MP's got the tick disease(s)!

[MaisyPancakes]

Dang it to all the buttholes and donut holes! But it was probably a matter of time...ticks are *everywhere* now.

MP's recent bloodwork showed "mildly low platelets, but nothing else weird," so my vet ran a SNAP4Dx (plus?) today—and she tested positive for Anaplasmosis and Lyme (I think)! I'm cloudy on the Lyme part because she was just trying to give me a super-quick ASAP update in between appointments and I'm terrible at retaining information over the phone...but the Anaplasmosis was more for sure. Either way, she and my rehab vet had already talked, and decided that the standard 30-day course of Minocyline is the way to go. (My regular vet and rehab vet are being super nice about working together because she's on lots of supplements/herbs for various things and they have to be careful about what to Rx, etc.) They said Doxy is currently 50 times more expensive and they've used Minocycline with equal success. My rehab vet and I had discussed in the past about Doxy/Minocycline's anti-inflammatory effects and once considered trying it anyway for MP's owies. So, hey, we will get to do that at the same time, I guess.

We were going to switch from Metacam to Galliprant for her pain meds, and also possibly replace the super-low-dose Amlodipine to an herb (forskholii), but my vets want to keep everything the same until the abx course is over, just in case. In addition to the Galliprant switch, we had planned some major-ish stuff like Ketamine drips that was making me a wee bit nervous—so I'm fine with waiting!

She's been progressively owie and tired and old, but as with old dog stuff, it seemed not necessarily much more pronounced than an anxious pessimist would expect. So, now my vets are kind of half-glad that some of the decline is due to the increased inflammation from TBD, and are hoping to see some improvement as we try to treat it.

Just letting y'all know, since it all kind of happened fast.

[SherriA]

Oh hell, that sucks. I hate ticks

I hope the abx work their magic and MP feels less ouch soon.

[JudyL]

Wow, I'm sorry to hear this, Nana, and I hope that antibiotic has MP feeling better very soon. I'm glad that your vet has another drug that also works well in these cases so that you don't have to rely solely on doxy.

The ticks are already out here too, and they will be bad this year with the mild winter we've had. Ticks and these diseases are plain evil.

[LisaT_II]

Wow, well, drat!

It's possible that mino is slightly more liver toxic than doxy, so I would use your favorite liver support (my fav is country life's Liver Support Factors).

With coinfections, some might argue that they take longer to clear, I don't know if that,s true or not. I think the more chronic they are, tends to be more relevant to how hard to clear.

I'm really glad your vet check for the TBD with the low platelets. Many vet's dismiss that as a lab artifact :-(

One recommendation worth thinking about is whether you want a measurement tool to monitor now and down the road. Generally they use the C6 for Lyme, and titers for anaplasmosis. Tick list preference is to go through protatek for titers because they specialize in this, but also the owner can send in blood and get results and pay cost, so much cheaper. Initially we run a panel to check for other confections that the snap can't get or doesn't get.

Generally we also recommend an aggressive dose, but not sure I would do that with a senior dog, but some might say with confections it's warranted. I'll just say that there is variation in dosing which is relevant if she doesn't seem to get better as she should or relapses.

She should feel better soon!

[MaisyPancakes]

Thank you all for your thoughts! And thank you, Lisa, for checking in! I gotta admit I was super afraid that I was doing it all wrong because it all got handled within a few hours (from dx to rx) and I'm used to lots of diddly-daddly asking around and things like that!

Yep, having the liver stuff on overdrive at the moment, especially because she had this whole sedation thing last Friday. I've just been using more SAMe and milk thistle and adding liver-y foods like artichoke in her veggie mix (and as tea), and tinctures of oregon grape, cleavers, etc.

I wonder if Protatek's test is what their lab was going to run for a lot more $ ($200-ish). My vet voted against it thinking SNAP would be sufficient to see if we need to take action at all, for now. I will look into the more thorough tests for checking progress, etc.

Now that I know she's got tick stuff going on, I'm convinced that she is extra gimpy today!! (It could be anything, but you know, now I can blame something!)

Thanks again, everyone!

[Sabine]

Poor MP, I hope she'll feel better soon!

[Amanda]

I'm sorry to hear this! Doxy helped with Zeke's gimpiness. I hope the abx do double duty for her!

[UpwardDog]

Bleeping ticks. I hope the treatment has her feeling much better soon. Keep us posted.

[LisaT_II]

At protatek, I think when I ran a panel of 8 things it cost maybe $160, I would have to double check. You want to think about it though, since you want an initial titer if you run titers. You can call protatek yourself and ask questions if you're curious.

Doxy makes me very tired!

Fingers crossed all is uneventful!

[MaisyPancakes]

Oh, that makes sense to do it at the start then after. Thank you! I'll try to talk to one of my vets about it as we've already started the abx on Tuesday. She had another seizure last night, then 2 this morning (kill me now), so my head's a bit cloudy at the moment.

[LisaT_II]

Oh no :-(

Tick disease can cause seizures, in particular Anaplasmosis tends to cause a lot of neuro signs, but so can Lyme. Of course it could be something else too...

On the tick list we have seen where vet's have minimized Anaplasmosis, but we have seen dogs very sick from it.

Jazz internal med vet really didn,t want us trying mino. I get her doxy from Canada and with a script it may be cheaper than here. Jazz is OTC there because she is small. But there were some reports that mino was better for neuro Lyme. The thing I don't know about mino is dosage. Doxy at the aggressive dose will kill bacteria, doxy at the lower dose only suppresses it and requires the immune system to do more work. This is why I think the aggressive dose of doxy often works better. What I do not know is if all this translates over to mino. Some dogs dosage really matters and if there is a range with mino and if she is tolerating the drug, it might be worth a conversation at some point.

There are some tick herbs that people use if you want to go that route, but I can't say anything about them with certainty.

[Jen]

I'm sorry! I wish I knew more to give good advice, but MP's a lucky duck she's got you. I hope the abx help her in all kinds of good ways.

[maxs_mommy]

Oh balls, I'm so sorry to read this. I really just wanted to chime in to say that I get Max's 100mg /30 ct. Doxy from Costco for about $20 a scrip. My local grocery wanted almost 140 for the same drug. If your vet is willing to call a scrip in somewhere, it might be worth price checking. GoodRX can be a helpful app to find prices.

[connie]

Nana, FWIW, you know my Rowley tested positive last year for Lyme, and we did 28 days of Doxy and then re-tested at Cornell and got 'clinically insignificant' results, which meant the abx had been effective (or so we assume) -- well, last week we did his 2017 annual test, and it was negative all across the board, for heartworm and Lyme and anaplasmosis and ehrlichia. Big relief.

My protocol is to treat every positive and that is what I did with R. He tolerated the Doxy well BUT needed probiotics for quite a while, later on, because his gut flora all got wiped out. So he had lots of green tripe, poor thing.

[connie]

Also, I do the SNAP 4-way test every year on all my dogs, I think everyone should. Because you're right, Nana, tick borne illness is freaking EVERYWHERE now.

[MaisyPancakes]

Thanks so much, everyone!! This morning is her last dose of Minocycline, huzzah!

***However***, I read *last night* that magnesium was one of the things I was to avoid giving at the same time as the drug, which I had been giving with her meals, this whole effing time. I can't even. Around the 4th day of starting, I found out about Ca, so I re-made my vitamin/mineral/supplement mix without Ca (it's a 12-meal batch of powdery kinds [i.e., not pills I'd have to crush]) and thought we were all good—because none of the things I read mentioned magnesium!!! (They did say to avoid aluminium and iron, also, but not magnesium!) I am just hoping that it would have been the same as eating fortified dog food, since all I was doing was dividing up the supplements evenly per meal, as opposed to say, giving ALL the stuff in one meal. We did avoid giving dairy of any kind near the ABX, and think we did all the other stuff right. SHEESH.

So, to assess whether or not the ABX did its thing (*despite magnesium!!*), do I need to send to the Cornell or Protatek or one of the special labs, instead of running the SNAP again? We only ran the SNAP at first, so we would not be able to compare whether things have changed in terms of "how positive" she was/is, since the ABX.

If I had ruined the Minocycline powers with my magnesium, then I am guessing we would then try Doxy, which I now know is not crazy $$$ if I try Costco—thanks for the tip! (I also have the Good Rx card—haven't been able to use it at Costco, but for Gabapentin and Metacam, it was cheaper through their own discount program.)

Thank you all! I don't know why, but this round of ABX requiring extra caution w/foods and stuff (even though I still effed it up) kind of kicked my ass. I am really hoping I don't have to do it again. But, here comes tick season... ARGH!!! My vet does not want to give her any of those tick killer meds, though, so we are considering getting some permethrin clothing type stuff instead.

[connie]

Nana, rose geranium oil keeps ticks away, if you can stand your dog smelling like someone's grandmother's closet.
http://www.care2.com/greenliving/rose-g ... ticks.html

And Cedarcide makes a good Tick Shield spray.
https://www.cedarcide.com/product/tickshield/

Those have to be applied way more often than chemicals, but that's not a big deal, to me.

The Cornell test: https://ahdc.vet.cornell.edu/docs/lyme_ ... r_dogs.pdf

Yes, we did the SNAP IDEXX test, got a positive, drew more blood, sent to Cornell; that test came back relatively low (scale was 10 to 100, IIRC, and Rowley was 13), meaning active infection but still acute, not chronic -- recent. Gave 28 days of Doxy, drew more blood, sent to Cornell again, got a 'subclinical' result meaning less than 10, so not an active infection. That's my in a nutshell understanding but it's probably much more informative than that. LOL! This year Rowley did not throw a positive on the SNAP IDEXX.

If you didn't do the Cornell test before treating, then I would think yes, just do another SNAP test when the treatment is done.

[MaisyPancakes]

Thank you, Connie! I talked to my rehab vet in the meantime (I see her more often than my regular vet) and she said to run the more detailed titer type test like the dilution thing you're talking about (which she said that pretty much any lab should be able to do), since SNAP only shows exposure and not levels/existence of infection. (She had low platelets, which tipped off my regular vet as an indication of tick disease—so, we treated it without seeing *how* infected she might be.)

Yeah, we *had* been going the herbal route for as long as I've had her, but I have been reluctant because of the seizure stuff. The permethrin, even though it's pretty hardcore, is supposed to not get on/in the dog (when using treated garments) once dry, so... In any case, all I know is that I can't effing win with these effing ticks. ARGH!!

[LisaT_II]

The Snap may be lyme positive for awhile even if treatment was successful, since it is only a yes or no question to antibodies rather than a numerical measurement.

[MaisyPancakes]

Thanks, Lisa! We finally got a tech appt for blood draw (was kind of complicated bc she's so hard to get blood from, and I had to request a team and their schedules didn't work out til then), and my vet is going to send the blood to their usual lab, who is supposed to be able to do the titer kind of test—not one of the places you guys have mentioned, but hopefully it'll be good enough. Since then, however, in the last 2 weeks, MP's had 1 engorged (fully) already. I am hoping that won't change anything we would do...

[LisaT_II]

Testing can be nuanced and controversial, hopefully MP has a straight forward case. None of the test focused on above work for Anap~ so hopefully your vet is referring to that.If it's a PCR test, there are all sorts of problems with those ( each test has issues).

Lyme should be monitored via either the c6 or the Cornell multiplex, but you do need initial values for comparison to make the most of it. They say that the c6 comes down over time after treatment and hits steady state at about 6 months.

For me, it was important to decide on how I would monitor regular bloodwork, or just the CBC. Things in the Chem that can often be abnormal are the proteins (usually the albumin), and the liver values.

Battling the ticks is just terrible.

[LisaT_II]

Btw, on the tick list (which is pretty dead now b/c of FB probably), I've seen a lot of anap~ dogs with seizures and they seemed to correlate with the severity of the disease. It would be great if they improved with this treatment.

[MaisyPancakes]

Thank you, Lisa! I wonder if they also should be running the CBC for platelet count (that is what flagged my vet for tick disease). It seemed like we were only running a titer thing. I'm feeling kind of overwhelmed at the moment—I hope I can ask for the right tests for her current, post-Minocycline situation. If PCR is problematic, am I correct in thinking that I be asking for the IFA kind for the Anaplasmosis, and then a C6 or Cornell for the Lyme?

All I know is that we use a lab called Marshfield in WI, and upon cursory look at the list of tick labs they offer, some of the tests indicate they use Texas A+M [IFA] and Georgia [PCR]—for multiple diseases, and for Lyme, there's a few kinds they offer, one being the Multiplex via Cornell. So, that would be good if I can do those. https://www.marshfieldlabs.org/sites/lt ... /Home.aspx

I suppose this means it would be much cheaper if I sent the stuff myself, but I'll be using insurance so it may not make a huge difference to me either way. It would be less potential for shipping/prepping error if I have nothing to do with packing, etc., probably!!! :S If I knew which test to ask for, then I could compare the costs to have the vet handle it all. (I know clinics have a certain volume agreement/discount w/the labs they use most often, so am not sure if it's somehow beneficial for me to use [Vet -> Marshfield -> Cornell] vs [Vet -> Cornell] or [Me -> Cornell]).

Thanks for bearing with me, friends!!! So far, no discernible change in seizure patterns I could make sense of (we have had 2 clusters [=2 in 1 day] 10 days apart most recently), and before that, some during the Minocycline period.

[LisaT_II]

Well, bummer about the consistent seizure activity :-( Neuro lyme is a thing too and nearly impossible to treat.

I've been knee deep in family stuff, but should be able to pop back tonight when I can get to my laptop and post more.

Did you see any changes or improvements on the Mino??? What dosage were you giving?

[MaisyPancakes]

Thank you, Lisa! I'm sorry about the family stuff; please, no need to stress on my dumb thing—I will figure something out!

She had a good ±week 10 days into the Mino (good = seemingly less gimpy, more peppy)—but this is difficult to discern, because she had reasons to be joyful (ppl she likes visited, etc.) and we happened to do more fun things. Her general gimpiness and aging is such that it's hard to attribute any of it to anything in particular: sometimes it seems to be the weather, other times the degree of exercise the day before, how happy she is (huge impact on her mobility), etc. After that one good week, though, she has been about the same, and as gimpy as she has always been, if not more, bit by bit. We gave Minocycline 100 mg/BID from 2/28 to 3/28, and she weighs 43lb.

From what I've read, it seems like it's not customary to do another round of abx just because of high-ish titers? Cornell's site said that one should test post-treatment as early as 6 weeks after beginning abx for acute/early disease, and 3 months for chronic type. I seem to recall that my vet considers this early/acute and not chronic. (Not sure about the distinction as we didn't do the pre-treatment Cornell test that apparently shows what stage you're in.)

Her previous SNAP 4Dx that was negative was on 5/5/16. Lots of bloodwork since then, but just no SNAP until 2/27. So, I'm assuming an infecting bite occurred sometime May-November-ish.

Thanks again!

[MaisyPancakes]

I just talked to my vet, and she is going to have the lab do this Quant C6 (she said she will look at the Cornell one, too, but the C6 one is what she usually orders), and we're going to rely on the CBC to watch the platelets instead of running an IFA or whatever else for the Anaplasmosis. (She is much more worried about Lyme.) She's happy to run anything I want, and wasn't trying to talk me out of it, but she really didn't think it was necessary to do the Anaplasmosis-specific test(s). In her view/what she's learned most recently, is that antibodies don't necessarily mean/predict disease or its severity, but is used more to make sense of other symptoms, etc. I think I'm OK with that.

The one thing I totally, totally forgot to mention is that she had an engorged tick a few weeks ago!!! That might mess with some tests, so I will email my vet and let her know.

[UpwardDog]

Wow, how did I miss this? Damned ticks. Do they think the seizurey stuff is related to the lyme or...?

[LisaT_II]

Especially if insurance is covering it, I would run the Ana~ tigers for a benchmark later. It is true that they don't correlate with disease severity (in fact the C6 doesn't either). The Titers aren't to help you determine right now, but to help later down the road, which is why she should have run them initially too.

Protatek is the tick lab I use, as does the internal medicine vet jazz has, because you get direct access to people that specialize in this. They all use either C6 or multiplex for lyme, and single lab results are not as helpful as lab results over time.

The problem with confections is that one can kinda be dormant until treatment, and then it can flair as the immune system has it's burden lessened not having to fight two at the same time.

Platelets typically are low in chronic form for ehrlichia, not as sure as with the Ana-.
So, for now,

[LisaT_II]

Can't post long threads from my phone on this site...

Was going to add that definitely blood counts and platelets should be monitored, and that's a lifelong thing, though will be able to spread out as she gets healthy.

You might want to call protatek on your own, ask what they recommend about testing, and get pricing for your vet. If you were paying i'd say you send in for cost savings But you have insurance.

Every single test is flawed. We choose the best information we have, and then it comes down to interpretation and intuition. There is no wrong answer because there is no right answer. Now, does that make things more clear? Lol, tick disease is a mess.. BUT there are lots of examples of good outcomes and MP couldn't be in more caring hands.

[LisaT_II]

Have you ever tried r-lipoic acid for MP? I know if I don't give jazz hers, her tremors/seizures return. That together with sunflower lecithin and baking soda seems to keep them in check. BUT, of course she is a very different dog than MP.