Puzzling Tick Panel Results (babesia)

[gracegirl]

I'll try to keep this short while still giving you all the details you need. I've had Grace for two years. My group does tick panel testing twice a year. I had Grace tested in October of 2006, as my group recommends having all the dogs tested "just in case". Grace was lethargic (a typical lazy greyhound) and also had a case of the on again off again runs when I first got her. The panel came back positive for Babesia with a titer of 1:160. I spoke with the vet at length and decided to treat her in February of 2007 with two Imizol shots 14 days apart. Other than the pain of the injection and the new-found hatred for the vet, the shots were not a problem. She bounced right back, her bowel movements got much better, and she became a bit more active. We did a CBC (complete blood workup) for her just before her Imizol treatment, everything was just fine. Did another titer for her in April 2007, came back again at 1:160. Decided to wait a year and titer one more time, knowing that if it stayed at 1:160 or dropped I would not need to continue with titers. So I got the results today....are you ready? She came back at 1:640! She is not acting sick, she is playful, runs around with Fenway, has great poo, and is otherwise a healthy dog. My first reaction (after "oh crud") was did the lab make an error?? The blood was sent to ProtaTek in AZ. She has not had any other blood work done lately. Any thoughts/ideas/suggestions?

 

My first thoughts on course of action were to post on greytalk, post to the tick list, and then titer again in the fall at the groups clinic in October.

[Guest karma98104]

Oh, gracegirl, I'm sooo sorry!!! That's rough!!! I don't have any experience, but personally- if she is feeling well, and acting healthy- I think I would just keep my fingers crossed and go to the group test in October. I hope you get way better advice from others though.

[Batmom]

I'd have your vet contact Dr. Birkenheuer at NCSU -- his email is under Clinical Trials, scroll down the page http://cvm.ncsu.edu/vth/ticklab.html .

 

If you decide to retest either by titer or PCR, I'd send the blood to NCSU rather than Protatek.

[gracegirl]

I'd have your vet contact Dr. Birkenheuer at NCSU -- his email is under Clinical Trials, scroll down the page http://cvm.ncsu.edu/vth/ticklab.html .

 

If you decide to retest either by titer or PCR, I'd send the blood to NCSU rather than Protatek.

Thank you! That is just the info I was looking for. Since TBDs are not common in WA state, there are not too many vets around here well versed in them. I'll have my vet contact Dr. Birkenheuer.

[ShantisMom]

No thoughts as I am clueless on it. But lots of hugs to you and Grace.

 

I have not retested yet as it was early and we thought we would still get the same results. Let us know what you find out.

[turbotaina]

I'd have your vet contact Dr. Birkenheuer at NCSU -- his email is under Clinical Trials, scroll down the page http://cvm.ncsu.edu/vth/ticklab.html .

 

If you decide to retest either by titer or PCR, I'd send the blood to NCSU rather than Protatek.

 

Yup. Protatek has been unreliable for babesia results. Any positive babesia titer from Protatek, I'd have redone through NCSU.

 

Also, sad to say, imizol doesn't necessarily get rid of all the bugs.

 

But again, retest at NCSU and then take it from there.

 

Good luck

[Guest Flint]

My Flint was also treated for Babesia and my understanding is that he will always have it and can suffer a relapse. Here is some more info.

 

http://www.vet.uga.edu/vpp/clerk/Cleveland/

 

Let us know how the retesting goes.

[Guest boondog]

Yep, it's PCR at NC State time. Good luck!

[Guest LynnM]

Send out a sample for a PCR, that way you won't have to wonder.

 

Lynn

[gracegirl]

Send out a sample for a PCR, that way you won't have to wonder.

 

Lynn

Right, but is it odd for a dog to have a positive titer, receive treatment, and then have the titer levels increase?

 

From my understanding of the PCR, a positive means the disease is clinical but a negative does not necessarily mean the disease is not present. So basically, you could send a sample for PCR, it could come back negative, and your dog could still be sick.

 

I need to call my vet, I've been in meetings all day and have not had time to do that yet.

[turbotaina]

Again, Protatek is not reliable when it comes to babesia results, so that titer may not even be accurate. If you want to run serology only, you can do that through NC State as well.

[gracegirl]

Again, Protatek is not reliable when it comes to babesia results, so that titer may not even be accurate. If you want to run serology only, you can do that through NC State as well.

I remember reading that so I think that will be my first course of action...the serology test only. Or would you recommend both serology and PCR both? My thoughts are that if the serology comes back low/negative then a PCR would be unnecessary, right?

[Guest boondog]

In this case, I would recommend doing the PCR. The titer measures antibodies and only indicates exposure, which may or may not mean active infection. A PCR is a type of DNA test and would tell you if the microorganism is actually present.

 

ETA: You might be interested in joining the TICK-L.

Edited May 7, 2008 by boondog

[Guest Flint]

Can I ask why you did the titre again this year? My vet doesn't recommend it unless Flint shows symptoms because we already know it's there, just dormant at the moment. Now I wonder if I should have him checked again.

 

 

[Guest LynnM]

Well, a PCR will tell you if there is DNA from the organism present. No DNA=No organism, and the test is very, very sensitive.

 

You already know the dog was exposed at some point. That's all the titer is telling you at this point... that there is/was an immune response to the presence of babesia Canis. Titer numbers do fluctuate, and the titer she had this time is still relatively low. It's most likely never going to drop to zero.

 

Lynn

Edited May 7, 2008 by LynnM

[gracegirl]

ETA: You might be interested in joining the TICK-L.

 

Details please! I couldn't find any info on this last night, I'd like to join.

[Guest myjazzy]

If you would like to re-do the titer, send serum and whole blood to NCU, that way, if after you get the results from the titer test, you think it is necessary you can have them run the PCR. That way you only have to pay for shipping once.

 

Tick List linky.

Edited May 7, 2008 by myjazzy

[Guest boondog]

ETA: You might be interested in joining the TICK-L.

 

Details please! I couldn't find any info on this last night, I'd like to join.

 

 

Sorry! I guess the link would've been helpful!

 

TICK-L

[Guest MZH]

Again, Protatek is not reliable when it comes to babesia results, so that titer may not even be accurate. If you want to run serology only, you can do that through NC State as well.

 

Meredith, could you please elaborate on Protatek unreliability with Babesia titers? I hadn't heard that before.

 

Our Rita had a positive Babesia titer of 1:320 before we adopted her. We gave her the imidobarb shots and 2 years after the shots, she's still got the same titer as per Protatek. I was shocked to see nothing had changed in 2 years.

 

At this point if I were to test yet again I'd do the PCR at NC since the Protatek titers haven't changed. Babesia is vexing.

 

Incidentally, I've asked about the unchanged titers on the Tick-L and didn't get any responses so if you do, I'd appreciate your sharing what they said. I'm very interested in hearing anything at all about Babesia. For all I know, Rita's titer may be even higher by now.

 

Marcia in SC

[turbotaina]

Again, Protatek is not reliable when it comes to babesia results, so that titer may not even be accurate. If you want to run serology only, you can do that through NC State as well.

 

Meredith, could you please elaborate on Protatek unreliability with Babesia titers? I hadn't heard that before.

 

Our Rita had a positive Babesia titer of 1:320 before we adopted her. We gave her the imidobarb shots and 2 years after the shots, she's still got the same titer as per Protatek. I was shocked to see nothing had changed in 2 years.

 

At this point if I were to test yet again I'd do the PCR at NC since the Protatek titers haven't changed. Babesia is vexing.

 

Incidentally, I've asked about the unchanged titers on the Tick-L and didn't get any responses so if you do, I'd appreciate your sharing what they said. I'm very interested in hearing anything at all about Babesia. For all I know, Rita's titer may be even higher by now.

 

Marcia in SC

 

Dr. Couto has noted in many of his speeches his difficulties with Protatek. They turned up an abnormally high incidence of babesia, when the same blood sent to other labs came back negative. When he confronted them about this and asked them to retest, they could not replicate results and won't discuss this with him.

[Guest MZH]

Hmmm, thanks Meredith.

 

The next time we draw blood we'll draw enough for a NC PCR. I'd be so relieved if she's really negative. The funny thing about Rita is that she had a full tick panel run along with 19 other fresh-off-the-track dogs. She was the only one positive for Babesia -- or anything -- so I figured it wasn't a fluke. Puzzling -- and fascinating.

 

Marcia

[Guest rosebudd]

Hello I have a son with Lyme disease and from what I have read on tick diseases they will alwasy test positive for it because it lays dormant in the body and every once and a while it will release little "guys" here and there and thats when you get a flare up in symptoms. I was reading an article from a doctor that said a year of antibiotics should be the course for tick diseases. Why the doctors don't do this I will never know. So I did an all natural route with my son and he has been taking cats claw for almost a year (they suggest 18 months). I read about a study that included lymes disease and the cats claw, of the people given only antibiotics their symptoms returned and they always tested positive for it, of the cats claw group 85%-90% tested negative after the 18 month treatment. Maybe taking the doggie to a holistic or all natural vet may be worth it. Hope this helps

[gracegirl]

I spoke with the vet last night. He was doing some research since these diseases are so rare around here so it took him a bit to get back to me (in fact, this is the first time he's even seen a positive titer for babesia). We decided to send samples to NC St. to titer again for babesia and he also recommended we do the PCR at the same. I'm taking Grace in on Tuesday or Wednesday to draw blood, and we'll overnight it to NC St. I'm still thinking I might do the titer first, then the PCR if the titer again comes back that high. If I can save a few dollars, that's fine by me. The vet also mentioned that I shouldn't be too alarmed that it came back higher, because the difference is really not THAT much. It seemed like a lot to me, but he reassured me the titers can go quite high so jumping two levels from 1:160 to 1:640 is not horrible.

 

So now it's just wait and see! I'm very curious to see what happens as I don't 100% trust the Protatek results. I'll keep you posted.

[Guest myjazzy]

Looking for an update on Grace's Babesia tests. Did you send the blood to NCU and, if so, what were the results? I just had my girl, Gem come back with a positive Babesia titer--1:160.

[feemandvm]

This case shows why testing all healthy dogs really opens up Pandora's box. Aside from teh expense associated with the testing, there is a risk of false positive results at some labs and then there is the fact that a positive titer shows exposure to the organism only and not true infection. It is easy to just "treat" a positive titer but Imizol isn't a benign drug and can have significant side effects. We also know teh shots are painful and not fun for the dog. I wouldn't treat myself with Imizol unless I knew I needed it so why would I do this to my dog?

 

Rescues would be MUCH better off doing complete bloodwork and urine analysis instead of doing TBD titers. If the bloodwork was abnormal, then pursuing TBD titers would make a lot more sense.

 

As others have said... start with a titer at NCSU, if positive do a PCR and have your vet consult with the TBD doctors there. If titer is positive, PCR is negative nad bloodwork and exam are good... it is hard to argue that treatment is warranted.