TICK PARALYSIS

Tick Paralysis
Megan OKelly
Baker College

TICK PARALYSIS

History
Patient presents with progressive hind limb paralysis, changes in bark, changes in
breathing pattern, gagging, grunting, coughing, regurgitation or vomiting. The patients body
temperature can also be affected, but may be normal in the early stages of tick paralysis. The
effects of the toxins effect the ability to regulate temperature so normal thermoregulation is lost.
Loss of thermoregulation can cause hyper- or hypothermia and in very severe cases of tick
paralysis the ability for the animal to shiver is lost. It is noted that hyper- and hypothermia are
often misdiagnosed because it happens so quickly.
Diagnostic Work Up
Laboratory tests specifically for tick paralysis are not available, but there are several
procedures that are sometimes helpful include a PCV, serum protein, and radiographs. With
normal serum protein the PCV will be increased which tells the doctor that there has been a fluid
shift into the lungs and results in a guarded prognosis. Other changes in the PCV include higher
glucose, cholesterol, and phosphate levels, along with a decrease in blood potassium levels. It is
noted that none of these are specific to tick paralysis and do not indicate severity or prognosis of
the disease. Radiographs would be used to assess the presence and amount of pulmonary edema,
megaesophagus, and aspiration pneumonia.
Physical Exam Findings
During a physical exam you should be looking and feeling for ticks. If the animal has long
fur you should be combing through in small sections as to be very thorough, or shave the dog
(with owner consent) to make it much easier to find a tick if there is one. There are certain

TICK PARALYSIS

species of ticks that favor the ear to suck from and that is where they will live so it is imperative
to check inside the ear and ear canal as best as possible. Be sure to check around eyes and mouth,
inside eyelids and cheek flaps, take collars off and check under them. Also check in between
every digit and between pads to ensure there was no tick attachment there. If there is no tick
present but the patient is showing the clinical signs of tick paralysis you should be looking for
the crater that is left by the tick once it is detached from the animal.
Discussion
Tick paralysis occurs when the saliva of certain female ticks enters the hosts bloodstream
while she is feeding and releases neurotoxins. Progressive paralysis starts from the hind limbs
and moves upward and can affect single organs with or without the classic paralysis presentation.
The progression of the toxins is not predictable and vary in every situation. The organs that are
affected can include the heart, airway, bladder, lungs, esophagus, and diaphragm, just to name a
few. If the diaphragm is involved, it can be and is most likely fatal. Ticks that are found should
be removed immediately, failure to remove ticks can result in death.
Treatment
Removal of the tick(s) is imperative and the animal typically starts to improve within
twenty-four hours and completely recover in seventy-two hours. There is a specific order in
which tick paralysis must be treated: first the toxicity and paralysis, second things such as
aspiration pneumonia, and any tertiary problems like chronic weakness. Tick antitoxin serum
(TAS) is an immune serum against the toxin and is the primary product of choice for treating tick
paralysis. It is important that TAS is given as early as possible, in dogs the dosage is 0.5-1mL/kg
and is given IV slowly over a twenty-minute period, and rushing this can cause anaphylaxis. If

TICK PARALYSIS

the animal has multiple ticks the dosage of TAS should be increased, however, there is no
specific data available for how much each animal should receive. It is crucial to minimize stress
caused to the animal so the toxins do not spread even further at a faster rate. Sometimes
Acepromazine is given subcutaneously before medications or handling is done to reduce stress,
however, this should not be done with patients who are depressed, hypotensive, or hypothermic.
Sometimes general anesthesia is required for animals who are severely fatigued or are having a
difficult time breathing, this allows for better management of oxygen, esophageal drainage, and
upper respiratory tract suction. Atropine can be used in animals who have an increased amount of
GI and respiratory secretions which lowers the risk of aspiration pneumonia. Antiemetic therapy
is also used for patients who are vomiting, if the patient is vomiting you must be sure to aspirate
everything out of the esophagus and upper respiratory to reduce risk of aspiration pneumonia.
Broad-spectrum bactericidal antibiotics are given in severe cases to help avoid development of
aspiration pneumonia, but it is crucial that they are given as soon as possible. Diuretics like
furosemide and cardiac medications such as Verapamil may also be given to help cardiac
function. While the animal is hospitalized, it should be repeatedly and systematically rechecked
for more ticks, especially if there is a failure to improve. Prognosis for tick paralysis is good,
about 95% of cases live with treatment of TAS and antibiotics, the other 5% who do not live are
often too far into the stages of tick paralysis and despite all efforts they cannot beat the dyspnea
and often times have advanced respiratory paralysis.

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5
References

Atwell, R., BVSc, PhD, FACVSc. (2014, January). Overview of Tick Paralysis. Retrieved July
27, 2016, from
http://www.merckvetmanual.com/mvm/nervous_system/tick_paralysis/overview_of_tick
_paralysis.html

Burt, A., DVM, Ellis, S., BSc., & Gammie, J., BSc, MSc, DVM. (1978, December). A Case of
Tick Paralysis in a Dog. The Canadian Veterinary Journal, 19(12), 347. Retrieved July
27, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1789437/?page=1

Sirois, Margi. Principles and Practice of Veterinary Technology. 3rd ed. Canada: Elsevier, 2011.
Print. Pages 232-233.

Tick Paralysis. (2016). Retrieved August 02, 2016, from https://www.atdove.org/video/tickparalysis