What's Biting Lady Bug?

Written by: Morgan Young 1ast Year Veterinary Student • 2018 Scholar

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History

Lady Bug is an 8 year old spayed female terrier mix with a two day history of difficulty breathing, lethargy, weakness, and inappetence. She presented to her referring veterinarian and radiographs were taken for concerns of aspiration pneumonia due to a recent episode of vomiting. She was sent home with Clavamox, an antibiotic.  She came to IVS when she continued to do poorly.

Physical Exam

• Febrile
• Warm joints
  It was noted that Lady Bug’s joints in her legs felt hot to the touch
• Painful
  Lady Bug was painful in her right front limb (especially in her shoulder), as well as in her neck
• Dyspnea
  Lady Bug had difficulty breathing, and was placed in an oxygen cage for support

Diagnostic Test Results

Several tests were done to determine the cause of Lady Bug’s symptoms. Radiographs (x-rays) and bloodwork were performed to help the doctor to diagnose the problem at hand.

SNAP test

• A SNAP test is a quick, reliable way to find if an animal is positive for a certain disease. The 4Dx tests for Heartworm as well as 5 tick-borne infections
• Lady Bug had a strong positive result for Ehrlichia canis, a bacteria transmitted via ticks

CBC/Chemistry

• A complete blood count (CBC) and a complete chemistry panel are performed to assess organ function and overall health of the patient.

• Mild thrombocytopenia; Total Protein=9.8; Globulin=6.7; ALK=347

Radiographs

These abnormal results correspond with standard clinical signs seen in Ehrlichiosis, which include hyperproteinemia with hyperglobulinemia, elevated alkaline phosphatase and decreased platelets.

These were taken to assess the patient’s forelimbs to see if the cause of pain could be identified. A narrowed cervical disk space was noted between C2-C3 and C5-C6 (black arrow) which could be the source of pain in her neck. There was also mild mineralization near the shoulder joint (white arrow).

Diagnosis

Ehrlichiosis: this infectious disease is diagnosed by detected antibody in the blood. It takes two to three weeks for the body to make antibodies to the bacteria, so early stages are hard to detect. Obtaining a positive indication for E. canis on a 4Dx test, along with the common clinical signs, which Lady Bug was exhibiting, confirms this diagnosis. The Brown Dog Tick is the most common carrier of this bacteria, and it is found worldwide, especially in warmer climates. It is possible that Lady Bug may have been bitten while she was living in Grenada, an island in the Caribbean.

Treatment & Prevention

Treatment:

• Doxycycline: While in hospital, Lady Bug was given intravenous Doxycycline, the antibiotic of choice for treating Ehrlichiosis. She was also sent home with oral Doxycycline to continue antibiotic treatment at home.
• Codeine: Given for pain
• Galliprant: Given for pain due to osteoarthritis

Prevention: Some vaccines can prevent tick borne diseases, such as Lyme, but most others are not available, therefore other means of prevention are necessary. There are several reputable brands of tick prevention medications that come in different forms, such as chewable, topical, and collars. Discussing tick-borne diseases in your area, and obtaining medication from your veterinarian is important to keeping a healthy pet. 

Progress

Lady Bug’s owner has reported that after several days of antibiotics, Lady Bug is doing much better at home. She has been able to jump onto her bed, and is acting more like her normal self. Here she is pictured on the right, resting comfortably with her brother, Bandy Bo James.

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Resources

• Dantas-Torres, F. (2010). Biology and ecology of the brown dog tick, Rhipicephalus sanguineus. Parasit Vectors, 3(26). doi:10.1186/1756-3305-3-26
• Peters, J. (2000). Canine Ehrlichiosis (E. Janovitz, DVM, PhD, Ed.) [Fact sheet]. Retrieved from ttps://www.addl.purdue.edu/newsletters/2000/winter/ce.shtml
• Tilley, L. P., & Smith, F. W.K., Jr. (n.d.). Blackwell's Five-Minute Veterinary Consult: Canine and Feline (6th ed.). Ames, IA: Wiley.
• Photos:
• [Adult female Brown dog tick]. (n.d.). Retrieved from http://www.cvbd.org/en/tick-borne-diseases/ about-ticks/tick-species/brown-dog-tick/life-cycle/

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