Allen M. Schoen, D.V.M., M.S.
Lyme disease is one of the most common tick-transmitted diseases in the world. There is much that is known about it, but also a tremendous amount that still is unknown. There are many varied opinions regarding symptoms, diagnosis, vaccination controversies and treatment options. Where I live, there are horse barns I visit where almost every person, horse and dog have contracted Lyme disease. It is epidemic. Being in the middle of such a hotbed, I have seen many diagnostic and therapeutic approaches that have and have not worked. I will share my opinion on this debilitating disease. Lyme disease is caused by an organism known as a spirochaete and named Borrelia burgdorferi. It is transmitted by tick bites. It has been found worldwide and in ancient Chinese medical literature they actually describe a syndrome very similar to Lyme disease, thousands of years before Lyme, Connecticut was named! In the United States, more than 90% of the cases occur in the Northeast, with high incidences in California and Michigan as well. It is fairly common in dogs, but rarely seen in cats, although I have seen some cats with it.
The main clinical signs include a sudden yet recurring lameness that may shift from leg to leg. Sometimes this lameness is associated with a fever and depression. Occassionally you will see swollen lymph nodes. Sometimes the joints may be swollen, warm and painful and they usually walk stiffly with a hunched back. Animals with Lyme disease really look painful and stiff and commonly are very sensitive to touch and may cry out with even the slightest touch. I have seen dogs that were diagnosed with intervertebral disc syndrome in their neck and crying in pain and it was actually Lyme disease causing muscle spasms in the neck and they only improved when they were administered the appropriate antibiotic. Sometimes you will see the classic red round target lesion around a tick bite on your pet and within a few days they may show the signs of lameness, fever and sensitivity to touch. I saw this on my own golden retriever and within a few days he woke up like a stiff 90 year old man that could hardly make it to his food bowl. I immediately treated him with antibiotics and he improved within twenty four hours.
If your pet is not diagnosed and treated immediately, the disease can spread to the heart, kidneys and the nervous system including the spinal cord and the brain, showing signs associated with these organs. The organism has been found in connective tissue, in joints, muscles and lymph nodes. It is one nasty bug! Besides these classic symptoms, how can your veterinarian diagnose it? If suspicious, it is very important to run a special blood test called a Lyme titer. Now, there are two types known as the Elisa test and the western blot test. My particular preference is to run the western blot test. It may take a bit longer to run, but I personally find it much more accurate, correlating with the presenting signs. It is not uncommon that the Elisa test is negative and your dog may still have Lyme disease. If your dog or cat or horse has many of the symptoms of Lyme disease and the test is negative, do not be fooled. I still recommend treating the animal aggressively with antibiotics. Often, I will not even wait for the test to comeback to treat my patient if enough of the symptoms are present to suggest Lyme disease. Believe me, I like to be as natural as possible and use antibiotics only when absolutely necessary, but this is one time when they are needed fast! Often times the response to appropriate antibiotics is quite rapid. In horses, I have developed an acupuncture diagnostic exam that I have found to be almost as diagnostic if not better than the standard laboratory tests.
Lyme disease has often been nicknamed the great imitator. This is because many of the symptoms can mimic symptoms of many other diseases since it can effect so many different organ systems. I remember one gordon setter puppy I saw and the first symptom of Lyme disease that showed up was lack of appetite and an arrythmia in the heart that I picked up on my exam. It only got stiff and lame three days later. Fortunately I knew the heart problem wasn’t there a few weeks prior on a normal exam and was suspicious of Lyme and we treated it successfully and the heart problem resolved. When considering Lyme disease as a possibility, one must also think about other tick-transmitted diseases such as Rocky Mountain spotted fever or canine erlichiosis. Arthritis, rheumatoid arthritis, other joint diseases as well as kidney failure or heart problems from other causes need to be considered as well.
What is the best treatment? As I mentioned previously, this is one place where I feel strongly that immediate antibiotic therapy is imperative. It appears that doxycycline, tetracycline and amoxicillin seem to be the best antibiotics against Lyme disease. I suggest staying on antibiotics for a minimum of a month, sometimes even longer. I have seen dogs that were only on antibiotics for two weeks and then it comes back with a vengeance and does not respond as well afterwards. A holistic integrative approach would also include using probiotics such as acidophilus to keep the healthy bacteria alive in your pet’s gastrointestinal tract. In addition, it has been found that the organism can actually further suppress the immune system. So I usually recommend nutritional and herbal support to boost the immune system as well. This would include a specifically prepared form of a western herb, prima una de gato, specific Chinese herbal formula’s and medicinal mushrooms. Sometimes I see chronic Lyme disease in a dog or cat and I will also use acupuncture to boost the immune system and relieve the pain and inflammation. Though homeopathy still appears to be controversial, in my experience I have found certain homeopathic remedies that may sometimes be helpful. The most successful of these include homeopathic Ledum and a Lyme nosode. Lyme nosode is a homeopathic remedy that is made from the killed organism, diluted, successed and potentized to the point that nothing of the original organism remains. For appropriate dosages of these remedies, you should contact a homeopathic veterinarian.
As far as prevention goes, this is a sticky wicket. There is a great deal of controversy concerning the dog Lyme vaccine. There is a great debate about how well they actually work as well as potential side effects. There are publications concerning its safety, but the researchers only look 24 hours after the vaccine reaction. Research at Cornell University veterinary school brings up some suspicion that there may be potential long term side effects of the vaccine, though nothing is certain. These side effects may vary from rheumatoid arthritis and all the major symptoms of lyme disease to acute kidney failure. Though nothing is definitively documented, I personally am very cautious and do not recommend vaccinating for Lyme disease even though it is so epidemic here.. Many veterinary schools and major veterinary centers do not recommend the vaccine for the same concern regarding potential side effects. I have seen all the symptoms of Lyme disease in dogs four to eight weeks after the vaccine and when I sent the western blot test to Cornell, it shows no evidence of the disease, only evidence of the dog having been vaccinated, yet the dog shows all the classic symptoms of the disease. There is a second generation dog vaccine out that claims that it does not have any of the side effects, however, I still remain cautious. In addition, there is a question of how well it works. Until more safety and decreased risk of side effects and efficacy are demonstrated, I suggest holding off and weighing the risk/benefit ration in your particular situation.
The best prevention still is checking your dog carefully and removing any ticks at least once a day. Collars do not seem to work that well, though newer ones seem a bit more effective. Some of the topical insecticides do seem to work well, but then one has to weigh the potential toxic effects of these insecticide from the beneficial effects of preventing ticks. Again, I tend to compromise and only use the topicals during the greatest incidence of tick usually in the spring and fall. It is all a balance! Keep your pets away from tick infested areas, check them daily and stay healthy and happy and tick free!!
If you would like a consultation with one of my Veterinary associates in the greater New York and Connecticut region, you can go to the practice part of my website, call the appropriate office and make an appointment with one of them to see how we can help your kindred spirit.
No article can replace the services of a trained veterinarian. This article is not intended to encourage treatment of illness, disease, or other medical problems by the layman. Any application of the recommendations set forth in this article is solely at the reader’s discretion and risk. You should consult a veterinarian concerning any veterinary medical or surgical problem. If a veterinarian is caring for your pet, for any condition, he or she can advise you about information described in this article.