Tuesday, March 27, 2018

Veterinarians Answer: Lyme Vaccine - Yay or Nay?

After a year of finding ticks on Cookie back-to-back, we were deliberating what the best options were to protect her from tick-borne infections. Lyme disease is the disease most commonly transferred by ticks. Lyme vaccine did make it on the list of things we discussed.

What do veterinarians think about this measure to prevent Lyme disease?


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The answer to the question where I practice is YES.

Which means for some dogs Lyme vaccine will never be needed, and for some, it makes a lot of sense.

In my area ticks are moderate in the probability of a pet having a tick attach and feed sometime over the course of a year.

Secondly, a sampling of local ticks revealed 10% are infected with Lyme. Multiplying the two numbers we end up with a relatively low probability of Lyme disease being acquired by any given dog, any given year in our area.

So I try to get people to concentrate on tick and flea control as those steps have high value to cost involved. This reduces the risk of attachment and feeding. Fleas are also controlled.

The vaccine is for those that travel to higher Lyme disease risk areas than my LOCAL environment, for households not able to engage with reliable tick control, and for those with a desire to vaccinate and control the risks they can control.

AGAIN these opinions are for MY area. Before deciding to or deciding not to vaccinate, ask someone who actually knows what the risks of Lyme are in your area.

These comments are wrong for both a high-risk Lyme area and a zero risk Lyme area.

Final thought, where I am there is a Rabies outbreak. Prioritize your pets preventative medicine measures according to the steps that grant the greatest value.

—Dr. Rae Worden, DVM, Fergus Veterinary Hospital
    Dr. Rae on Facebook and Twitter

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In the United States, there are several vaccines available to help protect against Lyme disease.

They all work by stimulating the production of antibodies against proteins expressed by Borrelia burgdorferi, the causative agent for Lyme Disease. These proteins are called outer surface proteins or Osp.

Why is this important?

OspA is expressed only when the bacteria in the mid-gut of ticks, and OspC is only expressed once the bacteria are inside dogs. Thus, ticks ingest the anti-OspA antibodies that subsequently kill the bacteria inside the tick. The anti-OspC antibodies attack the bacteria inside the dog.

Patients who do not live in endemic areas should not be vaccinated. There is no evidence showing vaccinating seropositive dogs without clinical signs is indicated; indeed, this course of action may have consequences.

For this reason, I recommend dogs be tested for exposure prior to receiving the vaccination. Vaccination may be appropriate for dogs living in a region where Lyme disease is prevalent. Dog parents should speak with their primary care doctors about the benefits, limitations, and potential risks of vaccination.

Unquestionably the best method for preventing Lyme disease is aggressive, year-round tick control. There are many products available, and pet parents should speak with their family veterinarian to identify the best option for their fur babies. When possible, one should also avoid common tick habitats like wooded areas, overgrown lawns, and low-lying vegetation.

—Dr. Christopher Byers, DVM, CriticalCareDVM
    Dr. Byers on Facebook and Twitter

Related articles:
Lyme Disease in Dogs – Borreliosis is a Bit of a Bugger!
Vaccines & Dogs – Which Ones Do They Really Need?


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To vaccinate your canine companion with Lyme disease or not to do so is a question with which many pet owners find themselves faced.

Lyme disease is caused by a spirochete (spiral-shaped) bacteria called Borrelia Burgdorferi that is transmitted from the bite of an infected tick into an animal host.

Prevention of Lyme disease can be accomplished by avoiding exposure to the organism by preventing the bite of Borrelia-carrying ticks (Ixodes or Deer tick).  Such can occur through geographic and lifestyle modifications and topical and oral preventive medications.

Lyme vaccination is available for dogs, but the decision to vaccinate your canine companion should be made while considering the below factors:

1. Geography and Climate


As Lyme disease-carrying ticks don’t thrive in all climates, your dog may live away from and never travel to an area where the disease may be encountered.

Parts of the US having greatest concern include the northeastern U.S., northern mid-Atlantic region, upper Midwest, and the northern California coast.  All ticks need an appropriate combination of warmth and humidity to support the tick life cycle so your place of residence, travel destination or seasonal climate may not match that in which the Deer tick prospers. If your pooch lives in or travels to the above locations of concern then being vaccinated for Lyme disease have a higher likelihood of being considered as being part of the veterinary health plan.

2. Lifestyle


If your dog lives in an environment where access to ticks is minimized then the risk of exposure to Lyme disease is minimized.  Dogs living primarily indoors lifestyles with minimal contact with grass, fields, forests, marshes, swamps, etc. are less likely to be bitten by any tick, much less the Deer tick.
If your dog has frequent access to the outdoors and areas where the tick lifestyle is supported then the risk of being exposed to Lyme disease is greater and vaccination may be considered.

3. Overall Health Status


Although most vaccinations available for our canine companions are generally safe, a single immunization could cause mild to severe health problems called vaccine-associated adverse events (VAAE). Mild examples of VAAE include lethargy, decrease appetite, soreness, and others. Severe examples of VAAE include anaphylaxis (allergic reaction), immune-mediated disease (IMHA, IMPA, IMT, etc.), and worsening of underlying ailments that are already present in the body.

Lyme disease is the vaccine most-associated with VAAE.

If your pooch currently has any significant health concerns then providing a vaccine (or more than one during a single appointment) at that time is not the appropriate plan, as doing so could increase the likelihood of VAAE.   Additionally, if your dog is taking immunosuppressive therapy to control immune-mediated diseases, cancer, or other ailments then providing a vaccination may not induce a protective level of immunity or could have detrimental health effects.

4. Potential for Unreliable and Short-Lived Protective Immunity


Lyme disease vaccination is considered a Non-Core vaccination (instead of a Core vaccination, like Rabies) as the vaccine may not convey a protective level of immunity, may not protect your dog for very long (booster vaccinations are recommended every 6-12 months), and although Borrelia bacteria are zoonotic (meaning it can pass from one species to another) it will not pass to owners from contact with their canine companion; it requires the tick vector to transmit it from among hosts/species.

5. Relatively Straightforward Treatment


If your pooch develops Lyme disease there’s a high success rate in resolving clinical signs when the diagnosis is made and an appropriate course of antibiotic therapy (Doxycycline, etc.) is undertaken.
Additionally, diagnosis of the disease and the cost of treatment are relatively inexpensive.

 —Dr. Patrick Mahaney
     Dr. Patrick on Facebook and Twitter 

Related articles:
Five Signs of Lyme Disease in Dogs
Lyme Disease: The Tragic Effects on Our Pets and Us

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In my opinion, the best way to protect dogs against Lyme disease is to use an effective tick preventative per label instructions.

Products that contain the active ingredient fipronil, permethrin, or amitraz can all work well. In extreme cases, dogs may need to be on more than one product at a time.

I had to use a monthly fipronil-based topspot and an amitraz collar on my dogs when we lived on a tick-infested farm in southeastern Virginia.

Talk to your veterinarian about which option would be best based on your situation.

Only when dogs are at exceptionally high risk for Lyme disease would I consider using the vaccine.

Dogs who spend a lot of time outside in the Lyme hotspots of the Northeast, Mid-Atlantic, and Upper Midwest would be candidates, but I would still emphasize the need for aggressive tick control over vaccination, even in these cases. I did vaccinate my dogs against Lyme when we lived in Virginia but stopped as soon as we moved to Wyoming.

 —Dr. Jennifer Coates, veterinarian, author of
Dictionary of Veterinary Terms
Vet-speak Deciphered for the Non-Veterinarian

     petMD contributor

***

Does your dog need to be vaccinated against Lyme disease?

The vaccination program that you and your veterinarian set up for your dog should take several things into account. This applies to all vaccines, core and noncore.

For most parts of the country, Lyme disease is not endemic and so is considered a noncore vaccine.  Ask yourself the following questions when considering vaccinating against Lyme disease, and answer honestly, your pet's health depends on it.

Is your pet at risk of being exposed to the disease against which you are vaccinating? In the case of Lyme disease, this requires exposure to the Deer Tick, Ixodes scapularis.

In spite of your answer to number one, if you live in a Lyme endemic area, your dog should be tested for exposure to Lyme Disease annually.  Has it ever tested positive for exposure to Borellia burgdorferi, the bacterial agent that causes Lyme disease?

Is the disease that you are vaccinating against serious?  In the case of Lyme disease, it is very serious.  We have seen fatal Lyme nephritis (kidney failure) at our practice.

Infection with the Borellia spirochete can cause chronic debilitating lameness in dogs that are not protected.

Is the vaccine that you are considering safe?  In the case of Borellia vaccines, there are many safe alternatives available. Most are composed of bacterial proteins, not complete bacteria.  While they may cause a local reaction (think about how your arm felt after your last flu or tetanus shot), they cannot cause Lyme disease.

While serious vaccine reactions are possible, they are rare.

Is the vaccine effective?  While not as effective as say a canine parvovirus vaccine, the newer subunit vaccines provide a high degree of protection against a serious disease.

So, if you answered yes to the above questions you should vaccinate your dog against Lyme disease.  Vaccination is part of the triad of disease prevention.  Tick prevention, prompt tick removal, and regular vaccination.

—Dr. Keith Niesenbaum, VMD, New York, Crawford Dog and Cat Hospital
    Dr. Keith on Facebook and on Twitter

***

Living in St. Louis, where Lyme disease is NOT the most common tick-borne disease, I advise against the Lyme vaccine. Sure, it's a great thing if you live in, say, Lyme, CT, where the disease is named after. (Lyme disease is most prevalent in the Northeast and Wisconsin).

In our area, the more common disease carried by ticks is Ehrlichia. There is no vaccine for that. So, your best bet for protecting your pet against Lyme, Ehrlichia, or any of the other diseases, is to actively prevent ticks! I do not recommend the Lyme vaccine here, because your pet still will need tick protection, regardless.

Nowadays there are many safe and effective products that either repel ticks or kill them before they have been able to transmit their disease (they have to feed for hours to do that!)

 —Dr. Karen Louis, DVM, VetChick.com
     Dr. Louis on Facebook and on Twitter

Further reading:
Is it a tick? How to tell if it’s a tick on your dog or cat – with pictures!
Ticks and their diseases


More from the series:
What Do You Consider The Biggest Breakthrough In Veterinary Medicine?
Vegan Diet For Dogs? 
What Is Your Biggest Pet Parent Peeve?
What Is The Biggest Toll Our Dogs Pay For Obesity?  
Heartworm Disease And Prevention  
Do You Often Have Difficulties Getting Clients To Believe Their Dog Is In Pain?
If You Could Be Granted One Wish, What Would You Wish For? 
10 Main Symptoms To Watch For In Your Dog

18 comments

  1. Hmmm... We have Lyme Disease here in Canada, too. I wonder if there's a vaccine for cats? I've never heard of one. I wonder if cats get Lyme Disease. Must get the peep to check this out with my doctor. purrs

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    1. I imagine cats can get it too; dogs can, people can ... but I really don't know about cats. Your vet should be able to tell you.

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  2. This is such a helpful post. I believe it will help people make an informed decision about whether or not to inoculate against Lyme disease. Having all the information here, and the advice of veterinarians will make a big difference to people's decisions.

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    1. Thank you, M, yes, it's the goal of this series, to provide a good spectrum of good information.

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  3. Yeah I struggle with this one. I mean ... We are way up North so it's a short season. BUT we have Lyme disease in the area. We also hike and Monte being 3.5 pounds means he's low to the ground. So far we've never found a tick on him. I hate using the flea and tick collar for him but his skin reacts really badly to the topical options. We put a little rash guard top on him (a t-shirt) and then the collar on top and ... that way the SECOND we are home it comes off. We live not he 9th floor so no ticks up here. LOL But I am keeping an eye out on the vaccines for the day when we go on a more long term trip to a high risk area.

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    1. We were considering the vaccine quite strongly, particularly since Cookie has history of adverse reaction to Advantix. We chose a different solution for the time being; last year we found no ticks on her so we'll go on with that one unless the status quo changes.

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  4. It was great to read all of those different vets takes on the issue -- while they mostly agreed, it was nice reading each one's different justification and analysis. Thank you! ~ Dear Mishu dearmishu.com

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  5. We have ticks and there has been Lyme disease here in Toronto. It scares me but I focus on prevention of ticks and fleas so far.

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    1. Prevention is the best route; the reason I even went to consider a different approach was Cookie's adverse reaction to the preventive. In endemic areas, both prevention and vaccine might be what is needed.

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  6. When I had my springer, Cassie, she was vaccinated for Lyme disease, since I took her to northern Wisconsin a lot for paddling and hiking trips. It was very common there. The problem was when Cassie developed a temporary paralysis the vet couldn't say if it was due to Lyme disease since she had been vaccinated, so showed positive for having it - even though what she had was coon hound paralysis. So once vaccinated, your dog will always test positive for it even if they don't have the disease. Also the vaccine isn't very effective I hear. Prevention is much better.

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    Replies
    1. Vaccines against bacterial diseases are always less effective. However, there is a new test out there which can distinguish between antibodies due to vaccination from antibodies due to infection. So the test IS out there now.

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  7. So helpful. Ticks aren’t super common here but back in WI where I’m from, or back east we would do tick checks all the time. It’s best to stay current about outbreaks as well.

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    1. Oh, you're so lucky that you can say that ... ticks are slowly taking over the world. It won't be the cockroaches, it will be ticks, I think.

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  8. Very informative post, and am Pinning to share. We do have Lyme here, so my Sibes do get vaccinated and I do a flea and tick preventative. Excellent info here, thank you!

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    1. Thank you. What is your experience with the vaccine?

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  9. Very informative, thank you! I love that you got several veterinarians to comment because, like us, they can each have a different opinion. We moved to AZ in 2008 and from then until 2015 I had not seen one flea or tick. They just aren't prevalent out here. But in the summer of 2015 we had the absolute worst infestation of ticks I have ever seen (and I grew up in the midwest where ticks are pretty commonplace). They were all over and Sulley would pick up new ones multiple times a day from our yard. It was disgusting. During that time I found out that none of the flea and tick meds were enough to cover dogs the size of Sulley. He basically needed a topical and a pill to sufficiently prevent the ticks from attaching to him. Fortunately, the tick issue was isolated to that summer and I no longer have to treat either of my dogs at all. That said, if the tick thing continued, I would consider the lyme disease vaccine. 10% of ticks is very high percentage to be carrying lyme. Again, thank you for such an informative post!

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    1. Yes, I love doing this series to be able to get all the different opinions. Sometimes they are all quite close, sometimes they differ quite a bit.

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