Treating for (chronic) Lyme/ Minocycline

[Iride]

We tested my 20 yr old gelding last week who has lost topline and has been walking slowly and showing a bit of extra effort getting up after lying down. He’s out with a herd 24/7 in a pasture in the NE. Plenty of ticks to go around here.

He did have acute Lyme once — a decade ago — and was treated with Doxycycline successfully.

Anyway, so the Multiplex test from last week came back from Cornell showing positive for chronic Lyme… OSPF: 2023 — which is very low in the range (but still positive), the range being 1250 - 26,000.

Apparently treatment recommendations for chronic (vs. acute) Lyme are now to treat with Minocycline not Doxy, as it’s supposedly more bioavailable and has more promising results when the diagnosis is chronic Lyme (infected anywhere 5m to 5 years ago). Of course I have plenty of Doxy on hand but No Minocycline!! Should I spring for the Mino and not use my Doxy? Should I even treat when value is this low? Sure the symptoms I mentioned above could be anything but you know when your horse has been seeming … different.

I welcome any input re the above.

[skipollo]

In May 2019 my horse came back chronic positive ~3700 on the Cornell test. We treated with one month of Doxy, and he did a complete 180. He went from borderline unrideable to competing in jumper classes within three weeks.

I did retreat him in December 2019 because he seemed symptomatic again, but we did not retest for that second round of treatment, and looking back at the other issues he’s had during wintertime, I don’t think it was a Lyme relapse.

We did retest him in March 2021 and he was negative. Yes the Mino is more bioavailable so more effective, but it’s a lot more expensive which is why we started with Doxy. I always said before if I had to retreat him, I’d use Mino, but again looking back at what I know now about his other discomfort issues (mainly caudal failure), if I had to retreat today, I would use Doxy again.

[Iride]

@skipollo
Thanks so much for sharing your experience. That is very encouraging to hear. I’m thinking maybe this plan: treat him with my Doxy for 30-45 days. Re-test a couple of months (?) after the last pills, and if he is still positive I’ll treat for another 30 with Mino. My vet is not that up on Lyme stuff (he’s tops for lameness issues) so I’m kinda trying to manage some of this myself! Any other input here is welcome.

[Simkie]

We don’t use doxy anymore. My vets treat when symptomatic, so if other causes of his issues have been ruled out, treating isn’t unreasonable.

Did you retest after his previous treatment, or any time in between? That chronic titer can take a LONG time to drop once they’ve been treated. Tough to know if it’s notable without a few more data points. I have one, for example, who had a OspF of over 10,000 several years ago. We treated, by all accounts successfully. Her OspF this year is about where your horse’s is, but we know from previous testing that’s continuing to trend down, and not indicative of active infection or something to treat.

[Iride]

@Simkie
Absolutely, good points and yes if I remember correctly he retested as negative way back then. Unfortunately I don’t have another baseline since then to go on.
All these years and Lyme still seems so challenging and imprecise to deal with!

[Simkie]

Also, are you pricing doxy vs mino with your vet? Or online? Because valley vet is just a few bucks apart:

https://www.valleyvet.com/ct_detail.html?pgguid=6a30725b-93ee-40dc-85e1-15c6eeecb87f

https://www.valleyvet.com/ct_detail.html?pgguid=6AC701B4-FE49-402B-82E2-F5CAC20B06EB

It’s been so long since we used doxy, I don’t recall if the dose is the same as mino? If your doxy is left over from your previous treatment, it’s likely long expired.

Lyme is definitely a bear, and there’s so little we know. But this is one where I don’t beat around the bush: go to the treatment that we know is more effective.

[Iride]

@Simkie The Doxy I have thankfully is current. Thank you for the link to Valley vet, I am pretty sure my vet will give me a prescription to purchase myself. That said, I have no idea what the dosage is for Mino. I am considering depending on cost getting it compounded, because I won’t be me administering, it will be the barn manager. Much easier to drop a scoop of powder, than to count out hundreds of pills, grind, mix with sweet stuff, etc. Sometimes these things are worth the cost, but I do get hives thinking about it!

[skipollo]

If you get it compounded in powder form, just a warning it tastes BAD. Like REALLY bad. You might have to orally paste it instead of putting in on grain. I pasted 2x/day with applesauce.

[Iride]

@skipollo
Thanks for the heads up. Will bring plenty of applesauce and Karo syrup!

Of course, this horse is 17.2 and his favorite thing is doing The Giraffe

[Simkie]

@Iride

That said, I have no idea what the dosage is for Mino

For a “normal” sized horse, it’s 20x100mg twice daily. I’ve never had one refuse to eat the caps straight up in their grain. There’s nothing involved but counting.

[ladipus]

Yes …do the Minocycline

[tabula_rashah]

We did Minocycline with my mare. Basically my vet said we could treat with doxy but they are seeing it be less and less effective so chances are we’d have to do doxy and then do minocycline anyway. The mino seems way less harsh on them too and easier to get them to eat

[Iride]

They were capsules? Or pills?

[Simkie]

@Iride

They were capsules? Or pills?

Capsules. From Valley Vet. The link is above.

[Iride]

He may not eat them. He wouldn’t eat Doxy in capsules. We had to open each one to get the powder out and dose him. He can smell meds a mile away

[Iride]

So I ordered a jar of apple flavored powdered Minocycline. 2 gram scoop, feeding 1 scoop twice a day for 30 days. Crossing fingers.

[Invested1]

Very similar boat to the OP.

For those who treated with minocycline, how quickly did you see a full recovery?

We did 3 days IV oxytet and are now on day 13 of the minocycline.
His fever is long gone, he’s pooping/eating/etc and have heard rumors that he’s back to his fun-loving self in the field but he still feels pretty lethargic under saddle. Is that still expected at this point?
(Put a call into my vet a couple hours ago but haven’t heard back yet.)

TIA!

[ZuzusPetals]

@Iride

… and dose him.

I read this as “… and hose him…” and thought: Wow. This is a novel approach for meds.

Sorry you’re both going through this.

[Martina]

I know this is kind of an oldish thread but wanted to chime in. My story is nearly identical to the poster. We did 30 days doxy followed by 30 days mino. I thought I would try to save a buck and ordered the mino in powder form. Mistake. It smells disgusting and you have to put so much in the syringe it was gross. My horse syringes well, but he still hated it. If there ever is a next time I would do the capsules and let him eat it with his grain.
After the 60 days of doxy and mino, his levels dropped from around 3k to 1k.

[Simkie]

Are you treating his belly at all? He might be feeling better from a Lyme perspective but worse from an ulcer perspective. I find they do need gastric support, even my “they never need anything” ones.