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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 29768
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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My dog has Lyme with swelling left side nd and front legs.

Customer Question

My dog has Lyme with swelling left side hind and front legs. she is on 150 mgs. Doxy 2 times a day for last 3 weeks and 850 mgs. Amoxicillin for the past 2 weeks no changes in swelling legs but now her right hind leg has started to swell. any ideas?
Submitted: 2 years ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 2 years ago.

We normally see a rapid improvement - within a few days - when doxycycline/amoxicillin therapy is instituted. The swelling you're seeing is worrisome for hypoalbuminemia - a lack of albumin in the blood (as you noted: "protein levels are off") causing a dependent edema - the swelling. This occurs due to excessive proteinuria - loss of albumin through the urine. It's a negative prognostic sign in Lyme patients. Make sure that Ruby's proteinuria is quantified with a urine protein:creatinine ratio. If the ratio is elevated as I'd expect, an ACE inhibitor such as enalapril should be instituted promptly in an attempt to reduce the loss of albumin through damaged glomeruli - the filtering organs of the kidneys.

Please respond with further questions or concerns if you wish.

Expert:  Dr. Michael Salkin replied 2 years ago.
I'm just following up on our conversation about Ruby. How is everything going?
Dr. Michael Salkin