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Chronic ehrlichiosis treatment.

Species: Dog
Breed: Black Russian Terrie
Age: 5-8 years
I have a 7 year old Black Russian Terrier that was diagnosed 1 year ago with Erlichiosis. Last December he was diagnosed as chronic stage Erlichiosis. He was prescribed 300mg Doxycycline 2 times a day for 3 weeks. His chronic stage reappeared three days ago and we are giving him the same dosage of Doxycycline as before. Should we continue the Doxycycline longer? 4-6 weeks? What about continuing with some lower dosage every day following the initial treatment? I have also read I should give him a probiotic about 2 hours after each Doxycycline dose - do you agree? Additionally I have read that I should give him Vitamin B and K once a day. Your thoughts? Thanks


Online vet, Dr. Marie

Dr. Marie replied:

Sorry to hear that Kahuna is struggling with Ehrlichiosis.

The questions you asked are really only able to be answered by your regular veterinarian. However, I'll give you a few of my thoughts.

There are three possible phases of ehrlichiosis:

Acute: A dog can show signs of ehrlichiosis within 1-3 weeks of being bitten by an infected tick. Symptoms are vague and include lethargy, enlarged lymph nodes, fever, and reduced appetite. Lab work will usually show reduced number of red blood cells, white blood cells and platelets. Some dogs will clear the disease and be clear of it, but then some dogs will go into a subclinical phase.

Subclinical: A dog with subclinical ehrlichiosis will often have no symptoms, but if bloodwork is done we will usually see a reduced number of platelets. Dogs with subclinical ehrlichiosis can go on to get chronic ehrlichiosis.

Chronic: A few months or years after the initiation of subclinical phase, a dog can start to go into the chronic phase of ehrlichiosis. When this happens there is damage done to the bone marrow cells that create red blood cells, white blood cells and platelets. This damage is usually severe and the symptoms include weight loss, lack of appetite, bleeding episodes and lethargy.

Unfortunately when a dog is in the chronic phase of ehrlichiosis it can be hard to treat. While some dogs can eventually be treated and recover, not all dogs do. The deciding factor on whether a dog recovers or not is how much damage has been done to the "precursor" cells in the bone marrow. These are the cells responsible for creating red and white blood cells and platelets.

It can take many months for a dog to recover from the chronic phase. Some vets report that the success rate for treatment of chronic phase ehrlichiosis is very poor. However, other vets have reported that most dogs make a recovery after 1-3 months of doxycycline treatment.

So, to answer your questions, it is likely not a good idea to reduce the dosage of doxycycline. The length of time that he will need to be treated will depend on how well he responds to treatment, and this will likely be gauged by bloodwork. We don't generally continue the doxy once a dog has gone into remission.

The idea of giving probiotics along with an antibiotic is in case there is disruption of the normal bacteria in the intestines. If your dog has diarrhea while on doxycycline then you can talk to your vet about adding a probiotic, but otherwise I wouldn't worry about it.

The idea of the vitamin K is to help reduce bleeding in animals that have ingested something (like warfarin) that affects certain clotting factors. I am not 100% sure but I don't believe vitamin K will help reduce bleeding that is caused by low platelet numbers (as is the case in ehrlichiosis).

The idea of vitamin B is to help with the anemia. It may have a marginal effect, but my gut instinct is that it will not really be that helpful.

I hope Kahuna makes a full recovery!

Dr. Marie

---This question was asked in our Ask A Vet For Free section.---


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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.