So, like I say, we're going to cover a variety of ticks and tick-borne pathogens tonight. But you know, the two main ticks that we're worried about in the UK are Isids that are present all over the UK. So we'll talk about these.

These are the ticks that come in day in, day out to our practises attached to poor old parasitized cats and dogs, the country over. And then we have dermaenter species that are much more focal in the UK. So just occupying small niches, mostly coastal in Wales and the south of England.

Ios transmit a wide variety of pathogens. So they transmit Borrelia, which causes Lyme disease, small babes, and something new to the UK that has arrived in the south of England, tick-borne encephalitis virus. In comparison, Dermaenter is far more monogamous, and the, the sort of main pathogen for dogs that we would be worried about with Dermacenter is Babezia canni.

Let's start off with Ios. So, these are inornate ticks. So, when we describe them and these inornate, we mean that they've got no decoration.

They're pretty boring to look at, you know, not very exciting unless you're me. But you know they are present on lots of dogs and cats throughout the UK. We're used to taking off the females, which are the sort of engorged feeding ticks that look a little bit.

It's called the castor bean tick because it looks a little bit like a sort of broad bean that you're taking off. What we tend to forget is that the nymphs and larvae in the sort of previous sort of life stages are very, very small, so nymphs are also capable of transmitting all of the sort of pathogens that I'm going to talk about, and they're only 2 to 3 millimetres long, so very, very easy to miss, even on very diligent tick exams. And this is a concern because like I say, both the female adults feeding and the nymphs are potential vectors of both Lyme disease, which is very common in the UK, and like I say, this newcomer called tick-borne encephalitis.

So this is just to show you, this is a photo I took down in the New Forest when I was lucky enough to go down there on a tick drag. It just shows how small these nymphs are. So that's a 5p piece, and you can see that this little active nymph is considerably smaller than that.

So, you know, very, very easy to miss. Lyme disease is a bit of a favourite among the general public, and, you know, especially pet owners, and I think it's fair to say that a reasonable percentage of them will have some familiarity with Lyme. And potential disease, sort of syndromes associated with it.

So, you know, it's one of those few like toxoplasma, toxicara that have that higher profile public awareness. You know, as a result, it's something that we're likely to get asked questions about. There's fear, I mean, real fear among people about chronic forms, you know, sort of long form Lyme, chronic Lyme, that people won't be able to eliminate it from, eliminate it from their bodies, and that it's going to be very debilitating long term, and that's fueled somewhat by the fact that it is quite difficult to diagnose definitively.

And you know things like serology, Western blotting in people, you know, have to be at a cut off when we're not unnecessarily treating people, especially on the NHS, and especially with responsible antibiotic use, but you know, it also needs to be sensitive enough that it's going to pick up potential cases. So, you know, it's always been a long term difficulty with human Lyme. And yeah, most people that are interested in Lyme disease will be aware that pets can be affected as well, particularly dogs.

And I mean, Lyme disease is in the press a lot, so these are just sort of some of the examples that crop up. You know, a few celebrities have got Lyme over the years, so Avril Levine was a bit of a trailblazer, Justin Bieber more recently, and the press love to run with this, so. You know, Avril Lavigne accepted death is a Daily Express headline in the bottom left hand corner.

As we all know, the Daily Express never deliberately undersells the story. So it's no wonder, you know, with headlines like this that the public are concerned. So, it's important that we put their minds at rest and that we keep any potential risks for them and their pets in perspective.

So, it's caused by this bacteria, the Borrelia burgdorferi group. There's various sort of subgroups of Borrelia causing different sort of forms of Lyme. There's a wide variety of clinical signs that can happen from infection, which I'll go through, in a minute.

It does have a zoonotic risk, a very significant zoonotic risk, but it's not direct. So if your cat and dog gets infected, there's virtually no direct risk to people. So people shouldn't be worried about still going on and cuddling their pets and having that close association with it.

But what dogs especially are are very good sentinels for infection. So, you know, if you're out and about in the wilderness, sort of, you know, skipping around, living the dream with your dog, it's very likely you're going to be exposed to the same ticks. In that environment.

So if your dog's infected with Lyme, it's entirely possible that you've been exposed in that same environment to infected ticks. So if you developed relevant clinical signs and your dog's infected, you know, you'd want to go and get that medical advice. We know that lime takes time, you know, it takes at least 16 hours, possibly as much as 24 to 48 hours for transmission to occur.

So it means that if we can rapidly kill or repel and kill ticks or find them and remove them within that time period, we're going to break that transmission. And what we know is that there's definitely increased incidence of human disease over the past decade. But whether that's happening in cats and dogs, unfortunately, is unknown.

So this is just to give you a flavour of how much human incidence of Lyme disease has gone up. So, you know, it went up massively over a sort of 150 year period from 2000 to 2015, 2016, but it's still been steadily rising year on year since then. And I mean there's absolutely no doubt that some of that is increased reporting.

There's been increased awareness of the signs, there's been increased public interest but some of that is genuine increase, genuine increase in exposure. And resultant disease and even these figures are likely an underestimate. In recent years, medical records, GP records have been looked at because Lyme isn't a notifiable disease.

And looking at sort of, you know, suspected and confirmed Lime on GP's books, it may actually be as much as 3 times higher than these figures suggest. So, you know, human Lyme is a real concern. And we think that there are hotspots, so these folk I worry that there's more Lyme or there's more exposure occurring, leading to more human infection.

And these are listed here, you know, sort of the classic sort of hotspots that you might have heard of. So New Forest, Thetford Forest, Exmoor, Lake District, the Yorkshire Moors, and Dale, and South Downs, all very well known. There's human lime hotspots.

This is just a little map that demonstrates this. So this is a density case density map for human Lyme. I get off the top of my head which year this was.

I think it was around 2015, 2016, but again it just shows where these pockets are and especially in the New Forest, which is the real sort of capital of England, capital of the UK really, for Lyme disease. What we don't know though is the comparative prevalence in dogs. And I mean it is currently completely unknown.

So there's been no country-wide zero prevalence studies done now in the UK for the past 25 years. So, you know, you're looking at any data you look at, it is, it is old data. There is EU wide reporting data that's about to be published, so hopefully that will include UK data.

So hopefully that will give us a bit more of a clearer picture. But in the meantime, really we're basing, you know, we know that dogs can get Lyme and associated clinical signs, so we're basing any relative risk on sort of lifestyle exposure and known exposure through ticks. I mean, there may be hotspots of canine infection, but we just don't know.

We don't have enough data to pin those down. But it's reasonable to say that if humans are enjoying countryside and being exposed in hotspots around the UK and they're taking their pets, there's a reasonable chance that they're going to be exposed in similar locations. So, when we're assessing the risk of exposure for dogs, it's a combination of the number of ticks that you're gonna be exposed to and the rate of infection in those ticks.

And, you know, the risk assessment at the moment on the basis of exposure is you've got round about sort of 2 to 2.5% of ticks on dogs and cats infected with Borrelia. So you know, we don't know to what extent those ticks are then transmitting the infection on to cats and dogs, but there is absolutely no doubt that for every sort of 20 to 25 ticks that cats and dogs are exposed to, at least one of them will be carrying Borrelia infection.

If there's not much known about Lyme in dogs, there's even less known about Lyme disease in cats. So again, no data for 25 years, but there was even less data even 25 years ago. And it's a frustrating thing to study in cats.

So in field studies, there's no correlation that's been found between infection and clinical signs in the field, and that has led groups like the American College of Veterinary Internal Medicine. To come up with consensus statements, statements stating that Borreliosis has never been definitely confirmed in a cat, so they're not entirely convinced that Lyme disease occurs in cats at all. I mean, I think the reality is that it does, but it's difficult to pair out because there's often co-infections with bugs like Anaplasma or Bartella that have very similar clinical presentations, especially in their acute phase.

I mean, we know that cats, infected and experimental conditions appear to be more resistant to clinical signs, even though the very similar pathological changes occur. But, you know, it is likely that if cats are exposed to enough Lyme, if they've got co-infections, that that is going to lead to some form of clinical manifestation. So the clinical signs that we're looking for are those of immune-mediated disease.

So, polyarthritis, joint disease can occur, acutely, fever, and depression, lack of appetite is very common, and you get lymphadenopathy. Fortunately, you very rarely get significant renal disease in dogs and cats. There is this condition called Lyme nephritis, which occurs in the US, in round about sort of somewhere between 1 in 50 and 1 in 100 canine cases.

But it's rare in the UK. I mean, phenomenally rare. But it is fair to say that over time, you know, there can be a degree of the myellonephritis can develop, but you know, you're looking at much less renal disease in the UK compared to the US.

Cardiac disease is extremely rare in cats and dogs, but it is recognised as a result of infection. What cats and dogs don't tend to get is the classic bull's-eye lesion sign. Erythema migraines, is a classic telltale sign, in, in people.

So, you know, if you get a classic bull's eye rash, History of suspected tick exposure, that is diagnosis enough in a human patient to potentially start treatment. But I just want to emphasise that that is not enough evidence in cats and dogs. So, I mean, this has been a bit of a debate over the years as to whether cats and dogs get these bull's eye lesions, and it's completely understandable, you know, that there is some confusion.

So these are lesions that have occurred on sort of, you know, cats and dogs. So this classic sort of circular sort of central pinpoint with the sort of ring around it, and you would look at those images on the right and you would say, surely that is Lyme. But they're actually not.

These are actually fly bite reactions. You can see just, just how similar they look to that classic erythema migraines rash. The debate has gone on, so, you know, some papers have stated that it's not recognised in cats and dogs, and some have stated that it's never been definitively reported in dogs.

CA C, which is the American equivalent of SAP, describe it as a rare phenomenon, and I mean there's absolutely no doubt that some clinicians do believe it occurs. I mean, essentially, the only thing that matters is does it have diagnostic value? And I, I would say no, given all the skin lesions can look very similar to it, and I think it's fair to say that certainly the vast majority of cats and dogs don't get it.

So, you know, it's not something unfortunately that we can rely on to the same extent in cats and dogs that we do in people. The diagnosis is tricky. The actual organisms very rarely seen on joint taps, and I mean the gold standard is to culture the organism, and that is, you know, notoriously difficult.

PCR is really useful, it's highly specific, but unfortunately it does have a low sensitivity on blood samples. You really need tissue either from the bite area, or, joint capsule, which, you know, is a little bit invasive, a little bit tricky. And that's why, you know, the vast majority of diagnosis in dogs is C6 serology, which, you know, is very sensitive, very specific, so, you know, very useful for diagnosis.

I mean it. It's a sign of exposure to infection. It doesn't mean that there's definitely ongoing infection occurring, but if you've got relevant clinical signs and you've got positive C6 serology, then that is absolutely sufficient grounds to treat, especially because if you can get in there early, then, you know, prognosis tends to be very good.

These tests have got a lot easier. They're a good patient side tests. There's an example of one in the bottom left right hand corner.

They're quick to run, they're reliable, and they're relatively inexpensive. And this has led to the question as to whether perhaps we should be screening healthy pets. It's a tricky one.

There is some use in screening healthy pets to see if Lyme is present in your local area, and then to monitor those pets, for sort of, you know, changes in the urine, changes in blood patterns, if they develop relevant clinical signs, . I wouldn't treat a subclinical serology positive pet though, it absolutely isn't a guarantee that infection is established and is ongoing. You know, if you do routinely screen, there is that potential that owners, if you get a positive, are going to want you to treat.

So, you know, screening has its benefits, but you've got to be prepared to have that discussion with clients. And if you are treating, you know, dox doxycycline is very effective, you know, for around about 4 weeks of treatment. There have been a couple of studies that suggest that doxycycline has a degree of anti-inflammatory joint activity, and has the advantage that it's excreted in the faeces if you have got any kidney issues, and the, the, bacteria are highly sensitive to it.

Now there is, as well as Lyme, a new boy in town transmitted by ID, and that is tick-borne encephalitis virus. So this is transmitted by Irius primarily in Europe and sort of Western Europe where it's spreading, and it has spread extremely quickly over the past sort of 10 to 15 years from its traditional eastern heartlands right through Europe, and I'll show you its distribution in a moment. This is a concern.

It's got a 1 to 2% mortality rate, with neurological signs in 10 to 10 to 20% of cases. This is in people, and this is why, you know, it's been so concern to countries like Denmark, and Holland, that it's recently moved into. It's not such a worry if you're going to go on holiday, you're going to go on holiday, then, you know, you're there for a week.

I mean, you're looking at 1 case per 10,000 human months of woodland activity and less than 1% of ticks in endemic woodland infected. So you've got to spend a lot of time skipping in the woods, living the dream if you're going to get infected. The worry is if it becomes endemic in your country and you work in those areas, you walk your dogs every day in those areas, then that risk of exposure starts to go up.

. Dogs are affected less frequently than humans, but unfortunately, when they are affected clinically, then, you know, fatality rates do tend to be very high, and this is the concern, with dogs, walking in endemic areas. This is just to show you, just to remind you that Ixoes Riinus is everywhere. So, you know, essentially it was always there waiting for the virus to move in.

I mean, there's only two types of country, country, the countries that are positive for Isoyus and countries where you haven't looked for Isoyus. So, you know, perhaps with the exception of Iceland. So, it, it was just there, it was just there waiting for this virus.

So what moved the virus? Well, we think that migratory birds have a lot to answer for. Deer move a lot of ticks around, but also, of course, increased movements of pets and people.

And as a result, this is a, a human risk website, but this just shows you where tick-borne encephalitis virus is now, and you know, that is a remarkable spread, in a very short period of time. So you know it's very likely that a sort of cocktail of factors, so improved habitats for ticks, favourable climates, increased migratory patterns, increased movement of pets and people have all led to this virus rampaging across Europe. And unfortunately, as you saw from that last map, that includes us.

So, there was a human case, untraveled human case in, you know, I'm getting old, time rolls by faster these days, but I'm gonna go with 2019 maybe. There was a case of untraveled tick-borne encephalitis in a person. And as a result, the virus was looked for, so it was looked for by antibodies in deer.

So deer don't carry the virus, but, they develop antibodies to it when infected ticks feed on them. The, the virus itself is maintained by small furry creatures, but they also looked for it in ticks, and they found, antibody evidence in the New Forest and the Thetford Forest and confirmed it in a tick in the Thetford Forest. So, unfortunately, we can be confident that it is now at least focally endemic, in England, and it's very likely, with the number of deer that we have, and the access that deer have, that you know that.

They're gonna spread, that the virus is going to spread from those locations. So it's important just to be aware of the clinical signs and to have it on your differential radar, and it's not a very, very good reason in those areas to have adequate tick protection in place. So, the sort of signs that we're looking for are acutely fever, you know, just like Lyme, you might get lymphadenopathy as well, but then it's these neurological signs that develop and they are many and varied.

So they can be associated with cranial nerves. But also generalised and proprioceptive deficits, seizures, tremors, paralysis, you know, all sorts of signs. But if you've got unexplained neurological signs and you've got the suspicion of tick exposure, then this should be on your differential list.

Unfortunately, the neurological signs, more often than nodding dogs progress and are fatal. But sometimes dogs can be nursed through with symptomatic treatments. So, you know, fluids, anti-convulsives if they're required, sort of sedatives, muscle relaxants, just try and nurse the patient through.

Diagnosis is tricky at the moment. You can try and isolate the virus, from blood, or from a CSF tap, but it's very difficult to do and it carries a low sensitivity. So antibodies are the way to go and, you know, if you get a fourfold increase of titis, then that would suggest that you have got an acute infection going on, but any increase in antibodytitis, would be suspicious.

Let's move on to Babezia. Now, so the Babezias are actually a broader church than some people realise. So, the famous and most pathogenic Babezia is Babezia Canni, which is transmitted by dermaenta reticulitis.

. And now this wasn't present in the UK. It certainly wasn't endemic. It was being seen in travel dogs, but wasn't endemic until 2014 when we had a now famous outbreak in Harlow.

The million dollar question is, you know, is it still endemic there? There are small Babezias though, like Babizia ulpis, which are transmitted by Ioes ticks. These aren't as pathogenic generally as Babizia canni, but they are present in patchy foci throughout the UK, and very little is actually known about their distribution.

And what all of these babes have in common is to varying degrees of severity, they can cause immune-mediated thrombocytopenia, and immune mediated hemolytic anaemia. So those are the signs with Bobesius that we want to be looking out for. Do a sensor that transmits Babeia Canis is very widespread in Europe, and although it's most common above this red line, it's becoming increasingly common south of it and has also pushed up north.

Denmark's extremely worried about dermocent ticks, and it's also pushed east and north into Eastern Europe, where a lot of our imported dogs come from. It is present in the south of England. Someone got a bit carried away with a spotty pen there.

It's not quite as widespread as that here. In the UK, it's got very, very focal distribution, and a strange one, it's strange for a couple of reasons. One is that dermaenter tends to like field and sort of brush environments in Mainland Europe where in the UK it tends to prefer beach holidays.

So you can see it likes a little bit of the Welsh coast, the southwest and the Southeast. The exception though, of course, being the field in Harlow, where the outbreak occurred. What's also strange is that dermoent has spread like wildfire across Europe haven't really moved out of its local foci in the UK.

We're not entirely certain why that is, but we shouldn't be complacent. We should absolutely be vigilant for the parasites. So this is the tick that we're looking for, you know, so there are, at the moment the University of Bristol, is doing surveys, for Derma Centre and the The tick surveillance scheme which is run by the government, also, you know, will identify ticks for free, but both of them are very keen that we keep an eye on where Dermaenter is in the UK so.

If you get a tick and remove it and it looks more exciting than I, you should be suspicious. So most exotic ticks, including Dermaenter, are beautifully decorated, and I would like to take a moment to enjoy how wonderfully decorated a dermaenter is. It's a tick that's made an effort.

So it's got a lovely decorated scutum. It's got eyes, decorative eyes, on the shoulders of the scuum. And it's also got these wonderful thing called festoons, which is the crimping round the edge, very much like a very well fashioned Cornish pasty, and lots of exotic ticks have these features and Isides don't, so this should be ringing some alarm bells if you pull off a tick like this.

The outbreak in Harlow is a really good example as to how exotic tick-borne pathogens can be isolated and trodden on before they get out of hand by cooperation between vets and between interested parties. So, between November 2015 and February 16, we have these four confirmed cases in untraveled dogs in Essex, and the first presented to the Royal Vet College were very classic signs thrombocytopenia, anaemia, sort of haemoglobin hemoglobinuria, not easy to say, never mind diagnose, you know, all classic signs of IMHA. Butbezia canis was confirmed very quickly, by the identification of pyroplasms on a peripheral blood smear, and we'll talk about diagnosis in a moment.

It was confirmed by PCR. What was done, which was very impressive, was that then where these dogs had been was triangulated and was tracked down to this field in Essex, and their dermocenter ticks recovered from infected dogs and they were confirmed by PC. Are to be derma centre and to be infected with the Beia cannis, but also a tick survey carried out on this field that all the dogs have visited, confirmed that ticks there were dermaenter and also positive by Babezia canni.

So what this proved was that it was a truly endemic foci that was there. Not only were these dogs untraveled, but they had absolutely been exposed by infected ticks in the UK. But having found that out, they were able to jump on it very quickly.

So clients were alerted in local practises as to the risk and the signs to look out for, so cases could be caught quickly and to put adequate tick prevention in place. The council leapt into action, and they put a wall up around the field. And they put signs up to stop, you know, to warn pet owners not to go in and stop them going in.

They had great fun cutting back brush, to go to war on these dermace tics, and all in all, you know, because of a combination of these measures and sharing of relevant clinical signs and cases between practises. The outbreak was contained and just absolute fantastic team efforts involving APHA involving tick surveillance scheme, local council, local vets, you know, wonderful. And, and as a result, after the initial excitement of that outbreak, not very much happened.

So, there were further cases. There was a case in an untraveled dog in Romford in autumn of 2016 and in where in an adjoining county in 2017. The long breaks between cases, we're not 100% certain if they were related.

An infected dermacenter tick was also identified in Wales. We're not sure if that was connected or if it was unrelated spread, but all of this demonstrates the need for surveillance, but also awareness of relevant clinical signs in areas where dermaenter is endemic. In terms of diagnosis, it's, the Bia is very straightforward to diagnose.

So, peripheral blood smears are the quickest way to do it, and actually quite sensitive for clinical cases. And you get the beautiful paired pyroplasms in these images, sort of, teardrop, or sort of pear shaped organisms, . You know, sometimes they're in pairs, sometimes they're on their own, sometimes they're in multiple groups, but I promise you will not misidentify them, and you can use this quick gea to, to stain them up.

You can use serology, but it takes time for infected cases to develop an immune response, and you also get cross reaction with other Apicomplex and parasites like toxoplasma and neospera. So the best blood test to do really is PCR and this also allows speciation, which is very, very useful in terms of, you know, whether it's canni or whether it's one of the small Babezias that may already be endemic. Treatments, forbesia canni, I'm sure we're probably more familiar with this with so many imported cases as well than we used to be, but Aiddicarb, injected 14 days apart, sort of 5 to 6 mg per gig, is, is highly effective at treating clinical cases.

Sometimes it will eliminate infection, sometimes it won't, but the primary aim is to get the clinical signs under control. It can cause nausea, so, you know, you might want to use it as an antiemetic, and you certainly want to have the atropine on standby, because of its anticholinesterase activity. But having said all of these things, it's generally pretty well tolerated.

Small Babezias, you don't treat with medicarb. There's a variety, of antibiotics that have varying sensitivities depending on the small Babezia involved. I haven't really got time to go into all of them now, but if anybody is interested or they have a specific case, if they contact me, then, you know, I can give you a protocol.

I want to talk a little bit about ripocephalus house infestations, cause ripocephalus ticks are a real game changer, especially in the UK, because of the way dermasenter and Isoes live, that the larvae need small birds and rodents to live on, and they only reproduce mostly once a year. So it makes it very difficult for them to infest homes unless you're, you know, Cinderella or unless you're Sleeping Beauty and you've got little birds fluttering around your house, you're probably not going to get an Ixo tick infection. Ripocephalus, though, which is being found increasingly on imported dogs and occasionally on imported cats, is completely different animals.

So it can complete its life cycle very quickly, and all of its life stages can feed on pretty much anything that moves. . It, it likes warm climates.

It likes Eastern Europe, it likes the Mediterranean, Africa, Asia, parts of the states. It does not like our UK climate, so it's unlikely to establish consistently outside, at least at current temperatures. But what it does love is centrally heated homes, because these allow it to persist over winter and to infest homes in a very similar way to fleas.

And this is a major concern because ripocephalus carry a number of zoonotic rickettsia, rickettsia bacteria from all over the world, and these are significant zoonosis to people. So the most sort of common one, most well known one in Europe is Mediterranean spotted fever caused by Rettsia cannui. And it's a really quite significant zoonosis.

And although there's no direct risk from pets, once you've got ripocephalus set up in your home, then there's a very clear risk there of you being fed upon. And you know, the nymphs are really difficult to spot. Not only are they tiny, but they're kind of semi-transparent.

And if you look at them on skin here, human skin from this paper, see how easy they would be to miss and for you to be fed upon and not even realise. And it's not just Mediterranean spotted fever, because we're seeing imported pets now from all over the world, there are a whole variety of exciting rickettsial fevers that could be transmitted to you via ripocephalus. So, Rocky Mountain spotted fever, the one of the biggest concern in the states, but also unknown rickettsias, and a variety of rickettsial subspecies present in Africa as well.

So we just need to be aware of these increased risks on rife, sort of in rife acephalus ticks on dogs imported from a whole range of countries all around the world. And in Europe as well, rhocephalus is really on the move. So if we have a look at this, we can see the tick traditionally lives south of this red line, but it has been pushing north, so it's pushed a long way.

In Eastern Europe, especially Romania, Bulgaria, sort of, you know, the traditional sort of eastern bloc countries from which a lot of our imported dogs are now coming, but also into Austria, seasonally into France as well. So, we need to be very aware of clinical signs associated with ripocephalus borne infections. And this is both from ticks that may be on dogs and cats, but also in dogs that may be carrying these infections when they arrive in the UK.

So anaemia and thrombocytopenia can be associated with Babezia vigeli, which is a slightly less pathogenic babezia that ripocephalus transmits, but also very common with aliia canni and. Psychically, psychically with plasma platis. So classically with plasma platis, you'll get thrombocytopenia, you'll treat it, it'll get better, but if you don't recognise the infection, then, sort of the thrombocytopenia will come back periodically.

And this is a very, very classic sign of infection with this parasite. You get lymphadenopathy and pyrexia, and this is really important to pick up quickly in the acute phase with Walichia. The Walichia isn't called in the acute phase and the body doesn't eliminate it in dogs, you get a chronic form that develops, and this is very often fatal with white cell suppression, thrombocytopenia, and chronic anaemia.

You can get neurological signs as well associated with alichia canni, so a wide variety in a very similar way to tick-borne encephalitis. So, it's very important to diagnose these tick-borne pathogens quickly, you know, both in terms of getting them treated and under control, but if you have a dog that's carrying a lick here, so you can monitor it, and you know, try and combat clinical signs early. Blood smears are useful.

I would always do a blood smear. You know, however low the sensitivity, it's about 4% fri alicia, probably similar for Anaplasma platys, but if you see the relevant life stages there, so morally, In white blood cells for aliia, the classic two dot, morally in platelets for plasma platis, then, you know, you've got your diagnosis right there. They do have limited sensitivity though, except in the case of Hepadazoo and Cannis where you'll often see in clinically affected dogs the classic gametocytes, that are in the picture at the bottom.

Serology is very useful. So for Eliia, quantitative serology to look for an increase in samples two weeks apart is very useful. But patient side testing serology, can, you know, give you information on whether exposure to infection has occurred.

Also very useful for the anaplasmas, and PCR, which is becoming increasingly cheaper either as part of external lab packages or in-house, is very useful for testing for Elichia, Barbezia, anaplasma, and hepadooin. So you've got a wide variety of tests that you can use. And you know, treatment is, well, doxycycline for all of these, sort of, you know, well except for Babezia, doxycycline is your sort of classic lethal weapon for 4 weeks, 10 mg per gig, once a day, with the exception of Hepadazoo as well, which you would treat like the beia with Amidicarb.

So very briefly, I'm going to talk about the risk of tick-borne pathogen exposure and what we might try to do to mitigate it, because the risk does seem to be going up, and this is largely because Increased tick numbers and their activity, but also geographic factors and very much lifestyle factors. So the more we enjoy the great outdoors, the more likely we are to contact ticks. We did the big tick project a few years ago now in the UK that gives us a flavour of where ticks are on cats and dogs, and that tended to highlight the very similar sort of hotspots that we've discussed for Lyme.

So again, you can see concentrations around the southwest of England, . The New Forest, Thetford Forest, Scottish Highlands, sort of Lake District, Yorkshire Moors, so very similar areas with Ixoes Riness predominating on dogs and it being a more mixed picture between Ixoes hexagonist and Ioes Riness on cats. But what was demonstrated by the Big Tick project where there was almost nowhere in the UK where you might not be exposed to ticks.

Slightly different picture if we look at ticks on cattle. So here, the more yellow, oh sorry, sheep at the top, cattle at the bottom. The more yellow the picture, the greater the risk and the tide of the lines, the greater the risk.

But this has something to do as well with where livestock are in the UK. But again, we can see, you know, Scottish Highlands, southwest of the country, sort of, you know, middle bounds, you know, also potential tick high risk areas. There's less seasonal fluctuation than there used to be, or at least it's more dramatic in a sort of two-phase sort of way.

So, traditionally, you know, we're all familiar with the idea of there being a spring peak of tick activity. Autumn peak and some increase in the summer and very little activity in the winter. Well, that has significantly changed, largely because of climate.

So now we've got one giant summer peak. Starting in sort of early spring and finishing in the autumn, but year-round exposure now to ticks can take place. They only need a minimum of 4 degrees C to get moving, and because, you know, the climate has become milder, they can find that now in most parts of the UK, even where I am in the frozen north.

There are a lot more ticks than we used to be. We know this from tick dragging, from the tick surveillance scheme, and this is because there's lots more forest habitat. It's wonderful that there's more green space, but if there's more green space, that means more ticks.

And you know, there's a lot more transport hosts, there's lots more deer, to move them around. So these have increased, forested spaces have increased, and with them, tick numbers pretty much year on year. But it's not just the ticks that have gone up, so our lifestyles have changed, and again, for the better, you know, there's increased outdoor recreational activity, and we like to, you know, take our dogs on this increased recreational activity, which is wonderful that we enjoy the great outdoors with our dogs together, but this means increased tick exposure.

And the other thing that's happened is that there's increased building in rural areas, increased green space in urban areas, and wildlife corridors in between them, and this brings us into much closer proximity with wildlife and the ticks that they carry. And this is called the crossroads effect. So there are swathes of the US with ticks chocker full of lime that no human or pet ever encounters because there's no one there.

But the moment you start to build in that space, the moment you start to have recreational holidays in that space, then suddenly that risk goes up. So how do we prevent exposure to all of these different tick-borne pathogens and diseases? A colleague of mine, Sue Little, said on a, on another sort of podcast the other, the other week that sort of clinicians come to a week in, week out and go, oh, there's another new tick pathogen in town.

They've discovered another one. How do we keep track, you know, of all these tick pathogens? And he said, well, really, at the end of the day, you've just got to stop exposure to the ticks, and that is going to do the job on all of them.

If we're going to do that for at-risk pets, we need preventative treatments, but we also need to remove ticks within 24 hours of exposure, I mean, ideally faster, as fast as possible, and to physically avoid them if we can. And it is very, very important to screen, imported dogs both for ticks, but also tick-borne pathogens, sort of, you know, in terms of using the tests that I described earlier. Preventative treatments, we have a wondrous array of spot on preparations, collars, tablets, so, you know, we should absolutely take owner preference into account, you know, as to which one they're going to find easiest to use, which one suits, the dog's lifestyle the best.

And what we want is to either rapidly kill those ticks or repel and kill them to reduce transmission. And to do that, we either need a pyrefroud or we need an isoxazole. Now, like I say, there are lots and lots of products available.

And they are absolutely essential in at-risk pets. So that's geographic risk, you know, if you've got high risk, high density of disease like the New Forest or the Thetford Forest, but also lifestyle factors. So if you've got dogs that are out in undergrowth, tall grass and pasture shared by ruminants or livestock, then you know, they absolutely need protection.

But we also need to remember that no product is 100% effective. I mean they're about 98% effective. They're going to kill 49 and 50 ticks.

Well worth doing, but the odd tick is still going to get through, and that makes tick removal essential. And just to remind you, you know, to remove ticks, we want to be using fine pointed tweezers or a tick hook. No use of fingers or blunt tweezers, cause that's gonna crush and stress the tick.

It's gonna regurgitate its stomach contents and salivary glands and actually increase the risk of disease transmission. You know, I say this every Tick Talk, but it's important to emphasise we do not need to torture our ticks by smothering them in petroleum jelly. We don't need to burn them.

We don't need to set them on fire. We just need to use a simple twist and pull action for tick hooks or a simple straight up action using dedicated tweezers. And don't forget that once you've removed them to send them off, either to the tick surveillance scheme, you know if you're gonna send them, do you send them the tick surveillance scheme, or if you think they might be doing a centre, contact the University of Bristol.

The University of Bristol has sponsored by SAP UK and Ireland, free plug, a wonderful key where you can go and visit and identify your own ticks as well. There have been studies that have indicated where ticks are most commonly found, and I mean that may be self-fulfilling prophecy a little bit because it may be where people most commonly look, but if you've got fractious patients, you really want to concentrate around the head, neck area, and the sort of undercarriage. You know, that's a good place to stand.

And then if your patient is compliant and we'll let you check the rest of them, well, absolutely fantastic. And don't forget that dogs are different heights, so there are some dogs like this, you know, sort of exploring Jack Russell that are gonna get absolutely covered in ticks because they're shorter than the grasses. And just to emphasise the importance of identification, I mean, sometimes we do get the truly exotic, so there has been the odd Halloma hunter tick with its stripy legs, extremely active, it's the only tick that's likely to run you down and rugby tackle you to eat you.

We've seen these in the UK. I mean, they, they, one has managed to overwinter in the UK. I mean, like, rife acephalus, it prefers tropical climes, but it's getting moved around by migratory birds, one on a horse that was found in the.

UK, and if they get in and it's a mild winter, they might manage at the moment to overwinter. So it is very, very important, to identify them, you know, just so we know, you know, that they are present in the UK and take appropriate action. And of course there's good old physical avoidance.

So the CDC in America with the country's leading medical minds chief exam chief advice is to stay on the path, which, you know, you know, ticks with the exception of Haloma can't leap off trees, they can't run you down, you've got to brush up against them. So staying on the Path if you can, is pretty sensible advice. As a person, if you're going off path, then abandoning fashion as I did on the Hadrons wall walk, is the way to go and tuck your trousers into socks, wear sort of, sort of, you know, skin coverage, even if it's loose fitting, it will help, you know, just to minimise that contact with vegetation.

And finally, just a very quick plug for SAP UK and Ireland. So I mean I'm, I'm pleased to say that we've been a point of cooperation with the APHA tick surveillance scheme, sort of drug companies, different vet experts over the years in terms of sort of tick control. We've also worked with local councils, which is really nice on certain projects like this tick walk down in Hampshire.

But you know, mostly we just provide advice and we've got lots of, you know, really useful downloads that are free on the website, but you can also put in, completely free advice queries if you've got any questions about ticks or any other aspects of parasite control, please do, just get in touch. And thank you very much. Sorry about the technical hitches at the beginning, but I think we got there a little tour through the wonderful world of ticks.

Thank you very much. Ian, thank you so much for that, and I'm sitting here grinning from ear to ear with your description of the higher, because it's, it's very poetic, but it's very true having dealt with them before. So yeah, it's.

Yeah, yeah. And, folks for attending, sorry again about the technical issues. We thought we had them sorted in the beginning, but, we rescued it, and it was more than worthwhile listening to Ian, sharing his knowledge with us.

So, Ian, once again, thank you for your time. Oh it's my pleasure. Thank you for listening.

And to all of you that attended and are listening to us on recordings, thank you again for paying attention. It is something which is not as uncommon as what we always used to believe in the UK. So paying attention to ticks and the tick-borne diseases really is worthwhile.

And, as Ian said, SSCAP is a, is a worthwhile organisation. So, yeah, they're there to help if you've got any questions. Give him a shot.

Yeah. Yeah, it's we've had no questions through so once again, a big thank you to you and thank you to everybody for attending tonight. To my controller in the background, Dawn.

Thank you for helping getting things sorted out as always. And from myself, Bruce Stevenson, it's good night.