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Brought to you by Elanco Animal Health

Overview

Canine Lyme disease will soon impact more pets in more places. The Companion Animal Parasite Council (CAPC) predicts a spreading endemic geographic range and increased incidence of Borrelia burgdorferi infection in dogs.1 In short, veterinarians not already diagnosing this disease may start seeing it, and those already seeing Lyme-positive patients can plan to see even more.  

Canine Lyme arthritis impacts quality of life with pain, lameness, fever, and often lethargy and inappetence. Although less common, Lyme nephritis can cause rapidly life-threatening protein-losing nephropathy that usually carries a poor prognosis.2 Pets may also pass along infected ticks to their human families.3 When possible, prevention is key. 

Tick avoidance and ectoparasite protection are the first lines of defense for dogs. In endemic areas, the exposure rate in dogs can be as high as 70%-90%.4 Although veterinary hospitals may intend to recommend 12 months of ectoparasite control for each pet, only 62% of pet owners even remember this recommendation and use only half a year’s worth (on average).5 Vaccination provides an additional effective way to protect pets from Borrelia burgdorferi.6

Improving the Protocol

Veterinarians may feel there is an increase in client concerns and misperceptions about vaccinating pets.7 Vaccination protocols should ideally provide at-risk patients with effective and safe vaccines while maximizing owner compliance and patient comfort. 

Establishing a Lyme Protocol

1. Efficacy

Borrelia burgdorferi avoids recognition by its hosts’ immune systems by varying its outer surface proteins (Osps); however, OspA and OspC provide antibody targets for vaccination.8 In a field study, Duramune® Lyme was 92.2% effective against natural infection6 and other studies confirm an immune response to a variety of Osps, including OspA and OspC.8,9

2. Safety

Every medical choice entails risk. The veterinary team’s goal is to choose treatments that minimize risk and are worth the expected patient benefit. A field safety trial of ULTRA™ Duramune Lyme found that 92.4% of clients reported no adverse events at all after two vaccinations, and signs reported were consistent with similarly designed studies.10 In another study, dogs already positive for Borrelia burgdorferi exposure prior to vaccination did not experience significantly more adverse events than dogs that were negative.11

3. Client Compliance

Owners may be more likely to agree to and keep up with vaccinations if their preferences and concerns are addressed. So that pets can receive fewer total injections per visit, the 1.0-mL Duramune® core and/or leptospirosis combination vaccines are available against Lyme. If the practice protocol instead includes a stand-alone Lyme vaccine, ULTRA Duramune Lyme is the first and only 0.5 mL Borrelia burgdorferi vaccine. Owners prefer vaccines with a lower volume.12 Both combination and stand-alone Duramune vaccines are manufactured using PureFil™ Technology, which is designed to remove extraneous proteins and cellular debris.

4. Comfort

Pet owners and veterinary teams both strive to keep our patients as comfortable as possible. There are multiple national continuing education efforts to reduce patient stress and fear in veterinary practices. The Lyme vaccination options for Duramune are designed to minimize discomfort and prevent unnecessary additional injections; pets receiving core vaccines and/or leptospirosis vaccines that day do not need an extra injection when using a Duramune Lyme combination vaccine. As a second option, ULTRA Duramune Lyme vaccine’s reduced volume, if given alone without additional vaccines, may offer improved comfort due to the 0.5 mL injection volume. As one veterinarian notes about ULTRA vaccines, “Administration time was reduced … with a wiggling or fractious dog, seconds count.”

Conclusion

Already, the human health care field is encountering outbreaks of infectious disease due to vaccination refusal.13 Some human patients wish they could receive the kind of Lyme disease vaccine their pets receive.14 For at-risk pets, comfortable, easy, safe, and effective vaccines are benefits all pet advocates can get behind.

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References and author information Show
References
  1. Yabsley M. The forecasts are in: 2017 will be a big year for heartworm disease and Lyme disease. Companion Animal Parasite Council: Pets & Parasites. http://www.petsandparasites.org/expert-insights/the-forecasts-are-in-2017-will-be-a-big-year-for-heartworm-disease-and-lyme. Accessed 30 Sept 2017.
  2. Levy SA. Overview of Lyme disease in dogs. Veterinary Team Brief. 2015;6:33. 
  3. Lyme disease: transmission. Centers for Disease Control and Prevention. 4 March 2015. https://www.cdc.gov/lyme/transmission/index.html. Accessed 22 Aug 2017.
  4. Littman MP, Goldstein RE, Labato MA, Lappin MR, Moore GE. ACVIM small animal consensus statement on lyme disease in dogs: diagnosis, treatment and prevention. J Vet Intern Med. 2006;20;422-434.
  5. Lavan RP, Tunceli K, Zhang D, Normile D, Armstrong R. Assessment of dog owner adherence to veterinarians’ flea and tick prevention recommendations in the United States using a cross-sectional survey. Parasit Vectors. 2017;10:284.
  6. Levy SA. Use of C6 ELISA to evaluate the efficacy of a whole-cell bacterin for the prevention of naturally transmitted canine Borrelia burgdorferi infection. Vet Ther. 2002;3(4):420-424. 
  7. Khamsi R. Is the anti-vaccination movement spreading to pet owners? New York Magazine. 4 Feb 2015. 
  8. Levy SA, Millership J, Glover S, et al. Confirmation of presence of Borrelia burgdorferi outer surface protein C antigen and production of antibodies to Borrelia burgdorferi outer surface protein c in dogs vaccinated with a whole-cell Borrelia burgdorferi bacterin. J Appl Res Vet Med. 2010;8(3):123-128.
  9. Chu HJ, Chavez LG Jr, Blumer BM, Sebring RW, Wasmoen TL, Acree WM. Immunogenicity and efficacy study of a commercial Borrelia Burgdorferi bacterin. J Am Vet Med Assoc. 1992;201(3):403-411. 
  10. Elanco Animal Health. Data on File. 
  11. Levy SA, Lissman BA, Ficke CM. Performance of a Borrelia burgdorferi bacterin in borreliosis-endemic areas. J Am Vet Med Assoc. 1993;202(11):1834-1838.
  12. Elanco Animal Health. Data on File.
  13. Phadke VK, Bednarczyk RA, Salmon DA, Omer SB. Association between vaccine refusal and vaccine-preventable diseases in the United States: a review of measles and pertussis. JAMA. 2016;315 (11):1149-1158. 
  14. Plotkin, SA. Bring back the Lyme vaccine. The New York Times. 18 Sept 2013.
Author

Cyndie Courtney

DVM VetChangesWorld.com

Cyndie Courtney, DVM, is a practicing associate veterinarian, recovering toxic team member, founder of VetChangesWorld.com, and recent 2015-2016 AVMA Future Leader who helped create a national veterinary team wellness program. She has an undergraduate business background and speaks and writes on various topics. Her research interests include the impact of burnout and compassion fatigue on interpersonal aggression in organizations. 

FUN FACT: Cyndie is a self-taught fife player and published haiku poet.

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