Vaccinating for Lyme

My little herd got their first Lyme vaccine last week.

I really agonized over this decision and before I was done, I think I had half a dozen vets on two continents agonizing over it with me.  I talked it over at length with my vet.  She talked it over with all of her colleagues.  I got in touch with some other vets I know and they talked it over.  In the end, together and separately, we all came to the same conclusion:

Given the near 100% infection rate in my little part of the world and the overwhelming likelihood of reinfection combined with the apparent safety of the vaccine when given to horses, it was really the only thing to do.  I've already found nearly 30 adult ticks and it's still only April, they are much worse in May.  I almost never find the nymphs, which are smaller than a pinhead and transmit 90% of Lyme disease.  What do you suppose the chances are of me being able to find all the ticks every day? 

I think I've already proven that I can't do it.  I doused everyone with the heavy duty permethrin, Tessa had a reaction to it and I still found ticks on the donkeys.  I am working on getting some guinea hens to, hopefully, kill ticks, but they won't be available until June.

As for giving the shot to the donkeys, one of these good people brought up an excellent point: almost none of the drugs we routinely give to donkeys has ever been trialed or been approved for use in donkeys.  

It took some digging, but I found that the vaccine has been used in quite a number of horses and we even found a few other donkeys who have gotten the shots so at least mine wouldn't be the very first.  None have reported adverse reactions.  In fact, the reaction rate in horses seems to be significantly lower than with most other vaccines they are routinely given.  This Lyme vaccine contains no adjuvants, which are what typically causes reactions.

Besides being worried about using the vaccine in the donkeys, we were worried about giving it to Tessa because she had quite a bad reaction a few weeks ago when she got her routine Spring shots (which she is not going to get again).  Of course, if we had known that she had Lyme before giving her those shots, we wouldn't have done it.  Such is the beauty of hindsight.  

Tessa does tend to be very sensitive and reactive to any possible irritant so giving her another shot, especially an experimental shot was scary as hell definitely worrisome.  Before she got the Lyme vaccine, we gave her a dose of banamine (NSAID) to help prevent problems.  It turned out to be unnecessary, but better safe than sorry.

All three of mine and RB's 2 mares all got their first shot last week and no one had any reaction whatsoever.  Emma and Ramsey were so busy mugging the vet tech that they never even noticed getting a shot at all.

(Hawkeye was treated for Lyme last Fall, but is showing renewed symptoms so is being retested.  If the test is positive again, he will have to be re-treated before he can be vaccinated.)

The vaccine protocol that is being used is pretty strict and has to be followed in order to be effective.  The vaccine used has to be the Recombitek Lyme vaccine made by Merial...

The protocol is three shots.  The first can be given any time so long as the animal tests negative for Lyme.  The second shot has to be given 3 weeks later, the third is given 3 months after that and then a yearly booster.  The timing does matter.

If the animal tests positive, it needs to be treated first. The shots can be started during treatment, mine got their first shot about 2 1/2 weeks into treatment.  Hopefully, it will start providing some protection before the antibiotics end next week and the ticks come out in force. 

This is not something I would have done unless I felt fairly confidant that it would be safe, be of use and if the Lyme situation in central NY weren't so bad.  Even if the vaccine works as hoped, I still need to be hyper vigilant about tick removal because the vaccine won't do anything to protect against other tick borne diseases.  Those are still rare (especially compared to Lyme) and the symptoms are more apparent so I hope we can avoid them.  There is nothing else to be done.

For anyone interested in learning more about this, all I can say is: talk to your vet.  Don't be surprised though if he/she refuses to even discuss it or completely rejects the idea because it is not yet approved.  You'll have to do your own research, weigh the risks, accept the liability and then find a vet who is willing to work with you. 

The Subtle Signs

Everyone is a lot happier since I started treating them for Lyme disease.  It is most noticeable in Emma.  I can't say when she started not feeling well as none of my animals ever exhibited outward signs of illness.  You always hear about flu-like symptoms, fever, etc, but I never saw any of that. Neither did RB with her horse or any of the (many) other animals I know about.  The symptoms of Lyme that I have seen are very subtle and easily dismissed as something else. 



In Emma, it was a gradual unwillingness to be touched and acting slightly withdrawn.  Emma loves a good scratching session, but slowly, she got to where she wanted no part of it.  It's a fairly common, but seldom mentioned  symptom of Lyme called hyperesthesia, which is defined as:

An abnormal or pathological increase in sensitivity to sensory stimuli, as of the skin to touch or the ear to sound. Also called oxyesthesia.

Heightened sensitivity to touch, often perceived as painful or irritating; commonly caused by nerve compression, shingles, chronic pain, or stress.

That about sums it up.  Emma went from being sweet and cuddly to stand-offish and grumpy.  It was easy to dismiss at first because of the cold (donkeys often don't like to be touched when it is cold or wet, I think it messes up their thermoregulation).   I knew there was something wrong, but it was so nebulous and incremental that I didn't see how bad it had gotten until I put her on antibiotics for the rash she developed and suddenly, just like that, she was once again her sweet, cuddly self sidling up next to me and pointing at the itchy spots.

That rash itself was an oddity that made warning bells go off in my mind.  Getting a staph infection out of the blue just because of a bug bite is the kind of thing you typically see only if the immune system is compromised.  Why would a young, healthy, well cared for donkey get a staph infection in the middle of winter?  

In Ramsey, I saw a subtle, shifting discomfort.  Not outright lameness, never a clear sign of pain that I could point at and say "there, that is the problem".  Rather, it was a general, body-wide achy-ness that I saw in an unwillingness to pick up his feet, frequent shifting of weight and mild grumpiness.

With Tessa, I only really see the signs now that they are gone.  She had been spookier than normal of late, which is not like her.  She didn't enjoy grooming. There were several occasions where she didn't want to let me catch her. At the time, I was just annoyed and baffled.  One of her faults is that she tends crowd and intrude on my personal space and yet I couldn't catch her? She too was mildly grumpy.

That slight grumpiness is the only common symptom I saw and all of these things were very small, vague and subjective.  They were easy to put off on the horrible weather, lack of exercise, etc.  The most notable "symptom" was that I went out to the barn each day and saw that my herd was not content anymore.  It's not easy to convince a vet that there is something wrong because, "my animals aren't happy anymore".  

Many vets don't even bother to treat Lyme in horses or dogs unless the animal has a notable fever or obvious, flu-like symptoms.  I've heard some of them say that nearly all the dogs and horses test positive, but they don't have symptoms so why bother to treat it.  I think the symptoms are just so individual and nebulous that they are often overlooked or dismissed as behavior issues or age related problems.  It makes me wonder just how many sick animals are really out there going from trainer to trainer trying to "fix" their behavior problems.  How many ten year old dogs or twenty year old horses have just been written off as being too old?  How many of those horses end up at the auction because they have a "bad attitude"?

I'm just glad that mine are doing well with treatment so far.  The first week was pretty rough as they all had some GI upset and weren't feeling great because of the medicine, but they are all doing better now.  That air of contentment that had been so lacking in the barn has returned and everyone is eager to be scratched and hugged once again.  I'm still trying to figure out how to keep it that way.