Submitted by Dr. Eileen Lammie, VMD
Beware all pet owners, hikers, walkers, farmers and loggers…Lyme is here and many biologists think that it may be a record year. In our office, we have had many more ticks on dogs and cats this winter. Also, we have had a sharp rise in Lyme disease cases in dogs. Lately, it seems that the first two cases we see on Monday mornings are acute Lyme.
Diagnosis in dogs is fairly cheap and easy. Our antibody screen gives us results in 10 minutes. A more definitive and more expensive test may be run to give us a number for the antibody level so that we can determine in six months if the disease is fully under control.
The background on Lyme is that it is caused by the bacteria Borrelia burgdorferi that lives in mice and spreads to the Ixodes tick when it feeds. The tick then feeds on deer, people, dogs, cats, horses, and wildlife of all sorts. The tick attaches then vomits into our bloodstream, which introduces the bacteria into our bloodstream. This usually happens on the second day it is attached.
The symptoms are similar in dogs and humans. There is low grade fever, feeling “poorly”, joint pain and swelling, sometimes slowing of the mind, seizures, heart problems and eye problems in people. 70% of humans develop a characteristic bullseye rash around the tick bite one month later. Dogs don’t develop the bullseye rash. Dogs can develop kidney disease that can be swiftly fatal; this outcome is not common in people.
I have had a lot of connection to Lyme disease. In the 1980s, in my practice in northern Pennsylvania, my friend’s husband who was a logger, told me about his unusual heart problems that the doctors could not understand. I suggested Lyme. I had just started to see dogs that showed joint lameness and fever that responded to antibiotics that treat Lyme. Because of worry for my community, I attended a human medical public health seminar at Rutgers University. After coming home, I organized a Lyme seminar for the town.
More than 20 years later, I got a very small baby tick, a nymph, which hid for a while in my ear crease and apparently gave me Lyme. One of my staff mentioned the black dot when I had my surgery hat on. I sent it out for identification. It was an Ixodes tick. Life is life and the next week I had to take an emergency trip to Colorado where my husband had a severe heart attack. When I was in the flurry of heart tests, cardiology consults and ejection fraction talks, I felt tired. I had a bit of a sore throat and swollen lymph nodes under my chin.
I wondered if I had a flu, or was exhausted. I also read about Lyme on my laptop. When we got home to West Virginia a week later and ran to the office for Saturday morning hours, I began to get aching joints. It was time for doxycycline. I had three waves of acute carpal tunnel syndrome so severe that my wrists were red/orange and I could barely oppose my thumb and first finger. I called one of the orthopedic surgeons in town. He said that acute carpal tunnel was very characteristic of Lyme. On Mother’s Day that year, I shuffled through the grocery store so pathetically that my kids and I broke out laughing. In a month, with the help of doxycycline, I was fine.
My western blot test, the human gold standard, was negative, but due to circumstances, it was taken after antibiotics were begun which often makes the test negative. Also, I found the tick, so I knew what was going on early. Often the tests are negative early in the disease.
Diagnosis in people is not quite as straightforward as in dogs. To be included in the official statistics, certain tests like the western blot must be positive. However, the CDC warns that Lyme has to be a clinical diagnosis with the presence of the tick, symptoms, and response to treatment. There is also a lab that will test a tick to see if it is carrying Lyme.
At the beach last year when my family got together after my mom passed away, there were 7 women, from age 7 to 70. Four of us had experienced Lyme disease! All of us spent lots of time outside. The only one that had any continual problems was the one whose doctor refused to treat the tick bite and symptoms until her lab tests became positive 6 months later. She now has chronic migraines and joint pain.
There is a new treatment that has been tried experimentally in people…application of a Zithromax gel to the site of the tick removal for three days – that is all! The final results are not in yet, but it is promising.
What can we do to protect ourselves and our pets? Repel, kill, and find what is still there is the basic plan.
My favorite prevention for dogs now are the oral treatments. I usually recommend the pill that gives three months of protection. With our warm climate, treatment should include winter months as well. (Two January days we had two cases of acute Lyme.) One holistic repellant to pair with this pill is a drop of rose geranium oil on the collar of the dog (not the skin). Another treatment that seems successful is the seresto collar. Some topical tick medicines, faithfully applied, have not been 100% successful in my practice.
For people, long sleeves and pants tucked into socks or boots are helpful. Deet has been recommended to repel, but some people use a drop of rose geranium oil on their boots. When my kids were young, we lived in a high tick incidence area, and we did tick check in the bathtub, checking all creases especially well. Sometimes we would throw our coats in the dryer on high a few minutes if we were in an infested area. Find that tick in the first twenty-four hours!
Last of all, what about cats, horses, cows and all the rest? None seem to be as prone as dogs and humans. Whether the symptoms are due to Lyme or something else is often difficult to determine. There is still a lot to learn but cases seem rare in other species.
