I am dedicating this next blog to Lyme Disease because we are seeing more and more cases of Lyme in our patients in this area and we feel that it is very important for pet owners to understand the risks associated and how to prevent their pet from getting Lyme.
Statistics At North Lake Veterinary Clinic: So far in 2014 we have run 1058 Heartworm/tick tests (4DX). Of these tests we have had 84 positive Lyme tests. 35 of these are dogs with new cases of Lyme disease (have never had Lyme disease before). Cats do not usually get Lyme disease so we do not preform routine screening tests for them.
At the mention of “Lyme Disease”, most people usually respond to me with stories of friends, family, and pets that have gotten Lyme disease. Although a lot of research has been done on Lyme disease, even the top researchers affirm that there are things we still do not understand about it at this time.
What we do know:
-We do know that Lyme disease is caused by a bacteria called Borellia Burgdorferi.
– Dogs become infected with this bacteria through the bite of a tick.
– Ixodes scapularis ticks (commonly known as the “deer tick” or “blacklegged tick”) are the type of tick that commonly carry this bacteria.
-When an infected tick bites and feeds on a dog’s blood, it will regurgitate this bacteria into the dog’s blood stream causing Lyme disease.
-An infected tick usually needs to be attached to/feeding on a dog for 48 hours before the Borellia bacteria is transmitted.
-Symptoms typically do not show up until 2-5 months after a tick bites the dog and transmits Lyme disease.
– To screen for Lyme disease, an annual tick screening test (4DX) that tests for Heartworm and 3 tick diseases is often utilized.
-Lyme disease was first named for Lyme, Connecticut where a number of cases were documented in 1975. Since then, it has spread rapidly through the north eastern states and also westward.
Click here to see a map of: Lyme Prevalence in USA
As you can see, we are in a high risk area where an estimated 1 out of 11 dogs test positive for Lyme disease. Although, the majority of these dogs will have no apparent symptoms, 5-10% of dogs that get Lyme disease will show illness, sometimes life threatening. Lameness, lethargy, decreased appetite, and vomiting are some of the symptoms noted by owners. In rare cases, dogs can go into kidney failure (called Lyme nephritis) and often do not respond well to treatment.
My first introduction to Lyme disease occurred with our family dog in upstate New York before I was even in vet school.
Our once very active black lab, Casey, had suddenly become lame in a front leg. My family attempted to rest her, thinking she may have sprained that leg. During her exercise restriction, it then became apparent that she was also limping on a hind leg. Casey was then brought to our vet where she was diagnosed with Lyme disease, a tick borne disease that was rapidly becoming more common in New York. Casey was treated with an antibiotic at that time which improved her lameness, but arthritic symptoms continued to plague her throughout the remainder of her life. We attributed this to her Lyme disease and I vouched to never let another pet of mine get Lyme disease.
Now that I am a veterinarian and have seen more aspects of Lyme disease, my biggest fear with Lyme disease is “Lyme Nephritis”. In this more rare complication from Lyme disease, dogs develop kidney failure that can be fatal. In my 6 years of practice, I have had 4 patients that I suspected had Lyme nephritis. These dogs were young dogs (under the age of 5 years old) and had all been historically healthy pets. In all cases, blood work and diagnostics showed these young dogs were in acute kidney failure with no other identifiable cause besides all testing positive for Lyme disease (with usually high C6 test results). Despite extensive efforts to treat these patients, they did not respond to treatment and were humanely euthanized. Deaths from Lyme nephritis can be prevented by preventing dogs from getting Lyme disease in the first place. This can be accomplished by year round tick preventatives and the Lyme vaccine.
How to protect your pet from getting Lyme disease?
1. Have your pet vaccinated! The Lyme vaccine that we have at North Lake Veterinary Clinic is a safe and highly effective vaccine. We had seen no long term negative side effects, although, as with any vaccine, rare vaccine reactions/anaphylaxis can occur.
Since moving to Wisconsin, my recommendations for the Lyme vaccine here have changed. I started off recommending it for dogs that I felt were at a higher risk (getting a lot of ticks, going outside a lot- in the grass or woods, traveling to northern Wisconsin, etc.) Then I had a family with 2 small dogs come to see me for their annual visit. We discussed the Lyme vaccine and they told me that these dogs rarely went outside and that the owner had never seen a tick on them. We decided that the dogs seemed to be at low risk for Lyme disease. Later both dogs tested positive on the 4Dx tick test for Lyme! Since that point I realized even some low risk dogs were getting Lyme disease and that worried me. I now recommend the vaccine for almost every dog in this area. Remember, it only takes one infected tick bite to cause Lyme disease and you may not always be able to see ticks on your pet (biting in places you like inside the ear, under the tail, between the toes, etc.). Deer ticks are tiny (smaller than a sesame seed) and if you think you can find every one combing through your pets fur you are usually wrong.
– 2. Use a good tick preventative (ideally year round) such as Nexgard, Frontline Plus or Vectra. Even if your pet has had the vaccine to help protect it again Lyme disease, there are other tick borne diseases such as Anaplasma or Erlichia that can be transmitted by ticks. Neither the Lyme vaccine nor the tick preventatives are 100% effective but if you combine the two together you are getting pretty close.
What to do if your pet gets Lyme disease?
Have a discussion with your veterinarian since there can be many options for treatment including not treating.
When I have a patient that comes up Lyme positive on their tick test (4DX Heartworm/tick combo test) I am immediately concerned. I know that most patients will live with Lyme disease and not show symptoms, but I can not tell from the 4DX tick test which patients may have more severe Lyme side effects, even kidney failure. To find out which pets are more at risk, I recommend doing a few additional diagnostics.
– Lyme C6 test: this is a blood test that helps quantify the dogs antibody level to Lyme (C6 protein). A higher level on the C6 test has been linked to more immune complexes in the body and more risk for arthritis, kidney disease and other problems from Lyme disease.
–Urinalysis: One of the first indicators of kidney problems from Lyme disease is increased protein in this urine test. We screen for an increased protein level to alert us that the dog may be more at risk for Lyme nephritis.
– Blood work: Especially if your pet shows symptoms of Lyme disease, blood work can help us find out if the kidneys are functioning normally or if we need to be concerned.
Treatment for Lyme Disease:
If a dog has a low C6 level and no symptoms, they may not need treatment. Discussion with your veterinarian is recommended.
If a dog comes up high on the Lyme C6 ( above 30), I usually recommend treating with the antibiotic doxycycline for 4 weeks to help decrease the Borellia bacteria causing Lyme disease.
If a dog not only has an elevated C6 level, but also protein on the urinalysis and/or elevated kidney values, I am more concerned for Lyme nephritis. I definitely start the doxycycline antibiotic right away. I then try to find out if these kidney changes are from the Lyme disease or from something else (that may be treatable) by performing other tests. If a dog is suspected to have Lyme nephritis, hospitalization and intravenous fluids may be recommended.
What Happens now that my dog has Lyme disease?
If your veterinarian has checked a Lyme C6 level and treated your dog with antibiotics it is often recommended to recheck a C6 blood test in 6 months to make sure the levels are coming down. It is also important to discuss any symptoms that you may see with your veterinarian. Often lameness can be treated with pain and anti-inflammatory medication to make your dog feel more comfortable.
Borellia bacteria are very good at hiding in your dog’s body. It may take a long time before your dog has cleared the infection (even years) and you may see your dog come up positive on future annual screening tests (4DX) from this original infection. Unfortunately dogs can also become infected with Lyme over and over again and annual screening tests (4DX) can not differentiate between a previous Lyme infection and a new infection. Discuss this with your veterinarian; if your dog has been Lyme positive in the past and come up positive on the annual screening test, your vet may recommend another C6 test to help make sure it isn’t a new infection that may need treatment.
Discuss vaccination with your veterinarian since dogs can become re-infected with Lyme disease multiple times. If your dog has gotten it once, they are at risk for getting it again so protect them with a Lyme vaccine and tick preventative!
***Please feel free to share this link with your friends and neighbors so they are as educated about Lyme disease as you are now***