Infectious Diseases Information Hub
How Do I Know If I Have Lyme Disease?
Lyme disease can be tricky to diagnose. The signs and symptoms can look like many other health problems. The ticks that spread it can pass other diseases on to you at the same time. Plus, the tests that check for it aren't exact. Because of this, you could be told you have Lyme disease when you don't.
This bacterial infection is spread through the bite of a young deer tick or black-legged tick. These eight-legged creatures, about the size of a poppy seed, can be found in wooded and grassy areas throughout the United States, especially in New England and the Rocky Mountains.
Because these ticks are so small, most people don't realize when they're bitten. But the longer a tick stays attached to you, the more likely it is to transmit Borrelia burgdorferi (the bacteria that causes Lyme disease), if the tick is a carrier.
If not found and treated, Lyme disease can lead to problems with your joints, heart, and nervous system. It can even affect your memory.
If you've been outside in an area where ticks are known to live, you should tell your doctor. They'll also want to know about the symptoms you're having. These details are crucial to making a diagnosis of Lyme disease.
Early symptoms that usually occur within the first month after a tick bite can include:
Symptoms that show up in the weeks to months after a tick bite include:
Symptoms that come and go are common with Lyme disease. They will also depend on the stage of the disease.
If your doctor suspects that you have Lyme disease, they may order two blood tests. These will look for signs that your body is trying to fight it off. The results are most precise a few weeks after you've been infected.
These tests are:
ELISA (enzyme-linked immunosorbent assay) test. This test can't check for the bacteria that causes Lyme disease. It can only look for your immune system's response to it.
Once Borrelia burgdorferi gets into your blood, your body begins to make special proteins called antibodies to fight it off. The ELISA test checks for those antibodies.
Although it's the most common way to check for Lyme disease, the ELISA test isn't perfect. It can sometimes give false "positive" results. On the other hand, if you have it done too soon after you've been infected, your body may not have developed enough antibodies for the test to detect them. This will give you a "negative" result even though you do have Lyme disease.
Western blot test. Whether your ELISA test comes back positive or negative, your doctor will need to do this blood test, too.
A Western blot uses electricity to split certain proteins in your blood into patterns. This is then compared to the pattern of people known to have Lyme disease.
At least five band matches means that you have Lyme disease. Still, not all labs have the same standards. There's a chance that you could get a "positive" result from one and a "negative" result from another.
Also, some labs offer a test for Lyme disease using your urine or other body fluids. These methods aren't approved by the FDA. Studies also show that the results often aren't correct. You may be told that you have Lyme disease when you don't.
Other tests: Lyme disease is called "The Great Imitator" because it mimics so many different health conditions. Your doctor may also want to do more blood or imaging tests to rule out:
If you think you have Lyme disease, it's a good idea to see a board-certified infectious disease specialist. This type of doctor is skilled in both diagnosis and treatment.
The tests that look for Lyme disease aren't foolproof, so your doctor may decide to start you on treatment based on your symptoms and the likelihood you've been exposed to ticks. Ideally, the diagnosis will be confirmed for treatment to continue.
How Often Should I Take My Dog To The Vet?
Key pointsYou can train dogs to sit, stay and come, but you can't train them to tell you they need a checkup. It's up to you to make sure your dog gets the preventive care, sick care and emergency care it needs.
How often should I take my puppy to the vet?Expect to make several trips to the vet in your puppy's first year of life.
Puppy's first checkupPuppies should get their first checkups when they're 2 to 3 weeks old — though unless you're a breeder or animal rescuer, you may not have a puppy this young. Here's what the vet will typically do during a young puppy's first visit:
Your vet may also ask if you have pet insurance. Pet insurance is optional, but if you are considering it, it's best to buy it when your dog is young and does not yet have health conditions. No pet insurance company will cover pre-existing conditions. So if your uninsured dog gets a diagnosis of an incurable condition like Addison's disease or type 1 diabetes, you'll be paying for that treatment out of pocket for life.
See if pet insurance is right for you: Is pet insurance worth it?
Puppy's next checkupsPuppies should get a second checkup at 6 to 8 weeks. The vet will perform another physical exam, and it will also be time to start your puppy's routine vaccinations for distemper, parvovirus and possibly Bordetella.
Your vet should also prescribe heartworm medication. Dogs need to take heartworm prevention medication monthly throughout their lives. Your vet will also recommend that your puppy begin monthly flea and tick prevention medication at around 8 weeks. This medication doesn't require a prescription. But it's possible to get a prescription for a single medication that protects your pup against heartworm, fleas and ticks.
Once your puppy weighs at least 2.2 pounds, microchipping is an option. This quick and inexpensive procedure injects a rice-grain-sized device with an identification number between your dog's shoulder blades.
At 10 to 12 weeks, it's time to start the DHPP vaccine series, which protects against these four canine illnesses:
Depending on your pet's lifestyle, your vet may also recommend vaccinations for leptospirosis, influenza and Lyme disease.
At 16 weeks, your puppy will need a third DHPP booster and its first rabies shot.
Rather than doing a full vet exam for boosters, you may be able to schedule an appointment with a veterinary technician or take your dog to a free or low-cost vaccine clinic in your area. Ask your vet if this plan is appropriate for your dog.
Around 6 months of age may be an ideal time to spay or neuter your puppy. Ask your vet for guidance.
Don't be shy about asking your vet questions. Whether you want to know how often your puppy needs a nail trim or whether its refusal to poop at the dog park is a problem, speak up.
Write down a list of questions before you head to the vet. That way, they can manage your appointment time effectively and make sure to address all your puppy's needs.
Special signs your puppy needs to go to the vetYour puppy may need additional vet visits besides its scheduled checkups. But how can you tell?
"The life of a puppy is all about bursts of energy. They'll play hard but then need to take a nap to recuperate their energy," said Stephanie Mantilla, a positive reinforcement-based animal trainer at Curiosity Trained. "One lesser-known indication of your puppy needing to go to the vet is if your puppy is sleeping a lot more than usual," she said. "If they don't seem rejuvenated after their nap and don't have their normal puppy energy, a vet visit is in order."
Here are some other signs your puppy may need an additional vet visit:
Some dogs are afraid of going to the vet or don't travel well. They may get anxious or motion sick. And some dog owners aren't sure how to restrain their dogs safely during car rides. These are all issues you should feel free to ask your vet about.
"Many dogs get anxious when they get in a car because the only time they ride in cars is to go to the vet office," Mantilla said. "Some symptoms include panting, drooling, excessive licking, barking and other signs of distress. Some dogs will even urinate or defecate in your car due to stress."
"If this sounds like your dog, one of the first steps is to make car rides a fun event for your dog," Mantilla said. "I recommend doing this with positive reinforcement training where you use treats, petting and verbal praise to reward your dog."
How often should I take my adult dog to the vet?After 6 to 9 months, your dog is no longer considered a puppy. You may be able to reduce the frequency of checkups. For adult dogs, vets typically advocate for annual or even twice-annual wellness visits.
"At any age, if you notice a change in your dog's behavior, even if the behavior is normal for other dogs, you should take them to the vet," Mantilla said. "Dogs are really good at hiding when they're in pain, so even a slight behavioral change from their normal routine can indicate they're not feeling well."
A typical adult dog checkup will include many of the same things as a puppy checkup:
As your dog matures, regular checkups will help you keep an eye on your dog's dental health.
"Some dogs can start showing signs of periodontal disease as early as age 5," Mantilla said. "This can start out as tenderness of your dog's gums where they'll favor one side of their mouth for chewing or not want to chew hard food items. As it progresses, your dog's gums will become more tender, and they may lose their appetite or become irritable around food."
How often should I take my senior dog to the vet?A dog's average lifespan varies by size and breed. For example, chihuahuas often live 15 to 17 years, and some small dog breeds can live up to 18. Large dogs typically live eight to 12 years.
Once your dog is in the last quarter of its life, your vet will likely take a different approach to its care.
The first big change is that even if your dog has been getting annual wellness exams for most of its life, your vet might strongly recommend twice-annual exams now, at a minimum. Older dogs are more likely to experience ongoing health problems like diabetes and thyroid disease.
Regular bloodwork and urinalysis could help detect illnesses at the earliest stages when they're most treatable. And when your senior dog has a chronic condition, more frequent checkups can help you stay on top of the disease's progression.
You'll want to be more attentive to your senior dog, keeping an eye out for possible signs of disease like these:
"Panting in a senior dog shouldn't be ignored," Mantilla said. "While it's normal for dogs to breathe more heavily after exercise or in warmer temperatures if simply walking from the couch to their bed puts them out of breath, your senior dog should be checked out at the vet. Excessive panting can be a sign of heart failure, cancer and many other illnesses."
Checkup schedule for dogs at each life stagePuppy:
Adult dog:
Senior dog:
If you think your dog is pregnant — perhaps she's gained weight, has a swollen belly or tires more easily than usual — you'll want to take her in for a prenatal appointment.
The vet will confirm the pregnancy through a physical exam, ultrasound or hormone testing bloodwork. They will do all the usual parts of a physical exam, but specifically look for problems that could impede a healthy pregnancy and delivery.
Plus, they'll get you up to speed on your pregnant dog's nutritional and exercise needs, what to expect as the pregnancy progresses and how to care for the mom and her puppies during and after birth. Based on the results of the first exam and how far along your dog is, your vet will advise you on when to schedule a follow-up visit.
When should I take my dog to the vet immediately?These are some of the emergency situations that could require an urgent trip to the vet:
If you think your dog may have been poisoned — for example, if you think it may have eaten chocolate, grapes, human medication or sugarless gum — immediately call your veterinarian or the ASPCA Animal Poison Control Center at (888) 426-4435.
If you're not sure if a situation is urgent, you may be able to contact your pet insurance company's 24/7 vet helpline for advice. You can also try calling nearby vet emergency centers, keeping in mind that they may be reluctant to give advice by phone without seeing your pet.
Can pet insurance pay for vet visits?Yes, pet insurance can pay for vet visits. However, your pet insurance may not cover all types of vet visits, and it might not cover every type of expense you incur during a vet visit.
Pet insurance typically pays for accidents, illnesses and injuries that your pet develops after you become a policyholder. Your insurer will expect you to share a portion of the costs through your premiums, deductible and coinsurance.
Pet insurance does not cover routine exams, though some pet insurance companies offer a wellness plan that you can add to an accident and illness plan. Pets Best offers a puppy wellness plan, for instance, that can help you budget for a wellness exam, vaccinations, microchipping, spay/neuter and deworming.
What does pet insurance cover?There are three types of pet insurance plans. Each offers a different breadth of coverage.
Accident and illness plansThis is the most comprehensive coverage. It covers things like hospitalization, surgery, specialty and emergency exam fees, diagnostic imaging, bloodwork, urinalysis, medication, broken bones and soft tissue injuries.
An accident and illness plan typically won't cover pre-existing conditions, wellness exam fees, dental cleanings and other predictable expenses.
Accident-only plansAccident-only plans will help you out if your dog gets stung by bees or your child plays too rough with your puppy. You'll be on your own to pay for all care related to diseases.
Wellness and routine care plansWellness and routine care plans can help you cover costs related to predictable expenses like spaying and neutering, check-ups, vaccinations, flea and tick medications and dental cleanings. They're usually sold as add-ons to accident and illness plans.
These plans generally won't cover basic needs like dog food or grooming.
Frequently asked questions (FAQs)
How does pet insurance work?Pet insurance works a lot like health insurance, with a deductible, coinsurance and annual maximum.
DeductibleMost pet insurers want you to pay something out of pocket before your coverage kicks in. That amount is your pet insurance deductible.
Reimbursement percentageOnce you've met the deductible, your pet insurance company will reimburse you a percentage of covered expenses. Reimbursement percentages range from 50% to 100%. They vary by company and, sometimes, by your pet's age at enrollment.
Annual maximumIf your dog ends up needing a lot of medical care in a short period, your annual maximum will be very important. It's the amount your pet insurer will pay toward your pet's covered care each policy year. Annual maximums can range from $2,000 to unlimited.
Compare pet insurance quotes from multiple carriers to see how different deductibles, reimbursement rates and annual maximums can help your monthly premiums fit your budget.
How much does pet insurance cost?Pet insurance costs an average of $45 per month for a dog for an accident and illness policy with $5,000 of annual coverage and $55 per month for an accident and illness policy with unlimited annual coverage, according to our analysis of rates.
How much you pay for pet insurance will depend on several things:
Looking to save? Best cheap pet insurance companies
What are my deductible options for pet insurance?Most pet insurance policies have an annual deductible, but some have a per-condition deductible. Here's how each type works.
Annual deductible:
Per-condition or per-incident deductible:
Lyme Disease Vs. Multiple Sclerosis
Multiple sclerosis (MS) and Lyme disease are diseases that stem from very different causes. MS is a life-long autoimmune condition that disrupts the communication between your brain and your body. Lyme disease can happen if you're bitten by a deer tick infected with the bacteria Borrelia burgdorferi.
But these two conditions can have overlapping symptoms. They even may look similar on brain scans, MRI, and other tests.
SimilaritiesMS and Lyme disease go through stages as your condition gets worse. Early detection is important for both illnesses. But getting a clear diagnosis often can be difficult because MS and Lyme disease can look like other conditions.
Here are some traits and symptoms that MS and Lyme disease have in common:
The biggest one is that MS has no cure, while most people with Lyme disease can recover fully within weeks with antibiotics. In some people, some symptoms of Lyme disease can linger for months or longer after antibiotics, a condition called post-treatment Lyme disease syndrome.
Other ways the two diseases differ include:
Geography. MS is most often diagnosed between ages 20 to 50. It tends to be more common among people who live in colder climates. Lyme disease, by contrast, tends to be concentrated in the Northeast, New England, and Great Lakes regions of the U.S. Lyme disease also tends to affect two main age groups, children and adults 40-50.
Disease progression. MS doesn't go away. About 90% of people will move from the first stage, relapsing-remitting MS (RRMS), to the second one, secondary progressing MS (SPMS), with more severe damage and disability. It can take up to 25 years for this to happen. Early treatment for Lyme disease can prevent it from going beyond the first stage.
Symptoms. Both conditions can lead to a range of problems. But most MS symptoms are neurological and involve the brain and the rest of the central nervous system. Lyme disease is an infection.
ContinuedThe main signs of MS include:
Symptoms of Lyme disease include:
Diagnosis. There is not a test for MS. Your doctor looks at your symptoms and rules out other illnesses. An MRI may show MS lesions on your brain or spinal cord. Your doctor also may order a blood test, spinal tap, and check how your nervous system responds to stimulation.
Diagnosis for Lyme disease requires two tests. One looks for antibodies to the infection. If that quick test is positive, a second antibody test will confirm that you have Lyme disease. Your body may not make antibodies for weeks or months after your deer tick bite. If your test comes back negative, you may need to be retested later.
Treatments. MS is a long-term condition. The main treatments are medications called disease-modifying therapies and biologicals. These drugs slow the disease and lessen the number of attacks. You also may need medications to treat related problems such as depression, muscle spasms, bladder issues, and sexual dysfunction.
Other MS treatments include:
Lyme disease can be cured when it's treated early with antibiotics. Sometimes symptoms, such as fatigue, pain, and foggy thinking, may linger long after your antibiotic treatment ends.
WebMD Medical Reference
SourcesSOURCES:
Mayo Clinic: "Multiple Sclerosis," "Treating RRMS," "Lyme Disease," "MS Symptoms," "Diagnosing SPMS."National Multiple Sclerosis Society: "Who Gets MS? (Epidemiology)," "Secondary Progressive MS (SPMS)," "Rehabilitation," "Types of MS."CDC: "Treatment for erythema migrans," "Signs and Symptoms of Untreated Lyme Disease," "Diagnosis and Testing," "Post-Treatment Lyme Disease Syndrome," "Lyme Disease Maps: Historical Data."Global Lyme Alliance: "Stages of Lyme Disease."Cedars Sinai: "Secondary-Progressive Multiple Sclerosis."Breast Cancer: "Low White Blood Cell Count."Ben Thrower, MD, medical director, Andrew C. Carlos Multiple Sclerosis Institute at Shepherd Center; Atlanta. Global Lyme Alliance: "How Chronic Lyme Disease Changed My Life."MS Focus: "Diseases that Mimic MS."
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