Veterinary Aspects of TickBorne Diseases on Nantucket Scott

Veterinary Aspects of Tick-Borne Diseases on Nantucket Scott White, DVM, MPH

Topics � Clinical Disease in Pets ◦ Anaplasmosis ◦ Lyme � Pets and Human Risk � Preventive Measures � Nantucket Experience

Clinical Disease in Pets Horses � Anaplasmosis (formerly Ehrlichia equi) ◦ Fever most common symptom ◦ Lymphadenopathy & vasculitis (swollen legs) less common ◦ Doxycycline or tetracycline � Lyme -- ? ? ◦ Most cases likely were anaplasmosis ◦ Overdiagnosed Cats -- ? ?

Clinical Disease in Pets Dogs -- Lyme and anaplasmosis � Acute cases: classic symptoms are similar ◦ Fever ◦ Joint pain or swelling ◦ Lymphadenopathy ◦ Often just mild, flu-like symptoms that resolve ◦ Vomiting with anaplasmosis ◦ More severe if co-infected ◦ Rare but severe thrombocytopenia (low platelets) with anaplasmosis ◦ Disease is mostly mild to moderate & very responsive to doxycycline ◦ Diagnosis & treatment straightforward

Clinical Disease in Pets Dogs � � � Asymptomatic but Sero-Positive on Routine Screening Tests ◦ Persistent Infection or Residual Antibodies ? ? ◦ Disease Risks ? ? ◦ Doxycycline ? ? Anaplasmosis ◦ Consider treatment if recent sero-conversion ◦ Additional blood tests invariably normal ◦ General consensus not to treat Lyme ◦ ◦ ◦ Consider treatment if recent sero-conversion Suspected increased risk of kidney disease in chronic infections Unlikely to prove infection with laboratory tests Evidence of kidney disease by testing for elevated protein in urine Treat or monitor based on results

Pets and Human Risk � Bring ticks to us ◦ Petting or grooming ◦ Living spaces ◦ Car � Activities with pets in infested areas ◦ Walks or rides ◦ Hunting ◦ Getting the “tennis ball” for the dog YES – Pets increase our risk of exposure to TBDs !!

Preventive Measures � Similar ◦ Avoid likely infested areas ◦ Tick checks ◦ Landscaping and spraying yard � Pet steps for preventing exposure to ourselves specific measures ◦ Topical products for dogs and cats �monthly, year-round �not repellants �fipronil? ◦ Vaccination and routing screening tests for dogs

Nantucket Experience ‣ Sero-positive rates in dogs are high ◦ ◦ ◦ N=100 Neg/Neg: 40 An: 38 L: 3 An/L: 19 60% positive for Anaplamosis, Lyme or both Anaplasmosis > Lyme @ 3: 1 � Ticks can be… ◦ anywhere ◦ very focal � ◦ present year-round (adults) ◦ “suddenly” around homes Seasonal owners and pets from non-endemic areas ◦ Unaware of risks and preventive measures ◦ Vaccinations/testing not available from regular veterinarian ◦ Onset of disease when return home