First, I will mention that Lyme does not have an "s" on the end.  Thus, it is Lyme Disease, not Lymes Disease or Lyme's Disease. 

I think one of the most important things that one should know about Lyme Disease is that the whole subject tends to be very controversial in the Veterinary world, as far as diagnosing, treating, and vaccinating.  It is also important to realize that Veterinary Medicine is not an exact science.  This means that there may not be one right way to do things; or too little is known to be able to determine which way is the best.  So, as Veterinarians, we draw on our experiences as a Doctor, and as a pet owner; and do our due diligence in researching the current journals to see what "they" (the "experts") are recommending.  But, even the experts don't agree!  So, we must come up to our own conclusions.

The major symptom of Lyme disease that I see is limping.  Dogs do not get the "bulls eye" lesion that people get.  Often in the Spring in our area, there are some bugs that bite the belly of dogs, and they get bright red flat circles on the belly.  Those can be mistaken for a "bulls eye".  Contact your Veterinarian if you are concerned about any skin lesions that you see.

The second most common symptom is kidney problems - protein in the urine, or full blown kidney failure. Sometimes, the only thing we will find is protein in the urine on a routine screen,and the pet is asymptomatic.  There are a lot of reasons why a pet can have protein in the urine, besides Lyme.  Your Veterinarian may want to do a urine protein:creatinine ratio on the urine to determine if the protein on the screening test is at a level to be concerned about.  You may notice your pet drinking more, urinating more, losing their appetite, or vomiting if your pet is in Kidney Failure from Lyme.  Confirming that Lyme is the cause of the kidney failure can be difficult, as there are also many causes of Kidney failure.  Lyme disease is fatal when it effects the kidneys.

Their are a couple different tests that can be done for Lyme disease.   I feel that the best test that is available is the Idexx 4DX  for a screening test; and the Lyme C6 for a confirmation test by Idexx.  The C6 can also be used to follow the treatment along.  Do I think the C6  is a perfect comfirmation  test?  Doubtful.  But, I believe it is the best test we have out there.  As I discussed earlier, your Vet may have his/her own experiences and opinions on this. 
Another lab, Antech, recently came out with a similar screening test to the 4DX, but uses a different methodology. 

If your pet has a positive Lyme test, a urine sample should be tested for protein to see if there is any kidney involvement.  Full blood work may also be done to look at the other kidney parameters (BUN and Creatinine, amongst others). 

The most common antibiotic for Lyme disease is 4 weeks of Doxycycline.  Amoxicillin can also be used, but is not generally considered the first antibiotic of choice.

If a Lyme C6 was done before treatment, it will be repeated 6 months after treatment is done.  We look for a 50 % reduction in the C6 level. 

Where does the controversy lie?

First, as previously mentioned, which test is best is controversial. 

Secondly, when a dog tests positive on the Lyme test, it means that the dog has been EXPOSED to Lyme, and has a LYME TITER (antibodies to the Lyme organism).  It does not mean they have Lyme Disease.  In order to have Lyme DISEASE, they have to have a TITER, and SYMPTOMS.

So, should pets with a titer be treated?  Some say they should not because we don't want to build up antibiotic resistance.  Others say they should because it is only a short course of antibiotic; and pets can die within a 2 week period if the Lyme gets into the kidneys. 

Another part of the controversy is whether a pet that has a TITER (positive on the test, thus antibodies to Lyme) should be vaccinated.  Some say that the antibodies that are produced from the exposure to Lyme will protect the pet if they are exposed again.  Others believe that those pets are at greater risk for getting Lyme again, so they should be vaccinated.  If the pet is treated with antibiotic, they would be vaccinated at the end of the 4 week treatment period.

I believe that most Veterinarians now feel comfortable with vaccinating pets at risk in Lyme endemic areas.  But, the Lyme vaccine is not needed for all pets, so it can be controversial as to who to vaccinate.   A small dog that rarely goes out, and never has ticks on them, will likely not get the vaccine.  Cats don't seem to get Lyme Disease. 

Dr. Mazzola has had a pet with Lyme Disease, and can add her own pet experience to aiding her clients in determining what is best for their pets.

This article is meant for information only, and contains Dr. Mazzola's personal experiences and opinions.  Please contact your Veterinarian if you are concerned about Lyme Disease in your dog.

Hypothyroidism (under-active thyroid) in a disease that effects dogs.  Cat's thyroid disease tends to be limited to hyperthryroidism (over-active thyroid).

The thyroid gland controls the metabolic rate of all the organs.  If it is under-active, a dog can have one, or many, of these:
1) act sluggish (lethargic, quiet)
2) slow heart rate
3) have hair loss which is "bilaterally symmetrically" ie. each side of the dog's hair loss pattern matches the other side.  The hair loss is usually along the back of the dog.
4) "rat tail" appearance to the tail. 
5) overweight or obese
6) anemia - low red blood cell count
7) chronic or intermittent ear infections.
8) elevated cholesterol
9) elevated liver enzymes (ALT or SAP)
10) Aggression or other behavior issues
11) Less common manifestations include eye and nervous system diseases; paralysis of the larynx (laryngeal paralysis); or enlarged esophagus (megaesophagus).

As with most diseases, these symptoms may not be just seen with hypothyroidism. Remember, Veterinary Medicine is not an exact science.  For example, allergies, parasites (fleas, scabies, demodex, etc), Cushings (adrenal gland dysfunction), and many other ailments can cause a pet to have hair loss.  Overfeeding can cause a pet to be overweight, etc.

The most common breeds that tend to be prone to Hypothyroidism:
Labrador Retriever
Golden Retriever
Dashchund
Boxer
Cocker Spaniel
Greyhound
English Bulldogs
Great Danes
Doberman Pinscher

There are different tests that can be used to test for hypothyroidism.  There are times when screening tests are done, and confirmation tests need to be added on.  Some pets will have part of the thyroid panel abnormal, but other parts will be normal.  There may be something on screening blood work that may give your Veterinarian reason to believe that you pet may be hypothyroid. For example some enzymes, such as SAP or ALT, and cholesterol may be elevated on the blood work, which could indicate hypothyroidism.So, it is not as simple as just picking one test and having that be abnormal.  Multiple tests may need to be done.  If hypothyroidism is ruled out as a possibility, then your Veterinarian may need to look into other possibilities for your pets symptoms.   

Once a diagnosis is made of hypothyroidism, your pet will be put on medication that they will stay on life-long.  Since each animal is an individual, the dose of the medication may need to be adjusted.  I generally recheck the thyroid level a month after starting the thyroid medication. If it is still low, the dose will be adjusted, and the level rechecked in a month.  If the thyroid level is OK, then the level should be rechecked every 6 months.  Remember, individual variations do exist, so please follow your Veterinarians recommendations.  Most Veterinarians will require that the recheck thyroid levels be tested 4-6 hours after the medication was given.   

If you would like to read more, I recommend Dr. Jean Dodds book, " The Canine Thyroid Epidemic: Answers You Need for Your Dog"

This blog is informative only, and should not be used to replace a Veterinarian's evaluation.  The article included Cynthia Mazzola DVM's opinions based on more than 20 years of practicing Veterinary Medicine.  Remember: there is more than one way to do things, and they could both be correct.

Ear infections, also known as otitis, are a very common problem in many dogs.  There can be underlying causes of chronic (having for a long time) or recurrent (keeps coming back) ear infections.   Some pets have underlying allergies to food, grass, trees, dust mites, etc.  Your Veterinarian may want to do some allergy testing on your pet if they keep getting ear infections.  Some dogs have floppy ears.  This makes for a deep, dark ear canal; which is a perfect environment for bacteria and yeast to grow.   They love darkness and moisture.   Young pets are more prone to getting mites.  Other dogs can have endocrine (hormone) problems. The most common being hypothyroidism (we don't see this in cats). 

When you see your Veterinarian, they may want to do one or some of the following:
1) Cytology - take a sample of the debris (junk) in the ear, put it on a slide, stain it, and examine it under the microscope.
2) Culture and Sensitivity - done on chronic or recurrent ear infections to find out specifically what bacteria are in the ear, and what antibiotic they are sensitive to.
3)  Allergy testing - either by putting allergens (thing that a pet could be allergic to) under the skin; or a blood test
4) Testing a blood sample for hypothyroidism of other blood tests.
5) Examine the ear canal to make sure that the ear drum is intact

You will often be instructed to clean the ears at home.  Follow your Veterinarians instructions.  This is what I have my clients do:
1) Fill The ear canal  with ear cleaner.
2)  With cotton, tissue or gauze wrapped around your finger, remove the cleaner and debris from the canal. The ear canal goes down and then in, like an "L", so it would be very difficult to puncture the ear drum with your finger. 
3) I do NOT recommend using a Q-tip at home.  Many of us Veterinarians will use them, but we know where the ear canal ends. 

You will likely be putting medications in the ears at home, too, depending on the type and severity of the ear infection.  Some infections have to be treated for a short course (10 days).  Chronic or recurrent ear infections may need to be treated for weeks or months; or we may need to find a protocol where you put the medication in a few times a week. 

Our House Call Vet has a medication compounded for chronic ear infections.      A special pharmacy puts together a mixture of medications into a sheep lanolin base.  This medication is put into the ear canal after Dr. Mazzola cleans the ear.  You do NOTHING at home for 2 weeks. One of my client said that she has no problem following those directions:  "do nothing!".  The medication is slowly released into the ear canal over that two week period of time.  In some pets, the medication can cause a decrease in hearing, because it is like putting a plug of wax in the ear.  This is transient (not permanent).   The ear is then rechecked in two weeks.  Just like with other treatments, sometime we need to do multiple treatments or intermittent treatments.  Many of Our House Call Vet's clients believe that this medication is magic!  Some pets that have not had any relief in years, will have relief with this medication. 

This information is not intended to be used in place of a good Veterinary physical exam and evaluation.  It is informative only.  Please contact Our House Call Vet or your Veterinarian to see how we can help with your pets ear infections.