Saturday, March 28, 2015

Plan of Attack

My vet and I have come up with a treatment plan for my little herd (with a bit of input from the great people at the Donkey Sanctuary - thank you).  The treatment for Lyme is generally 30 days of antibiotics, with doxycycline being the first choice.  There are several issues though, the main one being that doxycycline is in short supply and the price has become astronomical (I actually doubt that the supply is really limited anymore as the problem that caused the shortage happened in 2012 and has been long since resolved.  However, there is a lot of demand for it now due to the massive rise in Lyme disease and the drug companies are milking it for all its worth).  The cost of treating just Tessa would be $1500 for the doxy alone.  The two donkeys add up to about the same so add another $1500 plus vet visits.

Fortunately there are some other options.  My vet has treated a LOT of horses in the area and has had good results using minocycline instead instead of doxy.  It's not the first choice, but it seems to work.  In fact Riding Buddy had to treat Hawkeye last fall, which I have been meaning to write about, there is some really interesting hoof stuff there.....

At any rate, I can treat all three with minocycline for about $500 vs. the $3000 doxy would cost.  We weren't sure this was safe for donkeys as my vet has never used it in them before and I am not familiar with this drug.  However, the Donkey Sanctuary says it should be OK and I definitely trust them so we're going to try it.  If the price difference weren't so huge, I'd opt for the doxy, but a $2500 price difference.....yeesh!

The minocycline arrived this afternoon and everyone got their first dose.  I managed to get all of them to eat it with just a little help from the molasses bottle.  I'm very much hoping that that will continue, the last thing any of them need is sweet feed.

The really big worry is what to do after treatment.  Lyme is a bacterial infection so they can get reinfected as soon as treatment ends.  During the warmer months, I find at least 15-20 ticks per day, especially Spring and Fall.  I spend nearly an hour a day searching for and destroying deer ticks.  It obviously isn't enough and nothing seems to work to keep them off. 

Most worrisome is that it is the nymph stage of the tick's life cycle that transmits 90% of the disease and I almost never manage to find those.  The biggest adults are about the size of a sesame seed and the nymphs are the size of a pin head.  The nymph is the second in on the left.... 



The vet has suggested I try Ultra Boss, which is a highly concentrated Permethrin Insecticide.  She says it does seem to help, but I hate to use so much of that stuff.  I'll probably do it anyway because what else is there?  I am besieged.

Things are a little easier for the dog as there are some products that do work to kill ticks on dogs although, the ticks are rapidly becoming immune to them.  I used to use Frontline Plus on Tanner, but found that the ticks in this area are immune to it now.  I am currently using Vectra on Connor, we'll see how long that works.  He is also vaccinated for Lyme, which is somewhat controversial as there is some question of its effectiveness.  However, Connor's vet saw over 300 cases of lyme last year, with many of them resulting in catastrophic kidney failure (the first thing we did when Tanner got sick was test for Lyme - he was negative).  The dogs who have been vaccinated have not become ill so Connor got the shots.  I'll also continue with the Vectra because there were also over hundred cases of anaplasmosis just at that one clinic.  This is a very small town and only a very small percentage of animals ever get tested so those are very high numbers. 

For whatever reason, cats almost never get Lyme disease.  It's possible, but rare as they have a natural resistance.  I'd really like to see some research into what gives them immunity.  Maybe a better vaccine could be made from that?  Hopefully, someone is working on that.

There is no vaccine for horses.  However, many people in this area (and especially in areas like mine where the exposure rate is extremely high) are using the dog vaccine to vaccinate their horses.  I first heard of this several years ago and the risk seemed too high at that time.  Now....I might do it.  It's a questionable thing to do, but a lot of horses have now gotten the shots for several years with no adverse reactions and, so far, none of those horses have gotten Lyme or been reinfected.  I am not aware of any donkeys who have gotten the shots though so that is rather (a lot) scary.  Which is worse, a possible vaccine reaction or almost certain Lyme disease? 

Testing for Lyme is very simple now.  There are two options.  The first, easiest, cheapest test is called a SNAP test.  It only requires a few drops of blood or serum and actually tests for Lyme, anaplasmosis, ehrlichiosis and heartworm all in one.  The same test works for both horses and dogs and it only costs about $30.  The other Lyme test was developed at Cornell and is fairly new.  It is more expensive (around $70-80 here) and only tests for Lyme, but it gives a lot more info.  It can tell the difference between an acute or chronic infection and can differentiate between a bacterial infection vs. a vaccination response.  If an animal has been vaccinated for Lyme, you'd have to use the Cornell test.  The treatment is the same regardless of which test you use.

As for me, I have been tested several times over the past few years and, so far, am negative.  I've been bitten several times that I am aware of, however, a tick has to be attached for at least 24 hours and hot water will kill them.  Since life can not go on without a hot shower every morning, I've avoided the plague so far. 




25 comments:

  1. it feels good to have a plan doesn't it? Can you tell me more about the insecticide? We have ticks here as well and they are getting worse

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    1. This is a highly concentrated insecticide containing 5% permethrin and 5% piperonyl butoxide. You would apply just once every 30 days. Some horses do react to it so you should try just a small test patch on each animal before pouring it on them. Here is a link to the manufacturers label:

      https://valleyvet.naccvp.com/index.php?m=product_view_basic&u=country&p=msds&id=1047203

      I don't know if it will ship to Canada as I have never looked into that. You may be able to find a local equivalent.

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  2. my goodness. you really ARE besieged there! bless you! that's terrible (and terrifying!) and terribly expensive and worrisome.

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  3. The Islands off of Mass are probably thicker with ticks than the mainland. One such Island used to house delinquent boys who roughed it with adult supervision as an alternative to Juvenile prison. We visited severral times and because they had Guinea Hens, we could walk barefoot anywhere on the little Island. They had many of these but they are proven tic eaters.

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    1. I'm thinking about getting some of those, I have to do something! It doesn't look like there will be any keats available until June though, so that is more of a long range plan - if they don't get eaten.

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  4. I do use the dog 'Tick and Flea' Spray whenever I go riding with any mule. If you are bitten by a tick that has Lyme disease I think the markers always show up in the blood?

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    1. It takes 24-36 hours for Lyme to be transmitted from the tick to the victim. If you find them and pull them off before that time, I don't think it would show in a blood test. If they do transmit, then yes, it will show up in the blood. That's why the Cornell test is valuable, it can determine that.

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  5. Look up ' tick tubes', they are supposed to reduce tick loads by killing the first two stages on mice. Good luck.
    Sarah T

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    1. That's an interesting idea, definitely worth trying. Thanks for the suggestion.

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  6. A couple things:

    The Idexx Snap 4Dx tests were developed to NOT provide a false positive for dogs that had been vaccinated. The C6 antibody that is produced (and what is tested for) is only done so when there are live organisms in the animals system. You are right, though, the SNAP tests are not quantitative...they are more of a yes/no deal. It is actually really hard to isolate the organism itself...easier if you have the actual tick but most people don't. In terms of dogs with lyme, the vaccine is pretty ehhhh. Not a ton if research is out there. And a positive test does not necessarily mean that the dog has the disease and needs treatment. When we have dogs test positive we usually only do doxy they have symptoms as well and keep an eye on it if they don't. We have actually had a vaccinated patient (who has had yearly SNAP tests) test positive...

    What research IS out there suggests that the vaccine is pretty useless in dogs have been infected...

    Of course most of this applies to dogs because there's even less know about lyme in horses...but considering the fact that you are considering the canine vaccine, I definitely keep this stuff in mind. Vaccine reactions are rare but they are definitely something to be considered. The idea of injecting ANYTHING untested scares me!

    Lyme is a tough one for sure!:(

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    1. The vaccine does worry me, I was very hesitant to even use it on my dog. However, I have spoken with a number of vets in the area and their clinical results do not always agree with the research. I suspect that the Lyme bacteria are mutating. Dogs who test only faintly positive and would not ordinarily be treated are developing sudden renal failure from the Lyme disease. Some vaccinated dogs have still gotten Lyme, but they (so far) have not had renal problems. The research is not keeping up with reality.

      Apparently, there was a small study done at Cornell testing the safety and effectiveness of the Lyme vaccine in horses. I am trying to get my hands on it. According to my vet, who worked on the study, they had as good or better results in horses as they have had in dogs with no serious reactions. But it was just one study. The numerous horses who have had the vaccine in the past four years with good results carries more weight in my opinion.

      We're also seeing a large increase in the number of dogs who go into acute renal failure from leptosporosis. That also used to be very rare, but this vet saw six cases of it in one month last Fall. That is another very iffy vaccine that I have never used, but when you start seeing those kinds of numbers....

      Giving the Lyme vaccine to my equines is definitely scarey especially as it won't do anything to protect them the other tick borne diseases, which are also becoming epidemic. There is a fever that has hit many local horses that no one has even put a name to yet. It presents mostly in Spring and Fall as a sudden, very high fever with no other symptoms. It does not spread to other horses and appears out of the blue. In fact it is exactly like the sudden, inexplicable fever Emma got when she was pregnant with Ramsey. She seems to have been oneof the earliest cases. It does respond to antibiotics and banamine will control the temp so no one is in a panic.

      I won't vaccinate without more research and a lot of thought, but it feels like I need to do something. It all just gives me a stomach ache.


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    2. I hear ya on the feeling like you need to do something...I think what it comes down to is you just need to decide if you and the vets in your life really think it could help. If so, then go for it, but giving a vaccine for the sake of needing to feel like your doing something...I'd be careful there. Like I said, I get it, lyme is rough!

      And there is no doubt that research and clinical findings don't always mess. Clinicians are the TRUE researchers as far as I'm concerned.

      A HUGE thing we have to remember with vet med research is that the sample size tends to be really small (research is expensive and funding is always limited). I really struggle with drawing major conclusions from studies that only have 19 dogs/horses/etc. Just something else to think about...

      Lepto is another discussion entirely!!! Definitely have a good conversation with your vet about that one...definitely the highest reaction rate of any canine vaccine. Lepto isn't an incredibly endemic around here, but we try to stay away from that vaccine unless we have to...

      Good luck! I know it's HARD.

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  7. I'm glad you have found an alternative treatment (for the Doxy).

    I know that I was prescribed tretracyline for acne (when I was in my 20's) ... generic because it was inexpensive. I've also had doxycycline prescribed in the past (not recently) and not for tick diseases.
    I don't recall it being expensive ... it was prescribed because is was the less expensive/effective option.

    Interesting that a common antibiotic (off patent? I haven't double checked that) can be priced out of range for a serious illness that affects multiple species. I realize that an equine will require a much different dosage than an adult human, but $1500 for 30-day treatment for one adult horse? It definitely sounds like the pharma-types have jacked prices.

    My brother was treated for Lyme about 4 yrs ago (tick bite in June , sick by July). I don't recall him discussing high prices, but he was so out of it, he didn't even argue with me ! Treatment at that time I believe was 2 weeks of doxycycline. The hard part was just waiting to feel better.

    Definitely keep an eye on yourself. It's too easy to overlook fatigue and other symptoms as just being one of those days and I will feel better tomorrow.

    Good luck finding some Guineas . Would chickens or some other poultry work? I also understand that Guineas are not as easy to contain as other poultry. (no personal experience -- just watching them run in the road when I head out into the county).


    M in NC

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    1. Doxy used to be very cheap and easy to get. From what I have been able to figure out, there was a problem in 2012 with the manufacturing process and it got shut down for a while. The price went through the roof. The problems have been fixed and doxy is available, but the price has not come down. The cheapest price I was able to find was a $1 per pill, a horse needs 50 pills per day x 30 days = $1500.

      I think the demand is keeping the price high. People are desperate enough to pay for it regardless so why drop the price back to where it had been for years? It is still the only drug that will treat Rocky Mt. Spotted Fever and still the best choice for Lyme.

      Guineas can be rather obnoxious and they do not domesticate well. However, that is kind of what I need. i need them to wander and forage for ticks. They are effective, but not easy to control. When I lived in northern CA, there were flocks of them in every neighborhood to control black widows and ticks.

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  8. I live in CA and am being told by my vet that she can't get Vectra for my dog. I really don't understand that and I agree about sometimes the drug companies have their pocketbooks in this "shortage" or whatever is the reason. She is pushing a new monthly medicine. Right now, I have 2 more months of Vectra for Tessa but after that will have to research an alternative. I do like my vet so am perplexed. I wish you much success with your treatment with your "herd" including Connor. What a problem. Hate those darn bugs.

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    1. I have bought Vectra from amazon. I get it from a seller called Dr. Larry - it actually comes from a vet clinic a couple of hours from here, it seems to be the genuine stuff:

      http://www.amazon.com/Vectra-3D-Pack-Blue-Medium/dp/B0040ZJ5JS/ref=sr_1_1?ie=UTF8&qid=1427592914&sr=8-1&keywords=vectra+3d

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  9. Hi
    I live in western ma and hate putting all those chemicals on my animals. Once my son was born I became even more worrie because he hugs and kisses them all the time. I began looking for a more natural alternative for our horses and dogs and what I found was geranium oil. I started using it last year and my horse were the only ones coming in with no ticks. I would drop a couple drops in all the same places as the chemical tick repellents. In early spring when the ticks first come out I would have to do it every day and we got closer to summer I did it every other day then in fall back to every day. It works great on the dogs as well I put it on them when we are heading into the woods and as a bonus it works on us too. For the dogs a drop between their shoulder blade and the top of their tail and for us our wrist and ankles. Good luck! I HATE ticks!
    Meghan

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    1. Interesting, I will look into it. I wonder if it is a source of natural pyrethrins like chrysanthemum flowers? It's certainly worth a try, thanks.

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  10. All very worrisome. And some very interesting comments too. Geranium oil sounds interesting, I wonder would it work as a general fly repellent. I hope the treatment is successful for the herd and that you can come up with a preventative.

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  11. Homemade fly spray and bug deterrent that I've used for quite a few years now:
    http://mulewings.blogspot.com/2009/07/bugsbugs-and-july.html

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  12. I'm not sure if you can even get this in NY, but the guide dog organization I raise puppies for uses Activyl Flea Medication on their dogs. Like you we have issues with the fleas and ticks building up resistance to the medication. We have yet to have that issue with Activyl and it takes effect within an hour of application. It would probably takes some searching to find, but it may keep your pup protected. Although, from the comments it sounds like you already have a great arsenal of potential weapons to try.

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  13. Kris, praying for all these things to work for you and protect your babies!

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  14. Have you heard of Diatomaceous Earth (Food Grade)? Here are a couple of links for you to start research on:
    http://www.richsoil.com/diatomaceous-earth.jsp
    http://www.diatomaceousearth.com/natural-tick-repellent/

    I've been meaning to get this for our Mules, and I will soon. It sounds like a miracle safe solution! Even humans can take it. I'm going to try it for me, cats, dogs, chicken, and Mules. The person I bought our Mule from recommended it as she used it for the Mules. They ate it, and she spreads on the poop. Kills flys, ticks, fleas, and more! And I'm not sure how to change from Anonymous, but my name is Esther and I'm in California.

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  15. Astragulus is a herb recommended for use to avoid or treat acute lyme disease, but not for chronic lyme. I wonder if it would be ok to feed to donkeys as a preventative? Buhner's lyme protocol discusses it.

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  16. Hi there, just wanted to mention, I liked this article. It
    was funny. Keep on posting!

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