ACVIM Small Animal Consensus Statement on Lyme Disease in Dogs: Diagnosis, Treatment, and Prevention

Abstract

The purpose of this report is to offer a consensus opinion of ACVIM diplomates on the diagnosis, treatment, and prevention of Borrelia burgdorferi infections in dogs (canine Lyme disease). Clinical syndromes known to commonly be associated with canine Lyme disease include polyarthritis and glomerulopathy. Serological test results can be used to document exposure to B. burgdorferi but not prove illness. Although serum enzyme‐linked immunosorbent assay/indirect fluorescent antibody assay titers can stay positive for months to years after treatment, quantitative C6 peptide antibody paired tests need more study. Serological screening of healthy dogs is controversial because it can lead to overdiagnosis or overtreatment of normal dogs, most of which never develop Lyme disease. However, serological screening can provide seroprevalence and sentinel data and stimulate owner education about tick infections and control. Although it is unknown whether treatment of seropositive healthy dogs is beneficial, the consensus is that seropositive dogs should be evaluated for proteinuria and other coinfections and tick control prescribed. Tick control can include a product that repels or protects against tick attachment, thereby helping to prevent transmission of coinfections as well as Borrelia spp. Seropositive dogs with clinical abnormalities thought to arise from Lyme disease generally are treated with doxycycline (10 mg/kg q24h for 1 month). Proteinuric dogs might need longer treatment as well as medications and diets for protein‐losing nephropathy. The ACVIM diplomates believe the use of Lyme vaccines still is controversial and most do not administer them. It is the consensus opinion that additional research is needed to study predictors of illness, “Lyme nephropathy,” and coinfections in Lyme endemic areas.

Tick-borne Diseases (Borreliosis, Anaplasmosis, Babesiosis) in German and Austrian Dogs: Status quo and Review of Distribution, Transmission, Clinical Findings, Diagnostics and Prophylaxis

“…The presumptive diagnosis of LB in dogs implies several criteria (according to Littman et al 2006;Krupka and Straubinger 2010). These include a history with regard to tick exposure and living in endemic regions, diagnostic evidence of infection with the pathogen, exclusion of differential diagnoses, compatible clinical symptoms, and response to specific treatment including monitoring of treatment success.…”

“…Based on current information, pathogenicity (in the course of experimental and natural infections) in the dog has been demonstrated conclusively only for Bbss, especially in the light of Koch's postulates complying after experimental infections (Hovius et al 2000;Straubinger 2000;Straubinger et al 2000;Liebisch and Liebisch 2003a;Littman et al 2006;Wagner et al 2012;Skotarczak 2014). A. phagocytophilum is an obligate intracellular gram-negative bacterium, belonging to the order of Rickettsiales.…”

Diversity of Antibody Responses to Borrelia burgdorferi in Experimentally Infected Beagle Dogs

“…More recently, immunoassays based on whole cells have been supplanted by assays based on either the C6 peptide of the VlsE protein of B. burgdorferi or a small set of purified antigens (14). One potential drawback of assays based on the VlsE protein is its homology to the variable membrane proteins (VMPs) of relapsing-fever Borrelia spp., for which it is named ("VMP-like sequence") (16).…”

“…In the past, immunoassays for canine infections generally applied the same protocol as used for human infections, namely, a two-tier approach in which a whole-cell-based, enzyme-linked immunosorbent assay (ELISA) was conditionally followed by a Western blotting (WB) assay (14,15). More recently, immunoassays based on whole cells have been supplanted by assays based on either the C6 peptide of the VlsE protein of B. burgdorferi or a small set of purified antigens (14).…”

Infectious Disease

“…There can also be clinical signs attributable to vasculitis, thromboembolism, hypertension, uremia, and hypoproteinemia. 63 Anesthetic management of dogs with Lyme disease should include a complete evaluation of renal function and diagnostics to document the level of hypoproteinemia and any associated clinical signs such as edema, ascites, pleural effusion, etc. Blood pressure should be measured, and hypertension should be noted.…”