The American College of Veterinary Internal Medicine (ACVIM) has recently published a consensus statement on Lyme disease in cats and dogs (March 22, 2018). The ACVIM is the specialty college of the American Veterinary Medical Association that certifies veterinarians who are specialists in internal medicine. There is plenty of scientific and popular information about Lyme disease in cats and dogs available, so it is useful to see what these specialists have concluded as a summary statement about this very important disease.
Six veterinary internal medicine specialists collaborated and reviewed all the available scientific information. The material and manuscript was offered to the general membership of the ACVIM and the Companion Animal Parasite Council to consider and review to solicit comments before final publication of the statement.. The panel published their consensus statement in the Journal Of Veterinary Internal Medicine on March 26, 2018.
The full article can be found HERE.
Here are some of the more interesting conclusion edited for the general audience:
- There are at least 52 Borrelia Species. Different strains and co-infections of different types of Borrelia need to be researched. Also, other infections need to be considered in patients infected with Lyme disease.
- Lyme disease is spreading in North America because of persistent tick vectors and hosts. The percentage of positive dogs cannot be used as a measure of disease because most dogs that are exposed produce antibodies but do not produce clinical illness.
- Neurologic and cardiac manifestations of disease are not well documented in dogs
- Cats can test positive for Borrelia but it is not known if infection causes disease in cats.
- Current tests for Lyme disease used in veterinary practice all detect antibody to Borrelia in the dog. This is not thought to be proof of clinical signs and is not a predictor of the development of such clinical signs.
- Panelists agreed that Lyme arthritis requires 4 weeks of antibiotics treatment, with doxycycline the preferred antibiotic.
- Dogs who are positive for Lyme and also have Protein Losing Nephropathy (PLN) (Lyme Nephritis) should be treated by a specific protocol set out in the paper with specific medication combinations that are longer term.
- All healthy dogs that live in Borrelia endemic areas should be screened for Lyme disease. All positive dogs should be screened for protein in the urine.
- Most (4 of 6) panelists do NOT recommend treating dogs with a high amount of Lyme C6 antibody if they have no clinical signs and no protein in the urine.
- Tick control was recommended by 6 of 6 panelists to prevent Lyme disease and for the prevention of other tick borne-disease.
- Only 3 of 6 panelists recommended vaccination against Borreliosis (Lyme disease) in Borrelia endemic areas.
My observations and take home recommendations:
- Co- infections happen all the time in our local dogs; the most common co-infection is Lyme and Anaplasma.
- Lyme disease is spreading to other parts of North America and climate warming helps propagate tick populations locally; we see live ticks on dogs every month of the year and tick prevalence seems to be growing.
- A positive test in a dog without clinical signs is a very difficult challenge. We often do treat and use the Quantitative C6 test from Idexx as our guide. Clinical experience suggests that most such treated dogs feel better and their Lyme C6 levels decline over time and many go to zero.
- Doxycycline is a very effective antibiotic in the dog and can produce a dramatic change in the canine patient in only 24 hrs.
This paper is a good reminder that we should always check the urine of a Lyme positive dog for protein. Lyme nephritis is a devastating outcome and usually is fatal. - Tick control is an amazing tool at our disposal to markedly reduce Lyme infections in dogs especially if oral preventatives are used, based on our research.
- Our experience with Lyme vaccinations has been mostly positive and I would recommend it for any local dog with potential exposure to ticks (most of the local dogs!).
