Ehrlichia and Lyme Disease--Getting the Right Diagnosis

Consider Illnesses from Other Locations

We’ve been discussing how difficult it is to get the right diagnosis for a pet’s illness and have identified 5 problem areas:
1. Working with incomplete or misleading information
2. Being presented with a pattern of illness that isn’t normal or typical
3. Grabbing onto one major symptom and thinking that’s where the focus should be
4. Considering the problem only in light of what local pets develop
5. Using stereotypes such as breed or age

We’ve covered the first 3 problem areas; now, the fourth: Considering the problem only in light of what local pets develop. If we fall into this trap, we can misdiagnose pets that have Ehrlichia or Lyme disease.

“Arkansas” assumptions
In geographical areas that are thick with ticks, such as the southern United States, we have more tick-borne diseases, including Ehrlichia and Lyme disease. Because Ehrlichia and Lyme disease both cause joint pain, we may assume a lame pet from Arkansas has one of these problems. We’re especially prone to thinking a lame pet has Lyme disease or Ehrlichia if we run blood tests and find the pet’s blood has a rich supply of white blood cells programmed to attack the Lyme spirochete bacteria or Ehrlichia Rickettsia bacteria. The real problem with the pet may be hip dysplasia or cruciate ligament disease.

Urban assumptions
We make the opposite mistake if we have lame pets in urban areas of British Columbia Canada where ticks are rare. In urban BC, we may see a lame pet and assume it doesn’t have Ehrlichia and Lyme disease. We perpetuate this mistaken diagnosis by not running tests for these diseases and letting families know that the diseases are so rare in BC that we’ll save their money by not testing for them. Nobody wants veterinarians to run unnecessary tests, but we also don’t want a pet’s lameness to be misdiagnosed. If we limit our diagnosis to include only local problems that cause lameness, we may think the problem is hip dysplasia or cruciate ligament disease when the pet was rescued from Arkansas where it was exposed to both Ehrlichia and Lyme disease.

Take the time to get the diagnosis right
Getting the correct diagnosis often requires more than 15 minutes allotted for the typical office call. It can take longer because we need a thorough history of where the dog came from, how it has been treated in the past, just as we need a thorough history describing what is happening to it in the current living situation.

To help your pet get diagnosed correctly, be willing to pay your veterinarian time to ask all the questions necessary to identify problems that originate outside the local area.

What’s coming?
In the last several Caring for Pets blog entries, we’ve covered many problems that lead to misdiagnoses of illness in pets (Working with incomplete or misleading information; Being presented with a pattern of illness that isn’t normal or typical; Grabbing onto one major symptom and thinking that’s where the focus should be; and Considering the problem only in light of what local pets develop).

In the next blog, we’ll cover one more cause of misdiagnosis: Using stereotypes, such as breed or age.