Tick-carried diseases Fall 2011

Fall 2011: Vaccine and testing update and new tick carried disease identified 

The Wisconsin Veterinary Immunology Symposium sponsored by Boehringer Ingohliem brought Dr Goldstein, world renowned Lyme disease expert to Pewaukee Wisconsin!

The most striking information he presented was regarding the spread & prevalence of the disease on the east coast. They are finding over 70% of dogs exposed in the Ithaca New York area to Lyme disease making vaccination a core vaccine at this point.

Another point he made was that all dogs even dogs previously exposed should be vaccinated yearly because of the unique way the vaccine works producing antibodies in the tick that kill the bacteria not  in the dog.

He feels the Idexx 4 DX is an excellent test and should be used to screen all dogs, especially before the first vaccination. Using their  C3 C6 antibody test gives added information as to how high a response the dog has and can correlate with disease but not always.

He feels that all vaccines provide very good protection (there are three)

He feels all dogs that are exposed may benefit from a course of doxycycline although we cannot expect to clear dogs of infection.

He feels co-infection (see below) is a real threat.

He disagreed with Dr Rick Aleman with regard to Lyme disease causing platelet dip and emphasized screening closely for protein in urine to detect Lyme nephritis early.

He felt the new test being offered at Cornell was unhelpful diagnostically.

He felt Certifect or Frontline should be used monthly yearround for optimal protection and that annual screening using the 4DX Idexx test was the best prevention we could provide as practitioners.

Feel free to come with any questions to us regarding this important disease that affects dogs  & people.

A new bacterium has been discovered that affects people and possibly pets and is carried by the same ticks as Lyme disease and Anaplasmosis.  A collaboration by the CDC, University of Minnesota & Wisconsin & the Mayo Clinic included 24 researchers and was just published in the New England Journal of Medicine. See DVM 360 article for more information.

Fall 2010 :the most serious Lyme challenge ever

Due to unseasonably warm weather (my presumption) we are seeing the most serious challenge to dogs of Lyme disease in my 27 years practicing in Wisconsin.

In the past 3 weeks I have personally seen two cases that are classic Lyme disease and one ended very badly. We are also seeing record rates of exposure/infection.

The first was a good friend’s 9 month old Labrador puppy who on its first visit to our clinic presented with the classic lameness, painful joints and high fever typically associated with acute Lyme disease.

A positive Idexx 4DX Lyme screening test and confirmation with Idexx C3 C6 antibody test confirmed a very high antibody response to Lyme (376-normal is less than 30). Within 12 hours on doxycycline all signs & symptoms resolved.

How did this occur? Frontline had been applied but no Lyme vaccine had been given. Our speculation is that the puppy outgrew his Frontline dose and was bitten by an infected deer tick.

The second case was deadly. It was a 3 year old labrador that we had not seen before. The owner was traveling and was brought in by family members so the vaccination & use of Frontline history was unknown. The dog presented with the most serious form of Lyme disease Lyme Nephritis which is defined by a positive Lyme on the Idexx 4DX titer, backed up by a 444 on the C3C6, elevated  kidney values and protein loss in the urine.

We referred the dog to the UW Veterinary Hospital within an hour of diagnosis the owner was given was so poor (days or weeks on fluids with less than 25% survival rate) that the owner chose euthanasia.

Another a client who had just moved here from North Carolina (where tick carried disease is also quite common)  bring us a baggy with 6 to 12 attached engorged deer ticks. These dogs had not been on any monthly protection and were not vaccinated. These dogs had been exposed and will need follow up to determine if disease will occur. We prescribed doxycycline to try and prevent disease after the exposure.

Another client who had just come to us with their two dogs for their first wellness visit, we found 7 attached engorged ticks. Both dogs had had previous 4DX and C3C6 tests of over 500. Both dogs had been treated with doxycycline previously (which we repeated to prevent a co-infection)  They were both behind on their Frontline doses but had been vaccinated in October.

The two clinical cases highlight just how sick an unprotected pet can get especially labradors. (read breed specific information below that was presented at our state veterinary meeting last October)

The other two exposure cases illustrate how easy it is for protection to lapse and an infection (but not yet disease) to occur. We will follow these infected dogs closely using antibody levels, blood counts (especially platelets), kidney levels and urine samples to detect evidence of disease.

Anaplasmosis exposed dogs

We continue to see a fair number of anaplasmosis exposed dogs none of which have showed symptoms although many have slightly decreased platelet levels, a hallmark of  tick carried infection. Our protocol with these dogs is to perform baseline blood work (particularly platelet levels) Treat with 30 days of doxycycline if platelet levels are reduced and follow up with lab tests and of course good tick protection to prevent another bite that could cause a co-infected state and make the pet more likely to develop disease.

We will continue to update you on the seriousness of these diseases and the best prevention.

Be sure and keep up Frontline monthly year round and consider Lyme vaccination with the recombinant product (best safety & one year duration of immunity) ESPECIALLY if you have a labrador, golden retriever or a rescue that contains any of these breeds. Other breeds can certainly be affected but our awareness needs to be very high and we need to be aggressive in our diagnostics to catch these cases early so we can treat to prevent co-infections

Dr Ken

Fall 2009 Tick disease update

PREVENTING tick-carried disease in dogs

New information was presented at Wisconsin Veterinary Medical Association conference this fall by Richard Ford DVM, PHD and Dr. Rick Alleman; two internationally known experts on tick-carried disease in dogs.

1)  Golden retrievers & Labrador retrievers seem to be overrepresented to having Anaplasmosis and seem to be overrepresented in having Lyme nephritis which is often fatal.
2) The upper Midwest has one of the highest incidences of Lyme & Anaplasmosis in dogs in the United States
3) Many dogs in Minnesota and increasing in Wisconsin have both (co-infection) meaning both Anaplasmosis & Lyme.
4) The current vaccine (recombinant) made by Merial® for Lyme disease that we have been using for over 8 years is the safest and best available.
5) We will be monitoring a new vaccine just released by Intervet®  to see if it is as safe and can provide additional effectiveness.
6) These diseases cause chronic disease that cannot be eliminated by antibiotics (even if treated early).
7)  We have very good tests to identify these diseases as part of our annual heartworm test (Idexx 4DX).
8) A positive screening test to Lyme means infection but not necessarily disease.
9) A positive Anaplasma means exposure but not necessarily diseases (this is a fairly new test that is telling us where the disease is spreading right now)
10) Both speakers advised antibiotic treatment if positive tests indicate infection to “knock down” infection and continued monitoring throughout life to detect and treat chronic disease.

What tick carried diseases should we be concerned about?
Lyme & Anaplasmosis (Ehrlichia & Bartonella are much more common in other parts of country).

What are symptoms of tick borne disease?
Lameness, pain, low platelet counts, fever, arthritis, lack of appetite, lethargy, and rarely very severe kidney disease.

How can we prevent infection?
The monthly use of  Frontline®  year round and annual vaccination (Lyme disease only).

What should we do to detect these diseases early?
Just be sure and have your dog’s heartworm and tick panel test done yearly. In high risk dogs testing could be done every 6 months.

What if my dog tests positive?
Any positive screening tests should be followed by lab work including a blood count looking for low platelets, a urinalysis to detect protein loss  and a chemistry panel to assess the general health of organ systems.

Is treatment available?

Both speakers were very much in favor of treating both Anaplasmosis & Lyme disease aggressively with a 3 to 4 week course of doxycycline. Although there is not universal agreement to its necessity there seems to be much more to be gained than lost and it is a option that we exercise frequently at WFPC.

What about co-infection?

Co-infection was mentioned several times over the two days and is especially pertinent to us in the upper Midwest as both Lyme & Anaplasmosis infections are common. The concern is that having both infections together presents a higher chance of  disease.