Veterinary Medicine - December 2007 - (Page 778)

2007 Highlights O Central Practical advice from the presentations Answers to three commonly asked questions about Lyme disease Should you consider testing dogs that may have been exposed to Lyme disease and are showing no signs of illness? If the results are positive, should you treat asymptomatic dogs? And how should you monitor positive dogs in endemic areas for Lyme nephritis? Richard E. Goldstein, DVM, DACVIM (small animal internal medicine), DECVIM-CA D ogs with clinical signs of Lyme disease should be screened for exposure to Borrelia burgdorferi, the disease’s causative agent. If these dogs have positive test results, they should be treated with antibiotics, either doxycycline or amoxicillin. But obvious clinical signs may be apparent in only about 5% to 10% of dogs infected with B. burgdorferi.1 So the harder question is, how should we manage the vast majority of infected dogs that show no clinical signs? even if you are not going to use the information for treatment purposes. SHOULD I TREAT AN INFECTED ASYMPTOMATIC DOG? The answer to this question is still unclear. Ideally, we would approach the question from a risk-cost-benefit standpoint. We do know the following: 1. With or without treatment, dogs with Lyme disease may remain infected with low numbers of B. burgdorferi.2 2. Evidence suggests that in many cases treatment tends to lower Lyme antibody titers faster than they would decline without treatment.3 This more rapid decline may be true for bacterial load as well as for antibody titers. IDEXX Reference Laboratories, which offer the quantitative C6 assay, SHOULD I SCREEN ASYMPTOMATIC DOGS FOR LYME DISEASE? I would definitely recommend screening dogs suspected of being exposed to B. burgdorferi for two reasons. Obviously this is necessary if a dog is going to be treated based on a positive test result. Such screening can also serve as I am not sure we have enough evidence to make a fully informed decision about treating subclinically infected dogs. As we gain experience in this area and as controlled field studies are published, we will have a better understanding of how to answer this question. HOW SHOULD I MANAGE DOGS IN ENDEMIC AREAS FOR SUSPECTED LYME NEPHRITIS? Circumstantial evidence exists for a connection between Lyme disease and glomerular-tubular disease in dogs, and there are many anecdotal reports of a similar clinical syndrome in Labrador and golden retrievers and other breeds in Lyme-disease-endemic areas. We know now that anti-Borrelia burgdorferi antibodies are present in the kidneys of dogs with Lyme nephritis, but it is not known whether other factors or additional infectious agents play a role in Lyme nephritis in addition to infection with B. burgdorferi. ©iStockphoto.com/Linda & Jonas Engström Screen all dogs with positive Lyme disease test results for proteinuria or microalbuminuria. a useful marker for Lyme-infected ticks in your region and further the success of your tick control program recommend considering treatment when canine antibodies against the Lyme C6 protein are > 30 U/ml. 778 December 2007 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - December 2007

Veterinary Medicine - December 2007 Contents Letters Editors' Guest Thanking Our Valued Reviewers The Veterinary Medicine Interview: Dr. Joseph Harari Clinical Exposures Idea Exchange Answers to Three Commonly Asked Questions About Lyme Disease Practical Ideas for Managing Common Internal Medicine Problems A Tip for Interpreting Leptospira Species Titers Investigating Proteinuric Kidney Disease Counseling New Puppy Owners: Normal Play vs. Aggressive Tendencies 11 Guidelines for Conservatively Treating Chronic Kidney Disease CE Form Product Preview Advertiser Index Marketplace/Classifieds Mind Over Miller Merial Insert

Veterinary Medicine - December 2007

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