Tick Borne Diseases- Anyone With Medical Knowledge?

[Guest BooBooMama]

I remember when BooBoo was sick a couple of years ago (ended up being a virus) the E-Vet wanted to test her for tick borne diseases. I told him she was already tested and he said that there are several different types of tick borne diseases and there is not one test for all.

 

That being said, which tests should I request for Houdini tomorrow? The only titers tests I know of is the Snap3. Will that be enough? I have heard that each geographic areas of the US has different tick disease- she is from FL.

[Guest Energy11]

Here is what I did on all five of mine:

 

I had the vet draw and spin down the blood. Then, I sent it to Protatek Reference Labs in Arizona. You can just call them, and they will tell you which panel to check off.

 

Good Luck! Dee and The Five http://www.protatek.com/PDF/Requisition_Form.pdf

[Guest BooBooMama]

Here is what I did on all five of mine:

 

I had the vet draw and spin down the blood. Then, I sent it to Protatek Reference Labs in Arizona. You can just call them, and they will tell you which panel to check off.

 

Good Luck! Dee and The Five http://www.protatek....sition_Form.pdf

 

 

Thanks.

[Guest Energy11]

Here is what I did on all five of mine:

 

I had the vet draw and spin down the blood. Then, I sent it to Protatek Reference Labs in Arizona. You can just call them, and they will tell you which panel to check off.

 

Good Luck! Dee and The Five http://www.protatek....sition_Form.pdf

 

 

Thanks.

 

No problem! It used to cost about $52, give or take a buck. It IS A COMPREHENSIVE TEST,and worth the price! Good Luck!

[greyhndz]

I agree with Dee's recommendation. Cindy Holland at Protatek is very, very well-versed on TBD. She's also very accessible, and if you call to talk with her, she can discuss the case with you, and dependent upon your location and the dog's symptoms, she will recommend the appropriate tests. Cindy is a fantastic resource.

 

Protatek Info

 

Protatek Reference Laboratory

574 East Alamo Drive, Suite 90

Chandler, AZ 85225

Telephone: (480) 545-8499

Fax: (480) 545-8409

Dr. Cynthia Holland: The laboratory is operated by Dr. Cynthia Holland, Ph.D., an authority on tick borne infectious diseases. Dr. Holland has authored and co-authored over 75 papers in peer reviewed journals and scientific presentations. Dr. Holland was responsible for the original isolation and identification of Ehrlichia (Neorickettsii) risticii, the causative agent of Potomac Horse Fever.

 

For technical questions and consultation: Dr. Cyndi Holland - cholland@protatek.com

For general questions: Jennifer Podulka - jpodulka@protatek.com

 

[CaliforniaGreys]

What about Babesia? Isin't that a test all on its own?

[Hubcitypam]

You want a #47 at Protatek. It's the "greyhound special" -- Eherlicha, RMSF, Babesia and Lyme all for around $60. Before I knew better a vet here tried to charge me almost $100 for Babesia alone.

 

You can just have your vet draw the blood and pop in overnight mail. However, my previous vet was so impressed with the prices when I showed him what I was doing he immediately opened up an account with them.

Edited May 2, 2010 by Hubcitypam

[greyhndz]

What about Babesia? Isin't that a test all on its own?

 

No, b. canis is part of the routine tick panel. Req Form

 

The thing is, different strains of each organism are prevalent in different parts of the country, and there are different panels available depending on what testing should be done. Here's where Cindy is a huge help: she can make specific recommendations on testing for organisms that are prevalent in your area. Sometimes she will recommend adding on additional strains to test for. She'll also recommend if and when the dog should be re-tested to determine if titres are increasing, decreasing or remaining the same, which reflects the stage of disease.

 

If she suggests testing for one strain vs a strain on the generic tick panel, she'll often just substitute without any addl. charge.

 

I've found that it's usually far cheaper to have the vet or tech draw the blood, then package it yourself on ice and send it overnight. Cindy can tell you what to put on the requisition form, and you can either send a check or have them bill you.

[Guest BooBooMama]

What about Babesia? Isin't that a test all on its own?

 

No, b. canis is part of the routine tick panel. Req Form

 

The thing is, different strains of each organism are prevalent in different parts of the country, and there are different panels available depending on what testing should be done. Here's where Cindy is a huge help: she can make specific recommendations on testing for organisms that are prevalent in your area. Sometimes she will recommend adding on additional strains to test for. She'll also recommend if and when the dog should be re-tested to determine if titres are increasing, decreasing or remaining the same, which reflects the stage of disease.

 

If she suggests testing for one strain vs a strain on the generic tick panel, she'll often just substitute without any addl. charge.

 

I've found that it's usually far cheaper to have the vet or tech draw the blood, then package it yourself on ice and send it overnight. Cindy can tell you what to put on the requisition form, and you can either send a check or have them bill you.

 

I am trying to remember where my vet sent BooBoo's blood last time. I remember it was out of state because he thought it was the best place to test so he might be working with them already and the E-Vet may have soaked me with a duplicate test! I will call Cindy and ask her what she thinks. If she is already working with my vet I will simply let him send in the sample. If not I will bring along a form and bring Protatek to his attention.

[Guest Energy11]

You want a #47 at Protatek. It's the "greyhound special" -- Eherlicha, RMSF, Babesia and Lyme all for around $60. Before I knew better a vet here tried to charge me almost $100 for Babesia alone.

 

You can just have your vet draw the blood and pop in overnight mail. However, my previous vet was so impressed with the prices when I showed him what I was doing he immediately opened up an account with them.

Yep! That's the test all right! Yes, Babesia is included. I KNOW! Most vets don't test for Babesia, UNLESS you request it. Four out of five of mine had positive Babesia titers, but I did PCRs on all as well. Protatek is AWESOME!

[Batmom]

Is the dog sick, or are you just looking to screen?

 

Lots of folks use Protatek for titers and are happy with them. The major labs used by most vets (Antech, IDEXX) now offer rapid PCR panels (different technology than titering) in most areas of the country. U of Illinois and probably Iowa and Wisconsin as well do titers, not sure about PCRs. For a sick dog with unclear symptoms, I like North Carolina State University's tick lab as you can send the sample for titer and specify follow-up PCR if the titer is suspicious. You can probably do that at other universities but NCSU kinda specializes.

 

If the dog is just off the track and isn't showing signs of illness or funky bloodwork, I might go with the Snap-4 and wait 6 months before pursuing other testing. A dog straight out of a tick ridden environment is likely to have some significant antibody activity -- that's a *good* thing! -- and thus a rather high titer ... but in a healthy dog that will normally drop to a more reasonable and useful number over time. The Snap-4 (or older Snap-3) is designed to catch the really high ones, which are most likely to indicate current infection.

[Batmom]

The newer FastPanel PCRs do test for just about everything. See for example: http://antechonline....%20test3&n2=lt3

 

Here's some more info for the more geekily inclined: http://antechonline....s/ACVIM2009.pdf

 

And here's some info on IDEXX's similar tests: http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/reference-laboratories/diagnostic-updates/vector-borne-disease-panels.pdf

Edited May 3, 2010 by Batmom

[Batmom]

A high titer is not a good thing.

 

I didn't mean high enough to trip a snap 4, for example. If it were that high, you'd want to do some follow up testing.

 

A single titer unless exceptionally high is not terribly meaningful in a dog with good bloodwork and no clinical signs. It indicates that the dog was exposed to the organism, and that the dog's immune system mounted a response. It doesn't indicate that the dog has the disease or had it in the past.

 

AFAIK the only thing you'd see a vaccine-related response for is Lyme disease.

[kudzu]

If this is just a routine vet visit or new dog wellness check then personally I would just go with the Snap 4. If you wanted to get a baseline for possible TBD treatment in the future then it doesn't hurt to run the Protatek tests but know that the results may end up initially confusing you more than helping you. Well, that is if you are blood work numbers obsessed as I am.

 

A single titer unless exceptionally high is not terribly meaningful in a dog with good bloodwork and no clinical signs. It indicates that the dog was exposed to the organism, and that the dog's immune system mounted a response. It doesn't indicate that the dog has the disease or had it in the past.

 

AFAIK the only thing you'd see a vaccine-related response for is Lyme disease.

I think ehrlichia may be an exception here. Would you not want to treat for a positive ehrlichia from the tick panel even if it had been negative on the Snap4? Not sure about anaplasma but the Lyme & babesia I do agree on. Also, aren't the current Snap3 & Snap4 tests sensitive enough that they do not show false positive for dogs who had a Lyme vaccine? Or perhaps I should say, isn't that the manufacturers claim?

 

Testing for & treatment of TBDs in an asymptomatic or mildly symptomatic dog is not straightforward. Here is my limited experience in my usual long winded way. Both my Greys were negative on the Snap tests, Snap3 for the first dog when Snap4 wasn't out yet & Snap4 for the second. For both, we later sent out for tick panels & in both cases I chose to treat with doxy. We had sent out for the tick panel because they were symptomatic, though in different ways. For my girl, Lyme was the only positive result & it was equivocal. My boy came back similar for Lyme though slightly lower. Babesia was not included in his. Cannot remember why but likely because it wasn't sent to Protatek because of his different circumstances. We ran it later, allowing the vet to send to their usual source. The results though did come back from Protatek.

 

Treatment turned out to be the correct choice for my girl's equivocal Lyme results. Her symptoms resolved & she was like a new dog. Because her symptoms were vague, she was a new adoption with no medical history from racing & I had never had Greys before I really had no idea whether she was "normal" or not. (I adopted my boy a year after her.) Her bloodwork was normal. It was her symptoms, mild, lameness in a wrist that later seemed to shift to the other leg, that caused us to test further. The surprise was the change in her attitude, energy & activity level after treatment. Clearly there had been more going on than we realized.

 

For my boy's positive babesia results I thought long & hard before choosing treatment. His bloodwork, still out of wack after Lyme treatment, was the biggest reason we ran the panel. His other symptoms were vague & would have been presumed to be from age without the messed up bloodwork. The symptoms did not improve with doxy. The reason it was a hard choice is that his CBC & blood chem was not pointing clearly to babesia. There were other possibilities more likely possibilities. A couple were easy rule outs though & the last at that time required a bone marrow sample, a test I was not willing to subject him to. We did treat him with imidocarb. He handled it quite well except for the pain of the actual injection. He breezed through treatment. In the end, we found he has a form of leukemia, CLL. (That's a whole other long, vet med story.) I do not regret treating for both Lyme then babesia. We, the vet & I, made the best decisions we could with the info we had at the time. Hopefully we will never know if treating for babesia was correct or not. It may have been considering his CLL status. If my girl had tested positive for babesia I would have waited until after treating for Lyme to see how/if she improved before considering treating for babesia.

 

Will add that there are different babesia tests. They can look for the parasite in a blood smear. I doubt anyone would choose this test if the dog were asymptomatic. There is little chance of false positive. Testing negative on the blood smear doesn't rule out babesiosis though. At the same time testing positive on a Protatek panel for the antibodies doesn't prove babesiosis either since their test looks for antibodies not the actual parasite. Treating for babesia does not guaranty anything. As I understand it, it isn't like you treat & it is gone from the dog completely for life even without reinfection. If the dog is not currently sick, most vets would not encourage & may flat out refuse to treat. Treatment is expensive, painful for the dog especially if extra care is not taken & can be risky.

 

Won't go into my dad's story of HGE except to say it blessedly had a happy ending & treatment was similar to canine ehrlichia. Ditto on my BFs Lyme disease & my critter sitters RMSF. Thank heavens we have yet to deal with anaplasmosis. Rest assured, we do not take TBDs lightly around here yet we do not rush to treat just because of positive antibodies.

Edited May 3, 2010 by kudzu

[Guest BooBooMama]

If this is just a routine vet visit or new dog wellness check then personally I would just go with the Snap 4. If you wanted to get a baseline for possible TBD treatment in the future then it doesn't hurt to run the Protatek tests but know that the results may end up initially confusing you more than helping you. Well, that is if you are blood work numbers obsessed as I am.

 

A single titer unless exceptionally high is not terribly meaningful in a dog with good bloodwork and no clinical signs. It indicates that the dog was exposed to the organism, and that the dog's immune system mounted a response. It doesn't indicate that the dog has the disease or had it in the past.

 

AFAIK the only thing you'd see a vaccine-related response for is Lyme disease.

I think ehrlichia may be an exception here. Would you not want to treat for a positive ehrlichia from the tick panel even if it had been negative on the Snap4? Not sure about anaplasma but the Lyme & babesia I do agree on. Also, aren't the current Snap3 & Snap4 tests sensitive enough that they do not show false positive for dogs who had a Lyme vaccine? Or perhaps I should say, isn't that the manufacturers claim?

 

Testing for & treatment of TBDs in an asymptomatic or mildly symptomatic dog is not straightforward. Here is my limited experience in my usual long winded way. Both my Greys were negative on the Snap tests, Snap3 for the first dog when Snap4 wasn't out yet & Snap4 for the second. For both, we later sent out for tick panels & in both cases I chose to treat with doxy. We had sent out for the tick panel because they were symptomatic, though in different ways. For my girl, Lyme was the only positive result & it was equivocal. My boy came back similar for Lyme though slightly lower. Babesia was not included in his. Cannot remember why but likely because it wasn't sent to Protatek because of his different circumstances. We ran it later, allowing the vet to send to their usual source. The results though did come back from Protatek.

 

Treatment turned out to be the correct choice for my girl's equivocal Lyme results. Her symptoms resolved & she was like a new dog. Because her symptoms were vague, she was a new adoption with no medical history from racing & I had never had Greys before I really had no idea whether she was "normal" or not. (I adopted my boy a year after her.) Her bloodwork was normal. It was her symptoms, mild, lameness in a wrist that later seemed to shift to the other leg, that caused us to test further. The surprise was the change in her attitude, energy & activity level after treatment. Clearly there had been more going on than we realized.

 

For my boy's positive babesia results I thought long & hard before choosing treatment. His bloodwork, still out of wack after Lyme treatment, was the biggest reason we ran the panel. His other symptoms were vague & would have been presumed to be from age without the messed up bloodwork. The symptoms did not improve with doxy. The reason it was a hard choice is that his CBC & blood chem was not pointing clearly to babesia. There were other possibilities more likely possibilities. A couple were easy rule outs though & the last at that time required a bone marrow sample, a test I was not willing to subject him to. We did treat him with imidocarb. He handled it quite well except for the pain of the actual injection. He breezed through treatment. In the end, we found he has a form of leukemia, CLL. (That's a whole other long, vet med story.) I do not regret treating for both Lyme then babesia. We, the vet & I, made the best decisions we could with the info we had at the time. Hopefully we will never know if treating for babesia was correct or not. It may have been considering his CLL status. If my girl had tested positive for babesia I would have waited until after treating for Lyme to see how/if she improved before considering treating for babesia.

 

Will add that there are different babesia tests. They can look for the parasite in a blood smear. I doubt anyone would choose this test if the dog were asymptomatic. There is little chance of false positive. Testing negative on the blood smear doesn't rule out babesiosis though. At the same time testing positive on a Protatek panel for the antibodies doesn't prove babesiosis either since their test looks for antibodies not the actual parasite. Treating for babesia does not guaranty anything. As I understand it, it isn't like you treat & it is gone from the dog completely for life even without reinfection. If the dog is not currently sick, most vets would not encourage & may flat out refuse to treat. Treatment is expensive, painful for the dog especially if extra care is not taken & can be risky.

 

Won't go into my dad's story of HGE except to say it blessedly had a happy ending & treatment was similar to canine ehrlichia. Ditto on my BFs Lyme disease & my critter sitters RMSF. Thank heavens we have yet to deal with anaplasmosis. Rest assured, we do not take TBDs lightly around here yet we do not rush to treat just because of positive antibodies.

 

She has begun to limp so it is more critical now to rule out TBD's.

[Guest MZH]

Rita was treated for Babesia with the two shots and 2-3 years later with doxy because she still had the same titer. The shots were useless for her. Her titer just went down after 5 years of doing nothing else. She *was* on fluoxetene for nerves and T-storm phobia but every time she had a blood draw she was had huge sub cu bleeding, like 3 to 6 inches in size. She's off it now and it hasn't happene again yet. I don't know if iot's from the Babseia or the fluoxeten but I suspect the latter, not the former.

 

Rita didn't limp from her Babseia but she acted almost autistic when we first got her. From Babesia! I wish I knew! I'm glad you're having the test run.

 

Graham had one of the fast type panel from Idexx last year and it cost the vet $138. He was being tested as a blood donor. It was a big test, for sure.

 

Thanks for the links, Batmom. I'm putting them into the Medical Website Links section of the articles website. (I'm sorta geeky, too.) I'm sure Jordan has them in Greythealth too.

[Batmom]

If this is just a routine vet visit or new dog wellness check then personally I would just go with the Snap 4. If you wanted to get a baseline for possible TBD treatment in the future then it doesn't hurt to run the Protatek tests but know that the results may end up initially confusing you more than helping you. Well, that is if you are blood work numbers obsessed as I am.

 

Thank you for stating clearly what I was trying to say and fuddling up .

 

I really like the PCR to follow if titer (or symptoms) is suspicious.

[HopeForHounds]

If this is just a routine vet visit or new dog wellness check then personally I would just go with the Snap 4. If you wanted to get a baseline for possible TBD treatment in the future then it doesn't hurt to run the Protatek tests but know that the results may end up initially confusing you more than helping you. Well, that is if you are blood work numbers obsessed as I am.

 

Thank you for stating clearly what I was trying to say and fuddling up .

 

I really like the PCR to follow if titer (or symptoms) is suspicious.

 

 

That's what I would do too. One of the problems with testing is that you have to know exactly what you are testing for.

 

Jake had PCR tests for the basics when he became a blood donor. A few years after that he began to have odd symptoms, leg swelling, fever and lameness that suggested he had an autoimmune disease. His joint tap and other blood work came back okay. Even Dr Couto was baffled and said if I could bring him in a full flair up they might be able to figure things out.

At Christmas we had a crisis when two of his back legs were involved and he could barely stand. In desperation we went with tick disease treatment. The reason my vet chose to do that instead of testing is that she felt we could spend a fair bit of money on each titre test or just spend the money on treatment. One month of doxy and he has been fine ever since.

[Guest BooBooMama]

UPDATE:

Took Houdini to the vet and voiced my concerns that the standard Snap 4Dx did not cover Babesia. He works with Protatek so he is going to do have them run one of their more complete TBD panels - the Greyhound Special- and I paid the difference for the adoption group. I feel much better about that.

Thanks everyone.

[Guest Energy11]

UPDATE:

Took Houdini to the vet and voiced my concerns that the standard Snap 4Dx did not cover Babesia. He works with Protatek so he is going to do have them run one of their more complete TBD panels - the Greyhound Special- and I paid the difference for the adoption group. I feel much better about that.

Thanks everyone.

Good move on the Protatek testing! Hope it all works out positive!

 

We send you lots of love and many prayers!

[Guest BooBooMama]

I thought I had better update this here as well.

I ended up having a Greyhound Special TBD test from Protatek labs done on Houdini. Houdini tested positive for Babesia canis but she had a low score of 1:80. We followed up with a CBC and a VCLT test and everything looks normal as far as Babesiosis so my vet feels we do not need to treat with Imizol at this time. We will do a PCR in six months and if we see anything at that time then we will start the Imizol injections.

[Guest Energy11]

I have two with that titer ratio. PCRs all normal. Dogs WONDERFUL! They are both nine! I wouldn't treat, no way, but I would get the PCR done in the future.

 

I forwarded the other info you emailed me to my buddy and former vet/employer. I will get back to you when he gets back to me, but it all looks fine!

 

[Guest BooBooMama]

I have two with that titer ratio. PCRs all normal. Dogs WONDERFUL! They are both nine! I wouldn't treat, no way, but I would get the PCR done in the future.

 

I forwarded the other info you emailed me to my buddy and former vet/employer. I will get back to you when he gets back to me, but it all looks fine!

 

 

You are the BEST. Thank you for doing this for me.

As for the PCR, my vet wants to do it in 6 months to be on the safe side.