Here is a list of the current testing methods we have used on our dogs and their accuracy in my humble opinion. Many dogs that are infected from birth will never produce the titers necessary to detect disease in snap tests and with the latest information found in this wonderful piece, "Dogged by Discrepancies: The New CDC Lyme Disease Report Comparing National Canine and Human Cases" from the State of Georgia Lyme Disease Task Force, this further explains WHY the 3DX, 4DX and Lyme Quant C6 testing is unreliable. This paper is from 2011 while we had been suspecting the accuracy if the ELISA testing in 2009. In 2013 when we compare ELISA testing to Serology testing- we found everything in that paper to be true and thankfully our supportive vets started to back up what we were seeing and treated our dogs when they were positive via serology when a 4DX snap test was negative. Knowing that ELISA testing only tests for ONE STRAIN of Lyme disease, ONE STRAIN of Ehrlichia and ONE STRAIN of Anaplasma, with different strains being found all over the country and the south especially, the best support we have found to promote our testing philosophies below.
Fitzwilliam, pictured below, is a young English Setter we rescued from Virginia in 2012 that tested positive via IFA Serology for Babesia (via Michigan State University), Ehrlichia, Lyme disease and Rocky Mountain spotted fever (via IDEXX 371). Had we only done a typical 3DX or 4DX Snap test—ALL FOUR diseases would have been missed and he would have succumbed to these diseases in an agonizing death. Prior to his diagnosis and antibiotic therapy which now consists of doxycycline, Amoxicillin and Ceftin, Fitz had resource guarding and aggression. While he was fearful of people, he was also lethargic and had very pale gums. After a month on a doxycycline and amoxicillin, he is happier, running and playing with other dogs and locking on point. He is more trusting of people too. It will take many months of meds and follow up blood work to help him get better but his adoptive daddy promises to keep a close eye on his health. We are still researching treatment options for the Babesia.
I am trying to update this page as I get new data in, but this article "Lyme Quant-c6 assay vs AccuPlex4 Lyme assays" by Joseph Leeth DVM, was faxed to me recently by the Rascal Unit Animal Hospital in Dublin, Ohio. While it promotes the new AccuPlex4 Lyme testing, the author Dr. Joseph Leeth, does a GREAT job explaining what I have known for a very long time, that 4DX Snap Tests and the heavily promoted IDEXX Lyme Quant C6 testing are not reliable although he does a better job explaining WHY. I also really appreciate that his essay promotes the use of human research (AS DO I) as far as better testing and treatment ideas, and also that most vets really need better education and other testing options rather than relying solely on a POS/NEG testing result. Most of these tests are very similar to a human pregnancy test with a blue line or dot to note a Positive result. If a woman got a light blue response on her pregnancy test- her doctor wouldn't tell her she was slightly or mildly pregnant. That would be ridiculous.
2016: With the recent nationwide shortage of Lyme disease IFA slides for the IDEXX 371 Serology panel-- suspiscious-- YOU BET-- we are moving the Texas A & M panel to the top. I would still do the 371 as it is and assume Lyme disease is a co infection if there are any positive titers for Ehrlichia and RMSF.
Texas A & M Tick Panel #1 & #2 (click here) - IFA Serology for Ehrlichia, Lyme disease and RMSF--Babesia add on--Babesia titers are between 1:8 and 1:32 (very good), Ehrlichia titers start at 1:16, Lyme titers start at 1:60 and RMSF titers start at 1:20- no end titers. Decent testing. The techs at Texas A & M recommend treating any positive titer and do not use the term Exposure titer—this is VERY HELPFUL!
Antech AccuPlex 4- Heartworm antigen, antibody testing for Ehrlichia, Lyme disease and Anaplasma. This came out in February 2012 and is being promoted as a better snap testing tool compared to the IDEXX 4DX Snap test. As with the 4DX snap test, neither test for antibodies for Rocky Mountain spotted fever, the most misunderstood, under diagnosed and most problematic co infection from coast to coast--AVOID.
Antech PCR Panel/ Fast Panel (T980)- DNA testing for Ehlichia, Lyme disease and RMSF, etc- AVOID.
Antech SA 330- IFA Serology for Ehrlichia, Lyme disease and RMSF--Titers for Ehrlichia start at 1:80, so that misses titers hiding below that. Titers for Lyme and RMSF start at 1:64. The Lyme titer at 1:64 can be helpful but the RMSF titer at 1:64 misses low troubling titers below that.
Antech Western Blot for Lyme disease-- used once for a dog with a starting titer of 1:64. Lab suggested it was a low exposure possibly due to vaccine-however- follow up titers continued to climb to 1:1600.
IDEXX 3DX Snap- Heartworm Antigen/Ehrlichia/Lyme disease--misses early stage heartworm and misses most low titers for Ehrlichia and only test for one Lyme disease infection. Does not test for RMSF which is the most common co infection that is infecting our dogs. Not an accurate test- I can not stress this enough-- especially in dogs infected from birth. AVOID for tick borne disease testing.
IDEXX 4DX Snap- heartworm Antigen/ Anaplasma/Ehrlichia/ Lyme disease-- same as above.
IDEXX 371- IFA Serology for Ehrlichia, Lyme disease and Rocky Mountain spotted fever--Titers for Ehrlichia and RMSF start at 1:25 which is very helpful. Titers for Lyme disease start at 1:100 which is too high and many dogs struggle with titers below that. I always assume if a dog has a stubborn RMSF titer at 1:25 or 1:50, there is a Lyme titer being missed below 1:100. There could also be an Anaplasma or Babesia issue. Most ticks carry more than one pathogen and it is best to treat with dual antibiotics in case the co infection/ Lyme disease, usually, is hiding--especially when it may hide in cysts. We have several dogs that have had what a vet would call an "exposure" titer for RMSF that have popped up a Lyme titer post antibiotics. Many of these dogs have had additional health issues. Best test.
Here is a testimonial from Dr. Hanover of the Animal Hospital of Gurnee. Dr. Hanover has been helping with the IBR dogs since 2004 and he is the vet that helped us learn the most about the value of the 371 IFA Serology testing. While this lab is still available for testing, the IDEXX technicians will often push the Lyme Quant C6 or PCR testing as better options but I would trust the advise of a vet that uses this test routinely and helps his clients rather than advise from a Lab Rat!!!! Since the 371 is not currently in the IDEXX catalog- most of our vets have to order it this way 371 Written Order . Print this out and INSIST that your vet order this test!!!!
IDEXX 3716 Lyme Quant C6- ELISA testing for Lyme disease, IFA Serology for Ehrlichia and RMSF--ELISA testing for the C6 Peptide protein is not accurate in dogs and has been documented in humans as being considered malpractice by the state of Virginia for Lyme disease testing (VA Lyme Disease Task Force 2011). Most dogs with low titers for Lyme disease will be missed by this test as it seems the detectable protein will only show up in titers of 1:640 or above. Titers for Ehrlichia and RMSF start at 1:25.
IDEXX Lyme Quant C6 Real Time PCR- ELISA testing for Lyme disease, PCR/DNA testing for 10 other diseases-- PCR testing as a rule is a big waste of time. It is rare that DNA for any organism will be found in a blood sample and any previous antibiotic therapy will negate finding any DNA (most vets do not know this). Lyme DNA is especially hard to find as it migrates all over the body. RMSF DNA can only be found in the first two weeks of infection. AVOID.
Marshfield Labs- IFA Serology for Ehrlichia and RMSF, Western Blot for Lyme disease--titers for Ehrlichia and RMSF start at 1:64 (misses low titers for disease), haven't had enough experience with their Western Blot for Lyme disease accuracy.
Michigan State Tick Panel- IFA Serology for Anaplama, Babesia, Ehrlichia, Lyme Disease, RMSF-- Titers for Anaplasma start at 1:80 (could miss lower titers), Babesia, Ehrlichia and RMSF titers start at 1:40 (misses lower titers compared to Texas A & M), Lyme titers start at 1:160 (misses lower titers that IDEXX 371 can catch at 1:100). I only use MSU for Babesia testing if I can't send to Texas A & M since I am happy with the IDEXX 371. This is a good test for folks out of state because if their vet can draw the blood and spin, after refrigeration and shipping overnight- folks can pay for this on their own and receive results directly. The techs at MSU are very nice and helpful. I have also chatted with them about the Lyme Quant C6 testing and they agree that it is not an accurate assessment for diagnosing Lyme disease.
Missouri State PCR Panel- DNA testing for Ehrlichia, Lyme disease and RMSF--AVOID PCR testing. Prior to antibiotic treatment, this test was done on a Setter out of Joplin, MO. This Setter was positive for Ehrlichia only via DNA but missed the RMSF that we found post antibiotics at a starting titer of 1:1600.
NC State Tick Panel- IFA Serology individual testing for Anaplasma, Ehrlichia, RMSF, Babesia, Bartonella, Leishmania, etc--NC State only offers a 4DX Snap test for Lyme disease serology testing (I am dumbfounded by this--see notes for snap testing), Titers for all other diseases start at 1:16. I was told that a RMSF titer of 1:16 on a dog was NEG even though the titer on the dog continued to climb.