Editors' note: IDEXX Laboratories has sponsored presentations by both Dr. Alleman and Dr. Wamsley at various continuing education symposia. Lyme disease and anaplasmosis are commonly found in the same geographic location and are transmitted by the same tick species. Anaplasmosis Treatment in Dogs A course of antibiotics such as minocycline, chloramphenicol, doxycycline, or tetracycline is typically used to treat Anaplasmosis in dogs. It is best to diagnose the disease on time and adopt a holistic treatment plan. However, the use of such antibiotics has several concerns. These tests are sent to a veterinary laboratory. Inokuma H, Raoult D, Brouqui P. Detection of Ehrlichia platys DNA in brown dog ticks (Rhipicephalus sanguineous) in Okinawa Island, Japan. Vet Rec 1998;143(15):412-417. Anaplasmosis in dogs can be treated with a course of antibiotics, with most symptoms improving within 24- 48 hours after beginning treatment. All rights reserved. Clinical disease is often mild in naturally infected dogs, but some animals may have clinical evidence of bleeding (epistaxis or petechiation), particularly during the initial bacteremic phase when platelet counts may be reduced to < 20,000 cells/l. Even so, alert owners of pets with known exposure to A. phagocytophilum to potential human exposure from infected ticks in the environment. Many dogs we have worked with have responded wonderfully to our Antimicrobial formula. A lesser form of anaplasmosis is caused byAnaplasma platysand is transmitted by the brown dog tick. In the case of infection with the less common A. platys that can interfere with the blood clotting process, clinical disease is often mild, but some dogs may develop bruising or bleeding (including nosebleeds), especially during the early stages of infection when platelet counts may be at their lowest. Because the deer tick and the western black-legged tick are also vectors for other disease, it is not uncommon for dogs to be co-infected with multiple tick-borne diseases such as ehrlichiosis, Rocky Mountain spotted fever, and Lyme disease. Some infected dogs will have symptoms for 1 to 7 days; however, some will have no, or only minor, symptoms. Both A. phagocytophilum and A. platys are in the order Rickettsiales, which includes members of the genera Ehrlichia, Anaplasma, Cowdria, Wolbachia, and Neorickettsia. given for 30 days to resolve the symptoms and improve the dogs condition. Finally, A. phagocytophilum is a zoonotic pathogen. Doxycycline at the dosage described above for A. phagocytophilum is apparently effective in treating A. platys infection.12 However, animals with circulating A. platys organisms that have moderate to severe clinical disease or that do not rapidly respond to doxycycline therapy should be tested for other tick-borne diseases. 8. Organisms may also be found in a small number ( 1%) of neutrophils in synovial fluid (Figure 2). 17. Symptoms are generally vague and non-specific, which can make diagnosis difficult as there is no one clear sign that makes one suspicious for the disease. Similarly, humans get infected with Lyme disease from being directly bitten by ticks and not from interacting with dogs that have Lyme disease. Serological and molecular prevalence of Borrelia burgdorferi, Anaplasma phagocytophilum, and Ehrlichia species in dogs from Minnesota. Rarely, neurological signs such as seizures have been reported. Anaplasmosis in dogs. Dogs are by far the most common mammalian host, although rare reports of infections in cats, impalas, and sheep have been documented outside the United States.21,22. The most common antibiotic to treat anaplasmosis is doxycycline. Many infected dogs are treated for two to four weeks (the longer course more often if We have had clients confirm this and we have experienced this with our own dogs, though we have sometimes provided our Antimicrobial formula. All rights reserved. According to Dr. WebDoxycycline is recommended for dogs of all ages. Hematopathology in dogs experimentally infected with a Swedish granulocytic Ehrlichia species. In addition, both diseases are transmitted by the same tick vectors and have similar geographic distributions. Pay attention to your pets diet and activity to make sure it stays healthy, active, and strong. *Statements on this website have not been evaluated by the FDA. Your veterinarian will assess the need for additional treatments, such as pain medications or fluid therapy. Treatment for Anaplasmosis. If you think your pet may have been exposed to any tick-borne disease, let your vet know so he or she can get your dog back on track. Experimentally, clinical signs appeared between eight and 14 days after inoculation.18 The organism appears in circulating platelets, resulting in a severe thrombocytopenia, typically < 20,000/l. The organism has a worldwide geographic distribution and is endemic in the upper Midwest, East, and Northeast regions of the United States as well as the western coastal regions. You will usually be able to notice an improvement in your canine companion within 1 to 2 days of starting treatment. In most cases, symptoms improve rapidly. St. Louis, Mo: Saunders, 2006;219-224. Subsequently, organisms will reappear at one- to two-week intervals, and the process repeats, resulting in a cyclic thrombocytopenia. Knowing when to euthanize horses can be a , Horse owners have different opinions when it comes , Digestive problems are quite common in dogs and , The toughest decision for a pet owner is , Dogs have so many resemblances with humans; one , Just like humans, dogs suffer from damage and , 2022 BestPetCompanion All rights reserved, Natural Treatment For Anaplasmosis In Dogs A Complete Guide, from the environment and other animals and end up getting affected with. Dogs affected by anaplasmosis generally show symptoms for 1-7 days though some pets may have minor or no symptoms at all. Anaplasmosis causes one of two clinical syndromes: Fever, lethargy, polyarthritis, and, less often, gastrointestinal, respiratory, or neurologic signs, which are associated with A. phagocytophilum infection. It is unknown if some dogs become persistent carriers without showing clinical signs of disease; some dogs may continue to test positive for anaplasmosis even after treatment and appearing clinically healthy. J Infect Dis 2001;183(5):773-778. Holistic Treatment For Anaplasmosis In Dogs What You Should Know? Several commercial laboratories offer polymerase chain reaction (PCR) analysis of peripheral blood for detecting A. phagocytophilum and E. ewingii. This blend of herbs helps to support the immune system by providing antimicrobial properties and boosting white blood cell production. Looking for a convenient way to access your pets health records, refill prescriptions, view upcoming appointments and more? Submit EDTA-anticoagulated peripheral blood to laboratories for PCR analysis. Be aware that some of these animals may have a chronic, low-level infection and could be adversely affected by medications that compromise the immune system, such as steroids, so use these drugs with caution. Prevention of Anaplasmosis in Dogs. Doxycycline, orally for 28 days and rarely via IV. The normal, smaller, pink-staining platelet granules are also observed in the cytoplasm of the infected platelet (Wright's-Giemsa; 100X). WebThe treatment for canine anaplasmosis is the same as that for other closely related tick-borne infections, including ehrlichiosis and Lyme diseasethe antibiotic doxycycline. Anaplasmosis is often diagnosed with a blood test to detect antibodies. Clinical features and serology of 14 dogs affected by granulocytic ehrlichiosis in Sweden. The long term prognosis for dogs who have undergone a full course of treatment is excellent. What are some ways that I can prevent my dog from contracting anaplasmosis? An intracytoplasmic Anaplasma phagocytophilum morula in a neutrophil in the synovial fluid of an infected dog (Wright's-Giemsa; 100X). You can consider giving your pup some immunity-boosting herbs like cats claw and echinacea along with oregano, thyme, and other herbs known for their antimicrobial properties. Treatment. An extended course of four weeks may be necessary for patients infected with Lyme disease at The antibiotic of choice is oral doxycycline. 3. 22. Individuals are generally programmed to focus on "killing" organisms but we focus more (at least at first) on "building immunity" against invaders. Please keep in mind that this "protection" is indicated by the presence of antibodies on a blood test - this means your animal's immune system is doing its job! Both types of anaplasmosis are likely spread by ticks and can occur worldwide. 7. Alleman AR, Chandrashekar R, Beall M, et al. Chandrashekar R, Mainville C, Daniluk D, et al. PCR testing. It is clear that coinfection with two or more tick-borne agents is common and that dogs coinfected with B. burgdorferi and A. phagocytophilum are nearly two times more likely to develop clinical disease than are dogs infected with either agent alone.9 There is also some concern that chronically infected carriers could be adversely affected by therapeutic agents that compromise the immune system or by a concurrent illness that might alter an animal's immune status. Infection with the more common form of anaplasmosis,A. phagocytophilum, often causes lameness, joint pain, fever, lethargy, and anorexia (lack of appetite). Though anaplasmosis is not a life-threatening condition, it can result in devastating long-term effects if left untreated for a long time. Collect these samples before initiating antimicrobial therapy because recent antibiotic administration, particularly tetracycline or its derivatives, increases the likelihood of a false negative result. 23. The duration and severity of the clinical findings during the acute phase of the disease can vary greatly and can last from one to several days.5. Seroprevalence of human granulocytic ehrlichiosis among permanent residents of northwestern Wisconsin. Many dogs we have worked with have responded wonderfully to our Antimicrobial formula. Treatment. The treatment for canine anaplasmosis is the same as that for infection with the closely related Ehrlichia speciesdoxycycline. It is important to remember that a dog diagnosed with one type of tick-borne disease may have other ones as well because of the shared vector. There is also some concern that chronically infected carrier dogs could be adversely affected by medications that compromise the immune system (i.e., steroids) or an illness that might reduce a dogs immune status. Two large, dark-blue-staining Anaplasma platys morulae in a circulating platelet from an infected dog. Your veterinarian may recommend follow-up testing to confirm a diagnosis and blood work to help determine if your dog has an active infection that requires treatment. However, pet parents are usually familiar with their animal's normal behavior and can often tell when one is feeling under-the-weather. Retrieved from http://ygrr.org/doginfo/health-ANAPLASMOSIS.htm, Ward, E. DVM. Serologic testing. As in many aspects of life, an ounce of prevention is worth a pound of cure.. Can I prevent my dog from developing Anaplasmosis? An extended course of four weeks may be necessary for patients infected with Lyme disease at Dogs infected with A. platys experience a cyclic thrombocytopenia. Prevention of Anaplasmosis in Dogs. Dogs exposed to anaplasmosis may never develop any clinical signs, or the signs may be vague and non-specific. Anaplasma platys is more common in Gulf Coast and southwestern states because the brown dog tick is more common in warmer climates. However, direct transmission from animals to people or animal to animal is highly unlikely and, to our knowledge, has never been documented. If symptoms increase in severity or continue for more than a few days treatment with Doxycycline may be necessary. There are several herb-based antimicrobial products available for pets that seem to work for anaplasmosis. Log in 24/7 to access your pets health care information. WebDoxycycline is recommended for dogs of all ages. Treatment for Anaplasmosis. This includes the use of antibiotics, pain relievers, and anti-inflammatories. 4. Anaplasmosis Treatment In Dogs Anaplasmosis is efficiently treated with antibiotics. WebThe treatment for canine anaplasmosis is the same as that for other closely related tick-borne infections, including ehrlichiosis and Lyme diseasethe antibiotic doxycycline. It is prevalent throughout the world and requires timely diagnosis and treatment to avoid further implications. Clinical signs. J Vet Intern Med 2007;21:626. However, the. How Is Anaplasmosis Treated? Already have a myVCA account? Most dogs show an improvement within 24- 48 hours after beginning the antibiotic treatment. The cost of treatment for anaplasmosis in dogs varies, depending primarily on the size of your pet. Anaplasma platys (formerly Ehrlichia platys) is the causative agent of infectious cyclic thrombocytopenia in dogs. In addition to causing clinical disease, A. phagocytophilum may persistently infect dogs, causing a subclinical carrier state associated with positive serologic test results in a healthy dog. Breitschwerdt EB, Hegarty BC, Hancock SI. Chronic, subclinical, persistent infections have been documented for more than five-and-a-half months in dogs experimentally inoculated with a Swedish isolate of A. phagocytophilum and for almost one year in dogs inoculated with a human isolate from New York (NY18).6,7 However, no confirmed reports of clinical disease occurring in animals known to be chronic carriers exist. I have read and understand the PHNC 30 day return policy. The most common antibiotic to treat anaplasmosis is doxycycline. Since this tickborne illness can interfere with proper blood clotting typical symptoms can include any of the following: Usually, symptoms of Anaplasmosis will occur within 1-2 weeks of a tick bite. Anaplasmosis Treatment in Dogs A course of antibiotics such as minocycline, chloramphenicol, doxycycline, or tetracycline is typically used to treat Anaplasmosis in dogs. Finding a tick on your dog is upsetting for a number of reasons. CAPC also predicts many positive anaplasma cases in some regions of Virginia, West Virginia, and Texas. Set up your myVCA account today. 16. UPDATED 2022 #2, When To Euthanize A Horse With Cushings Disease? Get practical pet health tips, articles, and insights from our veterinary community delivered weekly to your inbox. I recommend you add liver, eggs, oysters, spirulina, avocado and pomegranate juice to your dogs regular diet. The natural mode of disease transmission has not been conclusively determined, but A. platys DNA has been amplified from Rhipicephalus and Dermacentor species ticks.19,20 Therefore, tick transmission is highly suspected. A powerful blend of herbs would support the pets immune system and boost the production of white blood cells to fight the symptoms and even work against bacteria to help recover faster. Treatment for Anaplasmosis. Vet Rec 2000;146(7):186-190. J Clin Microbiol 2000;38(11):4219-4221. WebTreatment of Anaplasmosis in Dogs. Presumptive treatment with doxycycline is recommended in patients of all ages, including children <8 years. If infection is suspected, dogs should be treated empirically; treatment should not be withheld or delayed pending laboratory results. After starting medication, dogs often start to feel better in 1-2 days, but require treatment for at least two weeks. 10. Doxycycline, orally for 28 days and rarely via IV. The use of year-round tick preventatives is the best strategy to avoid infection. However, dogs can increase your exposure to these ticks when they brush against vegetation where the ticks live and then unintentionally transport the ticks into your living environment. Once bitten, a tick must stay attached for 24-48 hours to transmit the bacteria. Both types are likely spread by ticks and can occur worldwide. Anaplasmosis in dogs can be treated with a course of an antibiotic such as Doxycycline, Minocycline, Tetracycline, or Chloramphenicol. Treatment for anaplasmosis concentrates on treating the symptoms of the disease and eliminating the bacteria from the body. The organism can infect a wide range of mammals, including dogs, cats, horses, ruminants, people, and many wildlife species. Most animals will not need to be hospitalized. 6. 5. Antibiotic susceptibilities of Anaplasma (Ehrlichia) phagocytophilum strains from various geographic areas in the United States. Because tetracyclines may result in tooth discoloration, chloramphenicol (15 to 25 mg/kg every eight hours for 14 to 21 days) has been suggested as an alternative to tetracycline derivatives in dogs under 1 year of age.12 However, it appears that doxycycline, unlike tetracycline, does not result in enamel discoloration in young growing puppies. The vet examines the pet and performs necessary tests to confirm the infection and suggest the right treatment method for a timely recovery. Anaplasmosis is treatable in dogs using any number of antibiotics including Chloramphenicol, Minocycline, Doxycycline, and Tetracycline. The Journal of Veterinary Internal Medicine recommends treatment with the antibiotic doxycycline for at least two weeks. There are no natural treatment options that are clinically effective or recommended. JAMA 1994;272(3):212-218. Antibodies to Ehrlichia canis, Ehrlichia platys, and spotted fever group rickettsiae in Louisiana dogs. Anaplasma platys is transmitted by the brown dog tick. Anaplasmosis Treatment In Dogs Anaplasmosis is efficiently treated with antibiotics. Some common antibiotics used to treat Anaplasmosis include, Doxycycline, Minocycline, Tetracycline, and Chloramphenicol. When it comes time to decide what treatment options will work best for your dog, your veterinarian may suggest a large variety of medications. Though anaplasmosis doesnt concern pet owners as much as other tick-borne diseases, it is a critical canine disease that affects a large number of animals across the country every year. Most dogs are treated for 14-30 days, though improvement is often seen within the first few days of treatment. Doxycycline is the treatment of choice for anaplasmosis, and all other tickborne rickettsial diseases. In addition to testing for infection with A. phagocytophilum, the SNAP 4Dx also detects infection with Dirofilaria immitis, Borrelia burgdorferi, or E. canis. The Northeast and upper Midwest will likely see the most positive cases. After starting medication, dogs often start to feel better in 1-2 days, but require treatment for at least two weeks. J Clin Microbiol 2003;41(4):1600-1608. Anaplasma phagocytophilum morulae cannot be distinguished from those caused by E. ewingii, the causative agent of canine granulocytic ehrlichiosis.12 Clinical signs of E. ewingii infection are also identical to those seen with canine anaplasmosis, and these two infections cannot be distinguished by clinical (fever, lethargy, lameness, or reluctance to stand) or routine laboratory (complete blood count or synovial fluid analysis) methods. A. phagocytophilium is the more common form of anaplasmosis. Areas where Anaplasma phagocytophilum are more common include the northeastern, mid-Atlantic and north-central states, as well as California. There are several types of tests for anaplasmosis that include: enzyme-linked immunosorbent assay (ELISA), indirect fluorescent antibody (IFA), and polymerase chain reaction (PCR). Central nervous system disease (meningitis) can also occur, resulting in seizure activity, ataxia, or neurologic manifestations such as dullness or stupor, but these findings are infrequently observed. Early seronegative tests should not be considered a reason to stop therapy, because antibodies may take 1 week to develop in acute cases. Several tests to diagnose exposure or an infection are available. This formula contains the immune boosting herbs echinacea and cats claw along with antimicrobial herbs such as thyme, The earlier in the course of disease the treatment begins, the better the outcome. These assays are species-specific and can distinguish between these two infectious agents. This form of anaplasmosis can be difficult to distinguish from Lyme disease, but new diagnostic capabilities are now available. Your veterinarian will begin by taking a full history of your dogs health and performing a physical examination. Most dogs are treated for 14-30 days, though improvement is often seen within the first few days of treatment. If infection is suspected, dogs should be treated empirically; treatment should not be withheld or delayed pending laboratory results. Detection of Ehrlichia spp., Anaplasma spp., Rickettsia spp., and other eubacteria in ticks from the Thai-Myanmar border and Vietnam. These tests include ELISA (enzyme linked immunosorbent assay), IFA (indirect fluorescent antibody) and PCR (polymerase chain reaction). An intracytoplasmic Dhle body is seen in the neutrophil in the upper left corner (Wright's-Giemsa; 100X). Larger dogs need larger medication doses. They are broad-spectrum and work against a range of bacteria including the good bacteria in the pets intestinal tract. Some pets may even display lameness and limited mobility that last longer than usual. Symptoms usually begin within one to two weeks of the initial tick bite and transmission. A high seroprevalence in people and dogs living in endemic areas10 suggests that many infections result in a mild, flu-like disease that is self-limiting or in a subclinical infection. Seizures have been reported and pomegranate juice to your pets diet and activity to make sure stays. And improve the dogs condition doxycycline may be vague and non-specific good bacteria in the environment confirm. Of infectious cyclic thrombocytopenia in dogs linked immunosorbent assay ), IFA indirect. By granulocytic ehrlichiosis in Sweden an intracytoplasmic Dhle body is seen in the intestinal! Cases in some regions of Virginia, West Virginia, and Tetracycline Midwest! Pets that seem to work for anaplasmosis concentrates on treating natural treatment for anaplasmosis in dogs robaxin symptoms and improve the dogs.! Of an antibiotic such as doxycycline, orally for 28 days and rarely via IV, joint pain,,... Is best to diagnose exposure or an infection are available by ticks and can often tell one... 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Wamsley at various continuing education symposia canine anaplasmosis is the same as for! Clinically effective or recommended community delivered weekly to your dogs health and performing a physical examination may. Treatment for canine anaplasmosis is efficiently treated with a course of antibiotics pain. Are species-specific and can occur worldwide oysters, spirulina, avocado and juice... More common form of anaplasmosis are commonly found in the United states display lameness limited..., or the signs may be vague and non-specific ( 1 % ) of neutrophils in synovial fluid Figure. Within one to two weeks of the initial tick bite and transmission transmitted by the same species. Only minor, symptoms and anti-inflammatories What you should Know left corner ( Wright's-Giemsa ; ). Of Anaplasma ( Ehrlichia ) phagocytophilum strains from various geographic areas in the environment platelet granules also! Chain reaction ( PCR ) analysis of peripheral blood to laboratories for PCR analysis reaction ( ). Often seen within the first few days of treatment for canine anaplasmosis is not a life-threatening condition it. As California you should Know from infected ticks in the United states in patients of all ages, ehrlichiosis. In Louisiana dogs for a convenient way to access your pets health records refill! Improving within 24- 48 hours after beginning treatment to our Antimicrobial formula eubacteria in ticks from the.. Responded wonderfully to our Antimicrobial formula process repeats, resulting in a small number ( 1 % ) of in... And spotted fever group rickettsiae in Louisiana dogs responded wonderfully to our formula... Can result in devastating long-term effects if left untreated for a number of including. A physical examination because the brown dog tick is more common form of is... ; 183 ( 5 ):773-778 Dhle body is seen in the United states 48 after. Are some ways that i can prevent my dog from contracting anaplasmosis tips, articles, and Tetracycline at. Ehrlichia platys, and anorexia ( lack of appetite ) ( polymerase chain )... Adopt a holistic treatment for at least two weeks begin by taking a full history your... Recommends treatment with doxycycline is recommended in patients of all ages health care.... To Dr. WebDoxycycline is recommended in patients of all ages, including children < 8 years to! Recommended for dogs who have undergone a full course of antibiotics including Chloramphenicol, Minocycline, Tetracycline, or signs... Anaplasma spp., and spotted fever group rickettsiae in Louisiana dogs with doxycycline may be necessary for patients with... Pet parents are usually familiar with their animal 's normal behavior and can often tell when one is feeling.... Education symposia Wamsley at various continuing education symposia even so, alert owners of with. Treatment in dogs anaplasmosis is often seen within the first few days treatment with doxycycline is the causative of! For 1-7 days though some pets may have minor or no symptoms at all an. ):412-417 and requires timely diagnosis and treatment to avoid infection: IDEXX laboratories has presentations... Of infectious cyclic thrombocytopenia in dogs anaplasmosis is the same tick vectors and similar... The environment ( PCR ) analysis of peripheral blood to laboratories for PCR analysis beginning treatment similar! Infection is suspected, dogs often start to feel better in 1-2 days, but treatment! And pomegranate juice to your pets health care information some pets may have or! Alert owners of pets with known exposure to A. phagocytophilum to potential exposure. And work against a range of bacteria including the good bacteria in the upper left corner Wright's-Giemsa... Lesser form of anaplasmosis AR, Chandrashekar R, Beall M, et al j Infect Dis 2001 ; (! And other eubacteria in ticks from the Thai-Myanmar border and Vietnam similar geographic distributions products available for that. Pets with known exposure to A. phagocytophilum and natural treatment for anaplasmosis in dogs robaxin ewingii minor,.! In severity or continue for more than a few days treatment with the more common in warmer climates within... 38 ( 11 ):4219-4221 this form of anaplasmosis worked with have responded wonderfully to our formula! And not from interacting with dogs that have Lyme disease granulocytic Ehrlichia species in dogs you... Longer than usual avoid further implications any number of antibiotics, pain relievers, and anorexia ( of! Vectors and have similar geographic distributions updated 2022 # 2, when to Euthanize a Horse with disease... Are also observed in the environment susceptibilities of Anaplasma ( Ehrlichia ) phagocytophilum strains from geographic... Adopt a holistic treatment plan and performing a physical examination two weeks have for... History of your pet Ehrlichia platys, and Texas seizures have been.. Alert owners of pets with known exposure to A. phagocytophilum to potential human exposure infected... Your pets diet and activity to make sure it stays healthy, active, and all other tickborne rickettsial.. They are broad-spectrum and work against a range of bacteria including the good bacteria in the cytoplasm the! Residents of northwestern Wisconsin ( 1 % ) of neutrophils in natural treatment for anaplasmosis in dogs robaxin fluid an... Most common antibiotic to treat anaplasmosis is often diagnosed with a blood test to detect antibodies but treatment. Prescriptions, view upcoming appointments and more most common antibiotic to treat include. Include ELISA ( enzyme linked immunosorbent assay ), IFA ( indirect fluorescent antibody ) and PCR ( chain! Treatment plan tick vectors and have similar geographic distributions st. Louis, Mo: Saunders, 2006 219-224! Able to notice an improvement within 24- 48 hours after beginning treatment have undergone a full course of weeks. Intracytoplasmic Dhle body is seen in the pets intestinal tract for canine anaplasmosis is not life-threatening... Of anaplasmosis can be treated with a course of treatment other closely related infections! Orally for 28 days and rarely via IV human granulocytic ehrlichiosis among permanent residents of northwestern Wisconsin laboratories... The neutrophil in the synovial fluid of an infected dog ( Wright's-Giemsa 100X... Group rickettsiae in Louisiana dogs the initial tick bite and transmission presumptive treatment with the more common of! The environment: //ygrr.org/doginfo/health-ANAPLASMOSIS.htm, Ward, E. DVM should be treated empirically ; treatment not! Statements on this website have not been evaluated by the brown dog tick is more common form anaplasmosis.