The Rip Van Wrinkler, XXI, Issue 2, May 2017

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SOME HEALTH & SCIENCE NEWS

1. Tick-borne diseases and Lyme.

2. The trouble with titers.

3. Hypothyroidism in Basenjis.


Tick Prevention: {Ed. I use Frontline topically once a month. I feel it is may be a tad more viable on our short haired dogs than some others, as application is easier. There is some thought that amber bead necklaces may help prevent ticks. I would use those in addition to Frontline. Dr. Dodds says use Frontline, but be careful in households with cats. I, myself haven't a comfortable feeling about putting tick tubes in my backyard.}


Dr. Jean Dodds on tick-borne diseases and Lyme -

DR. JEAN DODDS' PET HEALTH RESOURCE BLOG
CONSIDERED ONE OF THE FOREMOST EXPERTS IN PET HEALTHCARE, DR. DODDS FOCUSES ON VACCINATION PROTOCOLS, THYROID ISSUES AND NUTRITION.
VISIT HEMOPET.ORG OR NUTRISCAN.ORG FOR MORE INFORMATION.

TICKS AND TICK-BORNE DISEASES IN DOGS

Why is Lyme Disease arguably the most well-known tick-borne disease? One can surmise that the prevalence of Lyme Disease and the regular media coverage about it perpetuates its popularity. Of course, the name is easier to pronounce and remember than the other tick-borne diseases. Instead of talking about the disease first, let’s first categorize the ticks that spread a particular disease or diseases and then follow up with the diseases they cause.

Ticks:

American dog tick (Dermacentor variabilis)

Location: East of the Rocky Mountains and California Coastline

Diseases:

Rocky Mountain Spotted Fever (Rickettsia rickettsii bacterial infection)
Tularemia (Rabbit Fever)

Blacklegged Tick/Deer Tick (Ixodes scapularis)

Location: Upper Midwest, Southeastern, Mid-Atlantic and Northeastern United States

Diseases:

Anaplasmosis – Northeastern and Upper Midwest states
Babesiosis – Northeastern and Upper Midwest
Borrelia mayonii infection – Upper Midwest; particularly Minnesota and Wisconsin
Borrelia miyamotoi infection
Lyme Disease – Northeastern and Upper Midwest states
Powassan Disease – Northeastern and Upper Midwest states; Canada (Northern Ontario)
Brown Dog Tick (Rhipicephalus sanguineus)

Location: Worldwide

Diseases:

Rocky Mountain Spotted Fever – Brown Dog Tick primarily spreads this disease in the Southwestern United States
Ehrlichiosis

Groundhog Tick/Woodchuck Tick (Ixodes cooki)

Location: Eastern United States and Canada

Diseases: Powassan Disease

Gulf Coast Tick (Amblyomma maculatum)

Location: Southeastern United States; primarily along the Gulf and Atlantic Coastlines

Diseases: Rickettsia parkeri rickettsiosis

Lone Star Tick (Ambylomma americanum)

Location: Midwest and Eastern United States. Lone Star Ticks are found in Texas, but are actually named “lone star” because of a single white star-shaped dot on their backs.

Diseases:

Ehrlichiosis – Predominantly Southcentral and Eastern states
Southern Tick-Associated Rash Illness (STARI)
Tularemia (Rabbit Fever)
Heartland Virus Infection
Pacific Coast Tick (Dermacentor occidentalis)

Location: Along the US Pacific Coastline; primarily California

Diseases:

364D Rickettsiosis
Rocky Mountain Spotted Fever
Rocky Mountain Wood Tick (Dermacentor andersoni)

Location: Rocky Mountain States and Southwestern Canada

Diseases:

Rocky Mountain Spotted Fever
Colorado Tick Fever – Fairly isolated to higher elevations
Tularemia (Rabbit Fever)

Soft Ticks

Location: Ornithodoros hermsi tick species – Coniferous forests at altitudes of 1500 to 8000 feet; Ornithodoros parkeri and Ornithodoros turicata species – Southwest United States

Diseases: Tick-Borne Relapsing Fever – Primarily in Western United States

Western Blacklegged Tick (Ixodes Pacificus)

Location: California, Utah, Washington, Oregon, Nevada, Arizona

Diseases:

Anaplasmosis
Lyme Disease – Rare in this region

Diseases:

While acute and initial symptoms vary between each of the diseases, all of them present with practically the same acute, initial flu-like symptoms, such as:

Fever
Lethargy
Inappetence
Swollen Lymph Nodes
Stiffness of the Joints
Diarrhea
Vomiting

Why not call ALL of them “Lyme Disease”? There are several reasons against this classification:

Powassan Disease, Heartland Virus Infection and Colorado Tick Fever are viruses. Note: Powassan virus was first identified in Powassan, Ontario near where I did my veterinary school training in the 1960s! Babesiosis is caused by an intracellular red blood cell parasite. The rest listed above – including Lyme Disease – are all bacterium, and this affects treatment protocols.

The length of time it takes for a tick to transmit a disease. For instance, a tick must be attached for a minimum of five hours to infect a host with Rocky Mountain Spotted Fever.

The length of time for symptoms to present.

If left untreated, chronic conditions of these diseases can manifest differently.

Tick-Borne Bacterial Infections

What is fascinating about the tick-borne bacterial infections is that we treat the majority with doxycycline or minocycline and/or other antibiotics. This is because several of these bacteria are related. Think of them as second or third cousins. However, these bacteria are not related enough to be cross-protected by the Lyme Vaccine. The Lyme Vaccine only covers the bacteria that causes it: Borrelia burgdorferi.

Lyme Vaccine – Yes or No?

Choosing the Lyme Vaccine for your pet needs to be weighed heavily. First, you should consider the documented case risk for Lyme disease in your area. Second, you need to assess the exposure risk imposed by your lifestyle. Even in high-exposure risk areas, I would lean to not automatically vaccinating for Lyme disease, because preventative and treatment measures are easily available and reliable. If relevant clinical symptoms do occur, accurate diagnosis is important. Others have similar views.

University of California Davis Veterinary School of Medicine says:

The incidence of Lyme disease in California is currently considered extremely low. Furthermore, use of the vaccine even in endemic areas (such as the east coast of the US) has been controversial because of anecdotal reports of vaccine-associated adverse events. Most infected dogs show no clinical signs, and the majority of dogs contracting Lyme disease respond to treatment with antimicrobials. Furthermore, prophylaxis may be effectively achieved by preventing exposure to the tick vector. If travel to endemic areas (i.e. the east coast) is anticipated, vaccination with the Lyme subunit or OspC/OspA-containing bivalent bacterin vaccine could be considered, followed by boosters at intervals in line with risk of exposure. The UC Davis VMTH does not stock the Lyme vaccine or recommend it for use in dogs residing solely in northern California.

Ronald Schultz of University of Wisconsin School of Veterinary Medicine says:

There may be select areas in the state, “hot spots” where infection is very high and vaccination would be indicated, but dogs in most parts of the state would probably not receive benefit and may actually be at risk of adverse reactions if a large-scale vaccination program was initiated.

For instance, Wisconsin has a much higher risk of Lyme than a state like Maine. However, at our Veterinary Medical Teaching Hospital (VMTH), we have used almost no Lyme vaccine since it was first USDA approved in the early 1990’s. What we have found is infection (not disease), in much of Wisconsin, is low (< 10% infection). As you know, infection does not mean disease. About 3 to 4% of infected dogs develop disease. In contrast, in Western and Northwestern parts of Wisconsin infection occurs in 60 to 90% of all dogs. In those areas, vaccination is of benefit in reducing clinical disease. However, whether vaccination is or is not indicated, all dogs should be treated with the highly effective tick and flea medications available today.

Also, vaccinated dogs can develop disease, as efficacy of the product is about 60 to 70% in preventing disease, thus antibiotics must be used in vaccinated dogs developing disease, just like it must be used in non-vaccinated diseased dogs. Therefore, in general areas with a low infection rate of < 10% infection, the vaccine should not be used – as the vaccine will be of no value and may enhance disease (e.g. arthritis) directly or in some dogs that become infected. In areas where infection rates are high (> 50%) then the vaccine will be very useful.

Based upon these and other expert opinions, it can be considered irresponsible to suggest that all dogs in low-risk exposure states should be vaccinated for Lyme disease. Veterinarians should know, based on diagnoses in their clinic and other clinics in the area (town), how common the disease would be and then should base their judgment to vaccinate upon risk factors, and not on a statement that all dogs in a particular low-risk area need the Lyme vaccine!

W. Jean Dodds, DVM
Hemopet / NutriScan
11561 Salinaz Avenue
Garden Grove, CA 92843

References

“Canine and Feline Vaccination Guidelines.” University of California Davis School of Veterinary Medicine, Nov. 2012. Web. 13 Mar. 2017.

McQuiston, Jennifer, DVM. “Ehrlichiosis and Related Infections.” Merck Veterinary Manual, n.d. Web. 13 Mar. 2017.

“Ticks.” Centers for Disease Control and Prevention, 16 Aug. 2016. Web. 13 Mar. 2017.


THE TROUBLE WITH TITERS

HEALTHY DOG WORKSHOP

The issue of vaccination and over-vaccination is on many dog owners’ minds today. The case of Dr. John Robb, whose veterinary license has been placed on probation for 25 years for taking a scientifically based ethical stand and administering partial doses of vaccines, has been widely shared. A small dog half-dose vaccine study, which supports Robb’s theory, was published in the Integrative Veterinary Journal in the Spring 2016 issue. In this study, Dr. Jean Dodds showed that small breed dogs receiving a half dose of distemper parvo vaccine effectively responded, producing sustained increased antibody levels as measured in a titer test. A study concluding that smaller dogs have a higher risk of vaccine reactions, as well as noting other risk factors, was published in the Journal of the American Veterinary Medical Association in 2005.

Titer has become a very important and often controversial word in today’s veterinary world. No laboratory test in my memory has been more misunderstood, misinterpreted, misused, and downright maligned, by owners and veterinarians alike. While this simple test is used in determining that a dog has responded to vaccination and is immune to the rabies virus for travel to a rabies free country, it is not accepted as proof of immunity in the United States.

So why are dogs still being vaccinated frequently, when science does not support it? Why is the scientific test demonstrating immunity, the titer, disregarded by many?

FOR MORE

It is foolish to breed a dog or bitch without a complete thyroid panel in the anestrus before the breeding.

STILL AND ALWAYS OF INTEREST

A previously published article on hypothyroidism.


Hypothyroidism

in Basenji Dogs

by Karen P. Christensen

Since my own dog. Selket, was diagnosed with hypothyroidism (HT), I have had some time to research the symptoms of the disease. I have become something of a crusader, suggesting thyroid testing to dog owners for symptoms ranging from weight gain to seizures to infertility: the overweight, 4 year-old golden retriever (HT is very common in Goldens) at the kennel, who was having seizures; a friend whose year-old basenji is losing the fur from her puppy buns; the woman in the dog park with the greyhound (another high-HT breed) whose skin was callused, greasy and smelly, like Selket's; the couple at the vet whose 2 year-old lab is so overweight you could serve dinner on his back....

The reasons for this are simple:
The literature indicates that Hypothroidism is the most common endocrine disorder in dogs, and we know, for people, Synthroid is the third most used pharmaceutical in the USA. All of the above symptoms can be related to hypothyroidism.Using the proper tests, HT is relatively easy and inexpensive to diagnose. HT is extremely easy to treat with daily replacement therapy; and Treatment makes such a huge difference in the quality of life for the dog and therefore for its owner.

The case for regular thyroid screening for all dogs is easy to make. While treating a HT dog is not difficult, it is not a characteristic anyone would want to encourage in breeding, and which needs to be understood in breeding stock.  Hypothyroidism in basenjis has shown up in dogs as young as 12 months old.

Why to treat twice a day

A lack of thyroid hormone can cause a vast array of symptoms that are also common to other illnesses. Thyroid screening can thus be used to rule out hypothyroidism as the cause of some symptoms, as well as ruling it in. Many of the conditions, such as weight gain, lethargy, and joint problems, when seen in older dogs, are considered unavoidable symptoms of age. I considered Selket an old dog at 8 years, due to her lack of energy, thick skin, and lameness in her shoulder; at 11 years, I do not consider her old at all as I watch her romp with a much younger dog. The difference has been the diagnosis and treatment of hypothyroidism.

The reason for the symptoms is that thyroid hormones control metabolism of fats, carbo-hydrates and lipids; energy transfer; and cell maturation. This last is the cause of poorskin/coat quality, joint problems (cartilage does not regrow fast enough to replace what is worn off), and sterility (sperm and eggs do not mature.) Because lipids are not metabolized, a hypothyroid dog may have high cholesterol, which can cause seizures and heart problems due to plaques in the coronary arteries (atherosclerosis, the same cause of heart disease as in humans), as well as strokes.

The thyroid hormones regulate metabolism.

The high cholesterol that accompanies hypothyroidism (too little thyroid hormone) can, however, lead to atherosclerosis and strokes in dogs.

Thyroid function tests are affected by many things, including stress and medications. Several recent studies have demonstrated that phenobarbital therapy causes falsely low values on some thyroid tests. Recent seizures will also cause false lowering of the values, presumably due to the stress they cause. So test results need to be interpreted with these caveats in mind. If an animal tests truly low on thyroid function, then a trial of thyroid supplementation is indicated.

The blood serum sample from a hypothyroid dog may look like a strawberry milkshake - cloudy, thick, and bright pink. This is from the lipemia/high cholesterol and from hemolysis. I was pretty shocked and upset when I saw this in Selket's second sample (after a month on a low dose of levothyroxin, the synthetic thyroid replacement normally prescribed), since I expected a clear, pale yellow liquid. When I spoke to Dr Dodds (see below) she said this was a strong indication of hypothyroidism (which makes me wonder why we even had the sample analyzed instead of just upping the dose). Literature indicates the presence of high cholesterol makes measurement of one form of thyroid, T3, inaccurate for diagnosing hypothyroidism.


Monitoring your dogs:

Of course it is preferable to diagnose hypothyroidism before the dog becomes ill. Since it is relatively common in basenjis, it is not unreasonable to begin annual testing, as Wellness Care, after puberty. Testing must be done in anestrus, which means count 100 days from the first day of the heat cycle. 
By the way, you should do the same for male dogs who are around bitches in season. 


It is very important to have the right thyroid tests done.

I use Dr. Dodds (Hemopet Thyroid Testing) because she gives her opinion along with the test results. Since Hemopet is Not-for-Profit, the fee is quite reasonable. You can choose to have a complete panel + the OFA panel done. Jean knows the correct levels for basenjis, which she says is different from other sighthounds and other breeds.

TEST SUBMISSION FORM

And you can talk to her. You SHOULD talk to her, if you suspect your dog is hypothyroid, if you have results from a different lab, or if your vet gives you a hard time.  Email her or give call her at Hemopet. 

Total T4 or T3 measurement alone, or T3 & T4 alone, are not accurate for diagnosing HT. You need to have results for T3, T4, Free T3, Free T4, and TgAA. TSH levels are not particularly useful (65% predictive in canines).

Treating the hypothyroid dog is inexpensive and easy. They simply get a small pill twice a day of levothyroxine (T4 - Thyro-Tabs).

The pill should be given 1 hour before or 3 hours after meals, and not in milk products.
Peanut butter or steamed yams work fine to hide the tiny pills.


Finally, I have heard of some people who are reluctant to use thyroid replacement because it is synthetic, because it is a pharmaceutical, a drug. Well, it is a chemical the dog normally has. There is no herbal equivalent for synthetic levothyroxine. The synthetic drug contains only the T4 and no other biologically active molecules.
As for the drug companies possibly making money off of us, I'd say they make their profit based on the huge amount that's sold, because the per-dose cost is so low, it cannot be much more than it costs them to manufacture and distribute it.  


Here is a list of symptoms of hypothyroidism (that improve when T4 therapy is given); one or more other diseases or conditions could also cause most of them but HT is such a common condition, and is inexpensive and easy enough to test for.

Lethargy,

Mood swings,

Aggression,

Loss of energy,

Vestibular (ear) disease,

Poor coat, scaly skin,

Hypo pigmentation,

Body odor,

Skin lesions,

Weight gain,

Weight loss, picky eater,

Seizures,

Sterility,

Testicular atrophy,

Aspermia,

Absence of heat cycles,

Too many heat cycles,

Prolonged interestrus,

Pseudopregnancy,

Reproductive failure,

Re-absorption of fetus,

Joint problems,

Slow heart rate,

Stiff or slow movement,

Dragging front feet,

Head tilt,

Tragic expression/facial paralysis,

Balance problems,

Frequent vomiting,

Diarrhea,

Cardio-myopathy,

Megaesophagus,

Ruptured knee ligaments,

Corneal ulcers,

Dry eye syndrome,

High cholesterol,

Atherosclerosis,

Cold intolerance,

Heat intolerance,

Exercise intolerance,

Chronic infections,

Anemia,

Low white blood cell count,

Bone marrow failure,

Chronic hepatitis, etc.