Doug’s twist: Why healthy pets need lab work too

Welcome back to Tails from the Lab, a veterinary podcast.

As you may have noticed, we’ve made some exciting changes around here.

I am your new co host, Dr. Brad Ryan, senior professional services veterinarian at Antech diagnostics.

And I’m Dr. Holly Brown, a clinical pathologist and chief veterinary educator at Antech.

Together, we’ll be discussing real patients and bring in expert guests to offer deeper insights into the laboratory diagnostics used to solve interesting and challenging cases.

Welcome back, Brad.

Hey, I’m excited.

The first episode on anaplasmosis was well received by everyone that I spoke to that heard it. So I think we’re on a good roll here. And as we move into this topic of why we need to perform wellness lab work, it’s probably the most common request that I get as a professional services veterinarian from hospitals around the country.

Talk to my staff about why wellness lab work is so important and how do we convey that to owners who are perhaps coming in expecting just to get a few vaccines for their pet and maybe a year’s worth of heartworm and flea and tick prevention?

How can we get this, how can we get this message across to the general public?

You know, we have unique challenges in veterinary medicine, right, in that our patients don’t speak.

Right. And we often know that they can mask the clinical signs, that they have behavioral changes which may or may not be physical in nature.

And it really can be helpful periods of sickness and in health to get objective data, right. So to look under the hood, I say figuratively look under the hood and get that objective data from our patients so that we can uncover occult disease.

Certainly that’s one of the considerations, right. Even in healthy pets, that we don’t uncover a pathology. Getting that baseline value of what health looks like for them is really important because then we can trend those lab values and have earlier detection of disease and they inform us about risks, like risks to our patient.

Right? Right. But one health risks as well, right. Around infectious diseases. And I think that if we show case in point with our case on Doug today, help us understand that these catching things earlier, before they cross the clinical threshold, give us the opportunity to have earlier interventions, more successful outcomes with these longer healthier lives.

The studies will say, right? Studies have shown that we have, we can expect as our patients age to see abnormalities in their data, not just that it flags high or low.

Right. But that 15% of adult pets, right. In a large sort of big data study shown that they had clinically significant abnormalities, lab abnormalities in their adult ages that warranted further intervention or further diagnostics.

That number increases, right. As we get into the senior years that we had 20% of our senior pets and double that 40% in our geriatrics.

And it’s those studies, right? It’s that powerful data that has changed the guidelines, right. These expert evidence based guidelines. So we have CAPC and AAHA giving us recommendations around the infectious disease testing, right.

Which we touched on last time, we’ll talk about again today.

But going beyond that for a minimum database to look at the CBC chemistry for our organ function urinalysis to round that out.

Right. Both for cats and for dogs. Right. We have AAHA recommendations that we get a baseline sometime in their young adult years and that annual testing is recommending as they get to mature adult years and then maybe even more frequently, maybe biannually in their senior years.

Because again, the studies will say you will find abnormalities and we can detect those during periods of clinical health, meaning they haven’t crossed that clinical threshold. We can have early intervention for longer, healthier lives.

The case I’m going to talk to you about today is Doug. So Doug is a two year old male neutered mastiff and he had been adopted through a rescue group by a young couple. They were living in Alabama when they rescued him.

He was deemed healthy by the rescue group and then they moved up to Pennsylvania. They’d been up here in Pennsylvania for maybe about eight months and he was due for his annual exam and vaccinations.

He had appeared clinically healthy at home, no concerns, and he showed up at the veterinary’s off veterinarian’s office for physical exam and they detected no abnormalities at that time. They talk about what preventive care looks like and some of the protocols at our hospital they recommended screening with fecal testing, right.

So screening for infectious diseases of the GI tract as well as vector borne diseases. Right. So a blood test that they could look for our typical heartworm. Right. Disease as well as our tick borne diseases and catch him up to date on his vaccinations.

But they went beyond that to talk about again, the importance of having wellness data. Now he’s two years old and a giant breed dog. I mean he’s into his adult years, right.

Even at 2 and they don’t have any previous lab work on him.

So getting a baseline of what health looks like was the intention that they could trend at his annual visits.

So after some education, discussion with the owners about the risks and the costs together, they decided that yes, they would send off for this comprehensive wellness profile if you will sending it off to the reference lab so they could get comprehensive fecal testing, vector borne disease testing, as well as that minimum database.

Well, the first test they get back was their fecal testing. So they had sent off KeyScreen for fecal screening for GI parasites, PCR testing being very sensitive and it came back with undetected, no infectious disease were noted.

And this is the most comprehensive screening test that we have or GI parasitology.

And so we’re getting that peace of mind, not just that we’re negative for the things that we can find on flotation, like our common hookworms, roundworms, whipworms, but we’re also ruling out that we have an infection of any of the tapeworms, some of these protozoa species like Cryptosporidium, that oftentimes we miss on flotation.

And of course we have that extra information that not only do we not have hookworms, we don’t have drug resistant hookworms. Not only are we negative for Giardia, but we’re negative for any potential zoonotic DNA assemblage of DNA assemblages of Giardia and as well as negative on Coccidia species, pathogenic and non pathogenic alike.

So we have a nice comprehensive rollout list here.

Yeah, it makes us feel a lot more confident when we say that we’ve actually screened right. For infectious diseases of the GI tract. So I think historically, if you think about just doing a fecal flotation and we’d say that everything looks clear, we only tested for a handful of organisms. Right. A handful of nematodes that shed ova intermittently.

Right. That’s really insensitive in screening. So we could feel comfortable and it should be celebrated. Right. So while, you know, we had an introduction telling us that we can expect as our pets age that we can uncover occult disease, but that doesn’t mean there isn’t value in normal.

Right. That those normal results should be celebrated.

And as we see this, this case unfold, these owners are going to get a little bit overwhelmed with our other findings. We want to make sure to go back to saying, you know, this fecal screening is really important. There’s a lot of infectious diseases and a lot of GI parasites that young puppies will have. Right. They’ll have that at birth and they’ll have a lot of exposure when they are young.

And that it’s really important it should be celebrated that with their current protocols of deworming that he’s had historically and now have really proved successful. Right. So again, something to be celebrated because it sort of unwinds from there.

So when they get back, his vector brewing disease screening, he had Accuplex run an Antech reference lab and he came back as Borrelia burgdorferi positive. So talk to us about that, Brad.

Well, once again, the first conversation that we have to have. And keeping in mind that, you know, the country is rapidly changing, so we can go like even in my home state, you know, as of, as of the mid, you know, 2005, 2006 era, we weren’t seeing very many Lyme positive cases in Ohio. We didn’t even think that the black legged tick that is the vector for Lyme was even in our state.

But they moved on over from Pennsylvania and, you know, we went from rapidly emerging to fully endemic in less than a decade. You know, and that’s a story that’s been playing out all over the country.

It was the story that happened up in New England, which is now sort of like our poster child hotspot for, for lime. And, you know, we, we watch those CAPC forecast maps every year and we see that it’s just like this slow moving blob that’s coming southward and it’s moving westward.

So now into northern and north central North Carolina as well as eastern Tennessee. And then we’re seeing, you know, other dynamics that are playing out in the maps over on the west coast as well.

And so the point being that Lyme seropositivity can freak owners out when they’re not used to hearing about this or having these conversations regularly with veterinarians. And so the most important thing to explain right off the bat, especially in an animal like Doug that is presenting as clinically healthy and normal, is that we have far more animals that are testing seropositive, meaning that they’ve been exposed to this bacteria naturally through the bite of an ixodes deer tick or black legged tick.

Then we do actually see exposed pets who are clinically ill as a result of that bacterial exposure. So that’s the number one thing that we want to start with before we move into the reason why we need to do further testing to make sure that this seemingly healthy dog is in fact clinically healthy.

Right. And that, and to emphasize, you know, with these screening tests that specifically. Right. With Accuplex and looking at Borrelia, that we’re looking at the C6 peptide. So it does truly mean exposure.

Right. That vaccination wouldn’t interfere with that and create those same antibodies. And so we do know that he’s been exposed, but to reassure him, right, that clinical signs are thought to develop only about 5 to 10% of infected dogs, that it would be months, usually down the road after infection. So in contrast to our last episode, we talked about Toby and his anaplasmosis, right, where we just see, in one to two weeks, we see the clinical signs.

This is going to be a more chronic infection, right? So again, in humans, right, we have the more acute phase that we would see, but in dogs, we don’t see that part. We only see them, they become more chronic and we can talk to them about what that would look like, right. In Doug’s case, that we, when they’re clinical for Lyme disease.

And again, this is new to them, right? They’ve lived in Alabama their whole lives for coming up here. And while we have these conversations here in Pennsylvania all the time, right. We have to remember for every client, it can be a new conversation as it was for them. And so we were to have clinical signs of disease, typical tick borne disease signs, right?

Fever, inappetence, lethargy, often a variable lameness. They can have lymphadenopathy.

And then, not to scare them, right. But to also mention that a small subset of those who do show clinical signs, right, are at risk for developing a glomerular nephropathy.

So that protein losing nephropathy that can develop a Lyme glomerulonephritis, which is, you know, often highly fatal.

So we have that conversation about what Lyme disease and when they show clinical signs, what that would look like. And as they sit there sort of overwhelmed of thinking maybe they had missed or what they could have prevented.

And we think about this as being a new conversation for them. They moved up to Pennsylvania and yeah, they need to know like the risk that they have, right. As you talk about the ticks and their movement and understanding, you know, those CAPC maps, the prevalence maps that CAPC have on their website that they keep up to date, they really help inform areas of high positivity and risk. And, you know, in Alabama he was at much more limited risk, right? So if they tested him as part of that rescue group, as they probably did, he did not show those C6 antibodies.

But then move up to Pennsylvania in eight months gets you through at least one tick emergence, right? And he did end up showing those antibodies. So understanding that now with better information, they can have better guid.

Yeah. And so, you know, this is, you know, we always love to have an ACVIM consensus statement to be our northern star in a variety of different areas in veterinary medicine.

And there is a consensus statement that was put forth in 2018 from ACVIM on Lyme borreliosis in dogs, but it has remained sort of a, I don’t know, I should use the word controversial. But you know, we definitely do not have full consensus on every point in this consensus statement. And that has only, I think, perpetuated the muddy waters that we find ourselves, that we find ourselves in as veterinarians because, you know, it’s hard to have these like, definitive recommendations on how to move forward on a disease that quite frankly can be pretty emotional for owners to hear about. That my pet has been exposed to Lyme.

And once again, we need to first of all talk them off that ledge of the difference between exposure and disease and provide some data there that can provide some comfort, but also a foundation for moving forward with additional testing because we’re not going to know until we look at that lab data that we truly have a patient that is unlikely to need antibiotics at this time.

And so using the clinical decision making algorithms that we have at Antech, coupled with those guidelines that have come forth from ACVIM can really move us in the right direction to making a full assessment of what’s going on with Doug.

And in this case, again, Antech has us clinical decision making algorithms through these vector borne diseases which are become hand holding, right. And give us some guidelines to follow and what to do with these conversations that are happening every day in our practices.

So this positive C6 antibodies in a patient, that’s non clinical, the recommendation actually is to assess for the proteinuria. And while that seems like a jump, right, the idea here is that in an asymptomatic dog, right, maybe antibiotics are not warranted, right, for not showing any clinical signs, but there’s still that risk, right?

There’s that risk of that small percentage of dogs that develop that protein losing nephropathy or the glomerular nephritis.

And so early detection of that glomerulonephritis, of that sort of immune system overreaction, that sort of goes rogue, right, with the antigen antibody complexes that are going to plug up those kidneys and create that glomerular nephritis, that becomes often irreversible, right. When we detect them in a sick patient, if we can screen for that early, early detection of proteinuria before they show the rest of those clinical signs, would give us the opportunity to intervene even earlier and perhaps prevent that full blown glomerulonephritis.

So the next recommendation is actually to assess for proteinuria.

And fortunately, as you remember, in Doug’s case, we had sent off that complete minimum database. Right. So we had a urinalysis to pair with those results to quickly quell their fears.

Because his kidneys seemed to be functioning just fine, his urine specific gravity was highly concentrated at 1042. Really appropriate.

And he had no protein on his urine protein screen.

If he had had protein like a one plus or two plus protein, it would be important for us to try to quantitate that. Right. To try and deduce if we think this is truly coming from the kidneys.

So the first thing we would do, certainly as a, as a pathologist looking at this data. Right. Is to try and assess if that protein’s coming from the kidneys or if it could be from an inflamed bladder or a cystitis.

And so we always talk about the significance of a protein area in the absence of, of an active sediment. So looking at that urine sediment, if there are significant red blood cells or white blood cells in that urine sediment, right. That may be the source of protein. Right. And we should sort of work that up and treat that separately as a cystitis or a hematuria or a pyuria.

It’s in the absence of any significant red cells or white cells that if there was a one plus or two plus protein, I’d want to get the upc. Right. And that’s the recommendation that if you have proteinuria, if you in the absence of, of an active sediment, is that we run a UPC as a reflex.

Right. The urine protein to creatinine ratio. And that will help us account for the degree of concentration of the urine with that creatinine measurement. And if the protein is even higher than that, and then we get numbers and interpretive guidelines that would say, yes, this is significant.

We’re worried about protein loss through the kidneys of the MAR tubules and in this case, again, negative screen for protein in the urine. We can feel confident at this point that there’s no sign of glomerulonephritis and we can appease them.

Right. But furthermore, the guidelines will say if there is no protein area detecting. Right. Detected that we have to, well, always talk about the tick prevention, but then make a plan for routine screening of that urine for protein area.

Again, early detection being paramount to our being able to intervene and keep him clinically feeling well and avoid the glomerulonephritis so in this case they talked about quarterly screening, you know, mark their calendar and plan to bring them in for a urinalysis to make sure we don’t have any early detection approaching area, allowing us for an early intervention if needed.

Yeah. And that, you know, just to circle back to how we started this conversation about the ACVIM consensus statement, just for clarity’s sake, you know, the lack of consensus is really around this debate about do we treat with antibiotics or do we not treat?

And we have, you know, I know this from working in this role as a professional services veterinarian, that we have all different types of approaches out there. And a lot of that can be when you dig into it, you know, it can be a result of the way a veterinary practices can be the result of what they’ve experienced in their career.

And my first job in New Hampshire, fresh out of vet school, you know, that was, I worked for a veterinarian that was 30 years in the business and he had seen the whole trajectory from we don’t even know that Lyme is a thing that dogs can get to.

Why are all these dogs sick? And I don’t know why.

To, you know, at the worst of it, having to euthanize a lot of pets that were not on year round prevention because they did have the worst case scenario, they did have Lyme nephritis. And that, you know, that, that, that tragedy that they witnessed really led them to a place of, well, if any dog tests seropositive for Lyme, I’m treating all of them, you know, and it’s hard to judge somebody who is practicing with that as their frame of reference because that is valid and it is emotional.

And so really where we are now is looking at, you know, the numbers that we have and saying that, you know, it’s a small percentage of, of exposed dogs, relatively speaking, that even develop clinical signs and a smaller percentage even yet of those dogs that have the worst case scenario.

Is there room to be vigilant with our diagnostic testing so that we can also take into account that responsibility that we have as veterinarians to safeguard these antimicrobials and make sure that we don’t put ourselves at risk for the development of antimicrobial resistance?

Yeah, that is really well said.

No, I think it’s great. And I think then you also don’t feel, you feel armed, right. With a tool to get ahead of that.

Right. Of that by screening with that protein area. I don’t think historically we had thought about using that as A routine screening in these positive dogs.

Right.

And I, and I, and I experienced in that first year in private practice up in New Hampshire,

you know, pretty much any pet that wasn’t on year round prevention would, would end up testing seropositive for Lyme exposure, anaplasma exposure, often both.

But during that year I also met a lot of owners who were, who were living with chronic Lyme themselves because this was missed on the human side of the equation as well. And so as a, as a public health veterinarian myself,you know, I always like to remind veterinarians that even if public health is not your, your primary passion in life, the promotion of public health is embedded in your veterinary oath.

And so understanding that whenever the word zoonosis comes up, and although these vector borne diseases aren’t directly zoonotic, what we have is a situation where we oftentimes have pets and owners that are sharing a common lifestyle, outdoor, recreationally speaking, or they live in an area where for whatever reason those pets are bringing these ticks into the home.

And so we’ve created a new interface.

Right. In which we are at a higher risk of being exposed to these vector borne pathogens ourselves.

Because sometimes the ticks like to take a trip inside the house on the pet and then they like, you know what, I think I’m going to walk across the living room and walk up that, that human being’s leg sometimes in the middle of the night.

As a hiker myself, I probably have mentioned this before, but you know, I hike every day because I have giant schnauzers that will make my life miserable if I don’t give them an hour of exercise in the woods.

And so, you know, we’re, we’re, we’re dealing with this pretty much year round. Even when it gets into the 40 degree days in the winter, it can be pretty common that I find ticks on my pets and on my, on myself on the ride home.

And so just remembering that wherever we see vector borne diseases, particularly Lyme, Anaplasma, ehrlichia in our pet population, that is a canary in the coal mine that is letting us know that by default because we’re seeing an increased prevalence of Lyme in our county by default, the humans that are living in that county are at an increased risk over time for exposure to those diseases as well.

Yeah. And Doug’s owners need to hear that. Right. Cause this is new territory for them and I think they learned about it first from their veterinarian.

Right. About the risks that they had as well.

Yeah. A lot of times, if they’re not hearing it from their, if the general public isn’t hearing about these issues from their veterinarian, they’re not hearing about them at all.

And so we really do have such an important educational role to play in our communities with regards to public health.

And so once again, vector borne diseases, zoonotic diseases, whenever that is in the equation, we should go the extra mile and make sure that owners are aware of the potential risk that they have to exposure to those diseases, especially if they fall into the, what I call the YOPI category of young, which the CDC defines as anybody five and under. Older to be polite to the people on the lower end of the older range.

So CDC says if you’re 65 and up, your immune system may be waning to the point that you could be at an increased risk of serious clinical disease if exposed to a zoonosis.

And then our pregnant population and then our immunocompromised population, it’s always good to be familiar with those categories of disease. So you can articulate to articulate that to the public.

Yeah, that’s great.

And so while we have conversations around Borrelia and Lyme disease here in Pennsylvania all the time in the exam room. Right. Because of the high seropositivity as well as clinical disease and informing them about one health risk.

As you talked about interestingly on Doug, surprisingly and not common in our area in Pennsylvania, his accuplex results, he came back as heartworm positive as well as.

So talk to us a little bit about the difference in seeing the heartworm positive results versus seeing the Borrelia positive results.

Well, remember that all of our major screening platforms in veterinary medicine are multiplex platforms. So we have an antibody test for exposure to Lyme, Borrelia borgdorferi, Lyme bacteria, Anaplasma bacteria, Ehrlichia bacteria. When it comes to the heartworm component of that test, we’re actually looking at an antigen evidence of live organism, which is a very different conversation.

We’re a lot more concerned about the potential for that pet to need treatment. And we’re going to have to, per the American Heartworm Society guidelines, do some confirmatory testing in addition to that initial heartworm antigen that we detected on accuplex in order to know whether or not we do need to treat this patient for an active infection.

Yeah. And so while I said we don’t commonly get heartworm positive results, antigen positive results here in Pennsylvania, obviously where he came from gets a lot more positive.

Right. In Alabama. And again Using those CAPC prevalence maps, you’re able to see sort of an overview in the country of where you’re getting the highest positivity results. And interestingly for them, you know, they likely he acquired his infection right when he, when he was in Alabama and brought that up with them here.

And I think they were frustrated slash upset saying but we, he screened that he was healthy before he left. And we don’t know exactly what tests they, they use then in that screening.

But presumably, you know, while he was more likely to get infected when he was in Alabama, if it was early in the life stage. Right. Of looking at the life cycle for the heartworm infection in dogs, it’s not detected.

Right. So we’re talking about the antigen detecting detection that comes with months after exposure. Right. So we have the larval, the larvae that are transmitted that they’re going to mature through the bloodstream and it’s going to take them months before they are mature gravid females that have the antigen that’s detected to turn those test positive.

Right. So likely he did acquire an Alabama. He’s now up here in central Pennsylvania. He is showing the heart antigen testing saying yes, he has a positive infection. Right. Which was again news to them in this otherwise asymptomatic dog.

Which is, which is great. Which is when you want to detect them.

And we did do a confirmatory test. So while we, you can get false positives with any tests we did do, it is recommended to do a confirmatory test by another method which we did as well as screened his blood film and looking for microfilaria.

And he was microfilaria positive.

And so while we don’t see a lot of heartworm infection here in central Pennsylvania now with him having circulating microfilaria and certainly we have Culicoides mosquitoes right here in Pennsylvania and around us, he’s actually serving as an itis, right.

For other dogs to get infected in our area. So this is how things spread, right. This is where you see things, places you don’t expect to see them in talking about what we’re going to do about these heartworm positive results, you know, it’s important that we have the rest of his minimum database to look at his overall health right before we consider.

And fortunately again we have paired results because we sent this whole wellness package off to the reference lab and we get his CBC back and he has no signs of anemia, he has no thrombocytopenia as we could see if he had maybe active Lyme infection that makes us feel a little bit better about that as well.

He did, interestingly, have an eosinophilia. We don’t get tons of allergies here in central Pennsylvania as we did when I practiced like down in Georgia. And it did make us wonder on the eosinophils if maybe that really was from his heartworm infection.

Right. When parasites, we think of those that have a tissue phase like heartworm infection does and so something that they plan to recheck after treatment.

And fortunately, looking at his entire chemistry profile, everything fell nicely right within the middle of the reference interval. And so we were able to reassure them, coming behind some surprising diagnoses like exposure to Lyme disease or infection with Lyme disease and a known heartworm infection, that his liver function looks great, his kidney function looks great. Right. Everything else here is looking really good, which makes him a really good candidate for pharmaceutical treatment. Right. For treatment of adulticides.

And that’s just what they did for Doug. Right. So while he came in as seemingly healthy. Right. And we’re talking about the importance of wellness blood work because he had a normal physical exam.

So not just healthy to the owners, but healthy to us as well. Right. On physical exam. And why we use these diagnostics to get objective data about our patients. Right.

Sometimes they haven’t crossed the clinical threshold yet. That’s just when we want to detect them. So we can intervene earlier and keep them feeling that good as long as possible.

And so it was really thorough testing for GI parasites. Right. So key screen testing for the GI parasite PCR panel was really sensitive, testing around 20 different GI parasites. Right.

That were all negative. So we reassured them that their current deworming protocols. Right. Were appropriate. And he seemed to be doing well there. But on his vector borne disease screening, he did have the C6 antibodies for Lyme, which we talked about. We’re going to run. We are going to check periodic monitoring for proteinuria early detection. If he were to develop a glomerular nephropathy and for his heartworm antigen tests.

Right. That we are going to follow that with adulticide treatment, especially given that he had a normal chemistry report. Right. We could feel really good about him having successful treatment, which he did.

I think his case really highlights, you know, that you never know what you’re going to find.

Right. That’s why we do these screening tests and we cast a wide net.

Right. And that history really matters. It really affected his because we don’t tend to get Lyme positive results next to heartworm positive results. Right. So it’s a unique pattern just because they’re more commonly acquired in different areas of the U.S. right. But everybody travels, right? These pets travel. And now we’re finding that these, these vectors are traveling much more to and expanding in their geography.

And that early detection, as we did in Doug’s case. Right. Allows us to treat earlier. Right. Earlier intervention, keeping him feeling as good as possible.

And you know, really what we have to remember and what’s illustrated so beautifully in this case is that we have some heavy lifting to do in our profession around client education and communicating the value of wellness.

And it’s understandable why an owner would perhaps see or perceive that a two year old patient or. Sorry, it’s understandable why. Why an owner would think my 2 year old dog or my 2 year old cat is healthy as a clam. And I don’t think healthy as a clam.

Oh my God,

Holly.

I like it.

Clams are happy.

Healthy as a horse. Horses are healthy. Clams are happy.

All right, so let’s get it right here.

Yeah, so it’s, you know, it’s understandable why an owner who’s bringing in a two year old dog or two year old cat and they’re expecting routine vaccines and preventive medications, why they might think that, you know, going for blood work and all of these different diagnostic tests might be a bit of overkill.

And yet we talked about that aha study early on in our episode here, that one in seven seemingly healthy adult aged animals is going to have something that’s uncovered. And when we can, when we can diagnose these infectious diseases early as opposed to later,

not only are they easier to treat, but they’re not going to wreak so much havoc on the, on the patients themselves. And so we need to do that education,

communicating all the various reasons why annual wellness testing and getting baseline lab data is so important.

And then once we do have, if, you know, if we do have a patient who has, let’s say, who has confirmed exposure to Lyme, as was the case with Doug, it’s important to educate the owner about the reason why we do need to do additional lab testing. In this case, the CBC, chemistry and urinalysis was already there. But if it hadn’t been, why it’s so important in that seemingly healthy animal to make sure that we’ve looked under every rock in the lab data to make sure that Doug is indeed clinically healthy at this point in time and doesn’t need antimicrobials.

And then the client education beyond that, once again, first and foremost making sure that, that with an owner who’s hearing this news for the first time and is going to be probably very scared to hear that their pet has been exposed to Lyme, that we clarify the difference between exposure to Lyme and Lyme borreliosis as a disease state and how we can have a lot of peace of mind by looking at that,

that extra piece of information in the urinalysis to make sure that, that in fact we can continue to monitor and not treat with antimicrobials at this particular point in time.

Super important to remind owners that because we’ve tested seropositive, because Doug has tested seropositive for Lyme exposure today, that those antibodies have been shown to persist for as many as 17 months or more.

And so when Doug comes back next year and we run another Accuplex, we’re very likely going to see that that test result persists, that we’re going to see seropositivity for Lyme again a year from now in many cases. And so that just, that’s a reason to really double down and explain the value and the importance of year round compliance on prevention so that when we see that seropositive result for Lyme next year, that we can feel pretty confident that as long as the compliance was there on the prevention side, that we probably are looking at old exposure and not a new exposure that may or may not result in clinical disease this time around.

And then finally, once again, we can never stress the importance of public health enough when it comes to vector borne diseases, particularly tick borne diseases, because we share a home with these pets and the ticks that they carry.

And so that means that as equal opportunity infectors, ticks are just as likely to transmit these diseases to us as they are to our pets. And we want to make sure that owners are vigilant and screening their bodies when they get back from a hike and ensuring that they aren’t at an increased risk of exposure themselves.

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Tales from the Lab is a production of Antech Diagnostics. The intent of this podcast is to provide education and guidance with the understanding that any diagnostic testing and treatment decisions are ultimately at the discretion of the attending veterinarian within the established veterinarian patient client relationship.