Recognition of hepatozoonosis in four dogs that lived in Oklahoma thei
r entire lifetimes documents expansion of the previously recognized en
demic area of the disease. Salient clinical features are fever, marked
neutrophilic leukocytosis, periosteal new bone proliferation, myalgia
, weakness, muscle and generalized wasting, and lack of response to tr
eatment Transient, large-bowel diarrhea may be observed Each of the fo
ur cases had signs compatible with chronic, persistent inflammatory di
sease that were poorly and ultimately nonresponsive to antimicrobial t
reatment. Diagnosis was confirmed in one case by recognition of Hepato
zoon gamonts in peripheral blood leukocytes. Encysted forms of the org
anism were present in skeletal muscle and other tissues of each case.