Tick Fever

Tick Fever is one of the most common and most dangerous diseases that we see in dogs in Hong Kong.

However, although most people have heard of tick fever, many dog owners are not sure exactly what it is, what the symptoms are or how to prevent it. Tick fever does not affect cats, although there are similar conditions which means we should be careful with flea and tick prevention in all pets.

Tick Fever, as the name suggests, is a disease spread by ticks. Ticks have eight legs and look fairly similar to beetles, although they are actually are a type of arachnid (the same family as spiders).

They usually live in grassy areas and feed by biting and drawing blood from animals such as dogs and cattle.
Tick Fever itself is a protozoal organism (similar to bacteria) that lives inside the tick. When the tick attaches the dog and bites to feed, it injects the tick fever organism into the dog.

Before feeding ticks are small and flat, however after feeding they puff up and look a bit like a fat raisin.

If you see some ticks on your dog that are all puffed up, they may have infected your dog with tick fever. Read below for symptoms you should look out for.

Unfortunately there is no vaccine for Tick Fever, so the only way to stop your dog from getting the disease is to be diligent with your tick prevention.

Tick Prevention - vital for all dogs in Hong Kong.

New advances in tick prevention have changed the way we prevent Tick Fever in Hong Kong, greatly reducing the chance of infection. Two of the latest products, Seresto Collars and Bravecto tablets, are in a completely new class of medications, safer and more effective than previous preventatives. As these drugs are new, the Hong Kong ticks have not yet developed any immunity, greatly increasing the effectiveness of these new tools.

Bravecto and Seresto have been a real revolution in flea and tick treatment.

Bravecto is a tasty pill that lasts 3 months.

Seresto is a collar (that is not smelly) that lasts 7-8 months.

People normally buy Bravecto when they don't want the dog wearing a collar for cosmetic reasons, or they're worried about the collar getting lost.

People buy Seresto when they want to put something on that will last up to 8 months, and for the most cost-effective solution.

They both work within 2 hours of administration, and both are used as a standalone product by themselves - nothing else required just one or the other.

Some people in very high tick areas use both Bravecto tablets and a Seresto collar at the same time.  

Older products including Preventic Collars, Frontline Plus and Advantix do sometimes have a place for use additionally to Bravecto and/or Seresto for dogs living in areas with a very high tick population but we would not recommend these as the only preventative for ticks, as increased resistance is developing in the wild.

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The Disease.

Tick Fever is the common name given to the protozoa Babesia. There are two common strains that we see in Hong Kong, Babesia gibsoni and Babesia canis. However, both have similar symptoms and treatment. The protozoa destroy red blood cells in the body resulting in anaemia. If left untreated for too long, life-threatening anaemia may result and may require blood transfusions and a long hospital stay to recover. However, if treated early, most dogs don’t have to stay in hospital and can have the full course of treatment at home.

The most common first symptom is a loss of appetite. However, it often comes on gradually and to the inexperienced owner it may take some time to notice that anything is wrong. Sometimes a dog will not eat breakfast, but will eat his dinner and will eat his treats. Then the next day, he might not eat any of his dog food, but is more than happy to eat your human food. If you normally have a dog who eats like a vacuum cleaner and he becomes fussy all of a sudden, then it is a good idea to have him checked by your vet.

As mentioned above, the other common symptoms are lethargy (tiredness) and dark coloured urine. Often dogs will be reluctant to go for their regular walks and won’t want to play as much as usual. They may also be reluctant to walk up stairs. During the course of the disease, red blood cells are destroyed will be expelled in the urine which can result in very dark (rusty or red coloured) urine.

If you notice one or more of these signs it is best to get to your vet as soon as possible, ideally within 24 hours of noticing symptoms.

It is important to note that although the above symptoms may be a sign of Tick Fever, there are other diseases that can cause similar signs. It is important to get your vet’s advice and give your dog a thorough check-up, including blood tests, before a diagnosis is made.


When you see your vet, please let them know any relevant history including any previous illnesses, tick prevention, if you have spotted any ticks on your dogs and if other dogs in your area have had Tick Fever. If your vet suspects Tick Fever they will probably order a blood test called a General Health Profile. This initial blood test will give the vet a better idea as to whether your dog has tick fever. Dogs with tick fever generally have a lower than normal number of red blood cells and platelets. Although a good indicator, this test does not definitively diagnose tick fever. In order to get a confirmed diagnosis, a PCR test (or a DNA test), needs to be performed at an external laboratory. This usually takes 2-3 days for the results to come back. Depending on the severity of the case and your dog’s history, your vet may start treatment straight away, or they may wait until the PCR results have confirmed the diagnosis before starting treatment.


Different vets have varying protocols for treating Tick Fever. There is not one universally accepted treatment and each case will be assessed by the vet and given the appropriate treatment under the circumstances. Two currently accepted methods of treatment are:

1) Atovaquone/Zithromax: Atovaquone is an antimalarial drug that has been shown to be effective in Tick Fever cases. It is used in conjunction with an antibiotic called Zithromax. This is one of the most commonly accepted treatments in Hong Kong and has been used for the past 6-7 years. Treatment is usually 10-20 days long depending on the case. This is usually the first choice for treatment.

2) Tri-Therapy Treatment: This involves two injections two weeks apart and a 30 day course of three types of anti-protazoal medications.

3) Berenil Injection: This is an antiparasitic injection that is very effective against babesia and lower cost than the other two treatment options however there are higher risks associated with this treatment.

Your vet may choose one of these options or a combination depending on your dog's medical history.

Whatever treatment your vet chooses, it is vitally important that your dog receives the full course of medication. If your dog is sick after receiving the medication, please contact your vet to discuss this as soon as possible.

Most Tick Fever cases can be treated at home, however if your dog is anaemic or is very weak, the vet may choose to keep him in hospital to make sure his treatment and recovery have the best chances of success.
Most dogs make a full recovery from Tick Fever, however it is a very serious disease and can be fatal. Dogs at most risk are those with an already compromised immune system such as older dogs, young puppies or dogs who are already suffering from other ailments.

Following successful treatment of Tick Fever, it is advisable to have a repeat PCR Blood Test 2 months after the end of treatment.

What now?

Unfortunately having Tick Fever doesn’t result in any immunity for your dog. So keep up your vigilance and make sure your tick prevention measures are up to date.