Epistaxis and thrombocytopenia in dogs: ehrlichiosis
6-year-old German Shepherd from Andalusia, frequently infested with ticks, presenting with bilateral epistaxis, petechiae on the oral mucosa and lethargy. Platelets 35,000/µL, hyperglobulinaemia and negative Leishmania serology; Ehrlichia canis serology positive.
What is the treatment of choice?
chevron_right Show answer and explanation
A. Immunosuppressive glucocorticoids alone for immune-mediated thrombocytopenia
Platelet destruction has an immune-mediated component, but without treating the infection the disease is not controlled; glucocorticoids alone may make it worse.
B. Rhinoscopy with biopsy to rule out a nasal tumour
With 35,000 platelets/µL, nasal biopsy carries a high risk of severe bleeding, and the systemic cause has already been identified.
C. Oral doxycycline for about 4 weeks, monitoring the platelet count
Correct. Doxycycline is the treatment of choice for canine monocytic ehrlichiosis. In the acute phase, platelets usually recover within a few days, which supports the diagnosis.
D. Meglumine antimoniate and allopurinol
This is the treatment for leishmaniosis, which is seronegative in this dog; it has no effect on Ehrlichia.
lightbulb Key takeaway
In Spain, with epistaxis and thrombocytopenia, think of ehrlichiosis and leishmaniosis, which may coexist. Positive serology may reflect past exposure: interpret the titre together with the clinical picture and the response to doxycycline, and reinforce tick prevention.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.