By Dr. Michael Sterns, DVM, Alta View Animal Hospital, Mountainview, CA
The following is a guest post from a local veterinarian and long-time SF Bay area resident, Dr. Michael Sterns, DVM. He shares a story about the recent diagnosis of a four-legged patient with Lyme disease. It is rare for the blood tests to come back definitive in dogs so this case is unusual but the lessons are clear and relevant for all dog owners here and around the country.
I thought people might be interested in a case we saw last week, and might truly see how an ounce of prevention really is worth a pound of cure! Lyme disease in your dog is so easily prevented here in the SF Bay area, this story will surely leave you scratching your head. Happily, the dog in question will be OK – all because we caught it so early.
An eight-year-old Golden Retriever patient presented with “lameness” that he had struggled with over a two to four week duration. The owners had been on vacation for the last two months and the dog was being taken care of by a house sitter. The dog was not on any flea or tick control medications but otherwise had been healthy all its life. The only change in routine now was that the house sitter enjoyed hiking in the Los Gatos hills.
When the dog returned from these hikes, it was carrying a significant number of ticks, that were physically removed by brushing. Attached ticks were not reported. The dog was current on all standardl vaccines, but had never been vaccinated for Lyme disease.
We submitted a lab panel including chemistry and a urinalysis, and concurrently ran an IDEXX SNaP 4DX test that identifies antibodies to heartworm, Borellia (Lyme), Ehrlichia, and Anaplasma. The blood work and UA were normal, but the 4DX was positive for Borrelia burgdorferi, Lyme disease. We have performed > 350 4Dx tests in the last 2.5 years, and this was the first positive we have seen.
The next step is to measure quantitative C6 antibody (in motion) and immediately place the dog on a thirty-day-course of doxycyline. We will monitor C6 periodically as it should decline over time. Hopefully, the dog will remain symptom free, but
there is no guarantee.
This case is instructive at several levels. The incidence of Lyme is low in our area for several reasons, but the relevant aspects of this case to consider for all of you are as follows:
- We run diagnostics for a reason. You can’t treat what hasn’t been diagnosed properly.
- The vaccine is excellent and protective, just do it!
- Use an effective flea and tick product, it is cheap insurance.
- Run the 4Dx test, and if you dog is negative, vaccinate!
(I guess I used that one twice for emphasis.)
Several months ago, someone posted a link to the Nature story about the development of the human Lyme Vaccine that was near perfect, but pulled from the market because it was not reimbursed by insurers. It’s a great story. The canine vaccine was developed using the same technology, and with similar success in protecting against infection. Did I mention that you should probably consider vaccinating on a yearly basis?
About Dr. Michael Sterns, DVM
After graduating from the UC Davis School of Veterinary Medicine in 1984, Dr. Sterns began his career as an Equine Veterinarian. He earned his MBA from the Haas School of Business at UC Berkeley in 1990, and spent the next twenty-three years building small companies in human therapeutics, medical devices and research tools. companies such as CV Therapeutics, Telik, and Xenogen Corporation, where he was the Chief Business Officer.
Dr. Sterns returned to clinical practice in 2012, and now practices general small animal medicine and surgery at Alta View Animal Hospital in Mountain View, California. In addition to clinical practice, he participates in clinical trials for animal health therapeutics and medical devices for companies evaluating the veterinary market. Dr. Sterns is available for videoconference-based consultations through the Vet24seven app, now available free at the App Store.