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Background   Rhipicephalus sanguineus  is a ubiquitous tick responsible for transmitting  Ehrlichia canis  and most likely  Anaplasma platys  to dogs, as either single or co-infections. The objective of this study was to assess the effects of either simultaneous or sequential experimental infections with  E. canis  and  A. platys  on hematological and serological parameters, duration of infection, and efficacy of doxycycline therapy in dogs infected with one or both organisms. Six dogs per group were either uninfected,  A. platys  infected,  E. canis  infected,  A. platys  and  E. canis  co-infected,  A. platys  infected and  E. canis  challenged or  E. canis  infected and  A. platys  challenged at day 112 post-infection (PI). Doxycycline treatment was initiated at 211 days PI, followed by dexamethasone immunosuppression beginning 410 days PI.    Results  Initially, transient decreases in hematocrit occurred in all groups infected with  E. canis , but the mean hematocrit was significantly lower in the  A. platys  and  E. canis  co-infected group. All dogs except the controls developed marked thrombocytopenia after initial infection followed by gradually increased platelet counts by 112 days PI in groups with the single infections, while platelet counts remained significantly lower in the  A. platys  and  E. canis  co-infected group. Both sequential and simultaneous infections of  A. platys  and  E. canis  produced an enhanced humoral immune response to  A. platys  when compared to infection with  A. platys  alone. Likewise, co-infection with  E. canis  and  A. platys  resulted in a more persistent  A. platys  infection compared to dogs infected with  A. platys  only, but nearly all  A. platys  infected dogs became  A. platy s PCR negative prior to doxycycline treatment.  E. canis  infected dogs, whether single or co-infected, remained thrombocytopenic and  E. canis  PCR positive in blood for 420 days. When treated with doxycycline, all  E. canis  infected dogs became  E. canis  PCR negative and the thrombocytopenia resolved. Despite immunosuppression, neither  A. platys  nor  E. canis  DNA was PCR amplified from doxycycline-treated dogs.    Conclusions  The results of this study demonstrate that simultaneous or sequential infection with  A. platys  and  E. canis  can alter various pathophysiological parameters in experimentally infected dogs, and because natural exposure to multiple tick-borne pathogens occurs frequently in dogs, awareness of co-infection is important in clinical practice.

Experimental infection and co-infection of dogs with Anaplasma platys and Ehrlichia canis: hematologic, serologic and molecular findings