Alternative treatments for canine ehrlichiosis?

November 2, 2009 10:21 PM

My dog has Ehrlichiosis and is not responding to standard treatment (doxycycline). Any MeFites with experience or knowledge about alternative treatments or specialists in treating this disease?

Short of some off-label drugs (Imidocarb dipropionate), all I can find is information about palliative care. The disease is uncommon in the states (and even rarer here in Oregon) so I've been unable to find a specialist with much experience treating this disease.

posted by esome to pets & animals (7 comments total)

Talk to some greyhound rescue people, they're most likely to have dealt with it and can recommend vets who have treated it. The only place in the US I've heard of it being common, is in dogs coming off the tracks out west. From what I understand that's the main vector of the disease: the tick infestation from dog to dog at racing kennels.

Tried Tetracycline? "Treatment: Doxicycline at 11 mg/kg b.i.d. for 2 - 4 weeks, or longer.
OR
Tetracycline 22 - 33 mg t.i.d. (oral) for 2 - 4 weeks or longer.

Imidocarb Dipropionate can be used to treat chronic cases of Ehrlichiosis that
do not respond to Tetracycline or Doxicycline."

From here.

How long have you been treating? "response to the drugs may take one month." cite

"The most common antibiotics used to treat ehrlichiosis belong to the tetracycline family of drugs. They include doxycycline, tetracycline, oxytetracycline, and minocycline. These antibiotics have the greatest efficacy against Ehrlichia, and the fewest side effects." from here

Don't despair!
posted by Lou Stuells at 11:12 PM on November 2, 2009

I found a PDF entitled Emerging Tick-borne Diseases: A Roundtable Discussion with info from experts. Look in the text for the subheading "COINFECTION." Perhaps it's possible that Ehrlichiosis is not the only thing your dog contracted?

(Apologies for not reformatting this, but it would take too long!)

"The most impressive result that
we ever achieved in the Vector-
borne Disease Diagnostic Labora-
tory was the identification of six
different tick-borne organisms
from four different genera in a
blood sample from a dog in North
Carolina.We identified the DNA
fingerprint, not antibodies. So this
dog was walking around with six
organisms that we could detect,
and there are likely other organ-
isms in the blood for which we do
not specifically test.
A lot of our work relative to
coinfections evolved from trying to
help veterinarians understand why
some of their Ehrlichia patients
were not getting well.Ten years
later, I can tell you some dogs were
not getting well because they were
coinfected with Babesia or Barto-
nella species, which may or may
not be visualized on a blood smear
or respond to doxycycline adminis-
tration for six months."

posted by taz at 2:58 AM on November 3, 2009

A few things -

Regarding the Doxy some important info
One owner's personal experience with prevention and cure
Dr. Pitcairn's opinion on treatment
Prevention of Lyme

Hope this helps.
posted by watercarrier at 3:15 AM on November 3, 2009

My dog was on doxy for 12 weeks for erlichiosis after she came to me as a rescue from Arkansas. She had incredibly high counts at first,but then her labs started to trend down. It was definitely a long and worrisome time. She's currently a healthy and active 13 year old. If your vet is not famililar with treating it, a second opinion or having them talk to some one who is would be important. Best of luck to you and your dog-feel free to Memail and I can give you more specifics if you'd like.
posted by bookrach at 9:09 AM on November 3, 2009

Thanks for all the responses, I really appreciate the feedback and insight. Keep it coming!

@taz: We contacted a couple of the doctors from that round table just this morning and already got a response. Their indication is that there is a distinct possibility of co-infection in our dog. We may in fact have cleared the Ehrlichia and are now seeing symptoms of additional disease(s) such as Bartonella, Babesia or both. Such is the state of street dogs in Panama where we were living when we acquired our little pooch.

We're faxing medical histories, will likely order more blood work, and are keeping our fingers crossed. And even if this doesn't pan out, today is looking brighter, so thanks for that!

Thanks again to all!
posted by esome at 10:23 AM on November 3, 2009

Good luck! I hope you're pup is feeling much better soon!
posted by taz at 12:58 PM on November 3, 2009

Just adding a follow-up post for the record.

It turns out we were barking up the wrong tree, so to speak. The reason our dog's ehrlichia symptoms persisted (despite aggressive and repeated treatment) was in fact owing to co-infection (the ehrlichia had in fact been successfully treated). It was not, however, another tropical tick disease or related condition. Rather, she has been suffering from histoplasmosis, a common fungal infection (a yeast actually) which can affect cats and humans as well.

A simple fungal titer would have picked it up but none of the vets suggested it. The two diseases share many symptoms in common, which threw us all off track. We took her in for an ultrasound and a lab tech who was looking at a liver aspirate casually suggested it.

It's treatable but, owing to the advanced state of her infection, it's not clear that she will survive the treatment (itraconazole) which is very hard on the liver. She is already a bit jaundiced and only a couple weeks into a treatment that will last months. Nevertheless, she is showing small signs of improvement, so we are optimistic.
posted by esome at 5:09 PM on January 12