The following are real life cases of Lyme Disease in Dogs that have been treated by Dr. Mike Richards, DVM.
What is the incidence of acute renal failure in dogs who get Lyme disease? I live in an endemic area and have a beagle. I am outside in the woods/fields with my dog for about two hours a day. I have him vaccinated (apparently around 85% effective), I use Frontline, and also a tick collar. I still have found deer ticks on my dog so one of the doctors in the group that I see recommended that I don't take my dog out during tick season. This is very difficult as this area is LOADED with ticks and my beagle lives to run around out there and track the animals. He even has gotten deer ticks on him just in our backyard (although obviously not as many).
I am not too worried if he gets lyme that affects his joints because from what I understand the antibiotics are pretty effective. I am very worried however, that it affects his kidneys because I understand even if you pick it up early, he may go into renal failure. Another vet in the group felt with the vaccine, Frontline and collar, the risk is low. What do you think? Also, what are the signs of renal failure in dogs? Lethargy, vomiting, change in urine output? I want to be sure I will notice if my dog seems to be getting into trouble.
I have not been able to locate any studies that report a specific incidence for glomerulonephritis associated with Lyme disease. Glomerulonephritis is the form of kidney failure which is reported to occur from Lyme disease, so if you search for information based on that, you might be able to find something I missed. There are some veterinary internal medicine specialists who feel that kidney disease associated with borreliosis (Lyme disease) is not very common and others who feel that it occurs more frequently.
There has been some suspicion that the Lyme vaccines may be able to cause glomerulonephritis, but I do not think that this has ever been proven, either. I believe that the University of Pennsylvania's veterinary hospital was keeping track of suspected cases of this but I was not able to find a published study on this.
I do not practice in an area in which Lyme disease occurs very frequently and my personal experience with it is therefore pretty limited. However, it seems likely that using Frontline regularly, in conjunction with amitraz collars (Preventic tm) and vaccinating for Lyme disease should work pretty well to prevent Lyme infection.
If you go to the PubMed web site, http://www.ncbi.nlm.nih.gov/PubMed/ and search using this term: "Dambach DM", I think that you will find a study that discusses the kidney disease associated with Lyme disease. Clicking on the related articles link isn't too helpful but there is a little more information in some of the other articles.
The signs of glomerulonephritis are:
- weight loss (often the first sign)
- decrease in appetite or no appetite
- increased drinking
- increased urination
The lab changes are increases in blood urea nitrogen (BUN), creatinine, phosphorous, cholesterol and amylase. There is usually a decrease in total protein, albumin, and red blood cell count (so anemia exists).
Vetinfo has an overview of canine Kidney Failure Symptoms.
Early Symptoms of Lyme Disease
We live in an area endemic for Lyme (Northeast).
Our dog recently had a very large, light colored tick (IE not your classic dark brown/ black dog tick). We thought it was a skin tag (that's the color it was) so it stayed on for at least a week before we examined it with a hand lens, discovered its tiny legs and removed it. As I understand it, the deer ticks which carry Lyme disease are this color.
He was vaccinated against Lyme disease, last booster last year. I know this isn't 100% effective.
I know that the classic symptom of Lyme disease in dogs is lameness, I assume from arthritis. Are there any early symptoms we should be watching this dog for now? Should/ can he be tested (since presumably he has antibodies from the vaccine)? What is the time course from tick bite to symptoms? I don't suppose there is any way to look for a target rash as one can in humans and anyway as I understand it the characteristic rash doesn't always occur anyway.
I recently read a note from an epidemiologist in an area endemic for Lyme disease and he said that less than 1% of ticks in his area carried the Lyme disease organism. Hopefully, the odds will hold true and this won't become a problem.
The early signs of Lyme disease in dogs are supposed to be loss of appetite, fever and lethargy. Lameness may occur at the same time or may occur later. In some dogs, enlargement of the lymph nodes (usually generalized enlargement) occurs. In dogs, skin signs, heart disease, kidney problems and neurologic signs are reported to be rare. Symptoms of Lyme disease are usually delayed for several months but start to occur about 2 months after exposure and should show up by 5 to 6 months after a dog or cat is bitten by a tick carrying the bacteria (Borrelia burgdorferi).
I am hoping you won't have to deal with this problem but it would be a good idea to keep an eye out for telltale symptoms and to write down the date of the tick removal so you don't forget when it was, just in case.
Read more about six key symptoms of Dog Lyme Disease.
Lyme Disease Vaccination
I am a subscriber to VetInfo, and I have a question. Both of my dogs have tested positive for lyme disease. I am giving one Doxycycline for three weeks, and the other is going to do a round also. My vet still recommends that they be vaccinated for lyme and this confuses me. If they are already positive how can a vaccination help?
Also, one of my dogs, an Irish Setter named Ruby, has masticatory muscle myositis which she is taking pred for. Do you think this could interfere and make matters worse for her?
Please let me know at your earliest convenience.
Detectable titers to Lyme disease (borreliosis) occur in many dogs that show no signs of illness in areas in which Lyme disease is prevalent and in dogs that have been vaccinated for Lyme disease but have not had the disease. This makes it really hard to diagnose Lyme disease with certainty. The titers after vaccination may persist for a long time, so vets in areas in which this condition occurs often recommend vaccination even when titers are positive.
I don't practice in an area in which borreliosis is common. So I have limited personal experience with this condition. The general consensus among the textbook authors for the texts I have is that it is best not to treat dogs based on titer alone. If there are clinical signs of illness, such as painful joints, weight loss, decrease or absence of appetite, fever and enlarged lymph nodes and if ticks have been found on the pet within the last five to six months or are a likely problem in your area and there is a high titer to borreliosis, then treatment is necessary. Textbook authors don't always practice in areas in which Lyme disease occurs, either, though—so your vet's experience with this condition has to be weighed heavily in decision making.
Prednisone use does suppress the immune system and this can make it harder to eliminate an infection such as borreliosis. However, masticatory myositis can cause serious problems if it isn't controlled, too. I can't tell you what your vet will recommend but I would be willing to treat both conditions at the same time and hope that the treatment for Lyme disease was successful despite the prednisone use, especially if Ruby isn't showing any sign of Lyme disease, such as lameness or swelling of the lymph nodes— although I might opt not to treat for Lyme disease at all if this is the case. But I don't practice where this disease is prevalent and it really is important to keep that in mind when evaluating this advice.
Check out an overview of Dog Lyme Disease Vaccination.
Can Lyme Disease Spread from Dogs to Human?
I am a subscriber to VetInfo Digest. My dog Jake, an eight year old golden retriever was recently diagnosed with Lyme. He is on antibiotics; was also given etogesic for the arthritis symptoms, which he did very well on. He has completed his dosage of the etogesic, and I am wondering if there is something else we should be doing before arthritis symptoms recur or if we should wait until they do occur before giving additional medication. Also, I was wondering if Lyme in dogs is contagious to humans. Thanks!
I do not see much Lyme disease in my area so I can only report the consensus of the literature on the subject.
Lyme disease is not spread directly from dogs to humans. However, dogs can serve as a reservoir for the infective organism, Borrelia burgdorferi. Dogs that are infected with Borrelia organisms do develop high enough numbers of the organism in their blood streams to infect ticks that bite them. So if a dog in the household has Lyme disease it would seem to increase the risk to the humans in the household, since a tick could become infected by the dog and then attach to a person and pass the infection on. Therefore, it is very important to try to keep ticks of the dog and to check for ticks frequently.
There does not appear to be any reason to continue medications for the treatment of arthritis in dogs who have had Lyme disease after the arthritis clears up. If signs of arthritis returned at a later time, it would be a good idea to consider other possible causes, as well as reinfection with Lyme disease.
Read more about Treating Dogs with Lyme Disease.
Treatment for Lyme Disease
A short history before my question:
11 month old female Rottweiler whose X-rays showed hip dysplasia on the right rear and partially torn cruciate in the left rear stifle. Every night at midnight for 1 to 2 weeks she would wake up and start screaming in pain which NSAIDS did little if nothing to abet. During these episodes, she would sit bolt upright and start backing around the room on her haunches, as if trying to back away from whatever was hurting her. The episodes would last about 30 seconds and would come every minute or so until she fell into an exhausted sleep. During this, she was terrified and looked to us to stop the pain, which we couldn't do.
We took her to the vet every day and finally to an orthopedic specialist who said the hip dysplasia and torn ligament would not be causing these symptoms. He did a test for Lyme Disease, which came back positive. The medicine for Lyme Disease seems to be helping, as the symptoms described above have disappeared.
My question is, what are the symptoms for Lyme Disease in dogs? I think it can cause dementia in people. Is this the same for dogs? We are at our wit's end trying to keep her comfortable and would like to be able to recognize other symptoms as hey arise. How long should she be on the medicine?
Lyme disease in dogs usually causes lameness. There may be mild swelling of joints but often this is not present. Fever may or may not occur. Lymph node enlargement may or may not occur. Some dogs don't eat well when they are suffering from this infection and others appear to be pretty depressed. Much more rarely there may be kidney or neurologic damage associated with Lyme disease. Heart problems are also sometimes reported.
My personal experience with this disease is limited, as it is not as common in Virginia as in more Northern states. However, we do see a fair number of dogs that have positive titers to the disease without the clinical sign of lameness, so I think that a positive titer test has to be considered suspicious but not diagnostic. I have not seen a case of this involving neurologic signs so I do not know what the signs might be, although I do know that sometimes seizures are reported.
Antibiotics are usually continued for three to four weeks, although 14 days is the minimum recommended administration time. This partly depends on the antibiotic being used. Tetracyclines, including doxycycline, are most commonly recommended and they should be used for the longer time period. The new cephalosporins are also effective and may be used for the shorter time periods, which may be recommended partially due to the cost of these medications.
If lameness, particularly lameness that seemed to involve some incoordination, was the initial problem leading to the diagnosis of a cruciate ligament problem and hip dysplasia, I would be wary of two diseases that seem to be predominantly rottweiler illnesses. They are leukoencephalomyelopathy and canine neuroaxonal dystrophy. These disorders cause abnormal gaits.
Both diseases start out with mild clinical signs and gradually progress over time to severe incoordination. I think that leukoencephalomyelopathy may have some pain associated with it, since it is supposed to be possible to confuse it with cervical disc disease, but I am not certain of this. These are not common problems but since both are known to occur pretty much exclusively in rotties and both can appear to cause lameness, it seemed important to mention them.
We have seen the kind of pain that you describe in several young dogs with encephalitis. In general, the antibiotics that help with Lyme disease will also help with encephalitis, so if this is present, the treatment being given is probably appropriate.
It is important to remember that even if hip dysplasia isn't the primary problem, it can definitely be a contributing factor and it will sometimes cause enough pain to interfere with sleeping. In addition, this may be a future complicating factor if another illness is the predominant problem right now. So don't lose track of this problem in the search for others.
If the problems recur, it is really important to keep track of when the symptoms reappear and what might have precipitated them. Then get back in touch with your vet and keep working towards a diagnosis.
One thing that I think about, but have absolutely no way of proving or even really knowing for sure exists, is headaches in dogs. There are several causes of really severe headaches in juvenile humans, so it seems logical that this problem may occur in dogs. For this reason, I think that good pain relief is important when there are mystery illnesses. I tend to try the more potent pain relievers, such as carprofen (Rimadyl Rx), etodolac (Etogesic Rx), hydrocodone or even oxymorphone, earlier, rather than later. But again, I have no way of knowing, or proving, that this is a possible problem.
Keep in contact with your vet and the neurologist and keep reporting symptoms as they occur. This is an unusual problem and it can take a while to sort through all the possible problems in this sort of case.
Read more about Dog Lyme Disease Prognosis.
Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...