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Lyme Disease - Important Information You Need!

What thoughts go through your mind when you look at this picture? My first thought is “YUCK.” If I see one of these little creatures on my dog, I will undoubtedly be checking my own skin and hair for the rest of the evening.
I can’t help it, they creep me out. I also find them incredible. How such a tiny insect can cause such terrible disease is incredible and scary. I lived in the upper Midwest for most of my life. Lyme Disease is ENDEMIC there, meaning the disease was very common in the area I lived. We could take the dog for a walk on the road, and the furthest he would be off the road to go to the bathroom was maybe 4 feet, and he would at times come back with 15 ticks crawling on him. When you thought you’d found them all, two hours later you’d see more sitting on top of his head. Creepy.

We’d see most of the ticks on the dogs at the Veterinary practice in the spring and the fall. Did you know that ticks can be out in the environment if the temperature is above 32 F?
That means that if any point in the day is above this temperature, ticks can be present. For some areas of the US, this means they are out year round. Lyme Disease is most prevalent in the upper East Coast and Upper Midwest, but with the movement of animals over time, these boundaries are constantly growing. At my single doctor practice, we saw over 170 cases of Lyme Disease every year. We would keep a count on a small chalk board near the front door to impress upon pet owners the importance of prevention and treatment. Oftentimes when I would diagnose a dog with Lyme Disease, the human counterpart would tell me about how they also had it, or another member of their family had it.

Symptoms of Lyme Disease range from limping, lethargy, not eating, vomiting, unable to jump or play as usual, to auto-immune disease (where your body attacks itself), and kidney failure. It is such a devastating disease in dogs, and in humans as well.
It can be very treatable when caught early, but in cases where owners wait too long, the unfortunate truth is that we often cannot save these dog’s lives. Thankfully, we have a simple test we can do in the clinic that takes under ten minutes to diagnose not only Lyme Disease, but also Anaplasmosis and Ehrlichia (two other tick-borne diseases) and Heartworm disease. It’s a wonderful combination test that we Veterinarians recommend yearly.

If your Veterinarian offers you this test and you live in an area with ticks, your answer should always be YES PLEASE! Even if you have never seen a tick on your dog, the answer should still be yes. If you travel to an area that has ticks your answer should be yes. In short, your answer should always be YES! If there is a “good” time to find out that your dog is positive for a tick-borne disease, it is always when your pet is not showing symptoms yet. That means we have hopefully diagnosed it early in the course of disease, and treatment should work much better.

When a dog tests positive for Lyme Disease, a secondary test should ALWAYS be run. This is called a C6 antibody test. The first in-office test simply shows if a dog is positive or not, but doesn’t tell you how high the pet’s antibody levels are to the disease. The C6 test, specific to Lyme Disease, will return with a number between 0 and 800.
Anything under 30 is considered not significant. This means that your dog was bitten by a tick carrying Lyme Disease, and the dog’s body is mounting an immune response. This may be found in a dog vaccinated against Lyme Disease. However, if the pet is not vaccinated, is symptomatic (limping), and the number is below 30, it may just be that we caught the disease early before the number skyrocketed. More common is to get results back with numbers in the 200s, 500s, etc. This shows that it is a significant infection (number is above 30) and the pet requires treatment for Lyme Disease. So, that is reason number one to get the C6 test…..a starting value. The second reason to have the C6 done is so that we can monitor the pet’s progress with treatment over time. Doxycycline is the antibiotic used to treat dogs for Lyme. Treatment consists of once or twice daily treatment for 30 days. At the end of treatment if the pet is no longer symptomatic we discontinue meds and have owners monitor at home. Six months after completing the course of Doxycycline, we recheck the dog’s C6 levels.
This new number is compared to the first C6 number at the time of diagnosis. If the value has decreased by 50% or more, the treatment is considered successful. For example, if Fluffy’s initial C6 was 200, and the recheck C6 value is now 100 or less, that is great news and her treatment is considered a success. You might be asking…..”What, that doesn’t make sense, the number is still greater than 30?” True, but we were looking for a 50% improvement in the initial C6 number. At this point, we now check the C6 value once yearly and continue to watch the C6 value drop until the pet is completely negative for Lyme. In my experience, this takes on average 2 years. It does not mean that your dog is still infected with Lyme Disease, just that the residual antibodies are leaving the system. There are a few dogs that will have a persistently low C6 (ie C6 <10), and will always be positive.

Can all of this be prevented? Absolutely. I can’t stress how important the Lyme Vaccination is if you live in an area with a lot of ticks or travel with your dog to an area with a lot of ticks.
The vaccine is started around 12 weeks of age and boostered at 16 weeks of age. It is then boostered once yearly. What if your dog didn’t get the Lyme vaccine and tests positive for Lyme; are they still able to get the vaccine? Yes, but timing is important. I recommended to my clients to start the vaccine for their dog right after finishing the course of Doxycycline; this would give us the best chance of the vaccine working to its full efficacy, even with a recent infection.

Also, every month your dog should be getting a preventative for not only Heartworm Disease (see a future post on that), but also a preventative for fleas and ticks.
A common misconception is that you won’t see any ticks on your dog if they are on a preventative. These medications rather work once the tick bites the dog. The topical preventatives (Frontline, Advantage, etc) work by protection through the ducts in the skin. The oral preventatives (Nexgard, Bravecto, etc) work by protection in the bloodstream. Either way, once the tick bites the dog (or flea bites the dog) the tick will die prior to transmitting disease. Though some Veterinarians suggest these preventatives only certain months of the year based on where you live, I recommend them, and give them to my own dog, all year round. I have seen PLENTY of fleas and even some ticks in the winter on dogs.

A personal note about Lyme Disease…..our 10 year old daughter started complaining about pain in her knees. We assumed this was from overuse, running around at school/daycare, or growing pains. But, when she started hobbling around like a 90 year old, we decided she needed to see her doctor. We were told that it was probably growing pains and that she would be referred to a physical therapist for some exercises. I asked her doctor if this could be Lyme Disease, especially with where we lived, the fact that she played in the woods outside every day at school and daycare, and also discussed how many cases I diagnosed every year. I was told it was not likely, but I pushed for her to be tested anyway. Sure enough, she came back positive for Lyme Disease. So happy I was a bit pushy that day. Her recovery was slow, but I’m happy to report that a year and a half later she was the star runner on her cross country team, having led the team to many first place finishes. She runs a 6:25 mile and certainly leaves me in the dust!

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