Veterinary Microbiology 149 (2011) 172–176

Contents lists available at ScienceDirect

Veterinary Microbiology
journal homepage: www.elsevier.com/locate/vetmic

Research article

Anaplasmosis in dogs: The relation of haematological, biochemical and

clinical alterations to antibody titre and PCR confirmed infection
Urska Ravnik a,*, Natasa Tozon a, Katja Strasek Smrdel b, Tatjana Avsic Zupanc b
a
Small Animal Clinic, Veterinary Faculty, University of Ljubljana, Cesta v Mestni log 47, SI-1000 Ljubljana, Slovenia
b
Institute of Microbiology, Medical Faculty, University of Ljubljana, Zaloska 4, SI-1000 Ljubljana, Slovenia

A R T I C L E I N F O A B S T R A C T

Article history: Laboratory and clinical parameters of 149 dogs, exposed to Anaplasma phagocytophilum (A.
Received 2 May 2010 phagocytophilum), and 19 control dogs were evaluated and compared retrospectively. The
Received in revised form 21 September 2010 aim of our study was to determine statistically significant differences of selected
Accepted 8 October 2010 parameters between groups of patients, divided according to the immunofluorescence
(IFA) titres, in attempt to improve current diagnostic and treatment criteria.
Keywords: Exposure to A. phagocytophilum was confirmed by IFA and infection by PCR. Based on
Dogs the results, the dogs were divided into 8 groups (6 groups of seropositive dogs according to
Clinical pathology
the antibody titre, 1 group of PCR positive dogs, and a control group). Selected parameters
Anaplasmosis
were compared between groups. Thrombocytopenia was confirmed to be the most
prominent haematological change in IFA and/or PCR positive dogs. There were no
statistically significant differences in clinical and haematological observations between
groups of different IFA titre but clear overall differences between each IFA and PCR positive
groups compared to the control group. Our results showed the necessity of introducing
additional diagnostic procedures in clinical practice, since antibody titre and haemato-
logical parameters are not sufficient to confirm the clinical relevance of exposure to A.
phagocytophilum in a particular patient.
ß 2010 Elsevier B.V. All rights reserved.

1. Introduction nervous system (seizures or proprioceptive deficits) (Greig

Anaplasmosis is a tick-borne disease of animals and
humans that occurs worldwide. Although it can be caused
by a number of different species from the family Anaplas-
mataceae, in our study only infection with Anaplasma
phagocytophilum (A. phagocytophilum) was included.
Clinical signs of anaplasmosis vary but the disease most
commonly presents as an acute febrile syndrome with
elevated body temperature, lethargy, anorexia and reluc-
tance to move (Harrus et al., 2005). More localised signs
may be present, especially in the chronic phase of the
disease, affecting the musculoskeletal system (lameness),
the gastrointestinal system (diarrhoea), or the central
* Corresponding author. Tel.: +386 1 4779 277; fax: +386 1 4779 349.
E-mail address: urska.ravnik@vf.uni-lj.si (U. Ravnik).
et al., 1996; Harrus et al., 2005).
Haematological changes in dogs infected with different
Ehrlichia and Anaplasma species are similar, even though
they infect different blood cells, suggesting that direct
cytopathic injury is not the major pathologic mechanism of
cytopenias (Scorpio et al., 2006). Patients develop anaemia,
thrombocytopenia, and leucopenia.
Biochemical abnormalities in anaplasmosis may
include mildly elevated serum alkaline phosphatase (AP)
and alanine aminotransferase (ALT) activities (Harrus
et al., 2005), and hypoalbuminemia (Greig et al., 1996).
Urinalysis can reveal proteinuria—in Greig’s study (1996)
38% of dogs had proteinuria without evidence of lower
urinary tract disease.
The aim of the study was to determine statistically
significant differences of haematological, selected bio-
chemical, urine and clinical parameters between groups

0378-1135/$ – see front matter ß 2010 Elsevier B.V. All rights reserved.
doi:10.1016/j.vetmic.2010.10.005
 U. Ravnik et al. / Veterinary Microbiology 149 (2011) 172–176
of patients with different antibody immunofluorescence
(IFA) titres and PCR positive patients, in order to challenge
the current diagnostic and treatment criteria.
2. Materials and methods
2.1. Animals and inclusion criteria
The medical records of 149 dogs with suspected
anaplasmosis presenting at the Small Animal Clinic of the
Veterinary Faculty, University of Ljubljana, between 1999
and 2009 were reviewed retrospectively for haematological,
selected biochemical, urine and clinical parameters.
Dogs included in our study were considered to have
anaplasmosis based on their IFA and/or PCR positive result,
regardless of typical changes in clinical and laboratory
findings. This is not in agreement with current criteria for
active anaplasmosis (Harrus et al., 2005) but we deliber-
ately omitted those criteria since we were investigating
clinical relevance of different IFA titres.
Dogs were divided into 8 groups according to their
antibody titre and PCR result. 129 dogs were divided into 6
groups with IFA titre ranging from 1:128 to 1:2048, one
group consisted of 20 PCR positive dogs, and control group,
which comprised 19 clinically healthy, PCR negative dogs,
which were also seronegative to A. phagocytophilum.
2.2. IFA determination of A. phagocytophilum antibody titres
Serum samples were analyzed for antibodies to A.
phagocytophilum by the IFA method. Local antigen (A.
phagocytophilum), grown in a cell culture of HL60 cells,
was plated on slides. Serum specimens, diluted initially
to 1:128 in phosphate-buffered saline (PBS) containing
1% rabbit serum, were filtered. The diluted sera were
placed on the slides and incubated at 37 8C for 30 min in
a humidified chamber. After incubation the slides were
washed 3 times in PBS for 5 min and air-dried. Bound
antibodies were detected after incubation (30 min at
37 8C) with fluorescein isothiocyanate-labelled rabbit
anti-dog immunoglobulin G (IgG) (Sigma–Aldrich, MO,
USA) diluted to 1:64 in a serum diluent. Slides were
washed 3 times for 5 min in PBS, the second wash with
5% Eriochrome Black T (Sigma–Aldrich, MO, USA).
Specimens showing fluorescent intracellular inclusions
at a dilution of 1:128 were considered reactive and were
diluted up to 1:2048 and tested by IFA to determine the
titre.
2.3. PCR detection of A. phagocytophilum DNA
Whole blood from dogs was collected and leucocytes
extracted. DNA from leucocytes was extracted with QiaAmp
DNA mini kit according to the manufacturer’s instructions
(Qiagene GmbH, Hilden, Germany). The primer pair Ehr521
(TGT AGG CGG TTC GGT AAG TTA AAG) and Ehr790 (CTT AAC
GCG TTA GCT ACA ACA CAG) was used for screening all
samples. Amplified 293-bp fragments were specific for the
16S rRNA of genus Anaplasma and Ehrlichia (Kolbert, 1996).
All positive samples were additionally tested for the groESL
operon. All the amplicons were verified by sequencing.
173
Although samples were collected and analyzed over a
10 year period, PCR and IFA protocols remained
unchanged.
2.4. Haematology
Blood samples for complete blood count (CBC) and
white cell differential count (WCDC) determinations were
collected by venipuncture of v. cephalica, v. saphaena or v.
jugularis, into EDTA-containing tubes (MictrotainerTM,
Beckton and Dickinson, Franklin Lakes, USA). The haema-
tological parameters were determined by an automated
laser haematology analyser H*1 (Siemens/Bayer (former
Technicon), Munich, Germany) with species specific soft-
ware (H*1 Multi-Species V30 Software, Tarrytown, NY,
USA). The resulting CBC included white blood cells (WBCs),
red blood cells (RBCs), haemoglobin concentration (HGB),
haematocrit (Hct), mean corpuscular volume (MCV), mean
corpuscular haemoglobin (MCH), mean corpuscular hae-
moglobin concentration (MCHC) and platelet counts (PLT).
WCDC comprised determination of relative and absolute
values of neutrophils (Neutro), lymphocytes (Lympho),
monocytes (Mono), eosinophils (Eos), basophils (Baso),
and heterogeneous population of all large unstained cells
(LUC) that failed to exhibit any peroxidase activity.
2.5. Biochemical profile
Blood samples for determination of biochemical profile
were collected into serum separator tubes (Vacuette,
Greiner Bio-One, Kremsmunster, Austria) and stood for
30 min at 4 8C to clot, then centrifuged (1300  g for
10 min) to separate the serum. Serum samples were
assayed for selected biochemical parameters including
urea, creatinine, sodium (Na), potassium (K), chloride (Cl),
total protein, albumin, alanine aminotransferase (ALT) and
alkaline phosphatase (AP).
Serum concentrations of urea, creatinine, total protein,
albumin and serum activities of AP and ALT were
determined by automated chemistry analyser (RA-XT,
Siemens/Bayer (former Technicon), Munich, Germany).
Electrolytes Na, K and Cl, were determined by electrolyte
analyser Ilyte Na/K/Cl (Instrumentation Laboratory, Lex-
ington, MA, USA).
Biochemical profiles were determined in fewer sam-
ples: urea and creatinine concentrations in 65 samples, AP
in 36, ALT in 30, total serum protein in 28, albumin in 24,
and electrolytes in 32 samples. Biochemical profiles were
also determined in all dogs of the control group.
2.6. Urinalysis
Urine samples were analyzed within 2 h of sample
collection. Urinalysis included chemical analysis of urine,
performed by urine analyzer CLINITEK 50 (Siemens/Bayer,
Munich, Germany) using a standard multitest urine
dipstick, and microscopic examination of urine sediment.
Twenty-three samples of dogs, which were 19 seropo-
sitive and PCR negative to A. phagocytophilum and 4 were
PCR positive (all were also seropositive), were analyzed, as
well as all the samples from the control group.
174 U. Ravnik et al. / Veterinary Microbiology 149 (2011) 172–176

Table 1
Number and percentage of dogs according to the IFA titre and/or PCR positive result and their demographic data.

Group IFA titre Total Gender Age

1:128 1:256 1:512 1:1024 1:2048 >1:2048

IFA 17 29 24 34 19 21 144 92 (63.9) M 6.2

n (%) (11.8) (20.1) (16.7) (23.6) (13.2) (14.6) (96.6) 52 (36.1) F (0.5–13)
PCR + IFA 1 – 1 5 3 5 15 9 (60) M 6.0
n (%) (5) (5) (25) (15) (25) (10.1) 6 (40) F (1–14)
PCR 5 (3.4) 2 (40) M 2.8
n (%) 3 (60) M (1–6)

n, number of dogs; M, male; F, female; bold, patients with active anaplasmosis by currently acknowledged criteria.

2.7. Statistics were almost equally represented. Age of PCR positive

Data were analyzed with commercial software (Sigma-
Plot 11; Systat Software, Inc., USA).
All 7 groups (6 groups with IFA titre from 1:128 to
1:2048) and PCR positive group were compared to the
control group for each parameter using Mann–Whitney
Rank Sum Test or Unpaired t-test where criteria for
normality were met. Comparison of parameters between
groups was made using One-way ANOVA test, by Dunn’s
or Holm-Sidak method. Specific parameters compared
included CBC, WCDC, urea, creatinine, AP, ALT, total
protein and albumin in serum and protein in urine.
Correlation between anti-A. phagocytophilum antibody
titres and PLT concentrations was assessed using the
Pearson’s correlation analysis. Values of P < 0.05 were
considered statistically significant.
3. Results
animals ranged from 1 to 14 years (mean 5.2 years).
3.3. Clinical features
Clinical state was recorded for 126 dogs, 107 seropo-
sitive or PCR positive and 19 healthy (control group)
included in the study.
Dogs with lower IFA titres (1:128–1:1024) presented
with a wider variety of clinical signs than dogs with the
highest IFA titres (1:2048) and PCR positive animals, but
the most prominent and frequent clinical abnormalities in
all groups were elevated body temperature, lethargy, and
anorexia, which could be associated with an infectious
process, lameness and gastrointestinal signs (Table 2). A
relatively low percentage of seropositive dogs lacked
clinical signs, all in the groups with IFA titres 1:256, 1:512,
and 1:1024. 6.7% of seronegative and PCR positive dogs
were without any clinical signs.

3.1. A. phagocytophilum specific antibody detection by IFA 3.4. Haematological results

The IFA cut-off antibody titre was set at 1:128. 144 of
149 (96.6%) exposed dogs were IFA positive, of which 15
(10.4%) were also PCR positive.
The distribution of dogs according to their IFA and PCR
result and epidemiological data (gender and age) is
summarised in Table 1.
3.2. A. phagocytophilum detection by PCR
Twenty of 149 (13.9%) selected dogs were PCR positive,
and 15 of 20 (75%) also IFA positive. Males and females
Median data for haematological parameters of 149 IFA
and/or PCR positive dogs and 19 control dogs, and pairwise
multiple comparison between groups for selected para-
meters, WBC, RBC, Hct, PLT, Neutro, Lympho, Mono are
summarised in Table 3.
According to the current criteria for establishing
diagnosis of anaplasmosis (Harrus et al., 2005), dogs
included in our study exhibited significant discrepancies,
relative to the control group, in all selected parameters
except WBC values (Table 3). Median values for Neutro
were significantly higher and for Lympho and Mono

Table 2
Frequency of clinical signs in groups according to the IFA titre and PCR.

Clinical signs (%) IFA titre/PCR

1:128 1:256 1:512 1:1024 1:2048 >1:2048 PCR Control

n = 16 n = 25 n = 15 n = 20 n=6 n = 10 n = 15 n = 19

Fever, lethargy, anorexia 43.8 20.0 66.7 45.0 50.0 70.0 93.3 0
Lameness 37.5 40.0 13.3 30.0 33.3 50.0 33.3 0
Gastrointestinal signs 37.5 20.0 26.7 25.0 16.7 10.0 20.0 0
Spontaneous bleeding 12.5 8.0 20.0 0 0 10.0 0 0
skin disease 12.5 4.0 0 15.0 0 0 0 0
Epileptiformous seizures 0 20.0 6.7 0 0 0 0 0
Respiratory or urinary tract disease 12.5 4.0 6.7 5.0 0 0 6.7 0
No clinical signs 0 16.0 6.7 5.0 0 0 6.7 100

n, number of dogs; bold, patients with active anaplasmosis by currently acknowledged criteria.
 U. Ravnik et al. / Veterinary Microbiology 149 (2011) 172–176 175

Table 3
Selected haematological results (the median, minimum/maximum value) in seropositive and/or PCR positive and control dogs and pairwise multiple
comparison between groups for each parameter.

Group Parameter

WBC RBC Hct PLT Neutro Lympho Mono

(6.0–18.0  109/l) (5.1–8.5  1012/l) (0.35–0.55 l/l) (200–500  109/l) (60–80%) (12–30%) (3–10%)
xx xx xx
1:128 11.01 6.60 0.46 141.5 61.6 25.0 5.0
(n = 16) (6.52/58.38) 3.64/8.18 0.26/0.55 6.0/305.0 38.7/88.4 4.5/41.6 0.6/10.1
1:256 9.88 6.29xx 0.43xx 157.0xx 67.1x 19.6x 5.4
(n = 29) 4.72/26.82 3.05/8.39 0.22/0.62 9.0/381.0 33.4/93.9 0.6/43.7 0.5/14.6
1:512 11.29x 6.48xx 0.45xx 159.0xx 67.2xx 20.2x 4.5
(n = 23) 5.14/48.48 3.41/8.91 0.24/0.62 27.0/333.0 15.9/82.8 5.9/60.3 0.5/11.6
1:1024 14.58xx,a 6.74xx 0.46xx 187.5x,a 71.6xx 19.1xx 4.3
(n = 29) 3.07/44.35 2.03/8.44 0.14/0.56 10.0/398.0 48.0/88.2 5.4/40.5 1.0/12.4
1:2048 10.30 6.67x 0.475x 186.5x 65.0x 22.6x 4.6
(n = 16) 6.41/13.90 1.87/8.60 0.16/0.53 13.0/379.0 51.3/85.5 9.7/33.3 2.1/7.9
>1:2048 9.70 6.96xx 0.48x 234.0x,a 63.4 26.9 3.3
(n = 16) 4.26/20.70 4.57/8.28 0.32/0.57 69.0/346.0 45.5/76.6 11.0/43.0 0.4/8.1
PCR positive 9.75 6.43xx 0.435xx 49.5xx 71.6x 20.4x 3.1x
(n = 20) 3.79/21.90 5.11/7.75 0.34/0.55 8.0/364.0 42.2/89.3 6.9/44.7 0.3/7.4
Control 9.80 7.68 0.53 256.0 57.1 30.6 5.0
(n = 19) 6.72/12.82 7.05/8.97 0.46/0.60 220.0/452.0 45.4/74.8 11.4/46.6 0.4/13.9
x
Significantly different from control dogs. P  0.05.
xx
Significantly different from control dogs. P  0.001.
a
Significantly different from PCR positive dogs. P  0.05.

significantly lower than in the control group. Median
values for RBC, Hct and PLT were significantly lower than in
the control group except for the group with IFA titre
>1:2048 which exhibited median and mean values for PLT
within the reference range. There was no significant
correlation between different anti-A. phagocytophilum
antibody titres and platelet count (P < 0.05).
All other haematological parameters were also
compared, but the data are not shown due to only
small discrepancies. Median values for HGB were
significantly lower in PCR and IFA positive groups than
in the control group (P < 0.05). Median values for MCV,
MCHC and MPV were significantly higher only in
individual IFA groups.
3.5. Biochemical and urine parameters
Selected biochemical parameters were evaluated but
only a few significant differences were found. The median
value for AP was significantly higher in groups with IFA
titres 1:128, 1:256, 1:1024, >1:2048, and in the PCR
positive group than in the control group (P < 0.05). There
were also significant differences between groups with IFA
titres 1:1024 and >1:2048 for total proteins and 1:512,
1:1024 for albumins and the corresponding values for the
control group.
Urinalysis revealed significant differences in protei-
nuria between groups with IFA titres 1:128, 1:256, 1:1024,
and the control group.
4. Discussion
This study revealed statistically significant differ-
ences in clinical and haematological parameters
between the seropositive groups and the PCR positive
group and between IFA and/or PCR positive groups and
control group. However no statistically significant
differences were found between groups with different
IFA titre.
Our study was conducted on altogether 168 dogs. Males
and females were almost equally represented. Harrus et al.
(2005) reported the German Shepherd Dog to be more
susceptible to clinical canine monocytic ehrlichiosis. In our
study, German Shepherd Dogs were slightly overrepre-
sented but there was no significant difference in clinical
course of the disease. The mean age of IFA and PCR positive
dogs was 6.2 and 5.2 years with the youngest being six
months of age, which in contrast with Egenvall’s study
(1997) shows that even an immature dog can get infected
and develop a disease. The predominating clinical signs in
all groups were elevated body temperature, depression,
and reluctance to move, which could be associated with an
infectious process. This signs are similar to those described
in dogs with anaplasmosis in Sweden (Egenvall et al., 1997)
and USA (Greig et al., 1996).
Inconsistent with published data (Egenvall et al., 1997,
2000) was founding of the relatively large number of
seriously ill dogs with low IFA titres and low occurrence of
IFA positive dogs without clinical signs. This shows that
height of the IFA titre cannot be directly correlated to the
incidence of clinical signs although it is possible that not all
the clinical signs found in seropositive dogs could be
attributed to anaplasmosis.
The most prominent haematological change was
thrombocytopenia with the nadir in the phase of
bacteraemia. This is also the most consistent haematolo-
gical abnormality in canine monocytic ehrlichiosis (Harrus
et al., 2005). The pathogenesis of thrombocytopenia in
both diseases is poorly understood and has been attributed
to several immunological and non-immunological
mechanisms (Waner et al., 1995; Harrus et al., 1996).
Platelet numbers usually return to the reference range
within a few days after bacteraemia (Lilliehöök et al., 1998;
Harrus et al., 2005). The results of this study showed that,
176 U. Ravnik et al. / Veterinary Microbiology 149 (2011) 172–176
regardless of the antibody titre level, the acute clinical
signs of anaplasmosis are frequently accompanied by
thrombocytopenia. In contrast, dogs with different, albeit
high, antibody titres without thrombocytopenia showed
more chronic signs of the disease, mainly lameness and
stiff gait. This supports the hypothesis of clinical and
haematological changes being the result of an over-
whelming immunological response rather than the direct
influence of the antigen (Lepidi et al., 2000). More localised
signs commonly present in the chronic phase of the disease
may be explained by persistent antigen stimulation which
leads to an increase of immune complexes and associated
conditions (Day, 1999).
Median values of other haematological parameters
remained in reference ranges, although there were some
significant differences from the control group. In contrast
with Lilliehöök’s findings (1998) our study did not reveal
anaemia in the phase of bacteraemia, as all dogs in the PCR
positive group had Hct and RBC counts within the
reference range. Our results are in agreement with those
of Harrus et al. (2005) who did not list anaemia among
prominent haematological changes in anaplasmosis in
dogs.
WBC and WCDC values in dogs naturally infected or
exposed to A. phagocytophilum are very variable and they
cannot be used as markers of the course of the disease.
Even in the PCR positive group, the selected parameters
were not comparable with those found in experimentally
infected dogs during bacteraemia (Egenvall et al., 2000).
AP was the only biochemical parameter mildly elevated
in the seropositive dogs. Increased AP activity is commonly
observed in dogs with anaplasmosis (Harrus et al., 2005;
Greig et al., 1996). The other correlations between
biochemical parameters are not very secure because of
the very limited number of samples in individual groups
(maximally 5 samples).
Proteinuria, detected in some dogs in our study
suggested possible renal alterations in dogs infected with
A. phagocytophilum, especially in the chronic course of the
disease.
5. Conclusions
We found clinical and laboratory alterations in dogs
naturally infected or exposed to A. phagocytophilum that
were similar to those reported earlier.
The study confirms thrombocytopenia to be the most
prominent haematological change. It shows that, when
accompanied by even a very low antibody titre, it is
clinically relevant, because it indicates an ongoing
immunological response that will result in clinical signs
of the disease.
The results of our study support currently acknowl-
edged recommendations on diagnosing and treating
canine anaplasmosis (Harrus et al., 2005). However, they
underline the necessity of introducing additional diag-
nostic procedures in clinical practice in order to improve
understanding of the disease in a given patient. Since the
pathology of the disease is dependent mainly on the
immunological response, a cytokine profile or presence of
hypergammaglobulinemia could result in a better under-
standing of the phase of the disease and thus a more
appropriate therapy.
Conflict of interest statement
Neither of the authors of this article has a financial or
personal relationship with other people or organizations
that could bias the content of the article.
Acknowledgment
The authors thank Professor Roger Pain for review of
English.
The authors acknowledge the financial support of the
state budget by Slovenian Research Agency (Projects No.
P4-0053).
References
Day, M.J., 1999. Immune-mediated renal and reproductive disease. In:
Day, M.J. (Ed.), Clinical Immunology of the Dog and Cat. Manson
Publishing, London, pp. 171–215.
Egenvall, A.E., Hedhammar, A.A., Bjöersdorff, A.I., 1997. Clinical features
and serology of 14 dogs affected by granulocytic ehrlichiosis in
Sweden. Vet. Rec. 140, 222–226.
Egenvall, A., Lilliehöök, I., Bjöersdorff, A., Olsson Engvall, E., Karlstam, E.,
Artursson, K., Heldtander, M., Gunnarsson, A., 2000. Detection of
granulocytic Ehrlichia species DNA by PCR in persistently infected
dogs. Vet. Rec. 146, 186–190.
Greig, B., Asanovich, K.M., Armstrong, P.J., Dumler, J.S., 1996. Geographic,
clinical, serologic, and molecular evidence of granulocytic ehrlichio-
sis, a likely zoonotic disease, in Minnesota and Wisconsin dogs. J. Clin.
Microbiol. 34 (1), 44–48.
Harrus, S., Waner, T., Avidar, Y., Bogin, E., Peh, H., Bark, H., 1996. Serum
protein alterations in canine ehrlichiosis. Vet. Parasitol. 66, 241–249.
Harrus, S., Waner, T., Bjoersdorff, A., Shaw, S.E., 2005. Ehrlichiosis and
anaplasmosis. In: Shaw, S.E., Day, M.J. (Eds.), Arthropod-borne Infec-
tious Diseases of the Dog and Cat. Manson Publishing, London, pp.
120–133.
Kolbert, C.P., 1996. Detection of the agent of human granulocytic ehrli-
chiosis by PCR. In: Persing, D.H. (Ed.), PCR Protocols for Emerging
Infectious Diseases. ASM Press, Washington, DC, pp. 106–111.
Lepidi, H., Bunnell, J.E., Martin, M.E., Madigan, J.E., Stuen, S., Dumler, J.S.,
2000. Comparative pathology and immunohistology associated with
clinical illness after Ehrlichia phagocytophila-group infections. Am. J.
Trop. Med. Hyg. 62, 29–37.
Lilliehöök, I., Egenvall, A., Tvedten, H.W., 1998. Haematopathology in dogs
experimentally infected with a Swedish granulocytic Ehrlichia spe-
cies. Vet. Clin. Pathol. 27, 116–122.
Scorpio, D.G., von Loewenich, F.D., Goebel, H., Bogdan, C., Dumler, J.S.,
2006. Innate immune response to Anaplasma phagocytophilum con-
tributes to hepatic injury. Clin. Vaccine Immunol. 13, 806–809.
Waner, T., Harrus, S., Weiss, D.J., Bark, H., Keysary, A., 1995. Demonstra-
tion of serum antiplatelet antibodies in experimental acute canine
ehrlichiosis. Vet. Immunol. Immunopathol. 48, 177–182.