When Fleas & Ticks Necessitate a Trip to the ER

If you’re anything like me, I am NOT a fan of creepy, crawly creatures, especially if they are the ones that make their meals by feeding on me or my fur babies! We want to share why those monthly preventatives your primary veterinarian recommended are so important and when to recognize that your dog or cat needs more emergent care.

Most of us are familiar with the first tick-borne illness – Lyme disease.

The black-legged tick family, of which the deer tick is the most famous, houses the bacterium responsible for this, known as Borrelia burgdorferi. This is a notoriously tricky microbe to eradicate due to its spiral shape and the fact that it travels rapidly throughout the bloodstream. For Lyme to be contracted by your pet, the tick must be attached to them for at least 48 hours, so the best way to prevent systemic spread is to remove the ticks as soon as you find them. In cases where the signs are subtle, or your pet has other issues that may mask them, the best bet is to have your primary veterinarian include a Lyme test as a part of their bi-annual health screen (bloodwork).

Typically, we see dog patients much more often than cats, and of those, only 10% of dogs that test positive for Lyme will ever develop clinical illness. What we mean by ‘clinical illness’ is signs & symptoms that you can easily recognize, and for Lyme disease these include:

• Lameness – shifting from side to side, and front to back limbs; this can come and go
• Generalized stiffness, discomfort, or pain – unable to lie down or stand up without difficulty, vocalization
• Loss of appetite – refusal to eat even favorite foods
• Fever – rectal temperatures greater than 102.5 °F
• Lethargy – lack of energy, reluctance to activity
• Enlarged lymph nodes – ‘glands’ that are located throughout the body to ward off infection; most commonly noted under the lower jaw

When would any of the above constitute an emergency?

• When your pet is having pronounced difficulty walking and is in pain (lameness, vocalizing, joints are visibly swollen)
• If it has been more than 24 hours since they’ve eaten a significant amount when they have a very high temperature (above 103.5°F)
• They are ‘profoundly’ lethargic (refusal to get up, difficult to rouse)
• If you can feel noticeable swellings underneath their lower jaw

Should Lyme disease go untreated, more advanced complications can arise, such as Lyme nephritis (kidney damage/failure), Lyme carditis (heart damage), and other neurological effects. Please contact us should you notice any of the above symptoms.

Anaplasmosis is a lesser-known condition, but it is still one to be aware of, as its occurrence in dogs is on the rise. Our cat companions can also contract this disease, but the incidence is much less since most are indoor-only pets.

Anaplasmosis comes in two forms: Anaplasma phagocytophilium and Anaplasma platys.

Anaplasma phagocytophilium is more common infects white blood cells. This is the form that humans can also contract directly from a tick bite. It cannot be spread from pet to human. A. phagocytophilium is transmitted by the deer tick and western black-legged tick. These ticks can also carry Lyme disease, which is why it’s not uncommon to see dogs co-infected with multiple tick-borne illnesses.

Generally vague & non-specific symptoms include:

• Lameness & joint pain
• Lethargy
• Loss of appetite
• Fever (greater than 102.5°F)
• Less frequently seen – coughing, seizures, vomiting, & diarrhea

Anaplasma platys is less common and infects a dog’s platelets, the blood cells responsible for clot formation. The brown dog tick is the carrier of the A. platys form of the bacterium

Signs of this form are related to the body’s inability to stop bleeding and may include:

• Bruising (belly & groin)
• Red pin-prick lesions (gums, mucous membranes)
• Nosebleeds

Typically, symptoms arise within 1-2 weeks of the initial bite. If you note any of the above, please call your veterinarian or our emergency department at MVA and have your pet evaluated sooner rather than later, especially if you note any abnormal bruising or excessive bleeding.

Ehrlichiosis is yet another primarily dog issue. It comes in two forms: Canine Monocytic Ehrlichiosis (CME) and Canine Granulocytic Ehrlichiosis (CGE)

Canine Monocytic Ehrlichiosis (CME) transmission is via the brown dog tick and can occur within 3-6 hours of their attachment to a canine host. Symptoms tend not to arise for 1-3 weeks after being bitten and can include:

• Fever (greater than 102.5 °F)
• Lethargy
• Loss of Appetite
• Lymph node enlargement (under lower jaw, in armpits)
• Abnormal bruising & bleeding (gums, belly, groin)
• Ongoing eye inflammation (swollen conjunctiva, discharge)
• Neurologic abnormalities (head tilt, lack of balance, seizures – rare)
• Occasionally lameness

These will usually last for approximately 2-4 weeks if left untreated, and many dogs will seem to recover on their own and enter another phase of infection which may then last anywhere from months to years.

Canine Granulocytic Ehrlichiosis (CGE) is transmitted via the lone star tick, with the following symptoms that differ slightly from CME:

• Fever (greater than 102.5°F)
• Lethargy
• Lameness – common; more akin to stiffness when walking
• Vomiting/Diarrhea

Neurologic abnormalities (head tilt, lack of balance, seizures – rare)

Lyme Disease, Anaplasmosis, & Ehrlichiosis can be treated with the antibiotics doxycycline or amoxicillin – each case is different, hence the difference in treatment options. The earlier you recognize the symptoms, and the sooner treatment begins, the better the outcome is likely to be.

Most dogs are treated with these antibiotics for a full 30 days, though we may sometimes see improvement within the first few days of treatment. Currently we don’t know if some dogs become persistent carriers without showing clinical signs of disease, as some dogs may continue to test positive for any of these diseases even after treatment and seeming to be healthy overall.

In more severe cases of any of the above conditions associated with tick bites, hospitalization for IV fluids, blood transfusions, pain management medications, and/or immunotherapy may be recommended and medically necessary.

These are the many reasons your primary veterinarian recommends that you to keep up with those monthly preventatives for your fur babies, as the subtlety of these symptoms makes it a bit more challenging to diagnose, so keeping a sharp eye out for ticks on your pets, and anything that isn’t “right” with your pet, is a huge part of the preventative process. Remember to always keep our number handy should you have any questions or concerns, as we’re here for you and your pets 24/7/365!