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596 Lyme and Other Borrelioses

TREATMENT ■ C. vulpis: milbemycin oxime 0.5 mg/ Prevention
kg PO once Limit exposure to intermediate or paratenic
Treatment Overview
VetBooks.ir Administration of parasiticidal drugs to Possible Complications Technician Tips
hosts.
Certain breeds of dogs (e.g., collies) should
eliminate the parasite infestation, with other
medications used as necessary to decrease clini-
for MDR1/ABCB1-Δ gene mutations (p. 638).
cal signs secondary to inflammation. not be treated with ivermectin without testing • False-negative results are common when
examining stools for respiratory parasites.
Ivermectin dosages used for treating lung para- • Fresh stool samples obtained per rectum
Acute General Treatment sites can cause ivermectin toxicosis in animals are preferred for Baermann testing to limit
• With severe respiratory signs (rare), oxygen also taking flea and heartworm preventatives contamination and confusion caused by soil
administration may be necessary (p. 1146). containing spinosad. Albendazole may be nematodes.
○ Although secondary inflammation is myelotoxic. Rare complications of fenbendazole • ABCB1 testing is easily accomplished by
often seen with infection, glucocorticoid (e.g., pancytopenia) have been reported. submission of a cheek swab to the Vet-
therapy (antiinflammatory doses) should erinary Clinical Pharmacology Laboratory
be reserved for severe cases. Recommended Monitoring (www.vetmed.wsu.edu/depts-VCPL/).
• Thoracocentesis (p. 1164) for pneumothorax Clinical signs, thoracic radiographs, fecal exams
• Parasiticidal drugs Client Education
○ Fenbendazole 50 mg/kg PO q 24h for PROGNOSIS & OUTCOME Reinfection is possible unless pets are limited in
10-14 days (14-21 days for O. osleri) can opportunities to ingest known paratenic hosts.
be used for all LW types. Depends on severity of disease; generally good
○ Other approaches include for recovery with appropriate treatment SUGGESTED READING
A. abstrusus: ivermectin 0.4 mg/kg
■ Cohn LA. Diseases of the pulmonary parenchyma.
SQ once and repeated in 2 weeks; PEARLS & CONSIDERATIONS In Ettinger SJ, et al, editors: Textbook of veterinary
selamectin 6 mg/kg topically once internal medicine: diseases of the dog and the cat,
O. osleri: ivermectin 0.4 mg/kg PO, SQ Comments ed 8, St. Louis, 2017, Elsevier, pp 1108-1130.
■
once every 2 weeks for 3 treatments Lung parasites should be considered in any AUTHOR: Laura Ridge Cousins, DVM, MS, DACVIM
P. kellicotti: praziquantel 25 mg/kg PO young animal presenting for coughing and
■ EDITOR: Megan Grobman, DVM, MS, DAVIM
q 8h for 3 days (dog), 10 mg/kg PO q with radiographic evidence of interstitial or
24h for 10 days (cat) bronchial lung disease.

Lyme and Other Borrelioses Client Education
Sheet

BASIC INFORMATION CONTAGION AND ZOONOSIS • Incidentally seropositive dog (positive
• No direct transmission from pets to humans blood test result for antibodies to Borrelia
Definition • Seropositive dogs/cats are sentinels for burgdorferi in the absence of clinical signs
Lyme borreliosis is a disease caused by a bac- potential human infection. of disease)
terium that infects humans, other mammals, • Most seropositive dogs (95%) show no clini-
and birds. It is caused by a spiral-shaped, GEOGRAPHY AND SEASONALITY cal signs. In highly endemic areas, 70%-90%
gram-negative spirochete that is transmitted • In 2015, 90% of human cases reported of healthy dogs are seropositive.
primarily by Ixodes ticks. Other Borrelia bacteria in the United States were from 14 north- • Less than 5% of seropositive dogs show
can cause illness on occasion. eastern, mid-Atlantic, and upper Midwest the syndrome of Lyme arthritis (anorexia/
states (PA > NY > MA > NJ > CT > WI fever/arthritis). This occurs 2-5 months after
Synonyms > MD > MN > VA > ME > RI > VT > tick exposure in experimental beagle puppies
Lyme disease; non–Lyme borreliosis is tick- NH > DE). (self-limited), whereas adults have shown no
borne relapsing fever (TBRF) • Most human cases are reported between May clinical signs.
and November. • No experimental model exists for the less
Epidemiology • TBRF in dogs is seen in TX/FL (Borrelia common syndrome of Lyme nephritis (protein-
SPECIES, AGE, SEX turicatae) and northwestern states (Borrelia losing nephropathy [PLN] with glomerulotu-
• Susceptibility: humans, dogs, cats (illness in hermsii) bular damage). Patients with this syndrome
cats is rare) may present with signs of nephrotic syndrome,
• Young and middle-aged dogs more com- ASSOCIATED DISORDERS systemic hypertension, thromboembolic events,
monly affected Tick-borne coinfections are common, especially and/or signs of uremia (vomiting/anorexia).
anaplasmosis (p. 393). Lyme nephritis can • Cardiac, neurologic, or dermatologic
GENETICS, BREED PREDISPOSITION develop in predisposed animals. manifestations as seen in people are not
• Breeds associated with outdoor activities Clinical Presentation well documented in dogs.
• Labrador and golden retrievers appear
predisposed to Lyme nephritis. HISTORY, CHIEF COMPLAINT PHYSICAL EXAM FINDINGS
• History of tick exposure in a Lyme- • Most often, exam is unremarkable.
RISK FACTORS endemic area, although often tick bite is • Lyme arthritis: warm, swollen, painful
Tick exposure in endemic areas not recognized joint(s), fever, local lymphadenopathy

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