What To Expect At The Vets Office
If your pet has been diagnosed with uncomplicated Lyme disease, this is what you can expect to happen at your veterinarians office.
- Depending on the type of test used to screen for Lyme disease, a confirmatory test may be necessary.
- Urine protein screening — In general, only dogs who have symptoms of Lyme disease or protein in their urine should be treated with antibiotics.
- Dogs with protein in their urine should have regularly scheduled rechecks to monitor their condition.
Using Antibiotics To Treat Lyme Disease
Lyme disease is typically treated with antibiotics, although the type of antibiotic used depends on what stage of the disease you have.
After you remove a deer tick that has been attached to you for at least 36 hours the amount of time it takes for the tick to transmit the bacteria Borrelia burgdorferi there’s a 72-hour window during which your doctor may give you a single dose of the antibiotic doxycycline to prevent the development of Lyme disease. Doxycycline is prescribed to patients age 8 and older, except for pregnant women.
If you already have stage 1 or stage 2 Lyme disease with the telltale bull’s-eye rash but no other significant symptoms, your doctor will most likely treat you with oral doxycycline, amoxicillin, or cefuroxime for 14 to 21 days.
But if you have meningitis or nerve issues from early Lyme disease, your treatment will require taking intravenous ceftriaxone for 14 days.
Stage 3 Lyme disease is also treated with various antibiotics:
- For Lyme disease that causes arthritis, 28 days of oral doxycycline, amoxicillin, or cefuroxime is prescribed. Additional courses of antibiotics may be necessary, depending on the severity and persistence of your symptoms.
- For Lyme disease affecting the nervous system , two to four weeks of intravenous ceftriaxone or penicillin is prescribed.
Lyme Disease Surveillance In Canada
Lyme disease became a national notifiable disease in December 2009.
Canada continues to monitor the evolving geographic distribution and prevalence of infected ticks and cases of Lyme disease. Therefore, you must report clinically diagnosed or laboratory-confirmed cases to your provincial or territorial public health authorities.
Health professionals in Canada play a critical role in identifying and reporting cases of Lyme disease. See the surveillance section for more information on surveillance in Canada.
Consult the national case definition for additional information.
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Early Localized Lyme Disease
Early localized Lyme disease usually presents as an acute illness characterized by:
- the presence of a single, localized skin lesion known as erythema migrans
Not all patients will present with an EM. Therefore, diagnosis should not be based solely on the presence of EM.
Most patients will present with EMs within 7 days of the initial tick bite. However, the incubation period can vary between 3 and 30 days.
The skin lesion is characteristically an annular erythematous lesion greater than 5 cm in diameter that:
- slowly increases in size
- is usually painless and non-pruritic
The lesion sometimes develops central clearing, but it can be more homogenously erythematous. In dark-skinned patients, the rash may appear more as a bruise.
Variations of an EM are highly suggestive of Lyme disease and can take the following forms:
- blue-purple hues
- a bull’s-eye appearance
A skin lesion called erythema migrans can develop into a bull’s-eye at the site of a tick bite. It is shown here on a patient’s upper arm.Footnote 1
A typical sign of early non-disseminated Lyme disease is an expanding rash called erythema migrans. This can take on the appearance of a bull’s eye.Footnote 1
Some Lyme disease skin lesions are uniformly red and do not appear with the classic ring.Footnote 1
Some patients present with a central blistering lesion, commonly mistaken as a spider bite. This is likely due to an inflammatory reaction to the pathogen induced by the tick.Footnote 1
Azlocillin Comes Out On Top
The drug, which is not on the market, was tested in mouse models of Lyme disease at seven-day, 14-day and 21-day intervals and found to eliminate the infection. For the first time, azlocillin was also shown to be effective in killing drug-tolerant forms of B. burgdorferi in lab dishes, indicating that it may work as a therapy for lingering symptoms of Lyme disease.
Pothineni and Rajadas have patented the compound for the treatment of Lyme disease and are working with a company to develop an oral form of the drug. Researchers plan to conduct a clinical trial.
Rajadas is also a professor of bioengineering and therapeutic sciences at the University of California-San Francisco.
Other Stanford co-authors are Hari-Hara S. K. Potula, PhD, senior research scientist postdoctoral scholars Aditya Ambati, PhD, and Venkata Mallajosyula, PhD senior research scientist Mohammed Inayathullah, PhD and intern Mohamed Sohail Ahmed.
A researcher at Loyola College in India also contributed to the work.
The study was funded by the Bay Area Lyme Foundation and Laurel STEM Fund.
- Tracie White
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Full Recommendations For The Prevention Diagnosis And Treatment Of Lyme Disease
I. Which measures should be used to prevent tick bites and tick-borne infections?
Personal Protective Measures
Summary of the Evidence
Rationale for Recommendation
Although there is little systematic evidence supporting some of these measures for the prevention of Lyme disease, they may offer potential benefits with little effort, risk, or cost.
Properly designed studies performed with human subjects under realistic conditions are required to test the efficacy of personal protection measures. Similarly, research is needed to inform how to motivate the adoption and continued use of best practice personal protection measures.
Repellents to Prevent Tick Bites
Summary of the Evidence
In laboratory and field experiments involving human subjects, the use of DEET, picaridin, IR3535, oil of lemon eucalyptus , p-methane-3,8-diol , 2-undecanone, and permethrin reduced the number of ticks detected crawling on or attached to subjects compared with controls . Other commercially available products, including botanical agents and essential oils cannot be recommended due to insufficient evidence.
Late Or Chronic Lyme Disease Treatment
Experts agree that the earlier you are treated the better, since early treatment is often successful. Unfortunately, a substantial portion of patients treated with short-term antibiotics continue to have significant symptoms. The quality of life of patients with chronic Lyme disease is similar to that of patients with congestive heart failure. Doctors dont agree about the cause of these ongoing symptoms. The primary cause of this debate is flawed diagnostic testing. There is currently no test that can determine whether a patient has active infection or whether the infection has been eradicated by treatment.
The IDSA thinks Lyme disease symptoms after treatment represent a possibly autoimmune, post-Lyme syndrome that is not responsive to antibiotics. The IDSA essentially regards Lyme disease as an acute infection like strep throat that can be treated with a short course of antibiotics. The IDSA guidelines are now eight years old and do not reflect recent science.
ILADS physicians believe that ongoing symptoms probably reflect active infection, which should be treated until the symptoms have resolved. These physicians use treatment approaches employed for persistent infections like tuberculosis, including a combination of drugs and longer treatment durations. The ILADS guidelines have just recently been updated using a rigorous review of the medical literature.
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Azlocillin An Amazing Compound
The study team first tested to see whether different doses of the drugs could kill drug-tolerant borrelia bacteria grown on laboratory plates better than a standard Lyme disease antibiotic .
They carried out each experiment three times in triplicate . The team tested the drugs on different ages of bacteria, colonies that were 3 days old and growing rapidly, and colonies that were 710 days old and had reached a growth plateau.
At high concentrations, both drugs could kill all the drug-resistant borrelia cells and outperformed the standard Lyme disease antibiotic. When the study team tested the drugs at lower doses, azlocillin outperformed the standard antibiotic and cefotaxime, which left 20% of the drug-resistant cells alive.
The researchers tested the drugs in a small number of laboratory-bred mice that they infected with the bacteria. They treated the mice at different stages of the disease at 7, 14, and 21 days after infection.
They gave each mouse a daily dose of either azlocillin, cefotaxime, or the standard treatment for Lyme disease for 5 days. They cultured the mouse organs and checked for live bacteria using microscopy and genetic testing 2 days after the last dose.
The researchers found that both the standard treatment and azlocillin completely cleared the infection in the early stages of the disease, while cefotaxime did not.
We have been screening potential drugs for 6 years, Venkata Raveendra Pothineni, Ph.D., the lead study author says.
What Is Lyme Carditis
Lyme carditis occurs when Lyme disease bacteria enter the tissues of the heart. This can interfere with the normal movement of electrical signals from the hearts upper to lower chambers, a process that coordinates the beating of the heart. The result is something physicians call heart block, which can vary in degree and change rapidly. Lyme carditis occurs in approximately one out of every hundred Lyme disease cases reported to CDC.
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What Are The Side Effects Of Lyme Disease Treatments
Antibiotics, like all medications, have the potential for side effects. Any antibiotic can cause skin rashes, and if an itchy red rash develops while on antibiotics, a patient should see their physician. Sometimes symptoms worsen for the first few days on an antibiotic. This is called a Herxheimer reaction and occurs when the antibiotics start to kill the bacteria. In the first 24 to 48 hours, dead bacterial products stimulate the immune system to release inflammatory cytokines and chemokines that can cause increased fever and achiness. This should be transient and last no more than a day or two after the initiation of antibiotics.
The most common side effect of the penicillin antibiotics is diarrhea, and occasionally even serious cases caused by the bacteria Clostridium difficile. This bacterial overgrowth condition occurs because antibiotics kill the good bacteria in our gut. It can be helpful to use probiotics to restore the good bacteria and microbiome balance.
Herbs For Lyme Disease Treatment
Herbs have been used as a medicinal treatment for thousands of years. Many people have turned to herbal remedies to help provide relief from Lyme disease when antibiotics didn’t completely help eliminate symptoms.
One research study found that a combination of doxycycline and baicalein provides additional healing benefits. According to a 2020 laboratory study, seven herbal medicines have been shown to kill B. burgdorferi in test tubes:
- Cryptolepis sanguinolenta
- Scutellaria baicalensis
Garlic has antibacterial effects and may help prevent tick bites. One study determined that people who took garlic supplements reported fewer tick bites than the placebo group. Garlic essential oil has been shown to eliminate the bacterium that causes Lyme disease.
Garlic can interact with certain medications, so speak with your healthcare provider before using it to prevent or treat Lyme disease.
Steviaa natural sweetener and sugar substitute derived from the leaves of the Stevia rebaudiana plantmay be effective in treating Lyme disease. A study published in the European Journal of Microbiology and Immunology discovered that stevia extracts are more effective in killing Lyme disease bacterium in the lab than the standard antibiotics.
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For Depression And Anxiety
Both psychotherapy and pharmacotherapy have proven benefits for improving mood. Psychotherapy has many different types such as supportive, dynamic, cognitive behavioral, dialectical behavior therapy, transference focused psychotherapy each of which offers benefit. Pharmacotherapy also has many different types. For depression the first-line options usually are SSRIs, SNRIs, Tricyclics or other agents with more unique modes of action.
A few noteworthy tips on anti-depressant agents:
- Most anti-depressant agents also help in reducing anxiety. However the opposite isn’t necessarily true. Specific anti-anxiety agents such as clonazepam or diazepam may not necessarily help fight depression.
- Most anti-depressants take three to eight weeks before an effect is seen. Therefore, it is unwise to stop an anti-depressant after only three or four weeks, as staying on it another two to three weeks may lead to a good response.
- Dosage makes a difference. Some anti-depressants work fine at low doses some medications however are effective only at higher doses. Some medications are more effective as the dose is i increased. Other antidepressants may have a therapeutic range one has to achieve at least a certain dosage .
The Truth About Antibiotic Treatments
Until recently, many doctors in Canada tended to prescribe only one round of antibiotics, irrespective of the stage of infection. However, current research suggests that a single course of antibiotics is often insufficient for treating Lyme disease, especially if the infection has been untreated for several months.
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For Memory Concentration And Focus
Improving memory is a challenge. In Lyme disease, short-term memory problems and word-retrieval problems are common. These often improve substantially with appropriate antibiotic therapy. Over time, most patients regain their cognitive function.
When memory is a problem, consider that this could due to a primary problem with attention or with mood. An individual who can’t focus won’t be able to remember because he/she didn’t “attend” to the item in the first place. This happens to all of us when we hear someone’s name at a party if we don’t focus on the name and perhaps make a mental association to the name to enhance memory storage, we will forget that name within minutes. Patients with depression often experience problems with memory and verbal fluency when the depression is resolved, the memory and verbal fluency typically resolve as well.
- Medications: Attention can be improved with certain medications, such as bupropion , atomoxetine , modafinil , or stimulants . Medications that temporarily slow cognitive decline in Alzheimer’s disease or memantine ) have not been studied in Lyme disease.
- There is some evidence that online brain training programs can enhance concentration or processing speed.
- Neurofeedback may be helpful in improving attention, as well as in improving sleep and reducing pain. This has been studied for migraines, fibromyalgia, and ADHD.
What Is Lyme Disease
Lyme disease is caused by a bacteria, Borrelia burgdorferi. The disease was first recognized in 1975 when large numbers of children were diagnosed with juvenile rheumatoid arthritis in Lyme, Connecticut, and two neighboring towns. Further research showed that bites from deer ticks infected with the bacterium were responsible for the outbreak of arthritis. Ordinary “wood ticks” and “dog ticks” do not carry the infection.
In the U.S., the Centers for Disease Control and Prevention estimates there are about 300,000 cases per year, even though the number reported is much lower.
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Lyme Disease Treatment: 2 Herbal Compounds May Beat Antibiotics
Lyme disease transmitted via tick bite affects thousands of people in the United States and around the world. Currently, doctors use antibiotics to treat it, but could plant-based remedies be more effective?
Lyme disease is an infectious disease caused by the bacterium Borrelia burgdorferi .
The disease spreads to humans through the bite of a tick that carries the bacterium, and it affects an estimated each year in the U.S. alone.
Currently, healthcare professionals choose between three antibiotics in the treatment of Lyme disease. These are doxycycline, cefuroxime, and amoxicillin.
Sometimes, however, antibiotics are not effective in eradicating all traces of B. burgdorferi from the system, which means that the disease can persist.
When this happens, bacterial cells that have developed antibiotic resistance can continue to proliferate. These are known as persister cells .
Because of this, researchers have been looking into alternative modes of fighting the bacterium, and their first line of inquiry has focused on natural remedies.
In 2018, an in vitro study suggested that 10 plant-derived essential oils could help fight off B. burgdorferi.
Now, researchers from the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, and from the California Center for Functional Medicine and Focus Health in Berkeley, have conducted a new study that has led them to believe that two specific plants may lead to more effective therapies against Lyme disease.
Where Is Lyme Disease Prevalent
LD is spreading slowly along and inland from the upper east coast, as well as in the upper midwest. The mode of spread is not entirely clear and is probably due to a number of factors such as bird migration, mobility of deer and other large mammals, and infected ticks dropping off of pets as people travel around the country. It is also prevalent in northern California and Oregon coast, but there is little evidence of spread.
In order to assess LD risk you should know whether infected deer ticks are active in your area or in places you may visit. The population density and percentage of infected ticks that may transmit LD vary markedly from one region of the country to another. There is even great variation from county to county within a state and from area to area within a county. For example, less than 5% of adult ticks south of Maryland are infected with B. burgdorferi, while up to 50% are infected in hyperendemic areas of the northeast. The tick infection rate in Pacific coastal states is between 2% and 4%.
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Questions To Ask Your Veterinarian
If your dog has a positive Lyme test but no symptoms of the disease or protein in the urine, ask your veterinarian why he or she is recommending treatment. Experts currently recommend against antibiotic therapy under these circumstances because the dogs immune system is holding the bacteria in check and antibiotics are unable to eliminate the infection.
Dogs who have contracted Lyme disease do not develop prolonged, protective immunity and can be reinfected at a later date. Talk to your veterinarian about how best to prevent future infections. Options include measures to prevent the ticks that carry Lyme disease from biting your dog and Lyme vaccination.