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Lyme Disease treatment

Baxter's Mom
August 20th, 2007, 07:41 AM
Here's the deal. Our boxer Baxter was visiting in PA when he started limping, then progressed to vomitting and diarrhea. By day three my husband had to pick him up to help him go outside. He stopped eating and eventually stopped drinking as well. We couldn't get Baxter into a vet in PA, so my husband brought him back to NC where we took him to his regular vet clinic. They rehydrated him, and did tests for spider bite, poison, snake bite, and a "SNAP" test for heartworm, erlichia (sp?), and lyme disease and also took x-rays of the effected leg. All of this came up negative. They couldn't find a reason for the lameness, fever, or sudden illness. So they put him on antibiotics, and prednisone.

He improved rapidly and by the time we were finishing up the antibiotics we were reducing his prednisone dose, and weaning him off of it. Then he relapsed. After a week without the antibiotics he was headed back to being just as sick as he was when we first took him into the vet. I took him back and insisted on an extended tick panel after reading that these symptoms could be caused by erlichia and that the test they had originally done only tested for the most common type of the disease.

Again he was negative for the erlichia and rocky mountain spotted fever, but his Lyme disease titers were extremely high. Now he is back on the antibiotics, and prednisone at the original doses. This is not a common disease here in North Carolina. I am wondering if our vet could have not prescriped a high enough dose of antibiotic in the first place, or maybe we didn't have him on it long enough. He is not recovering as fast this time as he did the last, so I am wondering if he might have a drug resistant strain of the disease or a higher dose of the doxycycline since he has gained 10lbs since this all started.

Has anyone else dealt with this disease and seen a relapse like this? He is also still showing negative for Lyme disease when they do the "snap" test in the office.

His regular vet will be back from vacation this week, and the vet we saw last week was going to discuss the case with him again. We are also fortunate that they are willing to take questions that they don't have answers to, up to the vet school in Raleigh, so we may get answers through that channel.

I am just concerned that if we don't get this under control and cured, Baxter could end up with permenant damage to his joints, or worse to his heart and kidneys.

hazelrunpack
August 20th, 2007, 09:49 AM
Hi, Baxter's mom. Welcome to the board!

We live in a high Lyme's disease area--tons of ticks, spring and fall. In the 80s when Lyme's was emerging here as a problem, we had dogs that would come down with it every fall. We've had dogs tested negative for Lyme's but had high titers of antibodies to it. Never did understand that, but sometimes it happens. :shrug: We used to have similar relapses with Lyme's disease before the Lyme's vaccine was available.

Doxycycline often seemed to do the trick, but sometimes we needed a one-two punch to knock it down. The second drug was usually amoxicillin. (Something tells me that erythromycin is also a drug of choice for the second round, but our dogs do not tolerate it so we were unable to use it--however, this was more than 20 years ago so I may be misremembering.) Typically, they'd start on a 4-6 week dose of doxy, switch to amoxicillin for 4-6 weeks, then switch back to doxy for a week or two. The schedule varied on how well the dog tolerated the antibiotic.

The thing that concerns me about your dog is the use of prednisone in conjunction with the antibiotic. Dr Lee may jump in here and correct me, but I believe that the prednisone will interfere with the body's ability to clear the organism since it will reduce the immune system's effectiveness. My thought (but I'm no doctor) would be to ask about getting your dog weaned off the pred as soon as possible. If your dog is limping and uncomfortable, an nsaid drug like deramaxx can help without interfering with the doxycycline. And once the disease is under control, likely the limping will resolve on its own.

Also, I wonder about the blood profile. Do you know if your dog's platelents and white blood cells were low? The reason I ask is that 4 of our 6 dogs and hubby all came down with anaplasmosis (another tick-borne disease) last year--the only symptom in the dogs was some lethargy, low platelets and low WBC count. (Interestingly, hubby showed more of the symptom range that Baxter did.) Anaplasmosis is emerging here now the same way Lyme's was in the 80s. It was originally classifed as Ehrlichia equii but recently reclassified as Anaplasma phagocytophilum. The 4DX snap test from Idexx checks for it. Treatment is the same.

I know how difficult treatment of tick-borne diseases can be. :grouphug: It took our Cole more than 6 months to apparently kick the anaplasmosis and he's not out of the woods yet--he needs to be checked again in a few weeks. Three of the girls also initially tested positive in Feb, were treated with a short course of antibiotics since they showed no symptoms, and retested a few months later when one of them suddenly because symptomatic. They all were treated again with a longer course of antibiotics and all three are symptom-free now with high titers (showing a strong immune response...so this is good news if they're symptom-free).

Please keep us posted on how this all resolves. Best wishes for you and Baxter :fingerscr :goodvibes: