Lyme disease is a common disease found in horses, and we covered the details in our recent blog post, Lyme Disease in Horses: Fact vs. Fiction (check it out if you haven’t read it yet). So, once you’ve read that, let’s say you suspect your horse has Lyme disease, you’ve reviewed the facts vs. fiction, had your vet out to pull blood and done the testing to determine the status of the infection. What’s next?

Treating Lyme Disease in Horses

Treating Lyme disease starts with determining if your horse has an acute or chronic infection so that you can determine the best course of antibiotics and any supportive care your horse may need. The Snap 4DX Plus Test by IDEXX is accurate and less expensive than the traditional Western Blot titer test, or the now more commonly used Multiplex Assay test developed by Cornell University’s Animal Health Diagnostic Center. However, the simple snap test just shows a positive or negative and doesn’t quantify what type of infection your horse has. If you just need a quick yes or no, this is a good place to start, but to find out more information on the type of infection (acute/recent exposure, or chronic), you would need to do the full Multiple Assay by Cornell.

Acute vs. Chronic Lyme Infection

Acute infection indicates more recent exposure, where the horse has not yet or is in the earlier stages of being symptomatic. Symptoms can range from mild to severe, and early detection and treatment is key. There are a lot of options for antibiotics, and the most common course is a round of doxycycline which can be given for 30 – 60 days depending on your horse’s detailed lab results. Your vet will be able to discuss this and the other antibiotics available on the market to develop a plan of action.

Chronic infection is more troublesome, and challenging to deal with as it means the horse has been infected for more than 5-8 weeks, and can be as long as several months to years. If your horse tests positive for chronic antibodies and negative for acute, that means your horse has been infected for at least 5 months or more.

The challenge with chronic Lyme disease in horses is that the disease has often already taken a toll on the horse’s overall health, and worn down their immune system as well as their mood, appetite, and more. Every case is different, and chronic can be much harder to detect, as horses can have mild to no symptoms that allow them to go undetected for months to years before they progress to the point of bloodwork that leads to the positive diagnosis.

In addition, the chronic variation is more resistant to common antibiotics, and doxycycline is many times not effective. Minocycline is an alternative to doxy that can prove more effective in treating the chronic stage of Lyme, but is also significantly more expensive. Other options include intravenous antibiotics, however depending on your horse and your vet, in some cases this may require a catheter to be inserted and stay in throughout treatment and in many cases this requires hospitalization while the horse is on the medication.

If your horse has been diagnosed with chronic Lyme, it’s incredibly important to sit down with your vet and discuss all of the options, their costs, and how it fits into your budget and your horse’s living situation. In many cases, one round of stronger medicines can get ahead of the chronic disease and end up less expensive than months and months of administration of the more affordable but less effective drugs available today.

Read Cornell’s information sheet on the Multiplex Assay test for more information.

Supportive Care

Whether your horse has tested positive for acute or chronic Lyme, supportive care can also help his chances of making a full recovery and lessen side effects of antibiotics on the gut and digestive systems. Supplements to support the immune system, pre- and probiotics to help your horse’s tummy, and antioxidants to keep him strong as he battles Lyme disease are all good options.

Keep in mind that there may be days that your horse is not feeling like himself. He may be prone to mood changes, intermittent and/or unexplained lameness, footsoreness, and other symptoms that he hasn’t experienced before. On “bad days,” some horses prefer the comforts of a stall to rest as they recover, while others do better on turnout so that they can move around and stay comfortable. Talk to your vet, and remember you and your vet know your horse better than anyone, so develop a plan that keeps your horse as comfortable as possible throughout the treatment period.

1-Tyler and Duke

The right treatment for Lyme disease can help your horse get back on his feet.

Treatment Follow Up

When treating Lyme disease in horses, the best chances of success start with thorough diagnostics, selection of the right antibiotics, proper supportive care to keep your horse comfortable and minimize stress, and keeping a close eye on his progress. Once the round of medicine is completed, retesting between 15 – 60 days will help gauge the results (the timeframe in which to retest varies by the medication they were on, their test results, and what your veterinarian recommends). From there, you can evaluate if your horse needs another round of medication, if a change in antibiotics is necessary, or if he’s well on his road to recovery!

Do you have experience in treating Lyme disease in horses? What was your horse’s situation and how did you and your veterinarian opt to treat him and what was the outcome? We’d love to hear your stories so please share in the comments below!