Lyme disease

[Jen]

Hi Patrice, I read the information in the links provided but need to reread to fully understand all of it. I did speak with my vet who has the results- her creatinine level is 2.6, he told me it is high (above .5 is high and .50-1 is high normal). Her lyme dip stick test was faint positive not blue blue so he’s not entirely sure if its from the lyme disease, length of time on prednisone (14 months), or he though it potentially maybe lupus. He suggested next time I bring her in we do a lupus test. Her kidney test came back OK, three weeks ago but based on the information you provided that could just mean it’s at an early stage. He said if the elevated protein is indeed from Lyme that is not good. I’m thinking I should inquire about having the SDMA test. Will that test shed some light on what is causing the elevated protein? Would you also perform the lupus test to rule it out?
I adore Maggie and have been diligent in testing her and getting all necessary meds but between her AIHA, Lyme, surgery for removal of tumor in her ear, chronic ear infections, Xrays etc…in the past year I have spent a fortune. I would love to do anything to help her live a long healthy life but I’m starting to feel like all the diseases and afflictions are not a good sign for her having a long healthy life and at some point the money will be gone. I hate saying that.
I can get copies of the tests to download if you would be willing to review these. What is your suggestion as to the next step in figuring out what is going on? Is it the SDMA test?
Thank you
Jen & Mags

[Patrice]

Hi Jen,
Sorry for the delay in getting back to you.

This misinterpretation of the the Lyme test is a common mistake that vets make. We have discussed this many times on Tick-L. There is no such thing as a fainter blue color. The test is either negative or positive. It is a screening test. I have mentioned to you several times that once you have a positive test on this screening test the vet needs to have more extensive testing done to determine the degree to which the dog is infected with Lyme. Here is the language from Gil’s website about this. TAB, DVM is the consulting vet for Tick-L and occasionally answers our specific questions.

https://sites.google.com/site/tickbornediseaseindogs/tests
“I’ve said this before but I may as well say it again since many vets do not seem to be aware of it: there is no such thing as a weak positive on a Snap test. Any change in color means that active Lyme disease has been detected. However, the sensitivity of these tests is set high so that as many cases of active Lyme as possible can be detected; the result is that sometimes there will be false positives.

“Sensitivity is the ability to detect all the true positives. Specificity is the ability to detect ONLY the true positives. With tests there is typically to some extent a trade-off: Push sensitivity to the max and the specificity falls a bit with somewhat more false positives as a result. Maximize specificity and sensitivity drops a bit so that some true positives go undetected.” TAB, DVM”

What the vet is saying here is that they make the simple IDEXX SNAP 4DX+ test so that they will screen for multiple tick diseases (and heartworm) and catch ALL degrees of each disease. If there is a color on the test, then that means it is POSITIVE FOR DISEASE. But it cannot tell you WHAT DEGREE of infection the dog has. It’s like pregnancy tests, you will know you are pregnant but it can’t tell you how pregnant you are.

That is why I keep suggesting you contact Dr. Holland at Protatek. You could do the more extensive testing with IDEXX of the Cornell test if you wish. But only then will you know the degree of infection. The SNAP 4DX was never intended to do that.

There is so much information on that page about the tests for Lyme that I am leery of trying to explain all of it to you. It would be best if you print the page and have your vet read about the various tests and the results and the recommendations for how to interpret the results.

If this is truly Lyme Disease, the best thing is to continue to treat aggressively with doxycycline to eliminate it completely from the body.

If there have been complications to the kidneys due to Lyme Disease, then it is possible for her to still live a very complete life with some adjustments. You can learn how to control her food intake so that these wastes do not reach the level where they circulate back into the blood. (As seen by a high creatinine and BUN). Your vet is partially correct, Lyme nephritis is serious, but until further tests are done, we don’t know how much function she may still have available to her. Humans are able to live with one kidney for instance.

Lupus is a condition, one of many, that involves an overactive immune system. It isn’t exactly like the human lupus. Here are two excellent discussions about Canine Lupus.
http://www.veterinarypartner.com/Content.plx?P=A&A=2475&S=0&EVetID=0
http://www.veterinarypartner.com/Content.plx?A=2470

My humble opinion is that Lyme often looks like many conditions and can throw a vet off onto another path of diagnosis, such as thinking it is hip dysplasia (know someone who spent thousands of dollars tracking that down, only to find it was Lyme).

If there was a positive SNAP 4 DX test for Lyme, then there is some degree of Lyme disease. The only thing that would confuse this is if at any time in her history she received a Lyme vaccine. And there are tests mentioned on the page that can determine if what is reacting to the test is the vaccine and not the actual disease.
https://sites.google.com/site/tickbornediseaseindogs/tests
I assure you that Dr. Holland knows how to determine the degree of Lyme and whether this is a reaction to a vaccine, not the disease.

I would love to see any test results you have, just upload them using the Urgent Advice page on our website. They come to all the moderators in our emails.
my best
patrice