May is Lyme Disease Awareness Month. I have many diseases, and they each have various awareness days or months, so I generally don’t participate — it’s too overwhelming. In fact, May is also International MCS Awareness month, which means I could do a double-header if I was up to it. Which I’m not, due to Lyme making me too nonfunctional. (See the segue?)
I have three-dozen draft posts on a variety of other topics for After Gadget that I’ve never published. But I’m determined to finish and post these Lyme Awareness Blogs, even if I can’t squeeze them all in this month. They cannot be more unedited pieces languishing in my draft folder. The topic’s too important.
My inability to publish with any urgency or regularity tells you a bit about living with Lyme. Extreme exhaustion, trouble with memory and word retrieval, and poor stamina are all part of the picture. So is severe and relentless body pain, insomnia, migraines (and all that goes along with them), dizziness, weakness, and much more. That’s about enough of that laundry list.
You see, there are a lot of other terrific Lyme Awareness Month posts that tell “a-day-in-the-life of a Lymie” or explain symptoms or elucidate the bacteriological mechanisms behind the disease.
I hope you will read a few.
I recommend checking out this funny one by a guy at Lymenaide; or buzzing by this SpiroChicks post showing a video public service announcement she made; or a trip to Lymebites with its variety of little posts and links to other good Lyme information; or this noteworthy Infectiously Optimistic blog, where Candice has provided many of The Voices Behind the Disease (including yours truly).
Mandy Hughes eyes uncertainty in her struggle with Lyme.
I definitely urge you to rent and watch the film, Under Our Skin. It is a phenomenal piece of work, and it will completely transform what you thought you knew about Lyme disease.
Another unusual aspect of Lyme is that it affects people and dogs; both Gadget and I contracted it. Many disabilities cannot be prevented, or cannot be ameliorated. Lyme, to varying degrees, can — that’s what makes awareness so crucial.
Gadget and I both had Lyme here, but I didn't know it.
The next three After Gadget blogs will specifically address Lyme awareness from the service dog perspective:
- How Lyme can affect your dog, and what you need to know about it (that your vet might not).
- How Lyme can affect you, and what you need to know about it (that your doctor might not). **UPDATE: I finally wrote Part 2, about my Lyme journey, which is so representative of so many people’s, unfortunately.**
- How Lyme transformed my experience specifically as a service dog partner.
Note: Since this blog series focuses on awareness, I’m honing in on the issues that I think are most important for you to be aware of. My goal is to prevent more cases of Lyme — especially chronic or untreated Lyme — in dogs and people.
So, I’m going to skip a lot of general information. For example, telling you the name of the strange organism that causes this disease will probably not be what impels you to rethink the limp that comes and goes in your dog, or that frustrating “flakiness” of your sister-in-law. It won’t change your mind about whether you are taking adequate precautions against tick-borne disease (TBD). On the other hand, I hope this series will.
You probably wouldn’t be here if you didn’t care about dogs, so Part I is dedicated to . . .
Part I: Awareness of Lyme Disease in Dogs
Disclaimer: This information is presented for informational purposes only. I am not a veterinarian or any other kind of health professional, just an informed consumer. These are my own opinions, based on my experience and research. Every dog — and their person — is different. Always do your own research, and trust your instincts!
Side A: PREVENTION
This Petside blog in honor of Lyme Awareness Month is pretty typical of most veterinary Lyme articles, or a bit better. It urges daily tick checks, gives basic (though limited) information on how to remove ticks (though this Lyme site does it better), and warns that Lyme is a problem in every US state and in every country worldwide.
American Lyme Disease Foundation map showing highest concentrations of Lyme-infected ticks.
Please reread that sentence, above. I cannot tell you how many times I have heard people say, “Lyme isn’t a problem here.” Doctors, too, frequently tell patients with Lyme, “Oh, we don’t have Lyme in [our state].” Unfortunately, many veterinarians believe the same thing. Some will even refuse to test for Lyme or other TBDs. If your vet does this, it’s time to get a new (or a second) vet. These are not diseases you can afford to stick your head in the sand about.
The sad reality is that nobody can say with confidence, “Lyme isn’t a problem here,” because it’s a problem everywhere. Although the dots in the map above show where Lyme-carrying ticks are most prevalent, dogs migrate as much as people. They move across the country and the globe by car and airplane for breeding, as pets, and for competitions. And wherever there are dogs, there are ticks.
I know people and dogs who have contracted Lyme in cities with almost no vegetation; in desert areas, like Arizona; and in frozen areas, like Alaska. Lyme is spreading into areas where it was previously extremely rare. Certainly, in endemic areas such as the West Coast, the Great Lakes region, and the East Coast, vets should test and evaluate for Lyme as part of routine check-ups. But even in other areas of the country, when unexplained symptoms arise (and even some otherwise explainable ones), TBDs should be ruled out.
If the ground is not totally covered in snow . . .
The Petside article, as is true of most pieces on Lyme, focuses on the hot summer months as the danger time for ticks. In fact, ticks emerge and start feasting on our dogs (and us) in the early spring and continue through the late fall. I’ve found ticks on my dogs even when there is still snow covering much of the ground.
I live in one of the most Lyme-endemic areas of the country. As of this writing, we have found over forty ticks on Barnum; at least half have been deer ticks. We started finding them in March. Last year, we found ticks through November. In fact, in my area, the worst tick times are usually April/May and September/October. Therefore, depending on where you are in the country, if you start checking your dog for ticks in May or June, you might be too late.
The Lyme vaccine was banned for human use, yet . . .
The Petside article also suggests use of the Lyme vaccine. Most veterinary colleges and informed vets do not give the vaccine. First of all, there are multiple other TBDs that are potentially fatal to dogs, and the vaccine does not address them at all, so getting the vaccine is not a replacement for preventing tick-related problems. Further, the vaccine can cause Lyme-vaccinated dogs to contract an untreatable form of the disease, and it makes one of the most common veterinary Lyme test useless. In fact, several years ago, Jersey’s veterinarian — a very traditional vet — told me that, despite the huge number of Lyme cases their practice saw, their experience with the vaccine was that it was both risky and ineffective, and they now urged clients not to use it.
Tick prevention products not always “spot on.” . . .
Canine Lyme is transmitted by ticks (specifically by three species of ticks, the Deer Tick [or Eastern Black Legged Tick], the Lone-Star tick, and the Western Black-Legged Tick). Therefore tick-bite prevention is important. Most people (often urged by their veterinarians and groomers, who sell the products), use flea-and-tick pesticides on their dogs to combat ticks. It’s almost impossible to open a pet catalog or magazine or enter a pet-supply store without being bombarded by inducements to use these products. Advertising, of course, works. Flea-and-tick products are a billion-dollar industry. In 2006, Frontline and Advantage were the two top-selling flea-and-tick products. Advantage is made by Bayer. Only two Bayer products outsold Advantage that year — aspirin and a diabetes drug.
Unfortunately, putting Frontline or Advantix on your dog every month is not necessarily going to prevent your dog (or you) from getting Lyme. For one thing, these types of “spot-on” treatments require the tick to bite the dog to be effective; only after it’s stayed attached for eight-to-ten hours does the tick succumb to the poison it’s been drinking in the dog’s blood. Unfortunately, there is no scientific consensus as to how long a tick needs to be attached before it can transmit Lyme. Various “authorities” have told me 24 hours, 36 hours, and 72 hours, which strikes me as a pretty arbitrary range. Further, other TBDs can be transmitted within shorter intervals, such as five hours for rocky mountain spotted fever.
Equally important is whether these products work at all. I’ve been hearing from friends, neighbors, and veterinarians that formerly effective products no longer prevent ticks. These observations are affirmed by NRDC’s in-depth report, “Poisons on Pets”:
While pet products often are marketed for use against both fleas and ticks,
many are not particularly effective against ticks. . . .
Experts also have observed signs of insecticide resistance among ticks. They
simply are not as easy to treat as previously. . . . However, there is little or no hard data on the problem, since there has been no concerted federal effort to do the research and collect the data. . . .
Regional variation in resistance further complicates the picture. . . .
None of [even] the [tick-specific] products are completely effective.
Thus, new poisons are created, tested (in pretty nasty ways on puppies and kittens — just read the small print in the advertisements), marketed as “new and improved,” and sold to desperate consumers.
As someone whose life has been devastated by Lyme disease, it’s hard for me to argue against using something that works to prevent ticks to some extent, even if it doesn’t stop them all. I understand where the panic comes from.
However, as someone who is also chemically injured and made terribly sick by these toxic chemicals, knowing that I can be exposed at any time with dire consequences is also panic-inducing.
In fact, the Environmental Protection Agency has issued warnings about, and increased scrutiny of, spot-on flea and tick products, reporting that they have caused hundreds of deaths and thousands of cases of illness in dogs and cats. People, too, have been disastrously affected, especially small children, as discussed in the NRDC document, as well as numerous other sources.
Ultimately, knowing the risks to people, dogs, and the environment of tick pesticides, I urge safer options.
What are safer options? . . .
Solid science is emerging in the use of plant oils (essential oils derived from plants and trees) in repelling and/or killing ticks and other insects and arachnids. This EPA page provides an informational chart. I’ve done some research, and there seem to be several products on the market that repel ticks, fleas, mosquitoes, and other pests without toxic chemicals. Unfortunately, due to my sensitivity to (even natural) fragrances, I can’t use them, but for most, they should work. They generally require more frequent application than “spot on” treatments — usually once or twice a week, after getting wet, and before any expected exposure to ticks or other bugs. If you’re looking into a product that claims to be “natural” and only requires application once a month, suspicion is warranted. I don’t want to endorse specific products or stores, but this is a google search that should get you started. If you’ve used a nontoxic product that’s worked, please comment.
Even with a good, nontoxic tick spray . . .
Tick checking is crucial. The earlier a tick is removed, the lower the chances for it to pass an infection to your dog. Thus, every 24 hours at a minimum is best.
Many people think they tick check, but they are not doing a thorough enough job. For tick checking to work, every part of the people and animals at risk must be examined in detail, from toes to nose to tail to crown. On dogs, ticks’ favorite spots are usually the head (especially the ears), neck, shoulders, and legs. However, I have found ticks between toe pads, on lips, backs, anus, eyelids, and everywhere else on a dog.
If you have never found a tick on your dog, it’s because you’re not searching thoroughly.
If you live in an endemic area, and you don’t find at least several ticks per week on your dog, you are not searching thoroughly.
I know these are strong statements, but I make them based on hard experience.
For one thing, adult deer ticks are the size of a poppy seed when not engorged. Nymphal ticks are the size of a pin head when they are engorged. Most cases of Lyme transmission to humans — who are much easier to tick-check than dogs! — are caused by nymphs.
For another, frequently, other people tick check my dogs for me and tell me they didn’t find any, or they find one. Often, if I check again, I find at least one more. Once, Betsy and I found a deer tick larva on Gadget, the very smallest of ticks. We happened to be at the vet’s when we found it. It was so small, I didn’t think it was a tick until after I pull it off and examined it extremely closely to see that it had body parts. It looked like a skin fleck. When I gave it to a tech to ask her to dispose of it, she said, “How did you find this?” in an astonished tone. If vet techs in an endemic area don’t realize how small a deer tick can be, what are the chances we all overlook ticks if we don’t check thoroughly?
It takes Betsy and me, working together, at least an hour to thoroughly tick check one dog. Of course, if we had small, white dogs with short, soft hair, it would be a lot easier than large, dark dogs with long wiry hair! Even if you have a small, pale dog, looking is not enough. You have to feel every inch of the dog. This can turn into a nice nightly ritual where the dog gets a full-body massage. Gadget used to love tick checks. We called it “dog cuddling time.” He’d get very relaxed and floppy. Sometimes he would moan with pleasure or fall asleep. Barnum enjoys jumping on the bed and receiving the attention, but he still is very mouthy and wiggly, which makes it much more time-consuming. (Often, the only way we achieve it at all is that I click and treat Barnum for relaxed behavior, using the techniques outlined in Leslie McDevitt’s excellent book, Control Unleashed, while Betsy does most of the groping. Then, when she finds a tick, I pull it off.)
Sometimes Betsy or I will carefully check a leg or an ear and find no ticks, and then we will switch, and the other will find one, two, or three ticks that were missed on the same body part! Again, this is because ticks can be smaller than the dot over the “i” in this sentence. Here is a page that shows a variety of ticks, both enlarged and actual size, and before feeding and after engorgement.
Even if you don’t walk in the woods . . .
I’ve heard a lot of reasons people think their dogs (and they) are safe from Lyme and ticks. These include that they walk their dogs in the middle of the road, that they don’t take their dogs to the homes/lawns of other people (such as me) who know there are deer ticks in the area, that they keep their dogs to their own lawn, and more. If only it were so simple. (Some people also believe that if they or their dogs are ultra healthy, they will be immune. Sadly, this, too, is not the case, although as I mention at the end of the blog, a strong immune system is a major asset.)
Most people with Lyme get infected in their own yards. Some put this figure at 70 percent of Lyme cases. There is a lot of information on how to make your yard less attractive to ticks. Some simple things are keeping the lawn mowed (or doing away with a lawn — clover is nice instead) and getting rid of dry leaves, brush, and other debris that harbor mice, as mice as the main carriers of Lyme to people. This New York state guide to creating a tick-free zone around your home provides more detail. It seems extremely unlikely that our dogs are any less likely to pick up ticks around their homes — that they are only acquiring these blood-sucking hitchhikers in the woods or near the ocean. In fact, ticks prefer medium-sized mammals like dogs (thus, some species of ticks are even called “dog ticks”) though ticks will feed on anything with blood that comes their way, including much larger mammals (horses) or birds, etc.
Being aware of weather and climate issues is also important. Ticks prefer a moist environment because dry heat is dangerous to their exoskeletons. Thus, the biggest Lyme outbreaks are often in coastal areas, such as Cape Cod and Long Island. Articles that focus on hiking and dog park might mislead you: don’t discount walks on rainy days — or just running outside to potty. In fact, during wet spells, we had ticks crawling onto our driveway and up our doors!
Side B: DIAGNOSIS AND TREATMENT
Prevention of tick bites is certainly important, but as is probably painfully clear by now, it is not always possible. Given this, it is essential to know the signs and symptoms of Lyme and other TBDs and to do your best to make your dog as resistant to illness as possible.
Know thine enemy . . .
Among both physicians and veterinarians familiar with Lyme disease, it is known as “the great imitator,” because its symptoms can mimic those of so many other diseases, and because Lyme — and other TBDs — can affect so many systems in the body. Because Lyme and TBDs can sometimes be fatal in dogs, or at the least can turn into chronic health issues, it’s important to know the symptoms.
In Lyme disease, the most common symptom is lameness. It is often a sudden onset, and it might move to different joints, come and go. Swelling or tenderness may or may not accompany the lameness. Other stereotypical symptoms of sudden-onset Lyme are fever, loss of appetite, lethargy, and weakness. Kidney, brain/neurologic, and cardiac symptoms — that were not previously noted — can also be signs. Dr. Schoen’s article, Lyme Disease: Fact or Fiction, is a good one, not least because he lives and works in an endemic area and has seen the many permutations this disease can take. WebMD also provides a concise, yet useful, overview of canine Lyme. If you want a broader survey, a google search using keywords Lyme dogs symptoms is effective.
There are too many TBDs for me to cover all the symptoms and syndromes adequately, but I encourage you to learn about, at the very least, ehrlichia, babesia, rocky mountain spotted fever, anaplasma, and bartonella and make use of these links. This tick FAQ has an extensive list of symptoms, as well as listing diseases that might be mistaken for TBDs. This page on canine TBDs provides the personal, and heartbreaking, background for the urgency in proper diagnosis.
One site to bookmark is Cornell’s “Consultant” search engine. You can search by the name of a disease or by the symptoms your dog is displaying.
Testing, testing, 1, 2, 3 . . .
While laboratory tests can certainly prove useful in diagnosis, in Lyme and other TBDs, they are not always the most useful tool. As previously mentioned, a dog who has been vaccinated for Lyme will usually show a false negative on certain tests. However, it is also possible for a dog to have Lyme or another TBD and for the test to come back a false negative. This is why it is so important to know the symptoms, to be aware of your dog’s level of tick exposure, and to know the prevalence of the different tick diseases in your area. If enough signs point to a TBD, and especially if your dog is really sick and/or your veterinarian is not sure of the diagnosis, it is often prudent to treat for that disease and see if there is a response.
There is also controversy about when or whether to treat when a dog tests positive for Lyme. The conventional wisdom until very recently was that the great majority of dogs who are exposed to the bacterium that causes Lyme, and who therefore have antibodies for Lyme disease, don’t actually become sick. Many vets, therefore, did not (and most still don’t), treat a dog for Lyme unless she is showing obvious symptoms.
However, new studies are showing that dogs who appear to be asymptomatic might actually be experiencing symptoms undetected — either subtle clinical symptoms or those that only show up on lab tests. In fact, the infection might cause serious long-term damage if untreated even when there are no known symptoms. This article presents this new information. It is the best I’ve read on this aspect of Lyme in dogs; please read it, and bring a copy of it to your vet.
The Great Imitator . . .
Because Lyme tests are not always accurate, and because TBDs can resemble so many other conditions, if your dog exhibits symptoms that stump you and your veterinarian, it’s important to raise the question, “Could this be Lyme and/or another TBD?” In fact, even if your vet arrives at another diagnosis, you might still want to test and/or treat for a TBD if the symptoms are suspiciously similar. For not only might Lyme be masquerading as arthritis, a heart condition, or another condition, it might also be part of the clinical picture along with another disease.
This was the case with Gadget. When the ER vet told me she was pretty certain Gadget had lymphoma, she also said it could be a tick-borne disease, so we ordered a C6 ELISA test for Lyme or a Lyme PCR, if possible — a more accurate and detailed test than the in-house SNAP test — and a complete TBD panel from Idexx. As it turned out, while Gadget did have lymphoma, he also had a Lyme titer that was literally off the chart; it was above the highest titer level the C6 tested for. Treating his Lyme did not save Gadget’s life, but he responded very well to treatment with the antibiotic, doxycycline. His quality of life during his last few months was tremendously enhanced by treatment for Lyme. His energy and movement improved greatly. I only wish I had realized sooner that the slowing down I’d attributed to age and hypothyroidism was probably actually related to invisible joint pain.
Holistic and Conventional Treatment Approaches
Even among practitioners and clients who try to avoid medications, especially antibiotics, when not absolutely necessary, there is a near consensus that Lyme and other TBDs require “the big guns.” In fact, in my experience, many vets are not as aggressive as they should be when treating Lyme. The microbe that causes the disease is complex and tough. It often remains in the dog’s system even after a short (or even a long) course of antibiotics. Those who have been “in the trenches” of the Lyme life — be it human or canine or both — have learned the hard way that it’s best to hit this disease hard, fast, and sustained. For many vets and owners, this means combining antibiotics with other modalities (herbs, acupuncture, homeopathy) to fight the microbes with all possible weapons.
The best antibiotic to fight Lyme is doxycycline, with two exceptions. One is if your dog is allergic to this drug. If he is, amoxicillin is considered the second-best choice. The other is if you have a puppy whose bones are still forming. Doxycycline can interfere with calcium and affect bone growth, so this is something you and your vet will have to weigh. Treatment should be five milligrams per pound of body weight for at least two months. If your vet wants to take more of a “wait and see” approach without a darn good reason, find another vet!
If you live in a Lyme endemic area and/or you are unable to use any form of effective tick preventative, please take whatever steps you can to help your dog’s immune system fight off infection. While everyone wants their dog to be as healthy as possible, it’s worth noting that the microbe that causes Lyme disease attacks and suppresses the hosts immune system as soon as it begins to colonize. According to Stephen Buhner, the author of Healing Lyme, the degree to which someone gets sick with Lyme disease after exposure to the bacteria — both whether they get Lyme disease and how sick they get — is directly related to the strength of their immune system.
There are two approaches to applying this information. One is ensuring that your dog is as healthy as possible. This means the healthiest possible diet, the right balance of exercise and rest, freedom from stress when possible, and protection from harmful elements, including excessive vaccination, medication, pesticide, and the like. Again, some might also choose other health care modalities to shore up your dog’s immune system.
The second approach is to give your dog herbs (some use tinctures, others dried herbs as capsules) specifically shown to help prevent Lyme or to treat early-stage Lyme. This way, if your dog is exposed to Lyme-causing agents, you might head off the disease before it gets a foothold. The herbs in this list are sarsaparilla, cat’s claw, andrographis, astragalus, and resveratrol (Japanese knotweed — not the grape extract sold under the same name). Obviously, to learn the proper administration and dosage, you should consult an herbalist experienced with canine Lyme.
While Lyme-fighting supplements and a superbly healthy lifestyle can go a long way toward prevention of Lyme — or of chronic Lyme — they are by no means guarantees. Please don’t think that you don’t need to tick check just because you feed raw, don’t vaccinate, and don’t use pesticides. Anyone can get sick from this nasty, stealthy bug. By the same token, if your dog does get sick, please don’t blame yourself. We should all do the most we can to be aware and take preventative measures, but in the end, luck plays a factor, too.
Thank you for reading this long post!
May this information remain strictly academic for you and your dogs, for years and years to come.
As always, we welcome your comments and questions.
-Sharon and the muse of Gadget, with Barnum (the fast-growing, and so far, healthy, puppy)