Lyme
Lyme disease, named after the town of Lyme, CT, is carried by the black-legged deer tick (Ixodes scapularis) in the East and in the West by Ixodes pacificus or Ixodes neotomae. Larvae of the deer tick feed on mice, nymphs on mice and small mammals and the adult prefers to feed on deer, so those are the primary hosts at each stage of the tick's life. Lyme is endemic in the Northeast and has a foothold in the Midwest and in California.
The South has largely escaped Lyme disease, according to Dr. R. K. Straubinger in Lyme Borelliosis in Dogs (IVIS), because I. scapularis larvae and nymphs prefer to feed on lizards in this region and lizards don't maintain infection with B. burgdorferi. Infection in the South as of 2000 was low, often less than 1%.
Borrelia burgdorferi, the organism that causes Lyme, belongs to the order Spirochaetales so you will see them referred to as spirochetes. (Pronounced something like SPY-ruh-KEETS). Transmission of these bacteria occurs in the same way as it does with other tick-borne disease organisms but once inside the dog, B. burgdorferi spirochetes multiply very slowly, taking up to 12 hours to double in number, unlike most other bacteria which are speed demons by contrast. This is not, however, advantageous for us in fighting the disease.
B. burgdorferi proved to have an unusual survival mechanism: the ability to escape or overcome unfavorable conditions, conditions like those found in the tick's digestive system, for instance, by transforming into cysts (small sacs enclosing a dormant organism) then changing back again to normal when conditions become favorable. Dr. Willy Burgdorfer, for whom the organism is named, speculated that this might be the reason B. burgdorferi can cause prolonged, chronic and periodically recurrent disease.
At any rate, Dr. Straubinger says that a "moderate" antibody titer may be expected to last for years even after extended treatment ( 3 to 4 weeks is the time he mentions), especially when that treatment was long delayed. In my opinion, his conclusion would seem to support using the aggressive dosage of doxy we recommend on Tick List and the longer, 8 week, administration of the antibiotic. We believe that your best course is to hit these spirochetes hard and don't give them a chance to encyst, recover or hang around for years if at all possible.
Symptoms
Unlike dogs with ehrlichiosis, or humans infected with Lyme disease, dogs don't go through three clear stages. There is no rash. Dogs generally present with signs of arthritis in the joints closest to the tick bites. Two to five months after being bitten, the lameness that is the primary indicator of possible Lyme disease can come on suddenly and severely; other times it comes on more gradually. You may see shifting lameness where the dog favors one leg, then another. Lameness may come and go, sometimes for weeks at a time. The dog may go off his food. Neurological damage is possible. Seizures and changes in temperament, from dullness and disinterest to the opposite extreme of aggression, have been reported in dogs with Lyme.
Depression, swollen lymph nodes, moving stiffly or being reluctant to move at all, and joints that are swollen and warm to the touch may also be signs of Lyme disease.
Normally, Lyme is crippling but it doesn't kill. Unfortunately, some dogs develop glomerulonephritis or Lyme nephritis, a condition in which the glomeruli in the kidneys which filter the blood are inflamed and destroyed. It is incurable, though treatment and palliative measures may keep the dog more comfortable and extend the time he has left, sometimes for much longer than predicted.
What if there are no symptoms?
According to Dr. Tom Beckett, who has treated many, many dogs with TBD, "The problem is that freedom from symptoms does not equal freedom from hidden ongoing cumulative damage to systems and organs. One of the most prominant of these insidious mechanisms involves formation of immune complexes composed of bound~together Borrelia antigen and dog~produced antibody. Deposition of these complexes in joints is primarily responsible for the lameness that has traditionally been thought of as a hallmark symptom of canine Lyme disease. More recently veterinarians are recognizing that some dogs are developing a particularly nasty form of nephritis from deposition of these complexes in the glomeruli of the kidney. Less commonly, similar processes are responsible for serious pathology in the CNS (central nervous system), heart, and other organs."
IDEXX agrees. "While a variety of signs may appear, the most common signs of Lyme disease are hidden."
After Treatment
Dr. Beckett suggests monitoring a dog being treated for Lyme Disease with a CBC (complete blood count), serum chemistry and urinalysis
about every 7 to 10 days while the dog is on treatment, then a little less frequently. Six months after treatment is finished, you would do a recheck of the Quantitative C6 test initially done to establish a baseline number for the unique antibodies which give us a way to detect Lyme most reliably. With any luck, the repeat test will show the 50% drop in these C6 antibodies that means the treatment worked.
"The Lyme C6 antibody is unique among TBD antibodies in the rapidity with which it declines in event of successful treatment."
Cross infection with other tick-borne diseases is common.
Vaccinating a Lyme positive dog
A dog with Lyme-like Syndrome caused by vaccination.
Lyme-like Syndrome is a condition that occurs when a dog reacts badly to the vaccine and develops painful, debilitating symptoms of the disease itself without actually having it. There is no cure as there is no actual disease for antibiotics to fight. Few dogs react this way but you never know if your dog will or not until you vaccinate.
This is Indy
"In a nutshell, any symptom induced by lyme, seems to be able to be induced by the vaccine. My girl has more of a neuromuscular problem -- it affects her muscles -- they hurt, they swell, they have problems maintaining tone, her back and neck are affected, she has an eye that doesn't like to open all the way, she has severe digestive problems. Her last lyme vaccine was 7 years ago. She had made a partial recovery when some vet convinced me how dangerous it would be not to give her her "annual vaccination", so 6 years ago she had a 6-way combination vax and completely crashed. We have been battling it ever since.
"She ultimately was diagnosed through a Cornell Western Blot about 5 years ago, though I have known this for the last 7 years."
Lisa T.
A dog the vaccine may have helped and stopping it may have hurt.
This is Kelly two months before his diagnosis with Lyme.
At 100 pounds, Kelly was big for a greyhound and always a presence with his size, his calm, commanding temperament and his root beer eyes.
He was vaccinated for several years but when Frontline came out Ellie thought a topical tick preventive would be preferable to using the Lyme vaccine and she stopped giving it. It wasn't too long afterward that Kelly was not acting like himself and Ellie took him to the vet. The diagnosis was neurological Lyme.
His breeder, an FDA scientist, offered the only conclusion that made sense to Ellie: the vaccine had been keeping a low-grade infection in check but once she stopped vaccinating the spirochetes mutated, crossed the blood brain barrier and attacked his brain.
Kelly was on doxycycline when he suddenly went blind in one eye. His veterinary opthalmologist said that he had Lyme uveitis but the cause of the uveitis was in the optic nerve behind the eye. A day or two later, Kelly crashed so dramatically that Ellie went on a frantic search for something to help.
"We started on a Sunday night at the home of my vet who had gotten Rocephin from a nearby people hospital & called Tufts for dosage. By the following Tuesday, Kelly's sight was back. I dripped Rocephin twice daily for a month. The expense of the Rocephin ruled out the possibility of a brain scan so his breeder's conclusion never was confirmed.
"We took him off doxycycline in case it wasn't working and put him on amoxicillin; later, Kelly alternated between the two.
"Ceftin came after the IV Rocephin but Kelly was left with residuals that required I put him on steroids. That was 5 years ago. I never could wean him off, so now the steroids are taking their toll but he's still alive and almost 10 years old.
"The vaccine scares me now. Just don't stop giving it once you've started."
Ellie G.
Kelly never quite made it to 10.
A dog treated for and cured of Lyme disease.
This is Casey
Pam Barbe's Casey had Lyme disease. At any rate, it was supposed to be gone but the effects never left him. Look at his foreleg and you can see where the fur is sheared close. That's where he would hold his leg in his mouth and warm it to ease the pain.
You can find Pam's Samoyeds and her extensive section on Dog Health topics here.
Lyme Nephritis
Some dogs...and only some...develop a condition called Lyme nephritis, which is more or less chronic renal failure that progresses rapidly rather than at the slower pace of CRF as one of my dogs who never had a TBD experienced it.
Dr. Beckett replied to a member of Tick List who was distraught about his failure to catch his dog's problem with Lyme nephritis early on in this way.
"Normally a dog's kidneys have 300% of the capacity needed to provide vital day-to-day functions such as removing waste substances from the blood.
"Thus kidney damage can proceed in "stealth" mode until over 2/3's of kidney working units are knocked out of commission and functional capacity drops significantly below 100% of the capacity needed. Then waste products, etc., build up and this build-up finally produces visible symptoms and abnormal serum chemistry results.
"In addition to proceeding covertly, the kidney damage in Lyme nephritis can proceed quite rapidly.
"Don't beat yourself up because you did not recognize the problem before it became serious. I'd venture there were no outward signs that would alert an owner, no matter how attentive."
Glomerulonephritis: Morphologic, immunohistochemical and ultrastructural characterization of distinctive renal lesions in dogs putatively associated with Borrelia burgdorferi infection: 49 cases.
Glomerulonephritis (GN): Washington State University
Kidney Disease in Dogs: many links on renal disease.
Chronic Renal Disease and Failure: Washington State University
Modification of Drug Dosage in Renal Failure: WSAVA 2003 (scroll down)
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