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Lyme: test or just treat? Update: positive test results

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  • Lyme: test or just treat? Update: positive test results

    It just clicked into place for me today that my horse Monarch likely has Lyme. Weight loss, a bit dull, mostly lethargic on his rides (although he will perk up sometimes), and a bit stiffer than usual. When I finish a ride and untack he just kind of hangs his head like he is exhausted, even if it has been just a light hack. I feel kind of stupid, especially since my other horse tested positive earlier in the summer. And I had already scheduled the vet to come and look at him, but I really wasn't thinking Lyme.

    Now I am thinking I will call the vet tomorrow and see if I can go ahead and pick up some doxy and start treating him. If I wait until the test comes back that will be the end of next week (vet is coming on Tuesday). And if I do start him on the doxy tomorrow, will 4-5 days of treatment affect the Lyme test?

    Opinions? Thanks!
    Last edited by kcmel; Nov. 8, 2013, 05:07 PM. Reason: grammar!

  • #2
    Given that the Cornell test gives you pretty detailed info that can be useful in the future to compare, I'd say test. I felt a little bit different when the only test choices were more crude (and because I was experienced with what my horses acted like when they had lyme). But with the Cornell test, worth the info to know how infected and when the infection likely started.
    ~Veronica
    "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
    http://photobucket.com/albums/y192/vxf111/

    Comment


    • #3
      If you know you are using doxy, you could always have the vet draw the blood then start the doxy that day. If you are looking at using something else, then waiting for the results wouldn't be a bad idea. It would save you the cost of having to switch meds.
      "The difference between genius and stupidity is that genius has its limits." Albert Einstein

      http://s1098.photobucket.com/albums/...2011%20Photos/

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      • #4
        There is more than one Tick borne disease, a horse or human can actually have more than one at a time. a friend just lost one of her horses who was being treated for Lyme disease because he had another tick disease at the same time that didn't respond to the treatment given for the Lyme Disease. He ended up with renal failure and had to be euthanized.

        Get the test but ask about the other tick borne diseases also, then treat and treat agressively if positive. Doxycycline alone isn't always sucessful.

        Comment

        • Original Poster

          #5
          The only other tick-borne disease that I have ever tested for is anaplasma, and to my knowledge those symptoms are much more acute (high fever, etc.). What did your friends horse have?

          Comment


          • #6
            Subjective
            Objective
            Assessment
            Plan

            SOAP

            How can you have a Plan without an Assessment?

            Treatment with antibiotics without a demonstrated need for antibiotics leads to breeding bigger, better bugs.

            Patience is important. That includes patience in doing the first two parts of the SOAP.

            Get diagnosis, then treat; not the other way 'round.

            G.
            Mangalarga Marchador: Uma Raça, Uma Paixão

            Comment


            • #7
              Originally posted by Guilherme View Post
              Subjective
              Objective
              Assessment
              Plan

              SOAP

              How can you have a Plan without an Assessment?

              Treatment with antibiotics without a demonstrated need for antibiotics leads to breeding bigger, better bugs.

              Patience is important. That includes patience in doing the first two parts of the SOAP.

              Get diagnosis, then treat; not the other way 'round.

              G.
              Regretfully with Lyme that is not always practical. I know the testing for animals has improved greatly but the one they use on people is abysmally inaccurate. DH never tests positive but gets the symptoms. He has been treated twice based on symptoms that go away after the doxy and are gone for a year or so.

              Many vets in my area will start treatment based on symptoms since the horses and dogs tend to get such quick relief from the doxy. I am in OP's area and we have a really high prevalence of Lyme. The chances of it being Lyme is so high many vets are willing to start to treat rather than wait for the results.

              DH and I have had it multiple times. Sonny had it. My lab had it, friend had it, both of her dogs have had it, 2 out of her 3 horses have had it. Her one dog has had it twice and the other one had Lyme once and then anaplasmosis later.

              OP- I would be inclined to start treatment now based on symptoms as long as the vet does not think it would potentially screw up the results on the Cornell lyme test.
              Oh, well, clearly you're not thoroughly indoctrinated to COTH yet, because finger pointing and drawing conclusions are the cornerstones of this great online community. (Tidy Rabbit)

              Comment

              • Original Poster

                #8
                Thanks guys. I have a call in to the vet to discuss; I will let you know what she says.

                Comment


                • #9
                  Lyme is so poorly understood. Such a controversial disease. Good luck. I am struggling with a similar issues with my OTTB. I have decided not to treat for a Cornell test showing low positive on the chronic titer. I have made this decision based soley off independent research. Have not had ANY help from my vet or any other vets. I know more than any I have talked to. For example the last vet I tried to get an opinion said "I've never heard of doxy causing problems with ulcer prone horses". Really, yeah, you're fired.

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                  • #10
                    I talked with my vet recently about my horse and his issues. He felt that my horse wasn't presenting with typical Lyme symptoms and that he felt we should try a couple of other options first.

                    In our discussion on Lyme and the whole idea of treating prior to testing, he said he had read a paper recently that many of the horses who were treated for Lyme prior to the testing from Cornell returning improved significantly. When the tests came back negative, he looked into the reasons why the horses would have improved so significantly if it wasn't Lyme. He found that Doxy has anti inflammatory properties. The horses improved because the Doxy got rid of the inflammation that was causing discomfort, not due to fighting off the disease.

                    Food for thought.

                    Comment


                    • #11
                      I would absolutely test first. Doxy is an anti inflammatory and will cover up any pain and you may be in the same spot in a month when you're done treating. Also, if your horse has a high chronic level he might need something stronger than Dozy to treat it. The test isn't very expensive and made a huge difference for my horse. He did have very high levels and we used stronger antibiotics and now he's like a new horse. He also did not show the typical symptoms and was very stoic.

                      Comment


                      • #12
                        Doxycycline is also the drug of choice to treat anaplasmosis (formerly know as Ehrlichia) also. So even if the horse had some other tick disease, treating with doxy may have cured the disease. Some also suggest one day of IV oxytetracycline followed by 7 days of doxy or 4-5 days of IV oxytetracycline.

                        FWIW, we just had an outbreak of anaplasmosis at our barn within the last 3 weeks. 4 horses out of 8 were affected. All have recovered. Doxy was hard to get. Back0-ordered almost everywhere but compounding pharmacies. By the time mine arrived from Wedgewood, my horses were back to normal, leg swelling and fevers gone. Now, I have a large bottle of doxy capsules sitting around with nothing to do.

                        Comment


                        • #13
                          Originally posted by jawa View Post
                          I talked with my vet recently about my horse and his issues. He felt that my horse wasn't presenting with typical Lyme symptoms and that he felt we should try a couple of other options first.

                          In our discussion on Lyme and the whole idea of treating prior to testing, he said he had read a paper recently that many of the horses who were treated for Lyme prior to the testing from Cornell returning improved significantly. When the tests came back negative, he looked into the reasons why the horses would have improved so significantly if it wasn't Lyme. He found that Doxy has anti inflammatory properties. The horses improved because the Doxy got rid of the inflammation that was causing discomfort, not due to fighting off the disease.

                          Food for thought.
                          Maybe. Unless he tested for a whole host of other things too and they came back neg, he doesn't REALLY know what else was going on which might have been being addressed by the doxy.
                          Airborne? Oh. Yes, he can take a joke. Once. After that, the joke's on you.

                          Comment


                          • #14
                            Originally posted by jawa View Post
                            I talked with my vet recently about my horse and his issues. He felt that my horse wasn't presenting with typical Lyme symptoms and that he felt we should try a couple of other options first.

                            In our discussion on Lyme and the whole idea of treating prior to testing, he said he had read a paper recently that many of the horses who were treated for Lyme prior to the testing from Cornell returning improved significantly. When the tests came back negative, he looked into the reasons why the horses would have improved so significantly if it wasn't Lyme. He found that Doxy has anti inflammatory properties. The horses improved because the Doxy got rid of the inflammation that was causing discomfort, not due to fighting off the disease.

                            Food for thought.
                            That is true.... but even if that's true, if the doxy resolves the inflammation and subsequently the horse has no further problems-- is that so bad?!
                            ~Veronica
                            "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                            http://photobucket.com/albums/y192/vxf111/

                            Comment


                            • #15
                              Typically when treated with Doxy the horse will have to be re-treated a year or so later as many people on this board have said they had to do. If you could treat with Doxy once and never have a problem again then maybe it would be worth it but to me I think it just covers up an undiagnosed problem or doesn't fully treat the Lyme because it isn't strong enough.

                              Comment


                              • #16
                                Originally posted by stargzng386 View Post
                                Typically when treated with Doxy the horse will have to be re-treated a year or so later as many people on this board have said they had to do. If you could treat with Doxy once and never have a problem again then maybe it would be worth it but to me I think it just covers up an undiagnosed problem or doesn't fully treat the Lyme because it isn't strong enough.
                                I think there are so many protocols that the vets use for doxy it is hard to compare. One local vet does 30 pills twice a day for 21 days. Another says he has colic issues when he prescribes that many pills at once so does 20 pills twice a day for 30 days. I know some vets now do 45 days. Another vet does 50 pills twice a day for 30 days. All the same strength pill with about the same size horse. Which vet is under treating? Is the 45 day vet overtreating?

                                Plus if it is coming back a year later was it due being a new separate case or a flare of a chronic condition? Big controvery on whether chronic Lyme exists- at least in humans.

                                Personally I think 30 days is too short. I also think that the longer the animal/person has had Lyme before being treated you need to treat longer for it to be effective.

                                My Lyme doctor's protocol is to treat 4-6 weeks after the last symptom. Which is much easier to determine with a human. I don't tolerate doxy so I have use Amoxicillin three times a day plus Zithro once a day. Can we say probiotics?

                                Anytime I treat my horse or dogs with doxy I give a probiotic and the dogs get yogurt too. I figure it can't hurt.
                                Oh, well, clearly you're not thoroughly indoctrinated to COTH yet, because finger pointing and drawing conclusions are the cornerstones of this great online community. (Tidy Rabbit)

                                Comment

                                • Original Poster

                                  #17
                                  Here are Monarch's results:
                                  OspA Value: 398 Negative
                                  OspC Value: 502 Equivocal
                                  OspF Value: 4966 Positive

                                  So it looks like a chronic infection. Poor boy--he is so stoic that it is hard to tell when he is not feeling well. Until the last few weeks anyway. Even though the vet agreed that he looked quite dull, the good news is that he didn't really have any other symptoms such as soreness or lameness. I started him on the doxy on Tuesday when she pulled the blood.

                                  Comment


                                  • #18
                                    I would definitely do IV oxytet for a chronic infection. Jingles.
                                    McDowell Racing Stables

                                    Home Away From Home

                                    Comment


                                    • #19
                                      Originally posted by Laurierace View Post
                                      I would definitely do IV oxytet for a chronic infection. Jingles.
                                      Latest from Cornell: IV oxytet not necessary. Which is great, it's such nasty stuff.
                                      Some riders change their horse, they change their saddle, they change their teacher; they never change themselves.

                                      Remember the horse does all the work, we just sit there and look pretty.

                                      Comment

                                      • Original Poster

                                        #20
                                        I hope we don't have to do the IV oxytet. My other horse that tested positive early in the summer responded well to the doxy. His recent test looked good. But I don't have his original numbers--I will have to get them on Monday to compare.

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