Lyme Disease Mini Manifesto

I thought Lyme disease in dogs was complicated! Then I read that Lyme disease goes undiagnosed, denied, or poorly treated in humans.

Perhaps 200,000 people per year in the US suffer from Lyme disease! Wow! No wonder research into canine Lyme disease is spotty. It is poorly underfunded for humans, too. And no one says anything about whether or not it is an issue for cats or ferrets.

I’ve come across several known presentations of Lyme disease. I’ll describe them here, in case you are wondering about your dog’s situation.

The first case I saw was in 1998 in Philadelphia at the Matthew Ryan Veterinary Teaching Hospital Emergency Room. The Penn Vet small animal hospital and the emergency room in particular were the busiest in the country, with the highest caseload. It was my clinical year at school.

It was also my first time seeing a grown man cry. I didn’t know whether to ignore it and let him keep some dignity or hand over a box of tissues. I forked over the Kleenex.

“Thanks, doc.”

Why was this man crying? Because his 2-year-old female chocolate Labrador retriever was in full blown acute renal failure (sudden, total kidney shut-down) and positive for Lyme disease. He did not have money for dialysis in New York City, and no other treatment was going to work.

I decided I did not like Lyme disease.

As a practicing clinician, I saw the limping, aching, cardiac arrythmia, high fever Lyme disease which is treated with intravenous or oral doxycycline.

Then an affordable screening test was invented and packaged with yearly heartworm blood tests. In a small seaside town in Massachusetts, one in three patients screened tested positive for exposure to the Lyme organism. This means a tick carrying the Lyme borreliosis organism bit the dog and injected enough organism for the dog’s immune system to recognize it and create antibodies to try and wipe out the invading organism.

“How could she be exposed to Lymes, doctor? I carry her everywhere and she never has a tick on her!” Good question. I. Do. Not. Know.

Now what? Run a DNA test on all of those dogs looking for the Lyme bacterium? Nice thought. Except the organism famously sequesters and hides inside internal organs, instead of floating within convenient reach in the bloodstream.

Treat every dog as if it had Lyme disease? Not a horrible idea, not too expensive, perhaps unnecessary and inappropriate antimicrobial use. And, oh yeah! 20%, or 1 in 5 patients got a sick stomach and vomited the doxycycline. Yikes!

Most likely, the response of the immune system to the organism is more salient in the feeling of illness and disease, than the organism itself in the first place.  What this means is, we need to treat the immune system and the patient, not just administer antimicrobials and expect the body to naturally balance itself.  As you may already be aware, Western medicine of the past 100 years or so is not very focused on treatment of the patient as a whole organism.

Perhaps infectious diseases like Lyme disease are responsible for a certain large amount if the chronic diseases in people in the US? Perhaps early diagnosis and treatment could prevent further debilitation. Perhaps my positive screening tests for dogs are more likely to result from actually, actively infected dogs than anyone knows.

Suddenly, I rethink Lyme testing and treatment in my non-speaking and largely non-complaining patients. They need the benefit of the doubt.

If you live part time around the deer tick in the NE US or the black-legged tick of the Western US, talk with your veterinarian about tick prevention.

(For more information, Lyme disease and tick pictures, see Wikipedia.)

Faq’s Clients ask Doc Truli:

Q: Where does my dog get the ticks?

At the borders of grassy areas and brush, bushes, or trees. Suburban sprawl and strips of “forest” sinuating between miserably constructed box homes maximizes tick habitat.

Q: Please get political on us about wildlife management and ticks.

Sure! The deer tick in the Eastern US needs deer to winter over on a comfortable warm body, and the tick needs a mouse. Your dog is a side project. State gamelands committees consist almost exclusively of deer hunters who feel pressured to increase hunting license revenue. So they purposefully leave too much land as food for deer (grasslands, corn). When the deer start taking out cars and overrunning orchards, they issue extra hunting licenses to keep the deer population under control. (Notice their land management decisions set up the situation in the first place). More deer equals more deer ticks equals more sick pets and people.

Q: What can I do about ticks in my neighborhood/parks/condo association common areas?

First of all, walk your dog where you’re supposed to. A gentleman recently complained to me that the nature preserve where he walked his Labrador would not spray for ticks because it might hurt the wildlife. Well, your dog is not supposed to be playing in the nature preserve!

Your condo association has an obligation to help protect life and property. Your dog, technically, is both. Ask the association or better, the property manager to provide the exterminator contract with the products used and the schedule thy are contracted to follow. Insist.

In your yard, cut back fallen scrub and trees, get rid of garbage, cars, old wood, etc. Or keep your dog out of it. Do not feed your dogs outside, stray cats, or put out cheap bird feed where it will attract tick-infested rodents like rats and chipmunks.

New information, research, and perspectives evolve daily. Keep your eyes, ears, and mind open!