On Thursday I re-ran my German shepherd, Tessa's tick titers. It has been a year since her last titers, which were very high for erhlichia and Rocky Mountain Spotted Fever (RMSF).

We got the results back today and her titers are STILL high. I am worried because erhlichia can become chronic and end up killing or making a dog very ill. I need to get the actual numbers from the vet, I'm not sure what the exact levels were.

Tessa's last possible exposure to an infected tick would have been in November, 2010. She had head tilt, dizziness, (was falling over if she moved too fast) from a brain lesion from RMSF last April, was treated with 200 mg doxcycline every 12 hours for 6 weeks straight. Everything cleared up except for a slight head tilt.

She is now back on doxycycline at the same dose for at least a month.

I'm worried because I am now in Alaska where the vets never see tick illnesses.

My specific questions are whether anyone has recommendations of effective treatments to eliminate the ricketsial diseases. Would increasing the doxy dose help, or increasing the duration of treatment?

Any recommendations of a vet school in the lower 48 that has a vet skilled in treating these diseases?

Anything else I can do for my girl to boost her immune system so she can fight this bug once and for all?

And last, should I be worried about my husky, who had the same level of exposure to ticks? He had very such low tick titers last April we didn't treat him, but now I'm worried.

This wasn't the news I was hoping for. I'd say she's generally healthy, and always eats well... but there are cycles where she's more down. Could be normal- could be the disease.

Argh. I hate ticks!

Have you tried contacting Tufts?

I know the specialty there is more about bone and joint stuff, but I imagine that you can find people doing research about almost anything.

If my dog had any sort of serious problem, they would be my first contact.

Sorry about the titer news. Ticks suck.

I've had Erlichia. Intermittently I eat 250 mg tetracycline 2-3x a day for 3-4 days in a row. Tetracycline is the drug of choice in cattle. It is easier on me than Doxycycline. It controls arthritis flares. While Erlichia is not reported to have long term sequelae like Lyme, the illness changed me forever.

Not many drugs cross the blood brain barrier, so lesions there are tough.

The "meaning" of the titers that you are seeing is hard to know. Perhaps re-exposure cranked up your dogs immune system, much like a booster shot. A "PCA"
(might be the wrong letters) test is one which seeks the DNA of the agent in the blood, not just the immune response to it.
If you wish I will try to find an infectious disease specialist with whom you could chat. Be prepared for the lecture about over-use of antibiotics.
There is much about these agents of disease which is not understood.

Thanks so much for your response, Betty. I think the vet mentioned PCR (?) to test for the actual agent in the blood. She did say titers can be inconclusive.

If you could connect me with an infectious disease specialist that would be great. I absolutely agree that much of the aspects of these diseases are not understood. They are just plain strange (horrible). Tessa's had occasional weird limping bouts that I attributed to strain/injury, now I wonder if it's an erhlichia flare up.

Lauren, I thought about Tufts. I'll try giving them a call and see what options I have for a consult.

I am going to try to get the contact for a human MD who is super into these tick diseases and is an infectious disease specialist at my husband's clinic. While he is an MD he has been interested before in discussing veterinary cases.
I will PM you if he will speak to me.

Thanks Betty, I would really appreciate it. I've been spending too much time tonight reading about ehrlichia and it really scares me. Plus I can never spell it right... Titers were 1:256 for Rocky Mountain. 1:256(0?) for Erhlichia. Not sure what that means. We may need to run a PCR.

It sounds like double to triple the recommended dose of doxy, plus perhaps Imidocarb (imozol) may be warranted. The vet who saw Tess isn't in until Friday, but I'm getting a bit frantic after all this reading. 300 german shepherd military dogs died in the south pacific area due to ehrlichia. It doesn't mess around.

I may need to switch vets here, call around and see if anyone has experince in with tick diseases. I don't want Tessa to go chronic and die suddenly... as can happen. Scary.

And if it helps the human immunologist in being willing to chat, I do have some cell biology background, (so have a limited understanding of immunology) and I have a brother who is a family doc. and can help explain things to me. I am also willing to wade through medical journal articles (I do some of this type of stuff for work anyway). Whatever I need to do to find out and then advocate for the best treatment for my dog.

I'm just going to update this for anyone who happens to search for tick titers because they have a sick dog. Hopefully, this will help other people treat their dog effectively, and spend their money wisely on tests.

I called the internal medicine office at Colorado State University Vet School and was pleased, but somewhat suprised, to get a call back from the infectious disease specialist, Dr. L, this afternoon.

He said:

Don't waste money on any more tick titers. If the titers are greater than 1:1,000 they will probably never go negative. Clinical signs/results of certain blood tests are more important.

Anaplasmosis and Rocky Mountain Spotted Fever (RMSF) do not recur more than once. Do not waste money testing on titers for these.

Do test for: platelets, red/white blood cell count (CBC), protein in the urine (urinalysis), and globulins. If these are all normal, the dog likely does not have an active case of ehrlichia. Dr. L recommends testing every year. I may test more frequently initially, then go to once a year.

Asian strains of ehrlichia are what killed so many military dogs in WWII. American strains, while potentially deadly, are not usually cause of death.

Dr. L said that it is unlikely that ehrlichia will cause death, even in German Shepherds, who are more suscpetable as a breed.

I will have these tests run at the vet here and update with the results. If anything is abnormal, Dr. L said I could call him back for recommendations of treatment. I am so pleased he was willing to take the time to talk to me, up here in AK. It's always great to once again realize that there are so many good people in the world!

(and of course thanks to Dr. Betty, too).

This is all great to know, Kiersten. Thanks for sharing the info.

I'm just going to update this with Tess' blood work.

There were some irregularities in the blood and urine panel, but nothing that pointed to ehrlichia, according to the vet. I may run the numbers by the CSU vet if he's willing to take a look.

HGB was slightly high 18.1, normal range 12-18 (not worried)

MCH also slightly high at 25.2, normal range 19-25 (also not worried)

Platelets were high 685, normal range 200-500. Low platelets are one of the major signs of an active ehrlichia infection. I'm not sure why Tessa's would be high (the opposite). The vet wasn't sure either.

Eosinophils were high at 1800, normal range 0-1250. The vet said this is often a sign of worms or a parasite. I had Tess tested for heartworm, it was negative, and we're going to run a fecal.

Urine panel was fine, except there were a few struvite crystals. The vet wasn't too concerned and said to keep an eye on her for signs of discomfort while urinating or frequent urination.

Most of this information is more useful to a vet, but I thought I'd post anyway. I wouldn't be surprised if Tess has worms, as she came to me with a massive whipworm infestation, and has spent some time walking around very doggy areas, esp. at skijor races/dogsled trails.

The plan is to treat Tess for a month with 200 mg doxy twice a day, and re-run these labs every year.

I'll be de-worming her based on the fecal results (I need to bring in a sample).

Now that we're out of tick country, I'm hoping that her body may be able to clear this thing barring any re-infection.

For those of you in tick country, keep your pooches protected from these nasty buggers. Prevention beats treatment any day.

Thanks Betty, for all your help!

Worms!
Worms are great, something you can always fix.
Wishing you the best----