Holy Tick! Lyme nephritis is scary…and preventable

Titanic+free+hugs.jpg

To say that Lyme disease is a fraught topic would be a tick-tanic understatement. In dogs, the scariest outcome of Lyme disease is Lyme nephritis, which is a severe form of kidney disease with protein loss. That’s because many (most) dogs that develop this form of Lyme disease do not survive- even with aggressive therapy.

Deer Tick ID.jpg

Fortunately, this form of Lyme disease is uncommon. On the other hand, as more regions of Canada are taken over by deer (blacklegged) ticks that are able to transmit Borrelia burgdorferi (the bacterium that can cause Lyme disease)…there will consequently be more dogs bitten by infected ticks, exposed to the bacterium, and at risk for disease development. And we know that’s the case, i.e. there are more dogs who have been exposed to the bacterium in recent years (vs. 5-8 years ago) in multiple parts of Canada

From a clinical disease standpoint, we ‘think’ that for every 100 dogs who are bitten by infected ticks, about 10 dogs (i.e. 10%) will develop the more common form of Lyme disease (shifting limb lameness, feeling ‘off’ and quickly getting better with (or without) appropriate antimicrobials. Additionally, we ‘think’ that of these 10 dogs who go on to manifest clinical disease signs, approximately 1 dog (or half a dog if you prefer…which I don’t), will develop Lyme nephritis, i.e. 0.5-1% of all dogs who are bitten by an infected tick and test positive for antibodies to the disease will potentially go on to develop Lyme nephritis.

Image courtesy of Pam Boutilier, Cat in a BoxStudio

Image courtesy of Pam Boutilier, Cat in a BoxStudio

A recent publication looked at 40 dogs from California, USA believed to have Lyme nephritis (defined as being seropositive for Borrelia burgdorferi and having consistent clinical and diagnostic findings for acute renal injury with protein loss). The work was performed in order to find clues that will allow veterinarians to diagnose and begin therapy for Lyme nephritis sooner, more precisely, and ideally save more dog lives.

The study found that dogs with lower platelets, evidence of acute renal injury (specifically higher phosphorous, potassium, urea and creatinine), anemia and abnormal urine results (pyuria, i.e. white blood cells in urine) were more likely to have Lyme nephritis vs. other forms of kidney disease with protein loss. Additionally, Golden and other retriever breeds were noted to be more likely to have Lyme nephritis than other breeds. Shifting limb lameness did not appear to be a feature (i.e. there wasn’t a significant difference in dogs with Lyme nephritis having lameness vs. others), but this was difficult to assess.

limelight.jpg

There is much fear surrounding Lyme nephritis and no one (particularly yours truly) wants dogs to become sick and potentially die. However, while I’m thrilled to see clinical research in the Lyme-light, it’s REALLY important to remember that the best way to stop your dog from becoming ill due to Lyme disease (of any form), along with other canine tick-borne diseases, is through prevention that consists of the following:

 

1.      Consistent and timely application of veterinary approved tick prevention products

2.      Consistent and regular tick checks- with prompt tick removal

3.      Vaccination for Lyme disease

Effective prevention makes Lyme nephritis even less likely to occur, and although it’s markedly less headline grabbing…preventing disease from ever occurring will save more dogs than any kind of early diagnostic finding.