Lyme disease Flashcards
What is lyme disease
Borrelia burgdorferi (Bb) is a tickborne organism The organism is transmitted by Ixodes ticks
- What Clinical Syndromes are Associated with
Experimental Infection of Dogs with Bb?
95% exposed dogs = asymptomatic
Transient fever, anorexia, arthritis
How Common is Lyme Arthropathy in Dogs in
Clinical Practice?
Unclear
Has ‘‘Lyme Nephropathy’’ Been Definitely
Associated with Bb Infection of Dogs?
there are multiple reports of dogs with Bb antibodies
developing a unique renal histopathologic lesion, including immune-mediated glomerulonephritis, diffuse
tubular necrosis and regeneration, and lymphocyticplasmacytic interstitial nephritis.
BUT a causal relationship has not been proven
What are the Clinical Abnormalities Associated with Lyme Nephropathy?
Most reported cases of Lyme nephropathy
are clinically ill dogs presented mostly in the summer or fall months with an acute or chronic presentation of
renal failure with anorexia, vomiting, dehydration,
variable polyuria and polydipsia, and wasting. Abnormalities included vasculitis with possible edema or effusions; hypertension with possible blindness or heart murmur; thromboembolic events (eg, pulmonary thrombosis with dyspnea; saddle thrombus with hind limb weakness); and sometimes neurologic signs (eg, seizure, nystagmus, collapse) from vasculitis, hypertension, thromboembolic events, uremic encephalopathy, or meningitis
What are the Laboratory Abnormalities Associated with Lyme Nephropathy?
nonregenerative anemia, stress leukogram,
thrombocytopenia, hypoalbuminemia, azotemia, hypercholesterolemia, hyperphosphatemia, and sometimes hyperkalemia and hyperbilirubinemia. Urinalysis showed proteinuria and possible decreased concentrating ability with hemoglobinuria, hematuria, glucosuria, bilirubinuria, casts, and an active sediment with negative bacterial culture. Many dogs succumb within days to weeks, some with oliguric or anuric renal failure
What are the main ddx for painful swollen joints?
Lyme Anaplasma Erlichia IMPA DJD Trauma Borrelliosis Rocky mountain spotted fever Bartonella, Mycoplasma? SLE Septic arthritis Rheumatoid arthritis
What are the DDX for pain/ swelling near joints
Osteosarcoma Osteomyelitis Panoseteitis Myositis Hypertrophic osteodystrophy Hypertrophic osteopathy
What are the general principles of dx
No individual test result documents clinical illness
from Bb infection. Thus, the presumptive diagnosis of
Lyme disease should include
(1) evidence of exposure to Bb,
(2) clinical signs consistent with Lyme disease,
(3) consideration of other differentials, and hopefully
(4) response to treatment
Where is the organism often found
very rarely found in blood, urine, joint fluid,
or CSF ; it is more often found in connective tissue,
synovia, skin, or fibroblasts.
Hence serology often preferrred
What antibody tests are available
ELISA, IFAT, Westerm Blot
When Does the Qualitative C6 (one that demostrates natural infection) Antibody Assay Become Positive in Dogs Experimentally Infected with Bb?
Antibodies against C6 peptide generally can be
detected 3–5 weeks after infection, well before signs
were noted in the experimental model of canine Lyme
disease; the test stayed positive for at least 69 weeks
Are Results from Paired Assays Needed to Diagnose Canine Lyme Disease?
No
What Antibiotics can be Used in the Treatment of Lyme Disease in Dogs?
Doxy or amoxicillin
Minimum 1 month
What treatments may be needed along side ABs
Polyarthropathy could be immunemediated and improve faster with added glucocorticoids. Dogs with presumed Lyme nephropathy might require longer duration of doxycycline therapy and usually are treated with adjunctive therapies such as angiotensin-converting enzyme inhibitors, low-dose aspirin, omega-3 fatty acids, dietary therapy, and if indicated, additional antihypertensives, fluid therapy as needed, and possible immunomodulating drug therapy.
