Tick Transmitted Diseases Flashcards
Severe thrombocytopenia is more likely to be caused by which of the 4 mechanisms? (decreased production, immune-mediated destruction, consumption, or sequestration)
decreased production or immune-mediated destruction
typically, consumption and sequestration cause more mild thrombocytopenias
What are 4 potential mechanisms for developing thrombocytopenia?
- decreased PRODUCTION of platelets
- Immune-mediated DESTRUCTION of platelets
- CONSUMPTION of platelets
- Sequestration of platelets
What are 4 etiologies for pancytopenia caused by bone marrow disease?
- infection (e. canis, histoplasmosis)
- neoplasia (multiple myeloma, lymphoma, leukemia)
- immune-mediated (aplastic anemia)
- toxins or drugs (estrogens, chemo, azathioprine, phenobarb, etc.)
T/F: if morulae are not present within monocytes on your blood smear, this rules out E. canis
false – morula are suggestive of E. canis but an absence of them does not rule out the disease. you must put into context the clinical picture (lethargy, weight loss, hyporexia, fever, anemia, lymphadenomegaly, petechiae, etc.)
The sensitivity of this also decreases with chronic infections.
You could increase the sensitivity by looking at a buffy coat smear, lymph node aspirate, or splenic aspirate.
which tick transmits canine monocytic ehrlichiosis?
brown dog tick (rhipicephalus sanguineus) which is found throughout the entire US
Describe the “acute phase” (8-20d after inoculation) of E. canis infection
fever, lethargy, inappetance
lymphadenomegaly, hepatosplenomegaly, peripheral edema
uveitis, retinal disease
thrombocytopenia and thrombocytopathia
neurological signs
T/F: patients in the acute phase of E. canis infection can spontaneously recover after 2-4 weeks
true – they can either completely eliminate the infection or remain subclinically infected.
if they do not clear the infection on their own and present to you, you can prescribe doxycycline.
What defines the “subclinical phase” of E. canis infection?
you will detect it on a test, but there are no clinical signs present.
Describe the chronic phase of E. canis infection
similar signs to the acute phase +
bone marrow hypoplasia (pancytopenia)
protein losing nephropathy
polymyositis
marked lymphocytosis
bone marrow plasmocytosis –> hyperglobulinemia
Which two clinical features of a chronic E. canis infection may make it look like the patient has cancer?
marked lymphocytosis can be confused for lymphocytic leukemia
bone marrow plasmacytosis –> hyperglobulinemia can lead to monoclonal gammopathy which can be confused for multiple myeloma.
When performing antibody testing, there is cross-reactivity between E. canis and what 2 other organisms?
- E. ewingii
- E. chaffeensis
What is your interpretation of a positive antibody test for E. canis?
indicates exposure to organism but not necessarily an active infection
if you got a negative test result, it can still be false negative if the infection is acute.
Indirect immunofluorescent antibody (IFA) tests are considered the gold standard serological test for E. canis. IgG antibodies are reliable indicators of E. canis exposure. If you suspect your patient has been acutely exposed to E. canis, what should you do in regard to testing?
you should perform TWO consecutive IFA tests (7-14 days apart).
If there is a 4-fold increase in the antibody titers, this is suggestive of acute and active infection.
T/F: IgG antibodies may persist for several months to years after treatment and elimination of E. canis
true
Which of the following statements is FALSE?
A. ELISA (SNAP4dx) tests can assess IgG antibodies against E. canis
B. ELISA (SNAP4dx) tests are quantitative
C. ELISA (SNAP4dx) tests have a 97% sensitivity
D. ELISA (SNAP4dx) tests are considered point of care
B. ELISA (SNAP4dx) tests are quantitative
they are QUALITATIVE – positive or negative.
PCR can detect E. canis as early as _____ post inoculation
4-10 days
T/F: a positive E. canis PCR test indicates true infection
true because PCR test is detect E. canis DNA
Which PCR is more sensitive for acute infections – whole blood or serology?
whole blood.
serology is more sensitive for chronic infections.
What could potentially cause false-negative results of a E. canis PCR test?
antimicrobial treatment at the time of blood collection.
how do you treat E. canis?
doxycycline
(or can also use minocycline or chloramphenicol)
note that dogs with severe chronic disease may not respond to tx or their cytopenias may take months to resolve.
which breed is more susceptible to E. canis infections and has a worse prognosis?
german shepherds
What tick transmits ehrlichia chaffeensis?
Lone Star Tick (amblyomma americanum)
T/F: Ehrlichia chaffeensis and Ehrlichia canis are difficult to distinguish in canine patients because they cross react on ELISA and they cause the same severity of clinical signs.
false – they do cross react, but Ehrlichia chaffeensis rarely causes clinical signs in dogs and if a dog does show clinical signs they are usually much more mild than E. canis.
T/F: dogs may serve as a reservoir for E. chaffeensis infection in humans.
true
When a dog presents with lameness, joint effusion, and pain (polyarthropathy), what are your main differentials?
- non-erosive polyarthritis (immune-mediated polyarthritis that is either infectious, neoplastic, or drug/vaccine induced OR septic arthritis)
- erosive polyarthritis