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Canine Ehrlichiosis - Dr. Jibachha Sah, M.V.SC, Lecturer
Canine Ehrlichiosis - Dr. Jibachha Sah, M.V.SC, Lecturer
Canine Ehrlichiosis - Dr. Jibachha Sah, M.V.SC, Lecturer
(E. CANIS)
Dr. Jibachha Sah
M.V.Sc, Lecturer, College of Veterinary Science,
NPI, Bhojad, Chitwan, Nepal
jibachhashah@gmil.com,00977-9845024121
Introduction
●Ehrlichiosis is a globally distributed canine vectorborne disease (CVBD) transmitted by
ticks.
●Caused by the rickettsial bacteria Ehrlichia spp., ehrlichiosis affects dogs and humans
as well as other domestic and wild animal species.
●E. canis causes canine monocytic ehrlichiosis (CME). This disease, also known as tropical
canine pancytopenia, canine rickettsiosis or canine hemorrhagic fever, was first described
in Algeria in 1935 by Donatien and Lestoquard.
Etiology
● There are two different types of leukotropic diseases that are caused by ehrlichia
bacteria in dogs.
● The incubation period of the illness is 7-21 days in general and it has three stages as acute, sub-clinical,
and chronic (Woody and Hoskins ,1991).)
Breed Susceptibility
●CME was observed in wide variety of breeds with somewhat more predisposition in Labrador
retriever followed by Pug, Rottweiler, German shepherd, Lhasa apso, Pomeranian and Gaddi.
Age susceptibility
●Age-wise prevalence of CME recorded in dogs of varying age i.e. from 3 months to 9 years with
maximum number of cases in more than 1 year age group.
Transmission/Vector
●Typically, tick nymphs or larvae are infected with E. canis after feeding on a
persistently infected dog.
● A new host is infected via salivary gland secretions during blood feeding.
● Transmission of the disease has also been reported via blood trans fusion.
Zoonotic Potential
●A few decades ago, ehrlichioses were considered to only have veterinary relevance.
●The first human infection with E. chaffeensis was diagnosed in 1986 raising the
awareness of Ehrlichia spp. as zoonotic pathogens.(Maeda et al.,1987).
Acute Phase
●This phase occurs 1 to 3 weeks after the host is bitten by the tick. The Ehrlichia organism is replicating in
this time period and attaching to white blood cell membranes. During the acute infection, the platelet
count will drop and an immune-mediated platelet destruction will occur.
●The acute disease is characterized by high fever, depression, lethargy, anorexia, lymphadenomegaly,
splenomegaly, epistaxis, dermal petechiae and ecchymoses.
●The dog will be listless, off food, and may have enlarged lymph nodes and/or spleens. There may be
fever and even neurologic symptoms as well, but although the dog may seem pretty sick, this phase of
infection is rarely life-threatening.
●Ophthalmological lesions are frequent and include anterior uveitis, chorioretinitis, papilledema, retinal
hemorrhage, presence of retinal perivascular infiltrates and bullous retinal detachment (Komnenou et
al. 2007).
Subclinical Phase
●In this phase, the dog appears normal. The organism has sequestered in the spleen and is
essentially hiding out there. Dogs can stay in this phase for months or even years.
●●The only hint that Ehrlichia is hiding is a somewhat reduced platelet count and/or elevated
globulin level on a blood test.
●The blood protein level on a lab report is divided into albumin (an important carrier protein) and
globulins (every other blood protein including antibodies.) Long-term stimulation of the immune
system will elevate globulins, sometimes dramatically.
Chronic Phase
●Thrombocytopenia appears around day 10 and peaks in the third week post-infection, with platelet
counts ranging from 20,000 to 52,000/µl (normal range: 20000– 450,000/µl). There can also be mild anemia and
leukopenia.
● Pancytopenia due to bone marrow hypoplasia is characteristic of the chronic severe form (Harrus, et
al.,1997).
●Platelet consumption, increased splenic sequestration and decreased platelet lifespan are the
possible attributes for thrombocytopenia (Harrus et al. 1999).
●Thrombocytopenia by leading to immunological destruction of platelets (Lee pyle, 1980). and also
cause central nervous system
abnormalities in dogs.
● The most commonly observed hematological abnormalities are thrombocyto penia and
anemia(Harrus et al.,1997)
Biochemistry analyzing at Jibachha Veterinary
hospital
Abdominal USG done for organ dysfunction at Jibachha veterinary hospital
Source;Laxmi Bai et al;2017
●Increase in serum ALT, AST and alkaline phosphatase values in affected dogs, suggesting hepato-
biliary dysfunction dueinfiltration of perivascular mononuclear cells (Nair et al. 2016).
●Increased levels of AST and ALT might be due to histopathological changes in liver as a result of the
infiltration of perivascular mononuclear cells (Nair et al. 2016). Serum protein profile indicated
hypoproteinemia owing to hypoaluminemia and hypoglobunemia in affected dogs.
●The hypoalbuminemia seen in CME might be the consequence of peripheral loss of albumin to
edematous inflammatory fluids as a result of increased vascular permeability (Woody and
Hoskins 1991), blood loss, or decreased protein production due to concurrent liver disease as
suggested by elevated hepatic enzymes.
●Total bilirubin levels in affected dogs were higher as compared to healthy control which is due to
rise in indirect bilirubin levels owing to immune mediated RBC lysis. Mean urea and creatinine value
in affected dogs were higher than healthy control dogs.
●The increase in urea and creatinine values may be due to membrane-proliferative glomerulopathy
and interstitial nephritis. It has been suggested that the presence of inflammatory infiltrates rich in
lymphocytes might be responsible for immuno-pathogenesis of renal lesion in dogs with CME.
●Dogs with ehrlichiosis showed increased levels of SGPT, SGOT and serum creatinine suggestive
of hepatic and renal involvement in the pathophysiology of the disease.
●Traditional diagnostic techniques such as hematology, cytology, serology and isolation are valuable
diagnostic tools for CME; however, a definitive diagnosis of E. canis infection requires molecular
techniques (Harrus and Waner 2010).
●Poor sensitivity of blood smear examination might be due to low level parasitaemia that can be
detected by highly sensitive nested PCR (Lakshmanan et al. 2007).
●Anaplasmosis, canine Rocky Mountain spotted fever (another rickettsiosis), babesiosis, bartonellosis,
hepatozoonosis, and canine distemper should all be considered as possible differential diagnoses for
ehrlichiosis
Treatment
●For canine ehrlichiosis, tetracycline (22 mg/kg given every
eight hours) or doxycycline (5 mg/kg every twelve hours)
administered for four weeks is the recognized treatment.
●Recent studies have evaluated the efficacy of a spot-on formulation containing imidacloprid 10%
and permethrin 50% (Advantix®) to prevent tick exposure and thus E. canis infection in dogs.
Preventive efficacies of 95–100% were demonstrated in treated dogs living under natural conditions
in endemic areas(Otranto et al.,2010; Otranto et al.,2008).
References
Maeda, K., Markowitz, N., Hawley, R.C., Ristic, M., Cox, D., McDade, J.E. (1987): Human infection with Ehrlichia canis, a leukocytic rickettsia. Ne
Engl. J. Med. 316(14), 853– 856
Harrus, S., Kass, P.H., Klement, E., Waner, T. (1997): Canine monocytic ehrlichiosis: a retrospective study of 100 cases, and an epidemiologic
investigation on prognostic indicators for the disease. Vet. Rec. 141, 360–363
Harrus, S., Waner, T., Bark, H. (1997): Canine monocytic ehrlichiosis update. Compend. Contin. Educ. Pract. Vet.19, 431–444
Otranto, D., de Caprariis, D., Lia, R.P., Tarallo, V., Lorusso, V., Testini, G., Dantas-Torres, F., Latrofa, S., Diniz, P.P., Mencke, N., Maggi, R
Breitschwerdt, E.B., Capelli, G., Stanneck, D. (2010): Prevention of endemic canine vector-borne diseases using imidacloprid 10% and permethr
50% in young dogs: a longitudinal field study. Vet. Parasitol. 172(3–4), 323–332 36.
Otranto, D., Paradies, P., Testini, G., Latrofa, M.S., Weigl, S., Mencke, N., Capariis, D., Parisi, A., Capelli, G., Stanneck, D. (2008): Application of 10
imidacloprid/50% permethrin to prevent Ehrlichia canis exposure in dogs under natural conditions. Vet. Parasitol. 153, 320–328
DAVOUST, B. et al. Assay of fipronil efficacy to prevent canine monocytic ehrlichiosis in endemic areas. Veterinary Parasitology, v.112, p.91-10
2003
FISCHER, C.A.; EVANS, T. Uveitis: ocular manifestations of systemic diseases in dogs. In: RIIS, R.C. Small animal ophthalmology secret
Philadelphia : Hanley & Belfus, 2002. Cap.29, p.184-191
Laxmi Bai,Goel,Ricky Jhambh,Pawan Kumar and V. G. Joshi,2017. Molecular prevalence and haemato-biochemical profile of
canine monocytic ehrlichiosis in dogs in and around Hisar, Haryana, IndiaJ Parasit Dis (July-Sept 41(3):647–654
. Nair AD, Cheng C, Ganta CK, Sanderson MW, Alleman AR, Munderloh UG, Ganta RR. Comparative experimental infection seen in
dogs with E. canis, E. chaffensis, A. platys and A. phagocytophilum. PLoS One. 2016;11(2):e0148239. doi:
10.1371/journal.pone.0148239
.
Komnenou AA, Mylonakis ME, Kouti V, Tendoma L, Leontides L, Skountzou E, Dessiris A, Koutinas AF, Ofri R. Ocular
manifestations of natural canine monocytic ehrlichiosis (Ehrlichia canis): a retrospective study of 90 cases. Vet
Ophthalmol. 2007;10:137–142
Harrus S, Waner T, Bark H, Jongejan F, Cornelissen AW. Recent advances in determining the pathogenesis of canine
monocytic ehrlichiosis. J Clin Microbiol. 1999;37:2745–2749
Lakshmanan B, John L, Gornathinayagam S, Dhinakarraj G. Molecular detection of Ehrlichia canis from blood of naturally
infected dogs in India. Vet Archive. 2007;83:353–354.
Harrus S, Waner T, Bark H, Jongejan F, Cornelissen AW. Recent advances in determining the pathogenesis of canine
monocytic ehrlichiosis. J Clin Microbiol. 1999;37:2745–2749.
Bhadesiya CM, Raval SK. Hematobiochemical changes in ehrlichiosis in dogs of Anand region, Gujrat. Vet
World. 2015;8(6):713–717. doi: 10.14202/vetworld.2015.713-717.
Woody BJ, Hoskins JD. Ehrlichial diseases of dogs. Vet Clin North Am Small Anim Pract. 1991;21:75–98. doi: 10.1016/S0195-
5616(91)50009-7.
Shipov A, Klement E, Reuveni-Tager L, et al. Prognostic indicators for canine monocytic ehrlichiosis. Vet Parasitol.
2008;153:131-8.
Luckschander N, Kleiter M, Willmann M. Renal amyloidosis caused by Ehrlichia canis. Schweiz Arch Tierheilkd. 2003;145:482-5.
Woody B J, Hoskins J D. Ehrlichial diseases of dogs. Vet Clin North Am Small Anim Pract. 1991;21:75-98.
Lee Pyle R. Canine Ehrlichiosis. J Am Vet Med Assoc 1980; 177: 1197-1202.
Ristic, M. and Holland, C.J. (1993) Canine ehrlichiosis. In: Woldehiwet, Z. and Ristic, M., editors. Rickettsial and Chlamydial
Diseases of Domestic Animals. Pergamon Press, New York. p169-186.
Srikala, D., Satish Kumar, K., Amruth Kumar, V.V. and Tirumala Rao, D.S. (2012) Clinical and therapeutic aspects of canine
monocytic ehrlichiosis. Indian J. Vet. Med., 32(2): 109-110.
Nair AD, Cheng C, Ganta CK, Sanderson MW, Alleman AR, Munderloh UG, Ganta RR (2016) Comparative experimental
infection seen in dogs with E. canis, E. chaffensis, A. platys and A. phagocytophilum. PLoS One 11(2):e0148239