Tick Fever

Silent, Insidious, and Deadly

Ehrlichiosis and Babesiosis

All of us working on the front lines of the greyhound adoption effort are acutely aware of the wide spread infestation of ticks at greyhound breeding, training, and racing kennels, and the consequent need to "de-tick" incoming greyhounds. What most adoption volunteers are blissfully unaware of is that those very ticks--now forgotten--may well have exposed the greyhound to serious tick-borne diseases which can lead to illness and death months and even years after the greyhound has been adopted into a loving home.

These diseases, generically referred to as "tick fever", by greyhound trainers, are known in the veterinary world as:

CANINE EHRLICHIOSIS
A rickettsial disease transmitted by ticks infected with the ehrlichia organism.
CANINE BABESIOSIS
A protozoan disease transmitted by ticks infected with the babesia organism.

Although these infections are caused by two distinctly different organisms, they share certain characteristics: Both are transmitted by the brown dog tick (the vector); both organisms enter the dog's blood system and wreck havoc in the blood cells and immune system. Except for severe bleeding episodes that may occur after surgery the symptoms of this intracellular activity are likely to be subtle or unapparent. As the disease progresses, the organisms will multiply within the body and over a period of years slowly begin their treacherous course of debilitating multiple organ systems. Both ehrlichiosis and babesiosis can present very confusing clinical manifestations--long after exposure to the tick vector. Greyhounds who may now be living in geographic areas where "tick fever" is not considered as a diagnosis in vague canine illnesses are in particular danger of having the diseases overlooked. Babesiosis and ehrlichiosis present in three basic phases:

Acute Phase- of short duration.
This phase is likely to occur in the racing kennel; the greyhound may die out right of severe infection (of symptoms resembling distemper) or display only subtle symptoms which will likely go unnoticed except to adversely affect the dog's racing performance, causing the dog to "grade off" and thus be disposed of or go into an adoption program.
Subclinical Phase - 
The infected dog will likely be asymptomatic; although, blood work done at this time may show subtle abnormalities. It is likely that the heavy infestations of intestinal parasites (hook, whip, tape worm) and protozoan diseases (coccidiosis and giardia), which so often have to be dealt with in adopted greyhounds contribute greatly to the dogs inability to mount an adequate immune response to tick-borne disease. Consequently, many will enter the next and most insidious phase.
Chronic Phase -
This phase is likely to begin in a foster home or adoption kennel and end months or years later with a bewildered, bereaved adoptive parent whose heart (and pocketbook) has been broken by the premature loss of their beloved greyhound to a mysterious, misdiagnosed or unidentified disease.

A grim picture--but one that can be remedied, if it is addressed. The greatest challenge is the recognition of the symptoms and pursuit of the correct diagnosis. Identification of tick-borne disease is determined from a blood serum sample and analysis by a laboratory with the proper equipment to perform an Indirect Florescent Antibody (IFA) test. The IFA test will reveal the presence of antibodies to the disease in an infected animal and determine a titer level. It should be noted that this is not a test that can be performed in a veterinary office; in fact, many major veterinary schools rely on the expertise of outside laboratories for the tick titer test. While a CBC blood analysis may show blood abnormalities indicative of tick disease, interpretation can be misleading, and should not be relied upon as a definitive diagnosis.

Given the known exposure of racing greyhounds to ticks, the subtle display of symptoms and the life threatening properties of the diseases, the safest approach is the testing of every adopted greyhound. At a minimum, tick fever disease should be considered by adoption volunteers, adopters, and veterinarians in any former racing greyhound showing even one of the symptoms associated with tick-borne diseases. After these diseases have been ruled out by the proper diagnostic test, other less likely, more expensive diagnostic procedures can be pursued. It is equally important that tick-borne diseases be considered with older dogs in whom the disease is likely to be overlooked and attributed to the aging process or other common (old age) diseases. A healthy greyhound from racing stock should have a life span of 12 to 15 years but many are not even reaching 10. One has to wonder why.

Leading experts in tick parasitology suggest that ehrlichiosis and babesiosis are gravely overlooked nationwide due to clinical inexperience with the disease and the wide but subtle spectrum of clinical symptoms. They further conjecture that misdiagnosis and improper treatment have led to many unnecessary canine deaths. Once considered a disease of temperate climates, "tick fever" appears to be spreading in the United States. It is suggested by experts that it is gaining a foothold in areas where it is still not even considered as a diagnosis for vague, unexplained illnesses.

Although it is rarely considered in the diagnostic process, babesiosis has a long history in the United States. The existence of babesiosis was discovered on Florida greyhound farms in the 1930's. Recent testing done by the University of Florida on 400 Florida racing greyhounds from all over the state disclosed that over 50% were seropositive with the disease. Studies done by the University of Illinois in the early 1980's established the existence of babesia on greyhound farms in Mississippi, Florida, Oklahoma, Texas, and West Virginia.

Currently, the University of Illinois is finding a very high prevalence of babesia canis in blood donor greyhounds transported from West Virginia racing kennels. Tick titer tests on greyhounds frequently reveal concurrent infections of babesia canis and ehrlichia canis. Ehrlichiosis, thought to be brought into the US in the 1960's by military working dogs who had been in Southeast Asia, is now known to be endemic in Arizona. Along with babesia, it is rampant in Arizona racing kennels. This information was obtained through the efforts of a California based adoption group concerned with the number of greyhounds coming down with unexplained illnesses upon arrival and extending into the future, even 8 years after adoption. Subsequent testing of sick greyhounds and incoming greyhounds is revealing an alarming number of greyhounds testing positive for ehrlichiosis and babesiosis diseases. In this particular population of some 600 greyhounds adopted out, 30 have died of "mysterious diseases." An extensive effort is now underway by this particular group to warn adopters of the diseases and arrange for IFA testing on every greyhound. 

Anecdotal reports of fatal unexplained bleeding after surgery, strange unidentified illness and the death of greyhounds throughout the country with their typical close quarters, crowded conditions, wooden tick-infested crates and buildings are the perfect environment in which to perpetuate tick-borne diseases--regardless of climate. Parasitologists have been warning for years that interstate transport of greyhounds, living conditions and inattention to parasite control will cause widespread dissemination of tick disease. Their warnings, unfortunately, have fallen of deaf ears.

BABESIOSIS is an infectious blood disease. Progressive (hemolytic) anemia, a destruction of the red blood cells is the primary factor in the development of symptoms. As the disease progresses, it may affect the spleen, liver, muscles, circulatory, lymphatic, gastrointestinal and respiratory systems. It interferes with the replication of life sustaining cells in the bone marrow--producing a severely immuno-suppressed animal. Depending on which systems have been most severely affected by the babesia organism, infected dogs will begin to display some of the following list of symptoms:

  1. anorexia
  2. inability to put on weight
  3. weakness
  4. depression
  5. muscle wasting-particularly noticeable above the eye and along the spine
  6. lethargy
  7. intermittent fever - (pyrexia)
  8. jaundice (icterus) - characterized by dark urine
  9. blood in the urine
  10. abdominal swelling (ascites)
  11. swollen limbs
  12. pus like mucous in the eyes or nose (oculo-nasal mucopurulent discharge)
  13. mouth ulcers (ulcerative stomatitis)
  14. enlarged spleen (splenomegaly)
  15. central nervous system abnormalities
  16. seizures
  17. involuntary head palsy
  18. bleeding of the capillaries into the skin (purpura) causing blood spots or a rash
  19. massive, unexplained bruising (echhynotis hemorrhage)
  20. prolonged or spontaneous bleeding- particularly related to surgical procedures
  21. renal and kidney involvement- incontinence, increased thirst, increased urination
  22. unresponsive diarrhea

Some of the medical conditions and/or laboratory findings likely to be associated with babesia canis:

  1. Hemolysis--destruction of the red blood cells
  2. protein in urine
  3. anoxia and hypoxia--oxygen deficiency in the tissues
  4. hemoglobinuria--free hemoglobin in the urine
  5. bilirubinemia--laboratory finding indicative of jaundice
  6. positive Coombs' test--a diagnostic test to detect hemolytic anemia 80% of babesia cases are Coombs' positive.
  7. lymphadenopathy--abnormalities in the lymph system
  8. renal failure--kidney failure
  9. hepatic disease--liver disease
  10. serum protein abnormalities
  11. DIC--disseminated intravascular coagulation--a severe, complex clotting disorder
  12. thrombocytopenia--reduction in the number of platelets in the blood--a condition which predisposes the dog to prolonged or spontaneous bleeding episodes.

It is important to consider babesiosis as a possible underlying cause in greyhounds ‘diagnosed’ with any of the following conditions:

  1. DIC
  2. thrombocytopenia
  3. hemolytic anemia
  4. "doggie aids"
  5. Kidney failure
  6. autoimmune disease
  7. vague blood disorders
  8. Von Willebrand's disease

Although it has been established that acute phase babesiosis can be devastating in young puppies and that many adult greyhounds are IFA positive with babesia, there is still controversy in the veterinary community as to the detrimental effect on adult dogs in the sub-clinical phase during which the body's immune system and the disease have reached a "stand off". The risk of not treating the disease in an asymptomatic carrier is that the organism could seize the opportunity to overwhelm the animal during surgery, in old age, or undermine the body's ability to effectively counteract other diseases.

Consequently, some veterinarians feel the disease should be eliminated as soon as it is discovered. Others disagree and may be inclined to dismiss the disease because of the difficulty of obtaining a safe, FDA approved treatment. Given the potentially devastating effects of the babesia organism, we at least need to be aware of it until more information is available.

EHRLICHIOSIS is an infectious blood disease. A reduction in cellular blood elements is the primary characteristic of the disease. Although the organism lives and reproduces in the white blood cells (leukocytes), it has a particularly devastating affect on the lymphatic system and will ultimately affect multiple organs, systems, and cells: respiratory, circulatory, central nervous system, kidney, brain, liver, spleen, endothelium. Additionally, the severe depression of the immune system created by the disease opens the door to secondary bacterial infections and other complications.

Because the onset of visible symptoms are likely to be gradual in the chronic phase and subtle in appearance, alertness to the following conditions is imperative in order to catch the disease while it is still treatable:

  1. weakness
  2. cough
  3. labored breathing
  4. fatigue
  5. pneumonia
  6. intermittent fever
  7. arthritis
  8. muscle wasting
  9. discharge from nose or eye
  10. depression
  11. weight loss
  12. anorexia
  13. increased thirst and urination
  14. incontinence
  15. sensitivity of the skin
  16. head tremors
  17. disorientation
  18. seizures
  19. neck or back pain
  20. bleeding tendencies
  21. pallor due to anemia
  22. retinal hemorrhages
  23. bleeding into the skin
  24. rash
  25. nose bleeds
  26. spontaneous bleeding
  27. abdominal tenderness
  28. swelling of the legs
  29. swollen lymph nodes

Some of the common conditions and/or laboratory findings associated with ehrlichiosis:

  1. enlarged spleen or liver
  2. liver or kidney failure
  3. clotting disorders
  4. DIC--disseminated intravascular coagulation
  5. thrombocytopenia
  6. pancytopenia
  7. leukopenia
  8. abnormalities of platelet function, bone marrow, white blood cells
  9. anemia
  10. positive Coomb's test
  11. protein in urine
  12. elevated serum protein levels
  13. increased liver or kidney enzymes
  14. infection of the brain or spinal cord

Certain features of ehrlichiosis may mimic the following diseases:

  1. systemic lupus erythematosus
  2. brucellosis
  3. blastomycosis
  4. endocarditis
  5. immune mediated diseases
  6. thrombocytopenia
  7. pancytopenia
  8. myelophthisis
  9. cancer of the spleen or liver
  10. Valley Fever
  11. plasma cell myeloma
  12. leukemia

It is recommended that ehrlichiosis be ruled out before accepting these diagnoses as a definitive cause of the illness or condition.

Ehrlichiosis is known to be prevalent in racing greyhounds; there is no question among veterinarians who have dealt with the disease that it must be taken seriously and aggressively treated. Testing is simple and definitive; a positive titer at any level needs to be treated. Very good result can be obtained with readily available, inexpensive treatment--a 7 to 8 week course of tetracycline or doxycycline at the correct dosage. The extent to which other tick-borne diseases play a role in the health of racing greyhounds is not known at this time. However, Rocky Mountain Spotted Fever, another rickettsial disease, is known to be endemic on the East Coast as well as in its namesake states. Confirmed cases have been found in racing greyhounds in Texas.

EHRLICHIA PLATYS--a less severe disease--is thought to often accompany ehrlichia canis. Cases of babesia gibsoni have been identified in the pet population in Southern California. Because these diseases display similar symptoms to ehrlichiosis and babesiosis, one should also be cognizant of their existence when presented with an ailing greyhound. It should be noted that ehrlichiosis and babesiosis are contagious diseases. The most common methods of transmission is: Infected tick to uninfected dog--then, infected dog to uninfected tick--then, infected tick to another uninfected dog...and so forth.

Both ehrlichia and babesia organisms can be transmitted from an infected dog through transfusion and can be transmitted transplacentally.

 

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