States With The Highest And Lowest Risk Of Cat And Dog Illnesses

A pet falling ill or not seeming like their usual self can lead to a lot of worry and emotional strain. It can also be challenging for pet parents to know what warrants a vet visit—and how soon they should take their furry friend in for medical care.

Being proactive with your pet’s health can mitigate the risk of it falling ill and give you peace of mind. Small but impactful steps to take to keep your companion healthy include getting their routine vaccinations on time and understanding local and environmental risks that might affect their health.

Forbes Advisor analyzed favorable case rates for 11 dog illnesses and eight cat illnesses across all 50 states and the District of Columbia to uncover the states with the highest and lowest risks for pet illnesses.

View Pet Illness Statistics

States With The Highest Risk Of Cat and Dog Illnesses

Different environmental factors like air quality, outdoor surroundings and weather can affect pet health. These factors vary depending on where you live in the U.S., which means some states are at higher risk of pet illnesses than others.

1. West Virginia

West Virginia’s score: 100 out of 100

West Virginia emerges as the state with the highest risk for pet illnesses. While its landscape may allure nature enthusiasts and their furry companions, prolonged exposure to its outdoors pose significant risks to a pet’s health, such as tick infestations and other parasites.

• Lyme disease, a tick-related disease often transmitted by the deer tick, was most commonly detected in West Virginia in 2023 (17.2%).
• West Virginia ranked No. 1 in whipworms in dogs, a common intestinal parasite that can cause discomfort and irritation.
• This state had the second-highest percentage of hookworm and roundworm cases in dogs in 2023. These common intestinal parasites can also infect humans.
• The Mountain State had the third-highest percentage of positive cases of giardia, a parasitic disease, in cats last year.

2. Rhode Island

Rhode Island’s score: 80.71 out of 100

Rhode Island stands out as another surprising hotspot for pet health concerns. This coastal region faces notable challenges in safeguarding the well-being of your furry companion.

• Rhode Island ranked No. 1 for feline heartworm cases in 2023.
• The state ranked No. 2 for flea tapeworms, an intestinal parasite, last year (3.4% vs. the study average 2.2%).
• Rhode Island ranked in the top 10 states for cases of anaplasmosis (No. 6) and Lyme disease (No. 8, tying with New York) cases.
• Giardia cases among dogs were fourth-most common in Rhode Island (10.7% vs. the study average of 6.6%).

3. New Jersey

New Jersey’s score: 74.1 out of 100

New Jersey faces several challenges when it comes to pet health, including the prevalence of rabies cases, tick-borne diseases and intestinal parasites.

• New Jersey recorded the sixth most rabies cases in cats between 2017 to 2021, (89, more than triple our study average of 25).
• The percentage of Lyme disease and anaplasmosis cases among dogs in New Jersey were the 11th highest study-wide. Both diseases are commonly derived from a deer tick bite.
• New Jersey ranked in the top 10 states for hookworms (No. 9) and roundworms (No. 6) in cats. These intestinal parasites can stunt growth in kittens or cause anemia.
• Giardia prevalence among cats and dogs in New Jersey ranked in the top 15 study-wide, (14th highest in dogs and 12th highest in cats).

4. Kentucky

Kentucky’s score: 73.91 out of 100

Pets in Kentucky face various health risks, including intestinal parasites and viral infections.

• Kentucky ranks No. 2 for whipworm, an intestinal parasite, in dogs (1.1%, compared to our study average of 0.5%).
• Kentucky ranked in the top five states for feline immunodeficiency viruses (No. 4 for FIV ) and feline leukemia viruses (No. 3 for FeLV). Both diseases can be lethal for cats.
• Ehrlichiosis, a disease commonly transmitted by a brown dog tick bite, ranked fifth among dogs in Kentucky in 2023.
• Giardia cases among cats were sixth-most prevalent in Kentucky in 2023.

5. Maine

Maine’s score: 71.3 out of 100

Common tick diseases, fleas and tapeworms are prevalent in Maine.

• Anaplasmosis, a disease caused by a bite from a deer tick, was most prevalent in dogs in Maine in 2023 (30.6%, compared to our study average of 5.3%).
• Maine ranked No. 3 for detected Lyme disease cases last year. The illness is transmitted via infected ticks.
• Maine had the fourth-highest percentage of flea tapeworm infections in both dogs and cats in 2023.
• Roundworms, an intestinal parasite, were fifth most prevalent in dog cases in the Pine Tree state last year (2.4% vs. our study average of 1.7%).

6. Oklahoma

Oklahoma’s score: 70.15 out of 100

Given the widespread presence of flea tapeworms in cats and frequent cases of canine respiratory infections in the state, Oklahomans should be vigilant about potential health risks to their pets.

• Flea tapeworms among cats, an intestinal parasite caused by ingesting an infected flea, were most commonly detected in Oklahoma.
• The prevalence of canine respiratory infection cases, including the dog flu, were third highest in Oklahoma last year, tying with Delaware and Maryland (9.1%, nearly 5 percentage points higher than our study average of 4.3%).
• Oklahoma also ranked third-highest in hookworm (a parasitic disease) and ehrlichiosis (a tick-borne disease) cases in dogs.
• Heartworm in dogs, a potentially fatal disease, had the seventh-highest percentage of positive cases in Oklahoma in 2023. It’s recommended that dogs be tested for heartworm annually at their local veterinarian and take a monthly preventative medication.

7. New York

New York’s score: 66.23 out of 100

There are significant occurrences of giardia affecting both cats and dogs in New York. Dogs living in the Empire State are also at increased risk of Lyme disease and anaplasmosis due to tick bites.

• Rabies among cats was the fourth most common in the Empire State (122 cases in 2023), with nearly five times more cases than our study average of 25.
• New York ranked in the top 15 states in our giardia metric for both cats (No. 13) and dogs (No.15) in 2023.
• The percentage of positive cases of Lyme disease (No. 8) and anaplasmosis (No. 7), both often caused by a deer tick bite, ranked in the top 10 for dogs in New York.
• The percentage of heartworm cases among felines was 11th highest in New York (1.8%).

8. Mississippi

Mississippi’s score: 65.88 out of 100

In the Magnolia State, dogs had the highest percentage of positive cases for both heartworm and hookworm; cats exhibited a notable prevalence of feline immunodeficiency virus (FIV).

• Heartworm in dogs had the highest percentage of positive cases in Mississippi in 2023 (6.3%). It’s recommended that dogs test for heartworm annually at their local veterinarian and take a monthly preventative medication.
• Mississippi also ranked No. 1 in the percentage of hookworm cases in dogs.
• Canine respiratory illnesses, including dog flu, were second most prevalent in Mississippi in 2023 (10.6%, more than six percentage points higher than our study average of 4.3%).
• Mississippi had the second-highest percentage of FIV cases in 2023, and the sixth-highest percentage of feline leukemia virus (FeLV) cases. Both diseases can be fatal for cats.

9. Indiana

Indiana’s score: 65.69 out of 100

Indiana presents concerning rates of intestinal parasites in dogs to the prevalence of tick-borne diseases.

• The percentage of positive cases of intestinal parasites roundworm and whipworm in dogs ranked sixth-highest in Indiana in 2023 (tying with Kentucky for roundworm cases).
• Indiana had the seventh-highest percentage of flea tapeworm cases in dogs last year.
• Indiana ranked No. 9 in roundworm infections in cats, an intestinal parasite that can be fatal to kittens.
• Indiana ranked in the top 20 for Lyme disease and ehrlichiosis, both diseases often caused by tick bites (No. 16 for Lyme disease and No. 19 for ehrlichiosis).

10. Pennsylvania

Pennsylvania’s score: 64.75 out of 100

Pennsylvania didn’t fare well in the number of rabies cases for both cats and dogs from 2017 to 2021.

• Pennsylvania ranked in the top 10 worst states for tick-borne illnesses anaplasmosis (No. 9) and Lyme disease (No. 7).
• Roundworm in cats was detected seventh most commonly in Pennsylvania in 2023.
• Pennsylvania had the most rabies cases in cats from 2017 to 2021 (237).
• Positive rabies in dogs were detected fifth most commonly in Pennsylvania (14).

States With The Lowest Risk Of Cat and Dog Illness

While many environmental factors can influence pet health, these elements vary greatly depending on location within the United States. As a result, some states exhibit fewer pet health concerns than others.

1. Nevada

Nevada’s score: 0.00 out of 100

Nevada claims the rank of being the state with the lowest risk of pet illness. It has low rates of parasitic disease.

• Nevada ranked third-lowest in the percentage of positive cases of roundworm in cats, a common intestinal parasite (0.6%).
• Hookworms, another intestinal parasite, had the third-lowest percentage of cases among dogs in Nevada in 2023 (0.7%).
• The percentage of heartworm cases in dogs was seventh-lowest in Nevada (0.3%, lower than our study average of 1%). A monthly preventative oral treatment for heartworm is recommended by the American Heartworm Society, which dog owners can acquire from their local veterinarian.

2. Utah

Utah’s score: 0.43 out of 100

Utah stands out for having the lowest occurrence of hookworms and heartworms in dogs. The state also reported a mere 1% detection rate of feline leukemia virus (FeLV), ranking among the lowest in all states studied.

• Utah had the lowest percentage of positive cases of hookworms and heartworms (both intestinal parasites) in dogs in 2023.
• Utah recorded the fourth-lowest percentage of positive cases of hookworms in cats last year.
• Feline leukemia virus (FeLV) was only detected in 1% of tests in Utah in 2023, the fifth lowest study-wide.

3. North Dakota

North Dakota’s score: 8.62 out of 100

In North Dakota, there were hardly any cases of ehrlichiosis and whipworm in dogs, and cats also had very few instances of giardia.

• Ehrlichiosis, a disease commonly spread from a tick bite, had the lowest percentage of positive tests among dogs in North Dakota in 2023.
• Whipworm, an intestinal parasite that can cause significant irritation in the intestines, had the second-lowest percentage of positive cases among dogs in North Dakota last year (tying with New Mexico).
• Giardia, which spreads through ingesting contaminated stool or soil, was second-least prevalent in tests among cats in this state in 2023.

4. Hawaii

Hawaii’s score: 14.47 out of 100

Hawaii stands out as one of the few states with no recorded rabies cases in cats from 2017 to 2021.

• Hawaii had the second-lowest percentage of positive cases of heartworms detected in dogs in 2023.
• Roundworms in dogs, an intestinal parasite, had the third-lowest percentage of positive cases in Hawaii in 2023 (0.8%, compared to our study average of 1.7%).
• Hawaii recorded no rabies cases in cats from 2017 to 2021.

5. Idaho

Idaho’s score: 20.20 out of 100

Idaho has low—or zero—positive cases for a variety of illnesses among pets.

• Ehrlichiosis in dogs, a tick-borne disease, was positively detected in 0.7% of tests in Idaho in 2023, the second-lowest in this metric among our study.
• No feline heartworm cases were detected in Idaho in 2023, an honor shared by Montana, North Dakota, South Dakota and Wyoming.
• The percentage of positive hookworm tests in dogs in Idaho was the fifth-lowest study-wide in 2023 (0.9%, compared to our study average of 2.4%).

Pet Health Statistics Nationwide

• 88.1% of dog owners report taking their dog to the vet for a check-up at least once a year.
• 84.3% of dog owners report their dogs are up to date on vaccinations, with 9.7% reporting their dogs are not, and 5.2% being unsure.
• Nearly two-thirds (63%) of dog owners report not administering heartworm medication to their dogs on a monthly basis.
• More than half of dog owners (59.7%) report not administering flea/tick medication to their dogs monthly.
• Veterinarian care ranked as the second-most costly dog-related expense for dog owners in America.

Rabies Statistics

Rabies, a virus spread by bites from infected animals, is dangerous to both people and animals. Rabies infections frequently result in fatal outcomes once symptoms manifest. Domestic dogs are responsible for the majority of human rabies cases.

• Rabies is a viral, preventable disease transmitted through the bite of an infected animal and can cause complications in the central nervous system, which can cause brain diseases and/or death. ^[4]
• An estimated 5,000 cases of rabies are reported in America annually, with 90% of cases being among wild animals. ^[4]
• The remaining 10% of reported cases are estimated to be among domestic animals, including cats and dogs. ^[4]
• Raccoons, skunks, bats and foxes are the animals most commonly infected with rabies. ^[4]
• Ensuring your pet gets regular rabies vaccinations is a preventable measure for avoiding rabies ^[5] and is a legal requirement in most U.S. states. ^[3] Sometimes, proof of a rabies vaccine is a prerequisite for receiving a dog license.

Dog Flu Statistics

Dog flu, or canine influenza, is an illness caused by certain types of influenza viruses called "canine influenza viruses." It spreads from dog to dog and doesn't affect humans.

• The majority of dogs in North America do not have preexisting immunities to the canine influenza virus. ^[3]
• It’s estimated that nearly all dogs exposed to canine influenza become infected. ^[3]
• This virus can be asymptomatic in dogs, but nearly 80% show signs of infection. ^[3]
• Symptoms include thick nasal discharge, fever, lethargy, eye discharge and loss of appetite. ^[3]
• The fatality rate of canine influenza is estimated to be between 1 to 5%. ^[3]
• Secondary bacterial infections are more common than death due to dog flu, and are estimated to develop in 10 to 20% of cases. These infections can cause severe illnesses, such as pneumonia. ^[3]
• Most dogs recover from canine influenza in two to three weeks. ^[3]
• Treatment recommendations include increased hydration, nutritional supplementation and antimicrobials to prevent secondary infections. ^[3]
• The state with the highest percentage of positive canine influenza cases in 2023 was New Mexico.

Tick-Borne Diseases in Dogs

Thousands of dogs are infected with tick bites annually, which can cause a range of devastating diseases for dogs including anaplasmosis, ehrlichiosis and Lyme disease. ^[1]

Anaplasmosis in Dogs

• This disease is often caused by a bite from a deer tick, or a western black-legged tick, which are also the types of ticks that most commonly cause Lyme disease, increasing the risk of co-infection. ^[2]
• Anaplasmosis infections are most common in northeastern, mid-Atlantic and north-central states, as well as California. ^[2]
• This disease can infect white blood cells, which can cause inflammation in dogs. ^[2]
• Symptoms include loss of appetite, lethargy, lameness or reluctance to move and neck pain. ^[2]

Ehrlichiosis in Dogs

• Ehrlichiosis infections are caused by a bite from a brown dog tick or a lone star tick. ^[2]
• This disease is most commonly reported in the Southwestern region and in the Gulf Coast .^[2]
• Ehrlichiosis is on the rise amongst dogs ^[2], increasing the likelihood of positive cases from 1 in 50 in 2022, to 1 in 30 in 2023. ^[6]
• This disease can infect white blood cells and platelets, creating inflammation and blood clot issues. ^[2]
• Symptoms of ehrlichiosis in dogs include depression, appetite loss, runny eyes or nose, random nose bleeds, bruising near the gums and/or belly, joint pain and reluctance to move. ^[2]

Lyme Disease in Dogs

• Lyme disease in dogs is often caused through transmission from a deer tick and a Western black-legged tick. ^[2]
• Lyme disease has been detected throughout America, however, cases are most commonly reported in the Northwestern, mid-Atlantic, north-Central states and California. ^[2]
• Complications with Lyme disease include kidney damage, and at times, cardiac or nervous system symptoms. Severe cases can result in kidney failure and death. ^[2]
• Symptoms of Lyme disease in dogs include stationary legs, which can last three to four days and often caused by joint inflammation, reluctance to move (and/or fatigue), appetite loss and depression-like symptoms. ^[2]

Ticks in Dogs Statistics

• Nine of the 10 states with the highest percentage of positive cases of Lyme disease in 2023 are located on the East Coast.
• Positive Lyme disease cases were detected among dogs in West Virginia more commonly than any other state (17.2% vs. our study average of 3.3%).
• Eight of the 10 states with the highest percentage of positive cases of anaplasmosis are located on the East Coast.
• Maine ranked No. 1 for our anaplasmosis metric, with the highest percentage of positive cases last year (30.6% vs study average of 5.3%).
• Six of the 10 states with the highest percentage of positive cases of ehrlichiosis are located in the South.
• Arkansas ranked No. 1 in our ehrlichiosis metric, with the highest percentage of positive cases in 2023 (17.6% vs. our study average of 2.99%).

Tips for Maintaining Good Pet Health

Having a sick pet can be emotionally taxing for both you and your companion, but luckily there are preventative measures you can take as a pet owner to maintain a healthy pet, including:

Visiting your veterinarian annually for a check-up. Ensure your dog is up-to-date on vaccinations and administer heartworm, flea, and tick preventative medication every month to maintain your pet's health.

Engaging your pet's mind and body. Regular exercise and teaching your pet new tricks can help achieve a balance between mental and physical well-being, contributing significantly to their overall health.

Paying attention to seasonal changes. As weather shifts, so do the health risks your pet may face. For instance, limiting your pet's outdoor time during frigid temperatures or heat waves can protect them from frostbite or dehydration. Additionally, being mindful of factors like contaminated water while hiking can prevent your pet from any regional illnesses.

Keeping your pet safe and out of reach of hazardous materials. Secure trash, chemicals, and toxins, create a safe space at home, regularly clean your dog's belongings, and keep harmful foods out of reach to prevent illness.

Planning for unexpected trips to the vet. Even if you plan carefully and take precautions, accidents and illnesses can lead to big vet bills. Pet insurance helps cover these costs and might be cheaper than you think.

Consider Pet Insurance

Pet insurance is a great way to offset the expense of veterinary bills that can otherwise cost thousands of dollars. With pet insurance, pet owners typically pay vet bills upfront and then submit a claim for reimbursement. Unlike health insurance, most pet insurers allow you to visit any licensed veterinarian without restrictions.

There are various types of pet insurance plans available, including accident and illness coverage or accident-only plans. Accident and illness plans generally include coverage for a wide range of veterinary expenses like:

• Bone fractures
• Foreign object/toxic ingestion
• Dental issues
• Chronic illness
• Breed-specific conditions
• Emergency care
• Diagnostics
• Prescription medications

Accident-only plans specifically cover expenses resulting from injuries, such as your pet eating something poisonous or being bitten by another animal.

Some pet insurance companies give you the option to include wellness coverage. This covers routine care expenses like check-ups and vaccinations, ensuring your pet's health is always a priority. Additionally, there are plans specifically tailored to dog insurance and cat insurance.

Buying a pet insurance plan early on is better, as many plans do not cover pre-existing conditions. This means your pet may not be covered if it develops a health issue before you get insurance.

Since pet insurance plans come in various options, it's important to compare and choose the one that best suits your pet's needs and your budget. Keep in mind, some plans are more affordable than others, and some offer different benefits, such as general health coverage or emergency care.

Methodology

To the states with the highest and lowest risk for pet illness, Forbes Advisor analyzed all 50 states and Washington, D.C. across 11 dog-related diseases and eight cat-related diseases.

We allotted 70% of the total rankings to dogs and 30% to cats, due to relative ownership of these pets nationwide. Each pet-related disease is weighted based on the prevalence of each disease/virus.

Dog Diseases:

• The percentage of positive giardia cases: 9.5% of the score.
• The percentage of positive anaplasmosis cases: 9.5% of the score.
• The percentage of positive Lyme Disease cases:  8% of the score.
• The percentage of positive canine respiratory infections: 8% of the score.
• The percentage of positive hookworm cases: 7% of the score.
• The percentage of positive flea tapeworm cases: 7% of the score.
• The percentage of positive ehrlichiosis cases: 7% of the score.
• The percentage of positive roundworm cases: 4% of the score.
• The percentage of positive whipworm cases: 4% of the score.
• The percentage of positive heartworm cases: 4% of the score.
• The percentage of positive rabies cases: 2% of the score.

Cat Diseases:

• The percentage of positive roundworm cases: 6.5% of the score.
• The percentage of positive giardia cases: 5.5% of the score.
• The percentage of positive flea tapeworm cases: 5.5% of the score.
• The percentage of positive heartworm cases (including AG + AB): 3% of the score.
• The percentage of positive feline leukemia virus (FeVL) cases: 3% of the score.
• The percentage of positive hookworm cases: 2.5% of the score.
• The percentage of positive feline immunodeficiency virus (FIV) cases: 2.5% of the score.
• The percentage of positive rabies cases: 1.5% of the score.

Data on rabies cases for cats and dogs comes from the American Veterinary Medical Association and data for all other metrics comes from petsandparasites.org, which was developed, reviewed, and endorsed by the Companion Animal Parasite Council (CAPC).

Sources:

1. Pet Health Network
2. Animal Legal & Historical Center
3. American Veterinary Medical Association
4. National Foundation for Infectious Diseases
5. Center for Disease Control
6. The Companion Animal Parasite Council via petsandparasites.org