client informed consent lyme information

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client informed consent lyme information

Postby malernee » Sun Feb 27, 2005 5:57 pm

(Lyme Disease)

General Information
Borreliosis, also known as Lyme disease, can affect dogs, cats, horses, cattle, birds, wild animals, and people. White-tailed deer and white-footed mice appear to be natural carriers of the causative organism, Borrelia burgdorferi, a corkscrew-shaped bacterium. The organism is usually transmitted by the pinhead-sized, dark brown nymphs of deer ticks. Other types of ticks may also transmit the disease.
After the larva hatches from the tick egg, the young tick attaches to small rodents, such as the white-footed mouse. As it feeds on the mouse's blood, the larva becomes infected with the Borrelia organism. The larva matures into a nymph, which feeds on the blood of animals and people. The Borrelia organism is not injected into the host animal until the tick has been attached for 10 to 24 hours. Although adult ticks can also spread the disease, the nymph stage poses the greatest threat during the summer months because of its very small size.
Signs of Lyme disease are vague and resemble those of various other conditions. Initial signs include a rash, fever, joint swelling and pain, and swollen lymph nodes. Within days, weeks, or even months, more serious signs develop, such as heart, brain, and joint disorders. Painful joint swelling is the most common advanced sign.
A person is unlikely to contract the disease from a pet unless he were to remove an unattached tick from the pet and allow the tick to feed on him. The Borrelia organism has been found in the urine of infected animals, but the disease has never been proven to be spread via urine.

Routine Treatment is not indicated with serologic evidence of B burgdorferi exposure in the absence of clinical disease.

Routine Testing is not indicated with serologic evidence of B burgdorferi exposure in the absence of clinical disease.

A course of antimicrobials prescribed solely on the basis of arbitrarily timed serologic findings is unlikely to reduce morbidity or to be effective in preventing reexposure in an endemic area. ... ?p=600#600

Almost with out exception it would be difficult to justify vaccinating for lymes disease every year for florida dogs base on current evidence of medical benefit to justify cost and risk of vaccination.
There is still mixed opinion on the use of Lyme vaccine among veterinarian practitioners even in endemic areas. We do not use it but we are not in an endemic state. 90% of cases in humans (where the disease is reportable) occur in 100 counties in 8 states. Therefore, even if you have deer and you have ticks (we do), you won't necessarily have Lyme disease. Human lymes vaccine is now approved for use. It is not approved for use in children and older adults. the human lyme vaccine was taken off the market by the vaccine maker. It was not given as a series of vaccinations every year to at risk adults. Lymes vaccination in pets has been shown to have side efffects including those that can be fatal that have been associated with a clinical infection of the disease.If a pet is going to get vaccinated a Newer vaccinations like the ones used in human lymes vaccine should be used to help decrease the risk of vaccination side effects. Since most of the pathology associated with infection by the Borrelia burgdorferei organism is caused by the immune response, vaccination against Lyme may be counter productive. It seems that the disease is fairly easily diagnosable (if the pet hasn't been vaccinated) and treatable. - Treatment for lymes disease in the dog is highly effective. The cost of the antibiodic less than the cost of one lymes vaccination. Ticks carry other diseases much more of a problem than lymes disease in dogs. It makes more sense to spend money on parasite prevention to kill the ticks.
Below is a published article we offer as evidence of support.

Why I Don't Use Lyme Disease Vaccines

<<Compend Contin Educ Pract Vet 19[11]:1269;1272-1275 Nov'97 Perspectives in Veterinary Medicine 29 Refs
Meryl P. Littman, VMD, Dipl., ACVIM
Department of Clinical Studies School of Veterinary Medicine University of Pennsylvania Philadelphia, PA

- Veterinarians are increasingly concerned about vaccinations in general, the scientific basis for frequency of vaccination, and possible vaccine reactions (anaphylaxis, immune-mediated disease, sarcoma formation, and other adverse effects). Practitioners are weighing the risks and benefits of various vaccines as well as the justification for using a Lyme vaccine. As a clinician living in an endemic region and working at the Veterinary Hospital of the University of Pennsylvania, I am hesitant to administer any of the currently available Lyme vaccines. In a recent survey, 19 of 27 veterinary teaching hospitals in North America did not provide Lyme vaccination at all; the other eight hospitals only did so if the owner requested it and was traveling to an endemic region. It is often difficult to accurately diagnose Lyme disease in endemic areas for several reasons. Many normal dogs have positive antibody titers to Borrelia burgdorferi. These dogs have been exposed but do not show evidence of illness. When a seropositive dog does have clinical signs of illness, it is thus difficult to determine whether the signs can be attributed to Lyme disease. One study in an endemic region demonstrated that 89.6% of healthy dogs had positive Lyme titers. There is no apparent correlation between positive Lyme titers and the occurrence of clinical signs. Only 4.8% of naturally exposed seropositive dogs demonstrated a limb or joint disorder with lethargy, fever, or inappetence; however, 4.6% of seronegative dogs also demonstrated such disorders. Most dogs that are seropositive for Lyme disease have not exhibited clinical signs of the disease. In my experience, an even lower percentage (3% to 4%) may be actually sick due to Lyme disease; I have found that borreliosis is over-diagnosed in some endemic regions. Lameness related to various causes (e.g., trauma, degenerative joint disease, immune-mediated polyarthropathy, rheumatoid arthritis, or arthropathy related to other infections) may be too easily ascribed to borreliosis if the clinician's index of suspicion is high and the owners are eager to accept this fashionable diagnosis. I recommend preventing tick exposure in the hope of avoiding not only Lyme disease but also other tick-borne infections endemic in my region (e.g., ehrlichiosis, Rocky Mountain spotted fever, and babesiosis). I currently recommend monthly application of fipronil or an amitraz collar, to kill ticks before they attach and obtain a blood meal. Without such a meal, ticks cannot transmit organisms or lay viable eggs.
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