Hepatozooncanisinfectswhitebloodcells,causingvague,nonspecificsymptoms:
Lossofappetite
Weightloss
Lethargy

SymptomsofHepatozoonamericanum
Hepatozoonamericanumaffectsmusclecells,resultinginadebilitatingandpotentiallyfatalcondition.
AdoginfectedwithHepatozoonamericanumwilltypicallyshowseveresymptomsthatoccur
intermittently.Thesecanincludeanyofthefollowing:
Fever/depression
Generalizedpain
Lossofmusclemasswithchronicweightloss
Dischargefromtheeyes


Bartonellosis
BartonellaspeciesareGramnegativebacteriathatcancauseanarrayofsymptomsand
clinicopathologicabnormalitiesindogsandpeople.Priorto1990,therewasonlyonenamed
Bartonellaspecies(B.bacilliformis),whereastherearenowover36namedspecies,ofwhich17have
beenassociatedwithanexpandingspectrumofanimalandhumandiseases.

Theseemerging,zoonoticpathogensaretransmittedbyhematophagousarthropods,includingticks,
fleas,lice,sandflies,bitingflies,andkedsandbyanimalbitesandscratches.Dogsparticipatingin
activitiesthatbringthemindirectcontactwitharthropodvectors(ticksandfleas)andwildanimal
reservoirhosts(bitesandscratches),includingsearchandrescueoperations,hunting,borderpatrol
andotherfieldrelatedactivitiesareatincreasedriskofacquiringBartonellaspp.infections1

SymptomsofBartonellosis
Feverofunknownorigin
Endocarditis
Myocarditis
Polyarthritis
Hepatitis
Lymphadenitis
Neurologicaldisease
Panniculitisandsteatitis
Anemia(Regenerativeornonregenerative)
Bleeding(thrombocytopenia,cutaneousvasculitis,epistaxis)
Thoracicandpericardialeffusions

Prevention
Minimizingtickexposurethroughtheuseofacaricidalpreparations,avoidingtickinfested
environmentswheneverpossible,androutine,rapidremovalofticksfromdogsrepresentthemost
effectivemeansforpreventingalltickbornedisease.Fortunately,thereisnowabroadspectrumof
safeandhighlyeffectivetickpreventionproductscurrentlyavailableinthemarketplace,includinga
largenumbertopicallyappliedproductsinmanyapplicationformulationsandnewlydevelopedlong
lastingtickcollarsthatpreventtickattachmentandfeedingformonths.Also,morerecentlyavailable
areorallyadministeredacaricidesoftheisoxazolineclassthatkilltickssoonaftertheybegintofeedon
adog.Thankstosubstantialresearchanddevelopmenteffortsamongpharmaceuticalcompanies,
currentlyavailableproductsarefarsuperiortoproductsavailableinthepast.Anidealproductwould
repelorkillthetickpriortofeedingandwouldsubsequentlyrapidlykilltheticktoavoidattachmentto
anunprotectedpetorfamilymember.InmostregionsoftheUnitedStates,ticksareactivethroughout
theyear,thusdogsthatgooutsideneedtobeprotectedagainsttickattachmentandtickborne
diseasesyearround.

Veterinariansarefrequentlyconsultedaboutticksandtickborneinfectiousdiseases,thusyour
veterinarianhasbeentrainedtounderstandtheenvironmental,biologicalandpathological
interactionsbetweenticks,dogsandtheirowners.InthecontextofOneHealth,veterinariansplaya
criticallyimportantpublichealthroleinpreventionoftickbornediseasetransmissionthrough
educationandcommunicationwithclients,physiciansandotherhealthprofessionalcolleagues.When
ownersapplyrigoroustickcontrolmeasures,itishighlyprobablethattransmissionoftickborne
diseasestodogsandtheirownerswillbegreatlyreducedoreliminated.

References

1.BreitschwerdtEB:Bartonellosis,OneHealthandAllCreaturesGreatandSmall.Veterinary
Dermatology2017:96e21.

2.PrezVC,DinizPP,PultorakEL,MaggiRG,BreitschwerdtEB:Anunmatchedcasecontrolledstudyof
clinicopathologicabnormalitiesindogswithBartonellainfection.CompImmunolMicrobiolInfectDis.
2013;36:4817.

3.QurolloBA,DavenportAC,SherbertBM,GrindemCB,BirkenheuerAJ,BreitschwerdtEB:Infection
withPanolaMountainEhrlichiasp.inaDogwithAtypicalLymphocytesandClonalTCellExpansion.J
VetInternMed2013;27:12511255.

3.YanceyCB,HegartyBC,QurolloBA,LevyMG,BirkenheuerAJ,WeberDJ,DinizPPVP,Breitschwerdt
EB.RegionalseroreactivityandvectorbornediseasecoexposuresindogsintheUnitedStatesfrom
20042010:Utilityofcaninesurveillance.VectorBorneZoonoticDis14:724732;2014.