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As a veterinarian who deals with breeders and exhibitors, I am constantly reminded of the differences in my practice and that of veterinarians dealing with pet owners.
One constant difference in the two practice types is the effect of multiple dog populations in a household or kennel, and of exposure of these dogs to other dogs in venues where the transmission of disease is likely.
The other important difference in these two types of practices is the infinitely greater ability of the breeders and exhibitors to observe their dogs, and their better understanding of what constitutes normal behavior and normal health.
Articles about Lyme disease in dogs abound on the Internet. The articles I have seen on the subject indicate that dogs don’t get symptoms of Lyme disease other than lameness, and they seem devoid of attempts to evaluate the efficacy of antibiotic treatment.
Having suffered from chronic Lyme disease myself, I have some insight into the disease that those who haven’t been so affected might lack. Living in a multiple dog household, as well as seeing my patients has made me a good observer of the behavior and other signs of good or ill health in dogs.
In the early years of our diagnosing Lyme disease in patients, we had no one telling us how to diagnose and treat the disease, and no one defining the symptoms in the dog. Our practice consisted mainly of show dogs. We used clinical observations and the owners observations to diagnose the disease. Since these dogs had to return to the full bloom of health to compete in the Group ring, we began using chemistries to give us some information about the progress of the disease and the efficacy of treatment. A repeatable pattern of abnormalities in blood chemistry was found. As time went on and many many more patients were seen, it became obvious that the dogs were also showing some very good signs of Lyme that we could observe without chemistries.
I’ve been shocked that most clinicians do not seem to have an actual cure of the disease in mind, but simply the diagnosis by lab test and the treatment for 3 or 4 or 6 weeks with an antibiotic. Sometimes this is the best antibiotic, but frequently not even that benefit is available to the suffering dog. Some clinicians don’t treat a dog with a positive test because they aren’t lame. If you define a dog suffering from Lyme as a dog with a positive test and lameness, all the dogs you treat will be in the late stages of the disease. Lameness is a late sign.
I routinely identify myositis (inflammation of muscles) in my physical exam, lymphadenopathy (enlarged lymph nodes), postural abnormalities, depression and sometimes meningitis in the form of light sensitivity. Some of my patients have shown this so plainly that I marvel that other clinicians could have missed it.
If you confine your diagnostic indicators to the positive test and lameness, you will limit your ability to diagnose the disease and evaluate treatment effectiveness. I have often had to treat dogs for periods in excess of 2 years before they returned to the bloom of health. When they reach that point – the point it took me over 5 years to reach myself – the change in condition, posture, enthusiasm and energy is stunning. If you don’t observe your dog or your patient carefully, and have an intuitive understanding of the body language of disease and this disease in particular, you won’t be much good to your dog. I advise the owners of Lyme dogs to go to LymeNet to print out Dr. Burrascano’s guidelines.
I ask them to commit the symptoms to memory. In my practice we see or can easily infer virtually all the symptoms found in humans in our animals. Our clients are experienced in observing their dogs, and can manage to recognize improvement, Jarisch-Herxheimer reactions, and plateaus in treatment in their dogs.
Most pet owners would be unable to do this. Many practitioners may not have been called upon to really ‘cure’ dogs suffering from Lyme. However, the information in articles I’ve read recently is very alarming to me. I urge everyone with a pet that may be affected with Lyme to read the article on LymeNet, and even if they only own one dog, try to understand what their pet is trying to tell them, and to keep a diary of the dog’s behavior and progress or lack of it while on treatment.
LYME DISEASE, PREGNANCY AND MONTHLY HEARTWORM
Let’s start this discussion with the big word and get it out of the way. Jarisch-Herxheimer Reaction; Herxheimer or Herks for short.
When the body is harboring a significant amount of foreign protein, for instance, as in the form of migrating heartworm larvae, migrating larvae of intestinal worms, or the very large spirochaete bacteria that cause Lyme disease, it is faced with a set of problems which cause disease (such as Lyme).
When those living organisms die, due to treatment with monthly heartworm medication (any of the monthly meds) or due to treatment of Lyme disease with a good antibiotic, the body reacts differently to the dead protein in its tissues and blood stream. The dead spirochaetes may not be causing symptoms of Lyme any longer, but they now cause an extreme inflammatory response in the individual. The migrating larvae of intestinal parasites usually do no great amount of harm while live, but when dead they, too, cause a massive inflammatory reaction. Killing intestinal parasites as adults does not entail any such risk. Likewise, killing heartworm stages with the daily heartworm medications causes no risk of this nature.
The Herxheimer reaction in those of us who have Lyme disease usually manifests itself as feeling really ‘sick’ one to five days after starting on antibiotic medication, or after starting a different antibiotic medication, and often periodically while continuing on the same medication. This is taken clinically as proof that the disease is still active, and that the antibiotic is effective as well. So there is something good about feeling bad under these circumstances.
The exact same thing happens in dogs. The manifestations of Lyme disease in dogs are exactly the same as in humans. Anything from headache, feeling ‘sick’, kidney malfunction, heart arrythmias, stiff neck, headache, muscle and nerve pain, and joint pain can be affecting your dog. How do you know if your dog has a headache?
One day a Dane bitch walked into my office with feet swollen to about 3 times normal size. She had had her monthly heartwormer the day before, and her feet were swollen with edema due to the massive inflammatory reaction she had to the dead protein of intestinal parasites she was host to.
So, the point of all of this is, what happens to the pregnant bitch if she has this kind of reaction. What happens to sperm if the stud dog gets monthly heartworm and also harbors intestinal parasites. These are some of the matters which have led a significant number of veterinarians to say ‘no’ to monthly heartwormers. ‘No’ to all of them, since the precise chemical isn’t the problem, but the very mechanism of action of this form of heartworm control. All of those ‘monthlies’ which advertise control of intestinal parasites are actually saying they can cause this kind of problem.
When a new medication comes on the market, we are supposed to ask three questions:
- 1. Is it more effective?
- 2. Is it safer?
- 3. Is it cheaper?
Monthly heartworm medication gets a ‘no’ response to each of these questions. Is it good for your vet’s bottom line? Well, that one gets a ‘yes’. The rule for breeding animals, dogs or bitches is no monthly heart worm medication.
What about Lyme disease in pregnant bitches? We are strongly suggesting a Lyme Western Blot test in bitches before they are bred. First, Lyme disease can be transmitted to the baby from the mother. Second, the antibiotic medications we are most likely to prescribe to the pregnant bitch – due to their known safety in pregnancy – are Amoxicillin and Cephalexin (Keflex). These are also effective antibiotics for treating Lyme disease. Use of these good antibiotics can precipitate a Herxheimer reaction in the pregnant bitch with subclinical Lyme, disease which can cause resorption of fetuses. Ask yourself this; how many litters have been lost in the past 15 years in areas with Lyme disease due to Herxheimer reactions in pregnant bitches with Lyme disease? How many stud dogs have wiped out their sperm for a period of 6 weeks following treatment with a monthly heartwormer? How many pregnant bitches are given monthly heartworm medication?