Lyme Disease in Dogs

Lyme Disease in Dogs

Northern Minnesota has a very healthy population of ticks, making tick borne diseases also prevalent. Lyme disease is the most common tick transmitted disease and is caused by the spirochete bacteria Borrelia burgdorferi. In our area, it is spread by the Deer tick, also known as Ixodes scapularis. Other Ixodes species, found in other regions, also carry the bacteria.

Ticks & Transmission

In order to understand the disease and how it is transmitted, one must study its lifecycle. A host is an animal that has the disease, while a vector is a organism that transports and delivers the bacteria from one host to another. The original host is commonly the Deer Mouse, therefore lending the name to Deer Ticks. In Spring, female ticks lay their eggs, which hatch into larva. Due to their small size, they feed on small hosts such as mice, picking up the Borrelia bacteria and carrying it throughout its life. After a blood meal, they drop off and lay dormant until the following spring, when they molt into a nymph. Similarly, the nymph gets its blood meal from a host, then goes dormant until the following Spring, and molts into an adult. Nymphs and adult ticks can feed on larger hosts such as wildlife, dogs, and humans.

Ticks feed by burying their mouth parts, like a “feeding tube”, into their host. They secrete an anesthetic to keep from being noticed, an anticoagulant to keep the blood flowing, and attach themselves with a cement like substance and barbs to remain in place. Saliva from the tick also flows through the “feeding tube“, which carries the bacteria into the host. For Lyme disease to transmit, the tick must be attached for a minimum of 24-48 hours. Other tick-borne diseases can transmit in less time.

Symptoms

According to the American Veterinary Medical Association, approximately 90-95% of dogs who are exposed do not exhibit symptoms. The ones that do may develop only one or multiple of the following symptoms:

  • Limping/Lameness
  • Stiff joints
  • Swollen joints
  • Swollen Lymph Nodes
  • Inappetence
  • Lethargy/Fatigue
  • Fever
  • Heart & Neurologic symptoms are extremely rare

Testing

The test (Idexx 4Dx Snap) that we have at our clinic indicates if there are antibodies that the dog’s body has produced to fight the bacteria. A positive test does not mean the pet currently has the disease, but that it has been exposed to the disease at some point. In order to determine if the dog has an active infection, a C6 Antibody test can be sent to a reference lab. It measures the level of antibodies in the blood to the C6 peptide on the surface of the bacteria. A low level indicates they likely had the disease but either were successfully treated or the body fought it off on its own. A high level means they may presently have clinical disease, and we may need to treat the infection. To determine if the treatment was successful, a follow-up C6 is run 6 months later. If the antibody level has dropped at least 40%, we know the treatment course was sufficient.

Testing the pet immediately after a tick bite will not give an accurate result. It takes weeks for the body to create the antibodies that the test will detect. This is why we recommend yearly testing.

Treatment

Depending on if the patient is exhibiting symptoms, a positive in-clinic test may signal the veterinarian to prescribe a course of antibiotics or wait for the results of the C6 to determine if treatment is needed. The antibiotic that is chosen most often to treat tick-borne illness is Doxycycline. Improvement can often be seen within a few doses, but the entire course of antibiotics should be given regardless to prevent relapse as well as antibiotic resistance. Other tick-borne diseases have similar symptoms and are also treated with Doxycycline.

Long Term Effects

The Borrelia bacteria like to migrate into joints. Their presence causes inflammation which can cause swelling, pain, limping, and lameness. If left untreated, the inflammation can damage the joints causing chronic arthritis.

The long-term presence of the Borrelia antigens in the patient causes the immune system to remain active attempting to remove it. Over time the antibodies (proteins created to fight the antigens) can deposit in the kidneys causing inflammation and damage. It is important to monitor the kidney function of Lyme positive patients, which may include blood work or testing the urine for protein loss which indicates kidney damage. Canine kidneys are very sensitive, so steps must be taken to slow the progression of kidney disease. If the damage to the kidneys is not caught early, it will likely result in kidney failure. Symptoms of kidney disease can include increased thirst, increased urination, decreased appetite and lethargy.

How Lyme differs from Dogs to Humans

After being exposed to Lyme, 90% of humans will manifest symptoms, while only about 5-10% of dogs will develop any symptoms. Humans commonly see a bullseye rash around the tick bite as well as flu-like symptoms shortly after transmission. Dogs may have some redness around a tick bite, but only because the saliva is irritating and doesn’t mean they have contracted the disease. Dogs may not show symptoms for weeks or months after exposure. The antibiotic dose to treat Lyme also differs greatly in humans versus dogs. Read more about tick bites on our blog.

Prevention

Tick Prevention- There are many different tick preventives on the market in many forms (collars, oral chews, topicals). There are over-the-counter and prescriptions options, but the prescription options are by far more effective. The purpose is to either repel or kill the ticks before the 24 to 48-hour window of transmitting the disease. These preventives are most effective if they are given ahead of tick exposure and are allowed adequate time to build up in the patient’s system.

Vaccine- There are vaccines available for dogs. The vaccine introduces a modified version of the bacteria so the body can develop the same antibodies it would towards the disease itself. The vaccine we use (Elanco® TruCan™ Lyme) is 92.2% effective against natural infections. Therefore, it is still possible to become infected, even if vaccinated, especially in high endemic areas.

Tick Control- You can reduce the population of ticks in your yard by removing the habitat that ticks love (leaf piles, tall grass, stick piles, etc), keeping you yard well maintained, controlled burns, having a gravel barrier between the woods and yard, controlling the rodent population, and setting out tick tubes in the Spring & Fall. What is a tick tube?

Prevention for Humans

Prevention for your pet doesn’t just protect them, but also your entire family as they are less likely to bring the ticks into your home.

Humans should avoid wooded and tall grassy areas during tick season if you can. If not, wear light clothing so you can see ticks easier, tuck your pants into your socks, spray your clothing with a pyrethrin insecticide spray, and immediately check for ticks when done.

FAQs

My dog had Lyme disease, can he get re-infected? Yes, they can get re-infected by another tick.

My dog has tested positive, do I need to retest? Yes, thought they will still be Lyme positive, the Idexx 4Dx test doesn’t just check for Lyme disease but also for heartworm, Anaplasmosis, and Ehrlichiosis. After a while the antibodies may decrease, and the patient may test negative for Lyme.

Should my dog who is Lyme positive still get the vaccine? Yes, the vaccine can help prevent them from becoming re-infected and is likely helpful in preventing secondary issues like kidney failure and arthritis. Though, the patient should not be vaccinated if they have symptoms or are currently being treated for the disease.

Can my dog give me Lyme disease? No, it must be transmitted through a tick.

What about cats? Lyme disease has not been studied as extensively in cats as in dogs & humans. Yes, cats can also get Lyme disease, but are much more resistant to the bacteria and are far less likely to develop symptoms. There is no in-house test for feline Lyme disease, but a test can be sent to a reference lab. The Lyme vaccine has not been approved for cats. Cats should be kept on tick prevention if they are outdoors or have dog housemates that will expose them to ticks.

What is an endemic area and are we in one? An endemic area is a region where the disease is consistently present over time. Yes, Northern Minnesota is most definitely an endemic area. The Companion Animal Parasite Council is dedicated to increasing awareness of parasites by collecting credible data and dispersing accurate information to educate pet owners and veterinary professionals. See CAPC map.

If your dog is exhibiting symptoms of Lyme disease, or if you’d like to get them started on preventives, give us a call to schedule an appointment.

Inappropriate Urination in Cats

Inappropriate Urination in Cats

A common presenting complaint for cats is the issue of urinating outside the litter box. This can be a very frustrating problem for owners to deal with. It can disrupt a household and put a strain on the human-feline relationship. Determining the underlying reason can be a complex puzzle with multiple pieces.

Obtaining a Urine Sample

A clean sample of the patient’s urine must be collected and analyzed for the presence bacteria, crystals, WBCs, RBCs, and other important values. Obtaining that sample has its challenges.  We often employ a urine collection kit with non-absorbent plastic litter in a clean litter box. This may take some time as the patient is not accustomed to this setup and often holds their urine. If this method is unsuccessful, we may need to retrieve a sample via cystocentesis, carefully sticking a needle directly into the bladder, often guided by ultrasound, to extract an uncontaminated sample.

Urinary Tract Infection

The first thing to rule out with urinary issues is a urinary tract infection. UTIs are regularly treated with antibiotics, but isolating which bacteria is present in the urine indicates which antibiotic is needed. This is why a culture of the urine is often recommended.

Bladder Stones

Bladder stones develop when the pH of the urine is unbalanced, and an overabundance of minerals start to merge and harden. This problem can be diagnosed by taking a radiograph or ultrasound of the bladder. They are usually treated with surgical removal or diets specially formulated to dissolve the particular compound.

Diabetes

Another value that is measured in a urinalysis is the presence of glucose in the urine. This can clue us in that diabetes may be on the differential. Glucose in the urine can be due to stress, so more testing is required to definitively diagnose the disease. A symptom of diabetes is frequent urination, which may lead the patient needing to go when a litter box is not convenient.

Kidney/Thyroid Disease

Kidney disease and hyperthyroidism are common ailments in cats. Both have symptoms of frequent urination. The frequency or urgency leaves them little time to make it to the box and instead turning to the nearest available location. A low specific gravity of the urine may indicate the need to run blood work to check kidney function.

Blockages

The urethra is a small tube leading from the bladder to the outside world. It can become plugged with mucous and/or crystals, blocking the flow of urine. Since the kidneys filter toxins from the body and eliminate them through the bladder, the inability to urinate can cause a build up of toxins in the body. This is a serious and life-threatening condition.

FIC- Feline Idiopathic Cystitis

www.hillspet.com

Idiopathic means that we do not know the cause of inflammation in the bladder. This diagnosis is reached when other conditions have been eliminated. Treatment options may include anti-inflammatory pain medication, diet change, and environmental enrichment. Since cats are notorious for not drinking enough, encouraging increased water intake can help flush out the bladder.

Behavioral

Behavioral problems can be the most challenging to diagnose and resolve. Cats are creatures of habit and do not like variations to their routine. Even something small like moving the furniture around in the living room can stress them out. A larger change like a new human or animal in the household or moving can be even more upsetting.

With the invention of new products that relieve stress, we have more tools in our toolbox. Here are some examples:

  • Specialized Diets- Hill’s Feline c/d stress management or Royal Canin Urinary SO + Calm
  • Probiotics- Purina Calming Care®
  • Pheromone- Feliway® Spray or Plug-in
  • Pharmaceuticals- Fluoxetine, Gabapentin, etc.

Litter Box Aversion

Even after symptoms of a UTI or other issue have resolved, the patient may still associate the litter box with the pain caused from that issue. Moving their litter box to a new spot or offering them a new one may help them overcome this aversion.

Location Preference

Felines prefer a quiet, private place to do their business. If the litter box is in an area of high traffic or noisy area of your house, your cat may just need a change of scenery. If they are frequently eliminating in a specific spot in the house, move their litter box to that spot as it just may be where they feel most comfortable. The type of litter you use can be unfavorable to a cat.

Age Related

If a senior cat is having urinary issues and medical conditions have been ruled out, we investigate age related issues. Cognitive dysfunction may mean the cat is forgetting where to go or even getting lost in your house and unable to find the box. Try offering more litter boxes and placing them in areas around the house they most frequent. Arthritis can also play a role. They may be having difficulty getting in and out of the box. Consider a box with shorter sides or one that is wider allowing easier movement in and around. Make sure they have a box available on each level of the house in case they are unable to navigate the stairs.

In summary, inappropriate urination may just be the cat’s way of telling you that there is something wrong. There are other issues not on this list that could be the underlying problem. The important part is to observe the cat’s behaviors or reactions to treatment and communicate your findings with your veterinarian. Together, we can add up the pieces to the puzzle to paint the complete picture.

Canine Influenza

Canine Influenza

Canine Influenza, also known as “Dog Flu”, is a highly contagious upper respiratory disease caused by Influenza A virus, either the H3N2 or H3N8 strains. Both strains share many similarities. This is not the same as the Human Influenza A virus. At this time, there are no cases of it transferring to humans.

Where is it?

Historically, outbreaks of Canine Influenza have been seen in larger urban areas due to the increased use of spaces where dogs congregate such as dog parks, day cares, and boarding facilities. H3N8 was first reported in Florida in 2008 in racing Greyhounds. H3N2 was first reported in the US in 2015 in the Chicago area. Prior to that it was reported in Asia. Recently, small pockets of occurrences have been popping up in smaller communities as well.

How is it spread?

The virus is spread through aerosolized droplets (coughing or sneezing) and direct contact. The virus can live on contaminated surfaces (Examples: bowls, kennels, toys, human hands & clothing) for up to 48 hrs. Approximately 20% of infected patients can be asymptomatic (not show symptoms) but still be able to spread the virus. Whether patients are showing symptoms or not, they can spread the virus for up to 30 days.

Symptoms

Infected dogs can be asymptomatic. Symptoms can come on suddenly. Signs typically appear within one to five days after a dog is infected.

  • Coughing
  • Runny eyes or nose
  • Hard swallowing or throat clearing
  • Fever
  • Lethargy
  • Decreased appetite

Diagnosis

There are many different diseases with the same symptoms, which are commonly grouped together and called “Kennel Cough”. Therefore, a definitive diagnosis cannot be made on symptoms alone. A specific test must be run to conclusively diagnose the patient with Canine Influenza. This test requires a sample to be obtained with a swab from under the eyelid and another down the throat. Unfortunately, this test is quite costly which prohibits most clients from approving it.

Treatment

For most patients, no treatment is necessary. Supportive care is recommended to keep the patient hydrated and rested, allowing their immune system to fight off the virus naturally. Only when a secondary bacterial infection is suspected would antibiotics be necessary. Most patients recover within 2-3 weeks. A patient who is otherwise immunocompromised may lead to severe illness and pneumonia, which may require more aggressive treatment such as hospitalization and IV fluids. The mortality rate is very low, rough estimates suggest <1-3%.

Prevention

  • Avoid contact with other dogs (boarding facilities, daycares, dog parks, meeting dogs on walks, or other events with dogs).
  • If your dog is sick, keep them away from other dogs for at least 30 days, even if symptoms resolve.
  • Wash your hands thoroughly and change your clothes, after interacting with other dogs before coming home to yours.
  • Common household disinfectants can inactivate the virus.
  • There is a vaccine for Canine Influenza. Unfortunately, it is currently unavailable (on long term back order).

Are other species at risk?

No cases of either strain have been reported to be transferred to people yet. H3N8 has not been reported in cats, but there is evidence that the H3N2 virus can be transmitted to cats. Symptoms in cats are similar to those in dogs, but milder. There have been no reported deaths in cats due to H3N2.

Tick Bites

Tick Bites

We frequently receive phone calls from concerned clients who have pulled a tick off their pet and there is a red bump remaining. Clients are often concerned and not sure what to do. Here is a guideline to help answer common questions.

Red Rash

In humans we have been taught that the red, bullseye rash likely means Lyme disease. This is not necessarily the case in dogs or cats. A red, raised bump at the site of the tick bite is common due to the skin’s localized reaction to the tick saliva. A circular rash, especially on the abdomen, can also be from a fly or gnat bite.

How to remove a tick

It is recommended to wear gloves while removing ticks. Use a tweezers and grab the tick as close to the pet’s body as you can. Pull straight out in a slow, firm motion. Clean the area with an antiseptic. In some cases, the mouth parts of the tick may remain in the pet. It is important to try to remove them, if possible, to avoid a secondary infection. Otherwise, they will eventually fester and fall out.

Are antibiotics needed?

In human medicine, your doctor may prescribe medication to be taken the first few days after a tick bite. This is not the protocol in veterinary medicine. Overuse of antibiotics can decrease their effectiveness and create antibiotic resistance. Instead, it is recommended to watch for signs and symptoms of disease, which may take weeks to months to appear. Symptoms may include:

  • Lethargy
  • Loss of appetite
  • Limping
  • Swollen joints
  • Swollen lymph nodes
  • Vomiting
  • Fever

Should the patient be tested?

The 4Dx test we use for tick diseases and heartworm is an antibody test. This means it detects antibodies that the immune system creates towards the disease. The antibodies may not be present immediately; therefore, the test may be negative even though the patient is developing the disease. For Lyme disease, it can take up to 6 months to have the antibodies to test positive.

Tick Identification

There are 13 known species of ticks in Minnesota. The most common are the Deer tick and Wood tick. The Deer tick is the one most likely to transmit diseases and the only tick that transmits Lyme disease. Here are pictures of ones to look for:

Deer Tick/Black Legged Tick- (Ixodes sp.)

Photo Credit: Ticks | UMN Extension

Wood Tick/American Dog Tick (Dermacenter variablis)

Photo Credit: Ticks | UMN Extension

Lonestar Tick (Amblyomma americana)- rare in Minnesota, please consider sending the tick in to report it.

Where to look

Even if your pet is on a preventive, you should check them regularly for ticks. Especially after being in thick grass or wooded areas. Below is a diagram of places ticks are likely to be found on your pet.

To submit ticks to the University of MN for identification:

https://www.health.state.mn.us/diseases/tickborne/ticksubform.pdf

To submit ticks found on pets to be tested for diseases:

https://www.showusyourticks.org/

Probiotics

Probiotics

Probiotics are defined as “live microorganisms, which when administered in adequate amounts, confer a health benefit on the host.” Animals and bacteria have a symbiotic relationship, meaning they are mutually beneficial to each other. Without bacteria, animals could not survive. For example, the majority of the immune system is found in the gastrointestinal tract, which contains 70% of all immune cells. Therefore, a healthy GI system is essential to a patient’s overall health.

Disclaimer: Always consult a veterinary professional before starting probiotics, supplements, essential oils, or any over the counter medications.

Good vs Bad

On average, animals can have up to 4 pounds of bacteria in their body, depending on size. The majority of bacteria is found within the gastrointestinal system and is made up of both “good” (beneficial) and “bad” (harmful) bacteria. Both are necessary, but need to have the correct balance.

Balancing Act

There are many different causes for an imbalance in the good/bad bacteria ratio. Stressful situations (boarding, grooming, traveling, etc), antibiotic use, steroids, surgery, parasites, diet changes, toxins in food or water (chlorine for example), and dietary indiscretions and other factors can all cause a decrease in good bacteria.

Benefits

The advantages of probiotic use have been more widely studied in human medicine. Recently the ideas have been applied to veterinary medicine, though holistic veterinarians have proclaimed the value for many years. Here are some of the possible benefits:

  • Treating or preventing diarrhea
  • Inhibit growth of harmful bacteria (E.coli, Salmonella, Clostridium, Helicobacter, etc)
  • Regulates bowel function
  • Support healthy immune system
  • Decreases gas
  • Increase absorption of nutrients such as Magnesium
  • Produce enzymes to aid in digestion
  • Manufacture vitamins (Vitamins B & K, for example)
  • Lower cholesterol
  • Maintain proper pH levels
  • Maintain a healthy mucosal lining which prevents bacteria and toxins from entering the blood
  • Help control populations of yeast and bacteria that may lead to infections

Administration

Probiotics can be found in many forms; including powder, capsules, tablets, liquids, pastes, and in treats or food. Powders have been found to be most effective. Not all probiotic products are created equal. Often the bacteria are killed during the production process. Some products may not contain the correct organisms or exact amounts that they claim. It is important to consult a veterinary professional; they can help choose which product is right for the pet and their condition.

It is important to follow the directions specific to the product. Some may need refrigeration, have an expiration date, must be given with a meal, etc. If given incorrectly, the organisms may be killed by stomach acid before reaching the intestinal tract, which defeats the purpose. Side effects are rare when used as directed. More is not always better; the dose given should be determined by the veterinarian based on the patient, condition, and product.

Human vs Pet Specific

The answer to this depends on who you ask. A few sources have seen some benefit of human probiotics given to pets. Others argue that the organism should originate from the species it is intended for. The truth is, information and studies of both the human and companion animal microbiome (GI bacteria and environment) are still evolving. New research is concentrating on developing species specific products and their beneficial secondary effects. Purina® has released a probiotic product called Calming Care®. This particular strain of bacteria helps pets maintain calm behavior, promote positive behavior, and promotes a positive emotional state.

Based on the information we have, specific strains of these bacteria have been shown to be beneficial:

  • Enterococcus sp.
  • Lactobacillus sp.
  • Bifidobacterium sp.
  • Acidophilus sp.
  • Bacillus sp.
  • Streptococcus sp.

Could you pet benefit from adding probiotics to their diet? Your pet’s annual exam is an opportune time to ask questions. Give us a call at 444-5797 to schedule an appointment.

Arthritis

Arthritis

Arthritis is a common problem for both cats and dogs. We have gathered some information to help you identify the symptoms and take action to keep your pet enjoying their normal daily activities.

What Is Arthritis?

Photo Credit: Hill’s Atlas of Veterinary Clinical Anatomy

Arthritis is an inflammatory disease that affects joints. It is characterized by the breaking down of smooth cartilage that covers and protects the bones that form a joint. Any stress on the joint will increase the rate of degeneration. Once the cartilage is gone the bones grind against each other with regular movement, making even the slightest movement quite painful.

Symptoms:

  • Walking stiffly
  • Limping, lameness, or favoring certain limbs
  • Showing stiffness or discomfort when getting up from a lying-down position
  • Stiff, swollen or sore joints
  • Painful when touched in certain areas
  • Uncomfortable or painful in certain positions
  • Loss of flexibility in their joints
  • Hesitation to jump, run or climb stairs

Diagnosis:

Arthritis is a common ailment and should be discussed during your pet’s annual physical exam as they get older. Radiographs, as well as other diagnostic tests, can help determine the cause and location of the inflammation. The patient’s medical history, such as previous injuries or possible congenital conditions, can help your veterinarian determine the type of arthritis and best course of treatment.

Causes:

  • Joint infection
  • Dislocation or Trauma
  • Congenital conditions such as hip dysplasia
  • Immune-Mediated Polyarthritis (IMPA)
  • Obesity
  • Ligament, tendon or muscle injury
  • Fracture of a bone that involves a joint
  • Aging and natural erosion of cartilage       

Prevention:

Keeping your pet at a healthy weight may help prevent arthritis or slow its progression once the condition has developed. However, arthritic conditions cannot always be predicted or prevented, especially those that are congenital. Genetic tests are available to determine if your pet has the specific genetic markers and is at risk for developing these conditions.

Treatment:

Once arthritis has developed, there is no cure. The goal then is to prevent progression of the disease and minimize your pet’s pain. Some treatment options may include:

  • Prescription medication such as analgesics or anti-inflammatories
  • Nutritional supplements such as Glucosamine, Chondroitin or Omega-3 Fatty Acids
  • Physical Therapy or regular, low-impact exercise such as walking or swimming
  • Weight loss, if necessary
  • Surgery
  • Holistics Treatments such as Acupuncture, Herbal medications, & other alternative therapies

Note: Advil (Ibuprofen), Tylenol (Acetaminophen), & Aleve (Naproxen) are toxic and NEVER should be given to pets. Do not give your pet any other human over-the-counter medications without first checking with your veterinarian.

Feline Note: Cats are more sensitive to drugs and should only be given medication and supplements intended for use in cats.

At home suggestions to make your pet more comfortable:

  • Provide proper bedding such as an orthopedic foam bed
  • Have short, gentle play sessions
  • Provide gentle massages and physical therapy
  • Elevate food and water to shoulder level
  • Groom the areas that may be hard to reach
  • Provide ramps in place of stairs or a place they usually jump up to
  • Daily low-impact exercise such as walking or swimming
  • For cats, provide a little box with shorter walls

If you notice any of these symptoms or changes in daily routine, your pet’s yearly physical exam is a perfect opportunity to discuss these issues with your veterinarian.  Give us a call at 444-5797 to schedule an appointment.