Numerous locations in the United States are home to a number of tick species, including the deer tick. Most Lyme disease patients never saw the tick that bit them or any sign they were bitten. If you see a bullseye rash — which always signifies a deer tick bite — visit your family doctor or emergency care location.

Butler County residents should be aware of deer ticks, which can transmit Lyme disease to humans and pets.

That's the word from local experts who deal with the freckle-sized ticks and the health issues they cause every day.

Dr. Reginald Reginella, an emergency medicine physician with Butler Health System, said the Butler Memorial Hospital emergency room continues to see patients who present either a telltale bullseye rash that denotes a tick bite or symptoms that could be Lyme disease.

He said now is the time of year when ERs see the most tick-bite patients, but he is not noticing more patients this year than in previous years.

Reginella said while some patients see the bullseye rash and go to their family doctor or the ER, most Lyme disease patients never saw the tick that bit them or any sign they were bitten.

That is because the deer tick, which is the only tick that spreads Lyme disease, is the size of a period at the end of a sentence in a newspaper.

If a patient arrives at the ER with the bullseye rash on their skin, they are immediately treated with an antibiotic.

Others who come in with flu-like symptoms such as aches, a fever and chills, or patients with symptoms of Bell's palsy, in which half of the facial muscles are weakened, doctors may advise the patient to wait three to six weeks before being tested for Lyme disease.

Reginella explained that is because the patient may not have built up enough Lyme disease antibodies to show a positive result.

He said treating a patient who tests positive six weeks after the onset of symptoms with an antibiotic will cure Lyme disease.Doctors do not recommend offering symptomatic patients a course of doxycycline, which is the preferred antibiotic for Lyme disease, Reginella said.He explained that patients could become resistant to the antibiotic for other bacteria, and the side effects of doxycycline can be challenging for some patients.However, Reginella said those who ignore their symptoms and are not tested could develop more serious symptoms as the Lyme disease wreaks havoc on a variety of systems in the body.He said undiagnosed Lyme disease patients can suffer cardiac, neurological, orthopedic and other symptoms, which are difficult to treat once the disease has progressed that far.Known as “late Lyme disease” in medical circles, patients can experience heart arrhythmias, arthritis in various joints, memory issues, numbness and tingling in their hands and feet and other symptoms.The biggest problem with late Lyme disease is heart arrhythmia, which can sometimes require a pacemaker, Reginella said.Reginella advises anyone who sees a bullseye rash — which always signifies a deer tick bite — to visit their family doctor or emergency care location.“Ticks are everywhere, but Lyme disease is a very treatable, manageable illness if monitored appropriately,” Reginella said.

Dr. Eva Bonzo, a veterinarian at Seven Fields Veterinary Hospital, said all dogs in the county should be vaccinated against Lyme disease.Dogs at her practice receive an initial shot and a booster three weeks later, then an annual booster.Even if they receive the vaccine, Bonzo said dog owners should use a prescription flea and tick preventative year round.Topical medicines applied to the dog's skin, oral medications dogs can chew once per month, prescription flea and tick collars and other preparations are available at veterinary offices to protect dogs from Lyme disease, Bonzo said.However, pet owners must not assume the products can be used on cats.“Flea and tick medications that are for dogs can often be toxic to cats and shouldn't be used on them,” Bonzo said. “It is important to talk to your veterinarian to get the appropriate product for your pet and to ensure you are getting the safest and most effective product as well.”She said while dogs may not show symptoms of Lyme disease and it is rarely fatal, some dogs arrive at the vet with lameness, fever, decreased appetite or lethargy.More uncommonly, Lyme disease can also cause kidney or neurological diseases.Even dogs that have received the Lyme vaccine and regularly receive flea and tick prevention can develop symptoms of Lyme disease and should be seen by their veterinarian, Bonzo said.If the dog's Lyme disease antibody level is high, they can be treated with an antibiotic for one year to cure them, Bonzo said.

“Fortunately for cats, they are not affected by Lyme disease, but they still should be on flea and tick prevention for other diseases,” Bonzo said.She said Western Pennsylvania is a hotbed of activity for deer ticks because the area offers an ideal environment for the ticks to thrive.They can survive the coldest winter by hitching a ride on an animal or remaining under the snow until spring, Bonzo said.“A high percentage of the ticks in our area carry Lyme disease, and it can often be difficult finding and removing ticks on dogs,” she said. “Being on tick prevention greatly reduces the risk of not only Lyme disease transmission, but the transmission of other tick-borne diseases we can see in dogs.”More information on the number of Lyme disease cases and incidence of tick bites is available at www.health.pa.gov.