Canine Lyme Disease Nephritis

A Rare Fatal Complication of Lyme Disease in Dogs

Mar 6, 2009
Lorie Huston

Tick - Lorie Huston

Though the most common symptom of Lyme disease in dogs is lameness, Lyme disease can sometimes affect the kidneys, causing renal failure and eventually death.

Though the most common symptom of Lyme disease in dogs is lameness caused by joint pain and swelling, veterinarians are also recognizing a form of the disease referred to as Lyme nephritis. This is a form of Lyme disease which causes damage to the kidney of the dog and results in kidney failure and eventually death.

Symptoms of Canine Lyme Disease Nephritis

Lyme disease nephritis symptoms are those of renal failure and may consist of:

Vomiting
Not eating
Lethargy
Weight loss
Increased water consumption
Increased urine volume
Swelling of legs

Other milder symptoms of Lyme disease may have been noticed previously. The dog may have shown evidence of lameness, fever and/or general malaise. It is possible that the dog may been a chronic carrier of Lyme disease.

Diagnosis of Canine Lyme Disease Nephritis

Diagnosing nephritis caused by Lyme disease is based on identifying a positive Lyme disease antibody test using either a Idexx SNAP 3DX or 4DX or a quantitative C6 antibody level along with evidence of renal involvement.

Determining renal involvement involves blood tests (complete blood count, serum chemistry blood profile) and urine tests (urinalysis, protein:creatinine ratio).

Blood tests should reveal elevated BUN and creatinine values, indicating that kidneys are not functioning within their normal limits.
Blood tests will also likely reveal decreased protein levels due to protein loss through the kidneys.
Urine tests should reveal protein in the urine, resulting from abnormal amounts of protein passing through the kidneys and ending up in the urine.
Urine tests will also likely reveal a low specific gravity, indicating that urine is dilute because the kidneys are not able to work properly and create a concentrated urine.

Once it has been determined that both a positive Lyme disease antibody test and renal involvement is present, the next step is ruling out other causes of renal disease. A positive Lyme antibody titer or test does not automatically lead to a diagnosis of Lyme disease nephritis. Other tests which may need to be done include:

abdominal radiographs
abdominal ultrasonography
biopsies of the kidney

Treatment of Canine Lyme Disease Nephritis

Treatment for Lyme disease nephritis in dogs is aimed at improving the function of the kidneys. Potential treatments may include:

intravenous fluids
feeding a "kidney diet" with restricted phosphorus, salt and protein levels
phosphorus binders, such as aluminum hydroxide
calcitriol
antibiotics, including doxycycline
ACE inhibitors, such as enalapril or benazapril
gastrotomy or PEG tube to provide nutrition if not eating
kidney dialysis

Prognosis for Canine Lyme Disease Nephritis

The prognosis for dogs suffering from nephritis caused by Lyme disease is poor. Usually the disease is fatal at this stage.

Lorie Huston, Feature Writer, Pet Care, Sears Photography Studio

Lorie Huston - Lorie Huston, DVM

Comments

Apr 4, 2009 3:30 AM

Guest :

Our one year old labrador retriever bitch - Googly - has stopped eating after she had high temperature for two days (104.4). When taken to the vet she was administered antibiotcs and anti inflammatories through I.V.fluids. The vet advised us to keep an eye on her urine. Today I saw that she pissed blood red. Does it indicate nephritis. Am I supposed to be cautioned about something serious? - A life threat? Plz help. -Posted by julienjoy2000@yahoo.co.in

Apr 4, 2009 2:11 PM

Lorie Huston :

I'm so sorry to hear about your lab and her illness. I know how difficult it is to deal with a sick pet and how helpless it can leave you feeling.

As to what is causing the blood in her urine, I'm afraid that I can't answer that question with any accuracy without examining your dog. There are many different possibilities ranging from minor to serious. A reaction to a medication cannot be ruled out but other possibilities include bladder infections, bladder stones, kidney infections, bleeding disorders plus a whole lot of others.

Yes, Lyme disease nephritis is a possibility but I'm not sure how likely since I don't your dog's medical history. Had she tested positive for Lyme disease in the past? What testing has been done for her and what were the results? Is the blood present the entire time she is urinating or is it just present at the end? Has your lab been spayed? Has she been exposed to ticks?

I wish I had the answers you're looking for and wish I could help you more. The best advice I can give you is to contact your veterinarian and let him/her know about the bloody urine. Your vet is in the best position to advise you what to do from here.

Good luck and please keep in touch and let me know how your baby makes out.

Sincerely,
Lorie Huston

Apr 18, 2009 8:10 AM

Guest :

My 8+yr old cocker spaniel had his regular Vet exam. The result, he has kidney failure. No reasons given, "try this canine kit". We went to another Vet to get answers. Another $400. told us the same, however ran a test to determin it was kidney failure due to Lyme disease! He was vaccinated for the last 6 years. How did he get the Lyme disease and why won't our Vet tell us what he did or didm't do. We couted on this Vet to be our caregiver for our pet. This should not have happened and as a result we cannot get any answers so I now have a very low opinion of the Veterinary. If this had been a regular doctor...
I have spent $800 so far with no answers and information on what the time line is what to expect or how to prepare; they all are willing to set up more appointments to run more tests...that will do nothing for his well-being. I need to know how to care for him at home until his time has come. I will not put him through unnecessary drawn out painful
things that will only require more payments for incompetence.
Shirley for Ajay in Minnesota

Apr 18, 2009 2:36 PM

Lorie Huston :

Shirley,

Learning of your Cocker Spaniel's illness must have been devastating for you. You have my sympathies.

Unfortunately, it's very difficult for me to comment directly on your dog's illness because I don't really have a great deal of history or information about his condition. I can understand why you feel frustrated and upset. I can even understand your anger with the veterinarians involved. But the truth is, they may not be giving you the answers to the questions you're asking because they may not know the answers themselves.

Diagnosing any disease in a dog or cat can be difficult at best and there are many different things which can cause kidney disease or kidney failure. Lyme disease is one of those diseases but is only one of many possibilities. A positive Lyme disease test by itself does not always indicate with certainty that Lyme disease is the cause of the symptoms that your dog is suffering.

My suggestion to you would be to talk with the veterinarian(s) you have been dealing with and pose your questions directly. Try not be antagonistic. Let the doctor know you are simply trying to understand what is happening to your dog so that you can take care of him properly. Try not to make any accusations about any wrong doing. This will not accomplish what you need to do. Ask the veterinarian what you can do for your dog and let him/her know up front what your feelings about invasive or painful testing or treatments are.

It is likely that you will find the veterinarian is willing to work with you to try to keep your dog comfortable. It is also possible that the veterinarian may be able to suggest some simple options which could slow down the progression of the disease. Sometimes something as simple as a change in diet can make it easier for your dog's kidneys to do their work and can make a difference in your dog's health condition.

Good luck with your pet. I hope all turns out well for both of you.

Sincerely,
Lorie Huston

Apr 20, 2009 3:16 PM

Guest :

Our dog was diagnosed with lyme disease 4-6 weeks ago! Last week his belly started getting real big, I thought it was something he ate (he's a lab, and often times gets loose). Anyway, today, we brought him in and they did tests and his liver and kidneys are failing, we are going to have to put him down. I just found this site today, and it breaks my heart that they didn't do the blood tests when they did the lyme test. This is the only place that we found the Swollen feet as a symptom, which is what originally prompted us to bring him in. I wish the vets would have been privvy to this type of lyme. Regardless, we're going to have to spend some loving, quality time with him before we bring him in for his final visit!
:(

Aug 21, 2009 11:36 AM

Guest :

Our 4 year old lab was diagnosed with Lymse Nephris in June. His symptoms included lameness and not eating. Since being on NF kidney diet, no treats or bones, and treatment of Enalipro, aspirin, prednisone, fish oil capsules and 45 days of antibiotics (along with some other treatments for diarrhea and bladder issues) his protein-creatinine ratio dropped in 3 weeks from 15 to 1.8, huge improvement. His symptoms, however, have cropped back up again despite getting better for a couple of weeks. The doctor thinks the wasting away-weight loss and difficulty urinating are related to prolonged steroid use, but they do not want to completely take him off steroids (he is on 10mg and now weighs 61 lbs...originally 78 lbs). He has now been extremely restless and not sleeping at night, constantly starving despite continuing to feed him more (4 cans of NF per day) and is having diarrhea 2x per day, sometimes in the house. Do you have any suggestions on how to keep him comfortable and what to do next? Have you seen symptoms present themselves in this manner before and have any suggestions?
thank you for your assistance.

Aug 21, 2009 9:01 PM

Lorie Huston :

I'm sorry about your lab's illness. And I truly wish I could help you. Unfortunately, there are just too many variables at play here and without the opportunity to examine your dog and peruse previous history and test results, there is just no way for me to be able to tell you what is happening with your dog. I can tell you that Lyme nephritis can be very difficult to treat and how it occurs is not well understood at this point.

The best suggestion I can make to you right now is to sit down and have a discussion with your veterinarian about what he/she thinks is going on and how you can make your dog more comfortable. Your veterinarian is in the best position to be able to answer these questions for you as he/she is most familiar with your dog's illness and physical condition.

Good luck to you. I hope all works out well for you and your lab.

Oct 1, 2009 1:35 PM

Guest :

My siberian husky was diagnosed with Lyme Nephritis (& PLN) about 2 weeks ago. My vet suggested that we look at using immunosuppressive therapy to try to shock her system into freezing the kidney damage where it is. He said if her #s don't improve next week, we should really consider it then. Have you heard anything about using immunosuppressive therapy in pulse doses as a last ditch effort to help stop kidney failure?

Oct 3, 2009 8:31 PM

Lorie Huston :

I'm not exactly sure what you're referencing here. Calcitriol does have some immunomodulating effects and is frequently used in cases of glomerulonephritis (kidney disease, PLN) regardless of cause. Doxycycline also has some anti-inflammatory effects.

The fact is, each patient is different and must be evaluated based on their individual status. For this reason, it is very difficult to diagnose a condition without having examined a pet and nearly impossible to give accurate information regarding treatment of that pet over the internet without physically examining him/her. I would advise posing any questions you may have to the veterinarian treating your pet. If you feel more comfortable seeking a second opinion, consider asking your veterinarian if there is a specialist nearby who could consult on your pet's case.

Good luck. Having a pet with kidney disease is difficult. You have my sympathies and my best wishes for both of you.

Dec 1, 2009 10:56 AM

Guest :

Just lost our Best friend Last night!
Our little 3 year old Beagle Named Snoopy! He came to us 1 year old delivered on my daughters Birthday. He has slept under the covers with my 9 year old Daughter ever since! 1 month ago Snoopy lost his appetite and was tired, this came at the same time our kids were just diagnosed with flu. we thought it could be related, we waited several days hoping he would improve then went to the Vet. 4 days later that vet had lab work back saying High kidney levels and Positive Lyme! So we went to the Best Hospital in area and Began treatment 5 days later we brought our snoopy home with all his Meds, 4 days later had another recheck and they said stop the high blood pressure meds as it is fine. we where on Doxy Now and it was hurting Snoopys belly. after 2 weeks of fighting that they switched us to Amoxacylin and Snoopy was again interested in food, All seemed well for about a week and he had good weight and was still tired but full of life on walks outside! We were very hopeful and tried everything suggested along with his Meds! So just this last week his eyes were gradually getting Glassy! But he was eating and seemed to be improving! Ate very well all day then my wife thought he could not see! I took him from my daughters bed and in the hall light his eyes stayed dialated! We rushed him to the hospial again and they said high blood pressure had caused complete retna disconects! So now our baby was blind, They said to put him down then! My now 11 year old daughter was waiting at home for him so we had to bring him home! This was the day before her 11th birthday! She jumped in our bed the next morning on her 11th Birthday and asked so did they say wha twas wrong with Snoopys eyes! This was on her Birthday two years after we got this little Beagle! We had considered not telling her until the next day but Snoopy was in pain and now blind, his heart was beating like crazy so we had to tell her and help her understand it would not be fair to keep Snoopy suffering! That night after making calls all day looking for hope someplace we Brought our little Snoopy at just 3 years old back to the hospital to be euthanized! This was the hardest time we have ever had and Will really miss our Best Friend Snoopy! I know this will take some time To get feeling better but that little Guy got shortchanged! He was the cutest little Beagle we ever saw and The last month we all fell much deeper in love with him knowing he was in trouble! I miss him

Sep 20, 2010 5:49 PM

Guest :

We lost our 8 yo Australian Shepherd Bikkie one week ago today. She had starting a dry hacking cough 2 months ago which seemed to be kennel cough. She also had a low appetite for her regular dog food but still took treats readily. About two weeks into the cough she had some soft mucous and blood tinged stools plus mild weight loss and low exercise tolerance. We went to the vet who stated 'I really don't know what's wrong with her' but decided it might be girardia infection and Rx ed metronidazole for 5 days. Symptoms seemed to improve somewhat so we continued that Rx for another week. We changed her regular dog food to another variety thinking she might be just bored with the usual. She ate a full portion and show more energy that day and we were very encouraged. The next morning when i awoke she didn't greet me as she had every day. I thought this strange and checked on her, finding her eyes rolled back in her head. We rushed to the vet where she was examined, had blood drawn, an ultrasound of her abdomen. They determined she had had a stoke, her temperature had risen from 103 to 105 F just in the 45 minutes there, and she had fluid in her abdomen and suspected fluid on the brain with an elevated ICP. They told us she was beyond their care and recommended we rush her to an emergency vet hospital nearby. She was admitted there, found to have had a major stroke, elevated ICP, ascites, was coagulopathic with hypoalbumemia and significant protein in her urine. She was in critical renal failure and had a 12 cm clot in her distal aorta which was causing significantly reduced blood flow to her hind legs. Over the next 5 days, despite aggressive treatment her kidney function continued to decline and she had more strokes due to the loss of antithrombin III along with albumen in her urine. By the 4th day she stop making urine completely. On the evening of the 5th day of hospitalization we decided she had suffered enough. We are heart broken and miss her tremendously. We're searching for answers to this rapid decline. She had a serious case of lyme's about 5 - 6 years ago but symptoms resolved after 6 weeks of antibiotics. After her death, lab results came back showing she had also been exposed to Rocky Mountain Spotted Fever. Both can cause kidney damage. We don't know if its one or the other or both. We hoping a kidney biopsy will tell us something. She was a wonderful pet, involved in all our family activities, and she left us way to soon.

Dec 6, 2010 8:45 AM

Guest :

My mothers dog was diagnosed with Lyme disease about 2 years ago. Just recently he has been having to go outside more and more and now he's to the point where he is miserable. I looked it up because i was suspicious after he lost about 15 pounds. I'm completely shocked and devastated to read this and i severely hope this isn't what he has. He's 8 years old but he's part of the family. I'm not sure how my mom will be able to take this if it is.

Dec 6, 2010 9:06 AM

Guest :

Dec 28, 2010 11:00 PM

Guest :

My 6 year old black lab was diagnosed with lymes nephritis and were told that her prognosis was quite grim. The doctor even went so far as to tell us the day before that she was praying that my dog had stage IV lymphoma because the prognosis for that would be 6 months to a year and the prognosis for lymes nephritis was only a matter of days. Throughout the week her red blood cell count plummeted, her kidney damage was ongoing, and her creatinine numbers increased. All of these signs were devastating and we were sure that we were going to lose her. Her condition worsened in the beginning, but then she began to respond to her treatment.
We were told that a medication that she had been on for over a year could potentially have saved her life. She has had skin problems most of her life and it causes her to be very itchy. Our regular vet prescribed a medication called cyclosporine which is an immune system suppressant and so this helped when her immune system began attacking the lyme bacteria.
After 11 days in the hospital, I was able to bring her home. She is quite weak and has lost a lot of weight. Her kidneys have suffered some damage, but not enough that it will affect her daily life once she has recovered. The doctor says that she is not completely out of the woods just yet, but she has made remarkable progress and we are all optimistic.
When I found out that my dog had this horrifying disease, I googled it and read post after post that absolutely broke my heart: people describing the extremely fast decline of their dogs and puppies which usually led to death. I am so sorry for all of your losses and could not begin to imagine your pain. I want to give other people who might be going through this situation some hope. With an extremely caring and talented doctor/staff, a family who doesn't give up, and of course a little bit of luck, it is possible to survive this disease. Good luck to anyone dealing with this; I wish you nothing but the best!!

Feb 15, 2011 2:21 PM

Guest :

My dog was diagnosed with Lyme Nephritis in Sept 2010. Before she was diagnosed (late stage) she was brought into the vet for lameness. I thought maybe she jumped off the bed and hurt her back. A couple weeks later she was still lame so I though she may have Lyme disease. I was told in the past if she got Lyme disease she would have some lameness but an antibiotic would cure her. They put her on an antibiotic but didn’t run any tests. She got a little better for a few weeks but then she started to lose her hair on her face (outer coat). I thought that was really strange so I brought her in again. They tested her thyroid and it was borderline low. They thought that was the reason for the hair loss. About 5 weeks later she didn’t want to eat her regular food. I brought her into a different vet and they ran some test on her and realized she was quite sick and her kidneys weren’t functioning correctly. At that point it was chronic. They put her on fluids immediately. It was getting worse over the weekend so they suggested she should go to a 24 hour care hospital. We took her to the University of Minnesota. After many tests and a lot of money they diagnosed her with Lyme Nephritis. She was on many drugs in the beginning, including an antibiotic and anti-nausea meds. She is currently on Aluminum Hydroxide, Chlorambucil, Benezapril, Calicitriol, Amlodipine, Azodyl and Hill’s k/d food. I bought the Azodyl online at Amazon and it really made a huge difference. I believe that is why she is still around today.
The biggest frustration for me is my dog is very picky about what she is hungry for now. Some days she wants hard food, some days she wants soft food and some days I can’t figure out what to give her but she is hungry. I try veggies, bread and other tricks to try to get her to eat. My last resort is to feed her through her peg tube. However I do give her 200 mLs of water through her peg tube and some of her drugs every day.
A word of advice for anyone with a dog who was recently diagnosed with this disease…this is a very frustrating disease. Most of the time she is well and seems quite normal but she does have times when she feels nauseous and shakes. The vet tells me she would feel similar to a human having a cold or the flu at those times, based on the information they received from humans with chronic kidney disease. It’s tough to watch my dog go through those moments but right when I think she is potentially suffering and I might have to put her down she is completely normal the next day. That is the most frustrating part. I definitely wouldn’t put my dog down if she was fine and didn’t seem to be suffering.
So if anyone else has advice on what they did or are doing that would be great.

Jun 29, 2011 3:43 PM

Guest :

My 3 year old lab mix Rio has elevated BUN, Creatine and K (23, 1.7 and 5.3 respectively). I'm told these numbers are at the low end of what is considered "HIGH". Two months ago all of his blood tests were normal. We went to the vet because of some crustiness on his nose with the minor secondary complaint that he didn't seem quite himself (Not so wild and crazy at the dog park and a bit subdued at home) Could have been the heat, could be that he's maturing and isn't a teenager any more - in any case nothing alarming. He went to his agility class a week ago and was a model student. He isn't lame. Hasn't thrown up. No fever. He is turning his nose up at a few treats that he used to like, but no substantial weight loss from two months ago.

We know he had lyme disease as a youngster. It was treated with Doxycycline and he has been normal until now. He's spent the last 3 days at the vet with an IV to flush his system. He's back on Doxy. The results of the C6 are not back yet. If it is not lyme then what else could it be? If it is lyme and we follow the proper treatments is the prognosis still pretty grim or is there a chance for real recovery?

Thanks in advance for any info anybody can shed on the matter.

Jim

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