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Drug shortage prompts veterinarians to warn dog owners about tick-borne diseases this summer

  • Veterinarian Ellie Shelburne, assisted by Danielle Stuart, right, prepares to administer a vaccination for Lyme disease to Milo, thirteen weeks old, on Wednesday at Northampton Veterinary Clinic.<br/>KEVIN GUTTING

    Veterinarian Ellie Shelburne, assisted by Danielle Stuart, right, prepares to administer a vaccination for Lyme disease to Milo, thirteen weeks old, on Wednesday at Northampton Veterinary Clinic.
    KEVIN GUTTING Purchase photo reprints »

  • Veterinarian Ellie Shelburne administers a vaccination for Lyme disease to Milo, thirteen weeks old, on Wednesday at Northampton Veterinary Clinic.<br/>KEVIN GUTTING

    Veterinarian Ellie Shelburne administers a vaccination for Lyme disease to Milo, thirteen weeks old, on Wednesday at Northampton Veterinary Clinic.
    KEVIN GUTTING Purchase photo reprints »

  • A sampling of ticks (dead) that can transmit Lyme disease, with an engorged tick at bottom left. Dangerous ticks can be even smaller than these. <br/>KEVIN GUTTING

    A sampling of ticks (dead) that can transmit Lyme disease, with an engorged tick at bottom left. Dangerous ticks can be even smaller than these.
    KEVIN GUTTING Purchase photo reprints »

  • Purchase photo reprints »

  • A sampling of ticks (dead) that can transmit Lyme disease, with an engorged tick at bottom left. Dangerous ticks can be even smaller than these. <br/>KEVIN GUTTING

    A sampling of ticks (dead) that can transmit Lyme disease, with an engorged tick at bottom left. Dangerous ticks can be even smaller than these.
    KEVIN GUTTING Purchase photo reprints »

  • Veterinarian Ellie Shelburne, assisted by Danielle Stuart, right, prepares to administer a vaccination for Lyme disease to Milo, thirteen weeks old, on Wednesday at Northampton Veterinary Clinic.<br/>KEVIN GUTTING
  • Veterinarian Ellie Shelburne administers a vaccination for Lyme disease to Milo, thirteen weeks old, on Wednesday at Northampton Veterinary Clinic.<br/>KEVIN GUTTING
  • A sampling of ticks (dead) that can transmit Lyme disease, with an engorged tick at bottom left. Dangerous ticks can be even smaller than these. <br/>KEVIN GUTTING
  • A sampling of ticks (dead) that can transmit Lyme disease, with an engorged tick at bottom left. Dangerous ticks can be even smaller than these. <br/>KEVIN GUTTING

That’s because there is a nationwide shortage of doxycycline, essentially the only drug veterinarians use to treat Lyme disease and other tick-borne diseases in dogs.

It’s causing the drug price to skyrocket, said veterinarian Ellie Shelburne of the Northampton Veterinary Clinic. She said it used to cost about $25 to very effectively treat a large dog for Lyme. Now a dog owner could pay upwards of $600 at a commercial pharmacy.

“A lot of people can’t afford that,” Shelburne said.

Drug companies have attributed the shortage to increased demand and manufacturing delays.

Dogs aren’t the only species affected by the price increase. Doxycycline is used to treat infections in humans, so people with afflictions from Lyme to acne will also face the high prices at pharmacies. But unlike most people in the state, the vast majority of dogs don’t have health insurance to help cover the cost of the prescription drug.

Danielle Lorenzo, a veterinarian at the Florence Animal Clinic, said that while most dogs exposed to Lyme don’t show symptoms, about 10 percent come down with fevers, swollen joints, lameness and lethargy, and some can even suffer kidney damage. While there is a vaccine for Lyme, it isn’t 100 percent effective and doesn’t protect dogs from other tick-borne diseases that are also treated with doxycycline. Some, like anaplasmosis and ehrlichiosis, are common here and cause similar symptoms and weaken a dog’s immune system.

“We have a very big problem in this area with tick-borne diseases, not just Lyme,” Lorenzo said. “That’s why people need to use a good-quality tick preventive year-round. And if you’re still seeing ticks on your dog, add a tick collar. Sometimes the tick load is so heavy the topical tick preventive can’t keep up.”

Sick as a dog

Veterinarian Ted Diamond of Valley Vet Hospital in Hadley said that about 90 percent of dogs exposed to Lyme disease will never show symptoms and it probably won’t shorten their lives. But it’s important to treat the disease because multiple tick bites could compound the disease until the dog has severe symptoms, he said.

“I think people have an idea that Lyme is not that serious because the dogs don’t get that sick and it was treatable with doxycycline, when we could get it,” Diamond said. “But that’s not a reason to be lax. The best thing to do is to keep out of tick-infested areas and treat with preventative.”

Like Lorenzo, he said tick-borne diseases other than Lyme are another reason to try to prevent infection. “And with climate change, more tick-borne diseases that we didn’t used to have here are migrating north,” he said.

Plus, having a dog with ticks means more ticks in the house, where they could be a slight risk to humans.

Diamond said he doesn’t think it’s a substantial risk, and added that it is highly unlikely that a tick would detach once it has bitten a dog. “But sometimes they’re just crawling on the dog’s hair or if the dog has a tick repellent, they’ll drop off in the house,” he said, where a human could potentially pick them up and become infected with Lyme.

Nipping bites in the bud

Getting your dog vaccinated is the first line of defense against Lyme, but it doesn’t protect against other tick-borne diseases, so it’s best to just avoid tick-infested areas, Diamond said. Checking your dog for ticks after it has been outside is a good idea, too, but not always as easy as it sounds, he said.

“Some deer ticks are the size of a sesame seed and it can be really hard to find them on a dark-colored, heavily-coated dog,” he said.

Using a veterinarian-recommended tick-preventive — not just any product you find in the pet store — is very important, Shelburne said. “It’s important to talk to your veterinarian, not just about product effectiveness but also about safety,” she said. Some flea and tick treatments used on dogs could be deadly to the family cat if it rubs up against the dog, for instance.

While a high-quality topical preventive will repel and kill ticks, dog owners should keep an eye out for ticks and consider adding a tick collar, too. “If you’re still seeing ticks on your dog, you may need to use a more aggressive way to control them,” Lorenzo said.

Cost of treatment

Shelburne said the doxycycline shortage is a “huge deal,” because while there are alternative treatments for Lyme, doxycycline is the most effective, has the fewest side effects and also eliminates other tick-borne diseases. “Sometimes a dog is double- or triple-positive, and doxycycline is the only one to use on all of them,” she said.

The Northampton Veterinary Clinic hasn’t been hit by the shortage yet because the practice’s purchaser saw the shortage on the horizon and stocked up six months ago, Shelburne said. She said that only current clients will be sold the drug.

Valley Veterinary Hospital and Florence Animal Clinic are out of the drug and treating Lyme with the help of compounding pharmacies, companies that are licensed to mix drugs from raw ingredients or other drugs. It is illegal for veterinarians to buy and resell drugs from compounding pharmacies in place of FDA-approved drugs, but they can write prescriptions that allow their clients to buy a mixed drug similar to doxycycline directly from the pharmacy.

Shelburne estimated a month of treatment will cost the customer around $85 to $100 from a compounding pharmacy, but that’s a big improvement over leaving the customer to try to find doxycycline at a commercial pharmacy like CVS or Walgreens. Five Northampton-area pharmacies surveyed reported doxycycline prices of between $2.35 to $11.99 per pill. At that rate, it would cost the owner of a large dog between $235 and $1,199 to treat for a month.

Shelburne said the clinic will likely try to treat dogs with other antibiotics first, and only use compounded drugs if the side effects of the alternative antibiotic make treatment impossible. “You can’t treat them for a month if they’re throwing up every day,” she said.

The FDA says the shortage is expected to be temporary, but Lorenzo said the ticks are out now in full force and dog owners should do everything they can to avoid the parasites’ bites.

“The No. 1 thing is to do tick-prevention, year-round,” she said.

Rebecca Everett can be reached at reverett@gazettenet.com.

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