UKC Forums - lyme disease

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Posted by spencer smith on 03-14-2016 08:20 PM:

lyme disease

just had my little female diagnosed with it, never seen a tick on her, ivomec and use prevent tick collar keep them from getting on her I thought, didn't know there was a vaccine for it, once they go though the treatment will they be go as new or will it be something I have to deal with?? what are the signs of lyme disease are they all same symptoms for all tick diseases???or is each one different?

Posted by Adam Wingler on 03-14-2016 09:57 PM:

I've had 2 that tested positive, they apparently had it before I bought them, neither showed me any signs of illness. However, I've had others tell me it negatively changed their dog forever.

No help I know, just keep some doxycycline on hand, when and if it flares up jump on it with meds.

Posted by Bill Lash on 03-14-2016 10:29 PM:

lyme

This disease can leave many different side effects, It causes cancer,stomach disorders and many other harmful diseases, I'm no vet so I do not know why it happens. It is very common here, I have had dogs vaccinated and still get it, If you notice your dog loosing energy, not treeing as good, not hunting out, getting hot and panting when its cold out and laying in the water to cool off , more than likely the dog has lyme's. Doxy is getting almost impossible to buy around here, and when you do find it wow the price really went thru the roof. Every dog I own has been treated and some have never recovered fully, to return to the dog they once were.

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Posted by oklared on 03-15-2016 12:02 AM:

MAYBE ONE OF OUR RED DOG VETS WILL PUT SOME INFO ON HERE THAT WILL HELP.

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Posted by Richard Lambert on 03-15-2016 12:08 AM:

If your dog tests positive, you should treat them for sure. But there are false positives, depending on the test. If your dog shows no symptoms it may be a false positive. Why did the vet test them? As Mr Lash said, it is a terrible desease that can become chronic or lasting.

Posted by spencer smith on 03-15-2016 03:22 AM:

Bill lash

That's exactly what she was doing since summer time last year but her sugar count was down when they tested her too,Friday night was a bad hunt thought she was going to die at the tree,she's been on the medicine said Saturday and showing Improvement as of today

Posted by ahallada on 03-15-2016 06:12 AM:

Borreliosis Diagnosis & Treatment
Mark Rishniw, BVSc, MS, DACVIM (SAIM), DACVIM (Cardiology)View Mark Rishniw, BVSc, MS, DACVIM (SAIM), DACVIM (Cardiology) Profile

Introduction
Lyme disease can be serious in some dogs. However, Borrelia burgdorferi infection does not mean Lyme Disease in dogs (or cats). Testing for antibodies against B. burgdorferi is routine, but can lead to confusing results and unclear decisions about treatment. This FAQ discusses some of the controversies.

References

Clinical Use Information
What is the difference between B. burgdorferi infection and Lyme disease?
What is the current prevalence of B. burgdorferi infection and Lyme Disease in the US?
My patient tested positive for B. burgdorferi on an in-clinic test. What does this mean?
What other diagnostic tests should I consider, and how do I interpret them?
What is the probability of a dog developing clinical signs from exposure to B. burgdorferi?
Can I use serological tests to monitor disease progression, response to treatment or to provide a prognosis?
What should I do with a patient that tests positive?
Is there a breed predisposition to Lyme disease or seroconversion?
What drugs can be used to treat B. burgdorferi infection?
Is there any value to vaccinating dogs that are seropositive for B. burgdorferi?
What about general vaccination guidelines for B. burgdorferi?

What is the difference between B. burgdorferi infection and Lyme disease?
Lyme disease is a clinical syndrome resulting from an aggressive immune response to infection with B. burgdorferi. It can manifest as a relatively mild, self-limiting malaise (slight fever, anorexia etc), or can progress to a more characteristic arthropathy and in some instances, nephropathy (Krupka et al 2010). In humans, infection with B. burgdorferi results in a high probability of developing symptoms or clinical signs – some 90% of people who are infected will show clinical signs (CDC website). Consequently, the terms are often used interchangeably when discussing infection in people. However, many, if not most dogs will show no clinical signs of infection, or signs will be subtle and transient enough that they will fail to be recognized by the pet owner. Therefore, it is important to distinguish between infection with B. burgdorferi (current or previous) and Lyme Disease when discussing this condition in pets.

What is the current prevalence of B. burgdorferi infection and Lyme Disease in the US?
Records are extensive for human cases of Lyme disease. The CDC maintains exposure maps that show diagnosed cases by year until 2013 (note that these are people who were considered to have clinical Lyme disease, not just exposure – however >90% of humans exposed to B. burgdorferi develop clinical signs, so these do represent “exposure” as well). In 2013, 95% of human Lyme disease diagnoses were made in 14 states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin. These correspond with the distribution of the Ixodes tick vectors. Smaller pockets of infection occurred in central-northern coastal California, near Seattle and along the Florida coast.

Studies of seroprevalence in dogs, based on in-clinic sampling of pets presenting to first-opinion practices have been conducted (Bowman et al 2009, Little et al 2014). These show a very similar distribution to the human data. They also reflect the distribution of Borrelia-bearing ticks (black-legged ticks, Ixodes scapularis and Ixodes pacificus).

However, this does not reflect the prevalence of Lyme Disease in dogs in the US. It is actually not known what percentage of dogs that become naturally infected and seropositive actually develop clinical signs, and how many develop more serious disease manifestations such as arthropathy or nephropathy.

My patient tested positive for B. burgdorferi on an in-clinic test. What does this mean?
The most commonly used in-clinic test detects the presence of C6 antibodies. C6 is a synthetic peptide derived from VlsE antigen, and is only expressed by B. burgdorferi after entry into the vertebrate host. The IDEXX SNAP 4DX PLUS test detect C6 antibodies specific for B. burgdorferi infection. The Antech Accuplex 4 test evaluates 5 antibodies against various B. burgdorferi proteins, including OspA, OspC, OspF, P39 and SPL. The New York State Animal Health Diagnostic Center at Cornell University offers a Lyme Disease Multiplex assay. This assay measures concentrations of antibodies against OspA, OspC and OspF and has been validated in dogs (Wagner et al 2011, Wagner et al 2012). It purports to differentiate between vaccination-induced antibodies (OspA) and infection (OspC and OspF).

In endemic, high prevalence areas, many dogs that have access to outdoor areas will likely test positive using in-clinic tests (C6) at some point [3-8 weeks] following successful B. burgdorferi transmission. This occurs, because most of these dogs will have been bitten by a tick at some point in the past. Ticks require attachment and feeding on a dog for at least 24 hours ( although most studies in people suggest that the real risk of transmission begins after 48 hours of attachment and feeding) to allow the Borrelia spirochete within the tick to undergo structural antigenic changes, penetrate the mid-gut of the tick and then be transferred to the vertebrate host) (Kelly et al 1999). Most recently, seropositivity in the Northeast US was estimated at about 13%, and <5% in all other regions (Little et al 2014). Therefore, a positive test result in a dog from the more highly endemic areas is likely a true positive, meaning that the result is probably truly indicative of the presence of antibodies against B. burgdorferi. However, it is impossible to determine if the dog is infected at the time of testing, or if the test is detecting residual antibody. Furthermore, it is impossible to tell if the infection is recent, or persistent, but subclinical. More comprehensive tests, such as the Cornell Multiplex test, claim to differentiate between acute and persistent infections: OspC antibodies indicate acute infection, OspF antibodies indicate persistent infection (Wagner et al 2012). However, some experimental studies, with known single-time-point exposure to infected ticks showed that B. burgdorferi could be detected by PCR or culture up to 2 years after infection (Straubinger 2000).

On the other hand, a positive test result in an area without known Lyme disease endemnicity and Ixodes scapularis exposure, or where the prevalence is very low, is much more likely to be represent a false positive test result. In these areas, a positive test result from a multi-pathogen test (e.g., a 4DX SNAP PLUS test) should be noted and if clinical signs are supportive of Lyme disease, confirmed using an alternative testing platform (Littman et al 2006).

What other diagnostic tests should I consider, and how do I interpret them?
There are several other tests that can be performed. The Lyme Quant C6 antibody test is a quantitative version of the SNAP 4DX PLUS test. A Lyme multiplex ELISA (Luminex) is available through the New York State Animal Health Diagnostic Center (Wagner et al 2012). Western blotting, which evaluates serum for the presence of multiple antibodies that are characteristic of infection, can help demonstrate serologic evidence for infection. However, this form of diagnostic test is no longer available for commercial use in veterinary medicine (but still is part of the 2-tier analysis in human medicine). (Eschner A, personal communication).

In endemic areas, some argue that it might be more prudent to evaluate dogs for proteinuria and only perform serodiagnostics on dogs with evidence of proteinuria or arthropathy or dogs that are clinically ill with signs suggestive of Lyme disease. In breeds thought to be predisposed to Lyme nephropathy (e.g., Labradors, Golden Retrievers), such testing might be warranted yearly, although little evidence exists to support such a surveillance strategy (Goldstein R, unpublished). Additionally, clinicians should recognize that dogs with proteinuria that are antibody positive to B. burgdorferi do not necessarily have Lyme nephropathy. Many other causes of proteinuria exist and should be considered or investigated, rather than assuming that the proteinuria is due to B. burgdorferi infection.

What is the probability of a dog developing clinical signs from exposure to Borrelia burgdorferi?
Most humans exposed to B. burgdorferi develop clinical signs (CDC estimates that 90% of exposed humans will develop some clinical sign). However, in research studies with experimental challenge of dogs with infected ticks, 95% of dogs infected with B. burgdorferi showed no clinical signs, or vague clinical signs that were missed and resolved spontaneously (Littman et al 2006). The remaining 5% of dogs will mostly develop an arthropathy, weeks to months after exposure. However, other studies with experimentally challenged dogs resulted in arthropathy developing in 11/16 infected dogs, approximately 2 months after exposure (Straubinger 2000). A more recent study found that seropositive dogs in Europe failed to develop clinical signs of lameness or renal disease over a 2-3 year period after initial diagnosis (Gerber et al 2009).

Can I use serological tests to monitor disease progression, response to treatment or to provide a prognosis?
Multiple studies have examined the relationship between seroconversion and development of subsequent arthropathy or nephropathy, and concluded that no such relationship exists – just because a dog seroconverts, this does not predict future clinical disease (Gerber et al 2009, Straubinger 2000). While dogs can remain infected for >1 year after exposure, this infection is often subclinical. How many dogs clear the infection spontaneously is not known; however, at least 1 study suggests that infections persist for 500 days after infection (Straubinger 2000).

While dogs with high C6 antibody titers usually show a decrease in their titer with treatment over a 6-month period, there is no evidence that in a subclinical dog (showing no evidence of disease) such a reduction results in any better clinical outcome (reducing the risk of subsequent development of pathology) than in a similar, but untreated, dog (Levy et al 2008). There is scant peer-reviewed evidence that C6 antibody titers can be used to make treatment decisions in subclinically infected dogs, although this has been proposed by one investigator (Goldstein 2009).

What should I do with a patient that tests positive?
Some controversy surrounds this issue. Most experts agree that treating an apparently healthy dog that is seropositive, especially in an endemic area, where the prior probability of seroconversion is high, is unwarranted for several reasons (Littman et al 2006):

Most seropositive dogs will never develop detectable disease.
Of the dogs that develop disease, most will develop an arthropathy that can be managed at that time.
Drugs traditionally used to treat Lyme disease (doxycycline or minocycline) are expensive – therefore, unnecessary treatment confers an unnecessary expense on the client.
Adverse risks of antimicrobial treatment (e.g., diarrhea, antimicrobial resistance) likely outweigh any potential benefit.
Is there a breed predisposition to Lyme disease or seroconversion?
Several studies have observed higher incidence of seroconversion in some breeds (e.g., Bernese Mountain Dogs compared to other breeds in Switzerland) (Gerber et al 2007), or in development of more serious complications (e.g., nephropathy in Labradors or Golden Retrievers) (Dambach et al 1997). However, whether this is truly a breed predisposition, or merely an increased exposure risk (in hunting or outdoor breeds, or breeds that are simply more popular in certain areas), is hard to determine from the data presented in that study. However, this does not mean that dogs of other breeds are unaffected by B. burgdorferi infections or that they can’t develop more serious complications.

What drugs can be used to treat B. burgdorferi infection?
Tetracycline derivatives have been traditionally used to treat dogs and people infected with B. burgdorferi. However, a study has demonstrated that amoxicillin administered for 1 month, or cefovecin, in a depot preparation (Convenia), administered twice 2 weeks apart, were equally effective in reducing B. burgdorferi in dogs (Wagner et al 2015).

Is there any value to vaccinating dogs that are seropositive for B. burgdorferi?
Vaccination of seropositive dogs is controversial. Antibodies made following natural infection with B. burgdorferi are not borrelicidal – they do not eradicate the infection. Once in the dog, B. burgdorferi have has been shown to persist unless treated with antibiotics (Straubinger et al 2000). Likewise, sera from naturally infected dogs are not borrelicidal against B. burgdorferi in culture (or by extension, within the tick) due to the absence of expression of OspA antigen by B. burgdorferi upon infection (Straubinger et al 1995). Consequently, strategies have developed that target B. burgdorferi within the tick, using antibodies against an antigen that is expressed only in the tick phase of B. burgdorferi (OspA). These antibodies do appear to be borrelicidal, or at least prevent successful transmission of the B. burgdorferi to the vertebrate host.

One school-of-thought argues that once a dog is infected, it does not make sense to try to “protect” the dog from future infection because it is already “managing” the infection well by virtue of NOT showing any clinical signs. The counter-argument to this proposes that the probability of developing Lyme Disease might increase with on-going exposure to infected ticks and the associated increased antigenic burden (e.g., through serial B. burgdorferi infections). Some studies suggest such a possibility (Straubinger et al 1998). Others argue that this discussion is further complicated by the different vaccine types that are available (e.g., whole cell bacterins versus recombinant OspA). Due to the fact that bacterins contain more types of antigens, some have argued that there might be more risk for adverse effects (Littman et al 2006). Whole cell bacterins have been historically implicated in causing temporary post-vaccinal lameness in some dogs, but in general, veterinarians have been vaccinating dogs that are seropositive for B. burgdorferi for almost two decades without evidence of serious adverse events, regardless of vaccine type.

A study examining the bacterin-based vaccine found that vaccinating seropositive dogs reduced the incidence of subsequent clinical signs by 60% compared to unvaccinated dogs. However, vaccinating seronegative dogs reduced the incidence of subsequent clinical signs by 85%, when compared to unvaccinated dogs (Levy et al 1993).

In summary, unless tick control is absolutely perfect in killing ticks for the duration of the product’s labeled dosing interval, dogs (and humans) living in endemic areas will continue to get infected with B. burgdorferi. The decision to vaccinate seropositive, clinically normal dogs to prevent future infection holds logical merit from a re-infection standpoint; however, carefully controlled, randomized trials to answer the question of ‘absolute benefit’ do not yet exist.

What about general vaccination and prevention guidelines for B. burgdorferi?
Vaccination protocols have been developed, and are part of a three-pronged approach to reducing borreliosis. The acronym to remember is “V.E.T.” – Vaccinate, Educate, Tick control, although vaccination should be considered the third line of defense.

Vaccination, in combination with reputable educational resources on how to manage, avoid and remove ticks, both on the pet and in the yard, is important. Likewise, compliant, use of quality tick control products administered (or applied) to dogs throughout the at-risk time of year will go far in helping to reduce infection with B. burgdorferi from feeding ticks.

Lyme disease vaccines, regardless of type, play an essential role in helping to prevent B. burgdorferi transmission from tick to dog. Vaccines take advantage of a vulnerable outer surface protein (OspA) that the bacteria manufactures during its residence within the tick and prior to being transmitted. Antibodies generated against OspA via vaccination work by immobilizing and inactivating B. burgdorferi within the tick prior to it “hiding” (down-regulating) its OspA protein.

Two types of canine borreliosis (Lyme disease) vaccines exist for dogs: first generation whole cell bacterin preparations containing multiple B. burgdorferi antigens (including OspA) with adjuvant and a second generation recombinant subunit formulation containing purified OspA without adjuvant. Both vaccine types protect based on their ability to generate antibodies to OspA in the vaccine recipient.

Pups in endemic areas can be immunized at the earliest age listed on the package insert and then annually. Maternal antibodies to OspA do not appear to interfere with the ability of a pup to begin responding to vaccination when administered at the minimum age indicated on package inserts, because maternal-derived OspA antibody in the serum of pups wanes prior to 3 weeks of age. In endemic areas, a delay in immunization can increase the likelihood for infection especially when a new puppy owner is still getting used to purchasing and applying tick-control products. Regardless of vaccine type used, some Lyme disease experts recommend the addition of a single booster vaccine administered 4-6 months after the initial series of two followed by the annual vaccine given 6 months later.

Tick-control (acaracide) products in the U.S.A. include those made from members of the phenylpryazole, synthetic pyrethroid, macrocylic lactone, foramidines and isoxazoline families of compounds, none of which are labeled to prevent tick-transmitted pathogens in dogs. The Companion Animal Parasite Council recommends that tick products be used throughout the year as many tick species are active throughout the year or can become active when temperatures rise briefly during the winter months. However, in some regions tick exposure is seasonal, or dogs only access areas with ticks during specific times of the year – in such situations tick products should be used during the periods when tick exposure is likely.

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Posted by ahallada on 03-15-2016 06:49 AM:

Summary:

Lyme disease is a complicated disease. Clinical signs are actually due to the body's immune response to the bacteria. Clinical signs in dogs usually are related to inflammation of the joints (arthritis) and inflammation to the kidneys (nephritis). Most dogs that contact the bacteria through a tick bite do not develop clinical disease. Only 5% of dogs that have exposure to the bacteria through a tick bite show clinical signs in one study. In another study that percentage was higher. Therefore, a positive diagnosis of Lyme Disease should be made on 3 criteria, 1. Clinical Signs such as temperature of 103F/ Arthritis/ Protein in Urine, 2. Positive Lyme Test , 3. Response to therapy. Many dogs in non endemic areas can have false positive test results and even dogs that do show positive test results do not develop clinical disease. In my opinion, dogs that are in highly endemic areas listed above that test positive should be treated. Treatment with Doxycycline, Amoxicillin or Convenia for one month are all effective in treating the disease. Some dogs can develop a chronic subclinical infection (no signs) that do not show clinical disease but can last the life of the dog. Vaccination of dogs that test negative on 4DX tests have shown to be up to 85% effective in preventing clinical disease, where as dogs that test positive on 4DX show about a 50-65% response to newer subunit vaccines in protection from clinical disease.

The best prevention is a good tick prevention program. The best products I've found so far are NexGard and Bravecto. The newest product in the same class is being released this week and is called Simparica. It offers fast tick killing action within 4 hours of ingestion of the tablet. Simparica and Bravecto are not approved for puppies under 6 months of age. These products cover 100% of the body because they are oral tablets that work systemically. NexGard and Simparica last 30-35 days and Bravecto lasts up to 3 months. Bravecto should be given every 2 months during tick months in areas that are endemic for Tick Born Diseases, especially Texas for the Lone Star Tick. Tick collars and topical products don't cover all of the body, especially the head area where ticks like to attach. Ticks need to be attached for over 24 hours to transmit Lyme disease.

Remember that Lyme disease is only one of may tick born diseases affecting our hunting dogs. Ehrlichia, Anaplasma, Babesia, Rocky Mountain Spotted Fever (Rickettsia), Haemotrophic Mycoplasma and others are increasing in frequency in our dogs. This is why tick prevention is so important.

Posted by Richard Lambert on 03-15-2016 03:19 PM:

Thanks so much Doc, how much do we owe you?

Posted by spencer smith on 03-15-2016 04:16 PM:

thanks for the info.

the tests they ran on her was CBC. IDEXX HEARTWORM 4DX SNAP TEST-WIL, hopefully were on the road to recovery big change in her this morning.

Posted by Pastor Mike on 03-17-2016 10:57 PM:

Can tick born diseases cause thyroid problems in dogs?

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Posted by ahallada on 03-17-2016 11:03 PM:

quote:
Originally posted by Pastor Mike
Can tick born diseases cause thyroid problems in dogs?

That's a good question. Tick Borne Illness has the potential of causing sick euthyroid syndrome which happens when a dog is ill and the thyroid gland suppresses production of thyroid hormone. This is very common. So the answer is potentially yes it can. I was thinking of this the other day when I saw the number of Walker dogs reported with Hypothyroidism and was wondering how many of them were misdiagnosed.

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