Reader Question
I have a 3 y/o terrier mix who is about 10 lbs. She contracted Lyme Disease and was put on a course of Doxycycline and Rimadyl for pain after showing signs of lameness and discomfort. Shortly after starting the meds, she began to heavily drink and urinate. The rimadyl was stopped. Subsequent labs and tests (U/S and x-ray of kidneys, BP) delivered a diagnosis of glomerulonephritis (aka lyme nephritis?) when blood was found in her urine and a loss of protein was noted on labs as well as other related lab indicators (creatinine, BUN, etc). She is now on Enalapril to control protein loss, and she was put on a renal diet and omega 3 fatty acid supplements are added daily. As a result, her labs are much better - all values are in the normal ranges except albumin which is now 1.8-1.9 (one tenth of a point higher than one month ago when meds and dietary changes were made). My question is about ongoing tick/flea protection so she is not re-infected with Lyme Disease so as to avoid further compromising her kidneys and/or other organs. Are there any topical flea and tick squeeze-on treatments that are safe given her history? Advantix caused her seizures 5 months ago, which took us down this road (we stopped Advantix while looking for something else and she contracted Lyme disease). We read about the dangers of permethrin and others like it. Frontline Plus has fipronil and we're just not sure if this will be safe for her kidneys or if there are contraindications with her Enalapril meds. The smallest Frontline Plus dosing for dogs is "up to 22 lbs" and our dog is only 10 lbs which feels like it could be too much for her. This is the drug we are leaning toward but we are nervous
and need an expert opinion. We researched the all natural route (essential oils etc) but they have their risks and efficacy is questioned. Please help. We need expert advice. We know that her kidney disease has a very poor prognosis (and we are very, very saddened by it), but we want her with us as long as we can, and healthy and happy as long as possible. Can you direct us to a safe and effective solution. Thank you. Mel J.
Answer from Our Team
We're so sorry, Mel. You're doing everything you can for her, and preventing another tick-borne infection is the right goal. Because of her kidney disease, her seizure history and her medications, the final choice should be made with her vet or a veterinary internal medicine specialist, but here are the points to raise:
Choose a product that stops ticks quickly. Lyme experts prefer products that prevent tick attachment or kill ticks rapidly. They note that fipronil (in Frontline) doesn't kill ticks until about 24 hours after they attach.
Be cautious with isoxazoline chews. In 2018 the FDA warned that this class of flea and tick products (Bravecto, NexGard, Simparica and Credelio) has been associated with muscle tremors, unsteadiness and seizures in some dogs. Given her history, discuss the risks carefully with her vet before using one.
Dosing by weight band is normal. Spot-on products are labeled by weight range, so the band that includes her weight is the labeled dose for her. Ask your vet to confirm.
Skip the Lyme vaccine for now. Current specialist guidelines recommend not vaccinating dogs that are sick or losing protein in their urine.
Daily tick checks, prompt tick removal and avoiding tall grass and wooded areas also help. Our guide to Lyme disease in dogs explains Lyme nephritis in more detail.
This is general information, not a diagnosis. Please follow your own vet's advice.
