posted to sci.med.diseases.lyme :
www.askdrschoen.com/articles/lymedisease.html
I have seen all the symptoms of Lyme disease in dogs
four to
eight weeks after the vaccine and when I sent the western blot test to Cornell,
it
shows no evidence of the disease, only evidence of the dog having been vaccinated, yet
the dog shows all the classic symptoms of the disease.
Lyme Disease: Fact from Fiction
Allen M. Schoen, D.V.M., M.S.
Lyme disease is one of the most common tick-transmitted diseases in the
world.
There
is much that is known about it, but also a tremendous amount that still
is
unknown.
There are many varied opinions regarding symptoms, diagnosis,
vaccination
controversies and treatment options. Where I live, there are horse
barns I
visit where
almost every person, horse and dog have contracted Lyme disease. It is epidemic. Being
in the middle of such a hotbed, I have seen many diagnostic and
therapeutic
approaches
that have and have not worked. Today I will share my opnion on this debilitating
disease. Lyme disease is caused by an organism known as a spirochaete
and
named
Borrelia burgdorferi. It is transmitted by tick bites. It has been
found
worldwide and
in ancient chinese medical literature they actually describe a syndrome
very
similar
to Lyme disease, thousands of years before Lyme, Connecticut was named!
In
the
United
States, more than 90% of the cases occur in the Northeast, with
California
and
Missippi second. It is fairly common in dogs, but rarely seen in cats, although
I have
seen some cats with it.
The main clinical signs include a sudden yet recurring lameness that
may
shift
from
leg to leg. Sometimes this lameness is associated with a fever and
depression.
Occassionally you will see swollen lymph nodes. Sometimes the joints
may be
swollen,
warm and painful and they usually walk stiffly with a hunched back.
Animals
with Lyme
disease really look painful and stiff and commonly are very sensitive
to
touch
and may
cry out with even the slightest touch. I have seen dogs that were
diagnosed
with
slipped discs in their neck and crying in pain and it was actually lyme
disease
causing muscle spasms in the neck and they only improved when they were
administered
the appropriate antibiotic. Sometimes you will see the classic red
round
target
lesion
around a tick bite on your pet and within a few days they may show the
signs
of
lameness, fever and sensitivity to touch. I saw this on my own golden retriever
and
within a few days he woke like a stiff 90 year old man that could
hardly make
it to
his food bowl. I immediately treated him and he improved within twenty
four
hours.
If your pet is not diagnosed and treated immediately, the disease can
spread
to
the
heart, kidneys and the nervous system including the spinal cord and the
brain,
showing
signs associated with these organs. The organism has been found in
connective
tissue,
in joints, muscles and lymph nodes. It is one nasty bug! Besides these
classic
symptoms, how can your veterinarian diagnose it? If suspicious, it is
very
important
to run a special blood test called a Lyme titer. Now, there are two
types
known
as the
Elisa test and the western blot test. My particular preference is to
run the
western
blot test. It may take a bit longer to run, but I find it much more
accurate.
It is
not uncommon that the Elisa test is negative and your dog still has
Lyme
disease. If
your dog or cat or horse has many of the symptoms of Lyme disease and
the
test
is
negative, do not be fooled. I still recommend treating the animal
aggressively
with
antibiotics. Often, I will not even wait for the test to comeback to
treat my
patient
if enough of the symptoms are present to suggest Lyme disease. Believe
me, I
like to
be as natural as possible and use antibiotics only when absolutely
necessary,
but this
is one time when they are neededfast! Often times the response to
appropriate
antibiotics is quite rapid. In horses, I have developed an acupuncture diagnostic exam
that I have found to be as diagnostic if not better than the standard laboratory tests
and I will be publishing on that shortly.
Lyme disease has often been nicknamed the great imitator. This is
because
many
of the
symptoms can mimic symptoms of many other diseases because it can
effect so
many
different organ systems. I remember one gordon setter puppy I saw and
the
first
symptom of Lyme disease that showed up was lack of appetite and an
arrythmia
in
the
heart that I picked up on my exam. It only got stiff and lame three
days
later.
Fortunately I knew the heart problem wasn't there a few weeks prior on
a
normal
exam
and was suspicious of Lyme and we treated it successfully and the heart
problem
resolved. When considering Lyme disease as a possibility, one must also
think
about
other tick-transmitted diseases such as Rocky Mountain spotted fever or
canine
erlichiosis. Arthritis, rheumatoid arthritis, other joint diseases as
well as
kidney
failure or heart problems from other causes need to be considered as
well.
What is the best treatment? As I mentioned previously, this is one
place
where
I feel
strongly that immediate antibiotic therapy is imperative. It appears
that
doxycycline
and amoxicillin seem to be the best antibiotics against Lyme disease. I
suggest
staying on antibiotics for a minimum of a month, sometimes even longer.
I
have
seen
dogs that were only on antibiotics for two weeks and then it comes back
with
a
vengeance and does not respond as well afterwards. A holistic approach
would
also
include using probiotics such as acidophilus to keep the healthy
bacteria
alive
in
your pets gastrointestinal tract. In addition, it has been found that
the
organism can
actually further suppress the immune system. So I usually recommend nutritional
and
herbal support to boost the immune system as well. This would include echinacea
and
garlic as I have mentioned in previous columns of the Healing Arts.
Sometimes
I
see
chronic Lyme disease in a dog or cat and I will also use acupuncture to
boost
the
immune system and relieve the pain and inflammation. Homeopathic
remedies
have
also
appeared to be helpful. The most successful of these
incltlo...@interport.net
ude
homeopathic Ledum and a Lyme nosode. Lyme nosode is a homeopathic
remedy that
is made
from the killed organism, diluted, successed and potentized to the
point that
nothing
of the original organism remains. For appropriate dosages of these
remedies,
you
should contact a homeopathic veterinarian.
As far as prevention goes, this is a sticky wicket. There is a great
deal of
controversy concerning the dog Lyme vaccine. There is a great debate
about
how
well
they actually work as well as potential side effects. There are
publications
concerning its safety, but the researchers only look 24 hours after the
vaccine
reaction. Research at Cornell University veterinary school brings up
some
suspicion
that there may be potential long term side effects of the vaccine,
though
nothing is
certain. These side effects may vary from rheumatoid arthritis and all
the
major
symptoms of lyme disease to acute kidney failure. Though nothing is definitively
documented, I personally am very cautious and do not recommend
vaccinating
for
Lyme
disease even though it is so epidemic here. Many veterinary schools and
major
veterinary centers do not recommend the vaccine for the same concern
regarding
potential side effects. I have seen all the symptoms of Lyme disease in
dogs
four to
eight weeks after the vaccine and when I sent the western blot test to Cornell,
it
shows no evidence of the disease, only evidence of the dog having been vaccinated, yet
the dog shows all the classic symptoms of the disease. There is a new
dog
vaccine out
that claims that it does not have any of the side effects, however, I
still
remain
cautious and will wait for a year or two to see. I personally would
rather
treat my
dog for Lyme disease rather than risking the potential side effects of
the
vaccine. In
addition, there is a question of actually how well it works. Until more
safety
and
decreased risk of side effects and efficacy are demonstrated, I
recommend
holding off.
The best prevention still is checking your dog carefully and removing
any
ticks
at
least once a day. Collars do not seem to work that well, although some
of the
topical
insecticides do seem to work well, but then one has to weigh the
potential
toxic
effects of these insecticide from the beneficial effects of preventing
ticks.
Again, I
tend to compromise and only use the topicals during the greatest
incidence of
tick
usually in the spring and fall. It is all a balance! Keep your pets
away from
tick
infested areas, check them daily and stay healthy and happy and tick
free!!
_____________________________
Lyme vaccine protein linked to arthritis in hamsters
By Penny Stern, MD
NEW YORK, Feb 07 (Reuters Health) -- Hamsters inoculated with a protein
found in Lyme disease vaccines appear to develop arthritis if they are
later
exposed to the organism that causes the tick-borne disease, researchers
suggest.
However, the evidence is not strong enough to raise concerns about the
use
of Lyme disease vaccines in humans, according to the US Food and Drug Administration (FDA).
``We have not seen any data that would cause us to change the (vaccine)
label or lead us to believe that the vaccine is not safe and effective
when
used according to the label,'' an FDA spokesperson said in an interview
with
Reuters Health. She added that, ``as with all vaccines, we continue to
monitor for adverse effects.''
In the study, published in the February issue of the journal Infection
and
Immunity, Dr. Ronald Schell, of the University of Wisconsin in Madison,
and
colleagues vaccinated hamsters with recombinant OspA (rOspA).
OspA (outer surface protein A) is found on Borrelia burgdorferi, the tick-borne bacteria that causes Lyme disease, and is used in vaccines
to
protect against Lyme disease. The researchers then infected the
hamsters
with B. burgdorferi and found that 50% of hamsters given the highest
dose of
OspA developed ``severe destructive arthritis'' in a hind paw, as did
100%
of those given lower doses of the protein.''
According to Schell and colleagues, the study findings provide ``direct
evidence that OspA can induce arthritis.'' The investigators also found
that
the hamsters developed arthritis-like changes in their hind paw when
given a
version of OspA used in a Lyme disease vaccine for dogs and then were
infected with B. burgdorferi.
While the authors are careful to point out that no humans have been
shown to
develop vaccine-related arthritis after being naturally infected with
B.
burgdorferi, ``this does not rule out the possibility that rOspA is an (arthritis-inducing) agent,'' they caution.
It is their contention, based on their findings, that ``the present
rOspA
vaccines must be modified to eliminate potential side effects.''
However, the study in hamsters does not directly apply to vaccine use
in
humans, according to SmithKline Beecham, the manufacturer of LYMErix,
the
first vaccine against Lyme disease.
``We do, as a company, have very serious concerns about this particular
study,'' said a SmithKline spokesperson in an interview with Reuters
Health.
In particular, the dosages and the formulation of the dosage used in
the
study are not the same as that used in humans, according to the
company.
``We do not believe that you are comparing like with like. It's a bit
like
comparing apples with pears,'' she said. The product is safe and people
at
risk for Lyme disease should continue to take the vaccine, the company emphasized.
``As far as the safety and efficacy profile is concerned they should
continue to take it,'' she said. ``Obviously they will be taking it
through
their physicians or through their healthcare professional and we would encourage them to talk to their physician or healthcare professional as
indeed we all do -- really to carry on as normal,'' she added. SOURCE: Infection and Immunity 2000;68:658-663.
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