Many dogs that present for annual preventive testing (eg, for heartworm, Lyme, other tick-borne diseases) are Lyme-positive without apparent signs. Infected dogs are at a 5%5 to 10% risk of developing signs of Lyme disease and are unlikely to survive if they develop renal disease. 

Vaccinating Lyme-positive dogs has been demonstrated to be safe.6 Treating asymptomatic positive dogs has been demonstrated to reduce antibody titers7; however, there is evidence that Lyme infections are persistent even after antibiotic therapy.8

When a patient is diagnosed with Lyme arthritis, antibiotic therapy is initiated with injectable penicillin, followed by 14 days of oral amoxicillin.  For dogs presumed to have Lyme nephritis, discuss with the client further testing (eg, blood chemistry, complete blood count, urinalysis), in-patient care, intensive therapy, and a guarded prognosis.


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