CASE 1 -

Zola

Diagnosis and treatment for a symptomatic dog that tested positive for Lyme disease

Zola, a 6-month-old, spayed female Lab mix breed dog was adopted from a shelter and presented for examination on January 2, 2008. Owner reported that the dog had kennel cough, but it was resolving well with no medications. Otherwise, Zola appeared healthy.

case 1

Six days later on January 8, Zola was examined for a two-day history of lethargy, limping and anorexia. Both carpal joints and elbows were swollen and painful on flexion; the right shoulder was painful on extension. Exam results (HR=120, RR=16, T=102.6.) were consistent with polyarthropathy and mild fever.

A CBC and profile were performed and both tests were within normal limits, as were thoracic radiographs for pneumonia.

The dog was screened with an ELISA test for canine Lyme disease and anaplasmosis. Zola tested positive for Borrelia burgdorferi infection.

Zola was likely infected months previously as the last ticks seen were in November. Her recent change of environment and kennel cough were likely triggers for clinical Lyme disease, because many tick-borne infections manifest after a dog gets other infections or is stressed.

Treatment results:

  • Zola was started on doxycycline 10 mg/kg BID for 30 days (amoxicillin 20 mg/kg TID for 30 days would have been an alternative)
  • Two weeks after starting antibiotic therapy, the dog was vaccinated with a Lyme vaccine, a protocol Zola's veterinarian recommends
  • A quantitative C6 test was submitted, her level was 40 units/L
  • Retesting was recommended at six months with a goal of 50% decrease of the initial level
  • Monitoring the quantitative C6 level will reveal if Zola becomes reinfected or has a persistent active infection
  • Zola improved in 24 hours and has been healthy since then

This case demonstrates that:

  • Annual screening for Lyme disease is important, whether the dog is symptomatic or asymptomatic
  • A Lyme positive test, can confirm a diagnosis based on presenting signs
  • Treatment is clearly indicated for a positive, symptomatic dog
  • Lyme vaccination should be given two weeks after the start of antibiotic therapy to prevent future infection
  • Monitor for the quantitative C6 level annually to make sure the infection is under control
  • Most dogs will have a lifelong C6 titer (about 75%) even if the infection is under control

Preventing Lyme disease:

  • Zola's veterinarian, who resides in a Lyme endemic area, recommends the Lyme vaccine to every dog that is seen in the clinic
  • Zola received the Lyme vaccine two weeks after starting antibiotic therapy
  • Over the last five years, the clinic's Lyme disease prevalence went down from 45% to 20% since combining regular screening tests, treating, vaccinating and aggressive tick control
Lyme disease
has been
found in all 10
Canadian
provinces
The threat of Lyme disease is probably greater in dogs than in humans
Dogs will often show no signs of Lyme disease
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