While treating Lyme disease in horses is complex, a wide variety of alternative therapies can be helpful for different stages and manifestations of the illness.
Lyme disease (LD) has been recognized for 40 to 50 years, and is now the most commonly reported tick-borne illness in the US and Europe. It is also found in Asia and increasingly in Australia. Since LD occurs in so many locations, it should be considered part of a rule-out list when a diagnosis is not clear. While the technology used to diagnose Lyme disease in horses has not changed much over the last ten years, our understanding of the symptoms is becoming part of mainstream medicine. Additionally, although treating LD in equine patients is complex, we are finding that a wide range of alternative and natural therapies are effective at treating and managing it.
SYMPTOMS OF LYME IN HORSES
One of the most common signs of Lyme in horses is lameness or arthritis that is difficult to identify and may change locations. Other symptoms are anterior uveitis, neurologic signs, low grade fever, sensitivity to touch, weight loss, tremors, neck pain, lethargy and laminitis.
The key is that there is usually some degree of behavior change. About 10% to 15% of the horses in my practice area become dangerously spooky when infected with Lyme. The exact reason for this is unknown, but it may be due to one of the different strains. Sometimes Lyme appears along with or before/after cases of equine protozoal myelitis (EPM), particularly in older horses. And sometimes Lyme presents with neurological symptoms that look like EPM, but are negative to the EPM test, and positive for Lyme. The characteristic bull’s-eye skin lesion is not seen, most likely due to the horse’s hair coat.
LABORATORY DIAGNOSIS
Laboratory diagnosis of LD can be very difficult, partly due to the cleverness and changeability of the spirochete, and partly because the tests are not good enough yet. The main test is performed by Cornell University and is called the Lyme Disease Multiplex Test. It measures different stages of the disease but still does not correlate closely with the clinical signs. The test can be negative, yet a horse can still respond to treatment and behave like he has LD. It’s possible that we are actually treating other Borrelia species, or other tick-borne diseases for which we cannot yet test.
CANINE LD VACCINES BEING USED FOR HORSES
There are no LD vaccines approved for the horse, so canine vaccines are used. Vaccination can be stressful to the immune system and has led to relapses. A recent study showed that all current canine vaccines produced only short-term responses in horses. It is important to note that many, but not all, of these horses have negative responses to other vaccines, such as rabies, West Nile virus, and others, once they have had LD.
TREATMENT APPROACH — NO QUICK FIX
There is no magic bullet for treating chronic LD cases. The best approach is a multisystemic one, using a combination of conventional, complementary, and alternative medicine. Successful treatment includes support for the immune system, not just during the immediate treatment period but over the long term. Due to the Lyme spirochete’s ability to “recur,” the immune system must be prepared to respond at a moment’s notice.
ANTIBIOTICS MAY BE NEEDED
Antibiotics can be useful, especially in freshly diagnosed horses. Repeated rounds of antibiotics, or usage for two to three months or more, usually produces resistance but is detrimental. It is better to change to herbs and keep the spirochete guessing. The use of antibiotics suppresses the immune system in the gut, so the rest of the plan needs to support the horse’s immunity.
NATURAL TREATMENTS FOR SUPPORTING THE IMMUNE SYSTEM
• The microbiome is the DNA of the microbes living in the gut. Probiotics are an absolute necessity and should continue for many months after antibiotic therapy is finished. The purpose of giving probiotics over the long term is to restore the health of the microbiome. Since soilbased microbes make up most of the natural population of the gut, supplements that use soil origin microbes will more effectively colonize the gut.
• Vitamin C is well known for its action in the immune system and on collagen (4 g to 6 g twice a day).
• Noni (Morinda citrifolia) is an herb that supports the immune system and has excellent anti-inflammatory properties. In fruit leather form, it is relatively inexpensive and concentrated, while the juice can be quite expensive, more dilute, and contains a significant amount of sugar.
• Omega-3 fatty acids are anti-inflammatory and support the immune system. They can be obtained through feeding whole flaxseed (inexpensive), naturally stabilized ground flax, hemp seeds, or chia seeds (a very stable Omega-3 source). Flax or hemp oils can be used, but they must be refrigerated during warm or hot weather. Three to six ounces twice a day is the usual dose for seeds; less volume is needed with the oils. Blue-green algae also contains significant amounts of Omega-3 fatty acids.
• Medicinal mushrooms have excellent research showing their positive effects on the immune system, and are beneficial to various arthritic conditions. They are safe and can be used over the long term in a tincture or powder. I usually use a combination product unless I need to target a specific symptom.
PRIMARY ALTERNATIVE LD THERAPIES
- Homeopathics should be prescribed constitutionally, based on the presenting signs. Several medicines fit many LD symptoms quite well. Ledum palustre is one of the major homeopathics for LD; its symptoms include effects from toxic puncture wounds as well as insect bites — a tick bite is both. Rhododendron and Kalmia latifolia are also worth considering. Based on the constitution, other medicines have helped individual cases, including, but not limited to, Sulphur, Arsenicum album and Rhus toxicodendron.
- Western herbal protocols have also been used successfully. In general, the same herbal formulas should not be used on a continuous basis, since the spirochete is capable of developing a tolerance to the herbs. A rotation of formulas every month is best.
- Acupuncture is excellent for pain control, immune stimulation, and tonifying Qi or energy. There is no one point prescription since each horse is an individual. Some present as Qi deficient, some as Liver Blood or Yin deficient, and some as stagnation with pain in the muscles and joints.
- Chinese herbal medicines are effective in both early and late stage LD cases depending on the pattern presented. Current thinking is again to change formulas on a regular basis while actively treating the infection. Once past the acute or early chronic stage, long-term tonifying formulas are often needed. Herbs should be prescribed by trained Chinese herbalists, since the choice of herbs is based on a correct Chinese diagnosis.
CONSIDER EXERCISE AND STRESS LEVELS
Exercise at the level the horse is comfortable with is an important part of recovery. It is good for the immune system and mentally helpful for the horse. There is no benefit to pushing the horse beyond what is comfortable, so if he is having a bad day, a short walk will suffice.
Stress is an important factor in recovery from LD. It is beneficial to maintain horses under stress on adaptogenic, stress-relieving herbs such as Siberian ginseng root (Eleutherococcus senticosus) once they have recovered and returned to competition. It is also important to observe the amount of rest horses get at a barn. It has been shown that at many busy barns, horses actually get very little rest and sleep. This adds to stress, which suppresses the immune system.
PREVENTING LYME DISEASE
Prevention is difficult if you live in a LD endemic area. Topical anti-parasitics are toxic to the horse and the environment (if they are washed off in the rain and get into waterways). In some cases, it is easier to support the horse’s system to deal with the drugs than to treat chronic LD. In other cases, it is beneficial to use a more natural approach. For example, Guinea hens are effective at removing ticks from the environment, though they are noisy and may not fit in with the farm environment. Keeping grass mowed in the pasture is also helpful.
Topical essential oils and various insect repellant sprays can be useful but need to be applied frequently. Japanese knotweed root appears to be helpful in endemic areas but cannot be said to guarantee protection.
A new topical spray is available that prevents ticks from adhering to the hair (Ticks-Off®). This is an exciting addition to Lyme prevention protocols. It is non-toxic and therefore safe to add to a prevention program.
CONCLUSION
The treatment of LD in horses is complex and requires a willingness to keep reevaluating progress and make changes based on current symptoms. To prevent relapses and maintain optimal health, stress needs to be managed, the immune system needs support, and attention needs to be paid to how the horse feels. Tick and insect control is always a challenge, but must be an important part of managing the disease. Most horses can be returned to full performance, even with chronic LD, but many will require ongoing maintenance.
