It

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Its the only way to screen dogs quickly and
easily for Lyme, Ehrlichia canis and Heartworm in
your clinic!
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Why test, you ask?
Incidence is Growing
Dont have ticks or tick-borne diseases in your
area? Think again!
Experts agree that tick-borne diseases are being
uncovered everywhere and prevalence is on the
increase.
FACTS

• Ticks are second only to mosquitoes in
  disease transmission
• Ticks can carry more than one disease
• Dogs can be infected with more than one
  disease

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Believe it! Tick-borne diseaseis in your area.
Maps circulated by vaccine manufacturers ten
years ago attributed Lyme disease to the
northeastern and upper Midwestern states. Today,
the disease almost covers the entire contiguous
United States.Richard B. Ford, DVM, PhD, ACVIM
U.S. Canine Positive Lyme Results
Reported positives from over 3,000 veterinary
clinics over one year via phone surveys and
IDEXX reference laboratories results.
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What do you think are the two most common canine
infectious diseases in the United States?
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How common is E. canis, really?
Canine ehrlichiosis is the second most common
infectious disease in the United States, with the
most prevalent being canine parvovirus
disease.Hoskins JD. Seroprevalence of Ehrlichia
Dogs.Veterinary Forum, October 2000.
U.S. Canine E. canis Exposure
Reported positives from over 5,000 veterinary
clinics over two years via phone surveys and
IDEXX reference laboratories results.
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Isnt Heartworm Disease now under control?
A recent study demonstrated that, despite
tremendous awareness of heartworm disease, the
infection rate remains unchanged over the past
10 years. An estimated 240,000 dogs were
diagnosed with heartworm disease last
year. Approximately one-half of U.S. dog-owning
households are not using heartworm
preventatives. DVM Newsmagazine, July 2002.
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Testing for Heartworm only is not enough!
Introducing a newconcept in screening
The ParasiticDisease Screen
Test for Lyme, E. canisand Heartworm Disease.
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Why screen for these diseases? Why not just
test dogs you suspect are infected?
If youre not testing, you wont find it!
Screening is essential. You already screen for
heartworm disease on a regular basis, why not
maximize your evaluation? Screen for Lyme and
Ehrlichia too. Be your own epidemiologist! Know
the threat of these diseases in your patient
population. Early detection allows for early
intervention.
FACTS

• The 1 clinical sign of these diseases can be
  no sign at all.
• Symptoms are vague and can be misdiagnosed

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Lyme Disease Progression
Tick bite to transmission of Borrelia burgdorferi
organism is 24-48 hours. Lyme disease
transmission is a high concern in both spring and
fall. In spring, deer ticks must feed in order to
progress from a larvae to a nymph - and then
again - in order to mature into an adult tick.
Clinical Disease - 3 Phases
Acute Signs Lab Finding
Duration
Fever, lethargy, joint swelling, arthritis, shifting leg lameness /- Positive serology Bloodwork unremarkable Urinalysis proteinuria, cells, casts 7 - 21 days
Subclinical Signs Lab Finding
Duration
Subclinical Signs Lab Finding
Duration
No symptoms Positive serology Bloodwork unremarkable 1 - 3 years
Chronic Signs Lab Finding
Duration
Shifting leg lameness, arthritis, neurological signs, renal failure, cardiac arrhythmia, myocarditis Positive serology Organ system-specific Could be fatal
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CanineEhrlichiosisDisease Progression
Tick bite to transmission of Ehrlichia canis is
24-48 hours with incubation period of 1-3 weeks.
Vaccines are not available for E. canis and
exposure to E. canis does not provide immunity
from future infection. Re-infection will occur.
Clinical Disease - 3 Phases
Acute Signs Lab
Finding Duration
Fever, anorexia, lymphadenomegaly, mild weight loss, edema, and ocular and nasal discharge /- Positive serology Thrombocytopenia Variable leukocyte counts 7 - 21 days
Subclinical Signs Lab
Finding Duration
No symptoms /- Positive serology Thrombocytopenia Variable leukocyte counts Anemia 40 to 120 days (may last several years)
Chronic Signs Lab
Finding Duration
Anemia, depression, peripheral edema, chronic weight loss, bleeding tendencies, abdominal tenderness, anterior uveitis, retinal hemorrhages, seizures, arthritis /- Positive serology Thrombocytopenia Variable leukocyte counts Neutropenia due to secondary bacterial infections Pancytopenia Hyperglobulinemia Lymphocytosis (often mimicking lymphocytic leukemia) Could be fatal
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Can a dog be infected with Lyme disease, E.
canis and Heartworm all at once?
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Whats the defense against these deadly diseases?
Early Detection Prevention Client Education
The Parasitic Disease Screen
The Canine SNAP 3DxTM Test is the fastest,
easiest and most accurate way to screen dogs
simultaneously for Lyme, E. canis, and
heartworm disease

• 3 diagnostics
• Differentiation between vaccinated and naturally
  infected animals
• Experts agree to routinely test for E. canis,
  Lyme and Heartworm

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All dogs should have an annual Parasitic Disease
Screen. Why?
TRUTH IS

• Lyme vaccinations are not 100 effective.
• Dogs cannot clear Lyme infections on their
  own.
• Tick preventatives are not 100 effective.
• Ticks in the nymph stage are hard to see.
• The most common sign of these diseases are
  no signs at all.
• Heartworm, Lyme and E. canis can have
  devastating clinical outcomes.

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Dont waitfor the disease to test.

• SICK DOG TESTING Awaiting clinical disease and
  sending off for confirming diagnosis?
• TIME Is the lag time to results excessive?
• ACCURACY Do you understand the limitations of
  traditional testing methods?
• SUBJECTIVITY Do results depend on who is
  reading the tests?

Awaiting clinical disease and then testing?
With SNAP 3DxTM youll have the results in 8
minutes, allowing you to keep the dog in clinic
and treat immediately if necessary.
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Know for sure.Know right now. What are the
drawbackswith the way you maybe testing now?
Disadvantages of current assays
IFA
Specificity is poor, resulting in questionable
results.
Disadvantages

• Sick Dog Testing
• Time
• Accuracy
• Subjectivity

Sample 4453 8946 2212 0367 Laboratory A Titer 11600 11600 11600 13200 Laboratory B Titer 1320 11280 1640 12560 Laboratory C Titer 13200 1100 1400 1400
gt
gt
Dr. Johnny Hoskins, 2000
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Know for sure.Know right now. What are the
drawbackswith the way you maybe testing now?
Disadvantages of current assays
Western Blot
Used to distinguish between vaccinated dog and
infected dog BUT is highly subjective, costly and
takes 3-7 daysto run.
Disadvantages

• Sick Dog Testing
• Time
• Accuracy
• Subjectivity

Dog A
Dog B
Vaccines generate numerous bands on the Western
Blot, obscuring the ability to interpret the
bands needed to determine exposure/infected
status.
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Why should youuse SNAP 3DxTMas an
annualscreening tool?
The test is sensitive, quick and easy.
Here are some factors to consider

• Early detection means intervention can begin
  earlier.
• Currently available Lyme vaccines dont
  interfere with the Lyme test results of SNAP
  3DxTM by screening.
• One blood sample yields three test results -
  quickly, accurately and economically.
• By screening for Lyme disease and E. canis at
  the same time that you test for Heartworm
  Disease, you will increase the value of the
  annual visit for your clients.

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Bene?ts of testingin-house withSNAP 3DxTM

• Early detection allows for early
  intervention.
• The test allows you to begin follow-up
  diagnostics immediately.
• Clients are willing to pay more for immediate
  results.
• Your clients want to know which means better
  client satisfaction.
• You can use the time while the test is
  running to offer other products/services - 8
  minute consult.
• You dont have to call clients with results
  or spend time filing results from lab, which
  saves you time and money!

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How doesSNAP 3DxTM work?
Only the SNAP test offers gold-standard ELISA
technology in an in-clinic format.
Easy to interpret and more sensitive due to its
unique wash step and signal amplifier
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The LymeDiagnostic
SNAP 3DxTM makes all the difference because the
revolutionary C6 ELISA technology is unique.
With all of the advantages of C6 diagnostic
technology, you can identify Lyme infection in
clinically and sub-clinically infected dogs by
using the SNAP 3DxTM test.
The Technology Lyme Disease
C6 identifies infection C6 wanes
post-treatment C6 doesnt cross-react with
currently available vaccines
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Recommended protocol for Lyme disease
The SNAP 3DxTM peptide distinguishes between
patients that are infected from those that are
only vaccinated. Whole cell antibody titers
determined by IFA do NOT distinguish between
patients that have been infected, treated or
vaccinated. Western blot results are inherently
subjective and cannot reliably distinguish
infection from exposure.
Lyme Disease Result
Positive Result
Negative Result
Without Clinical Signs
Without Clinical Signs
With Clinical Signs
With Clinical Signs

• Lyme infection is unlikely pursue an
  alternative diagnosis
• Retest with SNAP 3DxTM test after one month. Dog
  may not have developed a detectable serum titer

• Patient has been infected with B. burgdorferi
• Consider empiric treatment with doxycycline or an
  alternative antimicrobial
• Monitor patient for development of clinical signs
• Review tick control protocol

• Patient has been infected with B. burgdorferi
• Treatment with doxycycline (or an alternative
  antimicrobial is indicated)
• Monitor clinical response to treatment
• Review tick control protocol

• Patient is not infected
• Treatment is not indicated

Philipp M., et al. Antibody response to IR6, a
conserved immunodominant region of the VIsE
lipoprotein, wanes rapidly after antibiotic
treatment of Borrelia burgdorferi infection in
experimental animals and in humans. J. Infect.
Dis. 2001184(7)870-878. Developed by Steven
Levy, VMD Roberta Relford, DVM, MS, PhD, DACVIM,
DACVP Terri Wheeler, DVM
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E. canis Diagnostic
The Technology E. canis
SNAP 3DxTM uses a highly accurate peptide-based
screen, for early detection.

• 98.2 specificity for E. canis exposure
• Early detection is critical - prognosis is
  good for early-stage infection
• Allows for prevention and proactive
  monitoring, not reactive treatment

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Recommendedprotocol forEhrlichiosis(E. canis)
E. canis Result
Positive Result
Negative Result
Clinical signs and laboratory data support
ehrlichiosis
Clinical signs and laboratory data DO NOT
support ehrlichiosis
Clinical signs and laboratory data support
ehrlichiosis
Clinical signs and laboratory data DO NOT
support ehrlichiosis
Treat Monitor
Options
Options
No Action

• Serum titer by IFA
• PCR
• Treat
• Closely Monitor

Suspect subclinical phase infection. Monitor CBC
every3-6 months for consistent hematologic
changes.

• Tetracycline
• Doxycycline
• Imidocarb
• Monitor CBC for correction of the hematologic
  abnormalities (3-6 months)
• Review tick control protocol

• Educate clients on risk versus benefits of
  treatment
• PCR
• Recheck normal bloodwork in 3-6 months
• Review tick control protocol

Clinical Signs Lameness, bleeding (usually
petechial and ecchymotic hemorrhages), lethargy,
weight loss, lymphadenomegaly, splenomegaly,
anorexia, anterior uveitis, retinal disease,
and/or occasionally neurological signs due to
meningitis. Laboratory Data Anemia,
leukopenia, thrombocytopenia, pancytopenia and/or
hyperglobulinemia. IFA results vary from lab to
lab. Developed by Edward Breitschwerdt, DVM,
ACVIM, Dean Cornwell, DVM Dean Basel, DVM, MS,
DACVP Roberta Relford, DVM, MS, PhD, DACVIM,
DACVP
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Dont let your guard down
Now that we have covered the facts, here is how
SNAP 3DxTM can protect your clients pets and
benefit your business
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Educate your clientson the importanceof a
ParasiticDisease Screen
Early detection is the best medicine.
Educational pieces are available to help you
educate pet owners about the dangers of
Ehrlichiosis, Lyme and Heartworm Disease.
Client Educational Pieces
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How can the SNAP 3DxTM test help build your
practice?
Diagnose, Prevent and Treat
Use the SNAP 3DxTM test to increase the value of
annual testing for your patients and your
clinic! Due to the increased prevalence and
awareness of tick-borne diseases, your clients
will understand the importance and value of
screening and preventatives - not just for
Heartworm - but for tick-borne diseases as
well. By screening three deadly diseases in one
blood sample, your clinic can offer an annual
Parasitic Disease Screen to clients - in just 8
minutes!
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What are youwaiting for?
With over 6,000 clinics offering the SNAP 3DxTM
test to their customers, and over 3 million tests
used, theres never been a better time to
increase the value of an annual visit.
Better medicine. Better business.
The test SNAP 3DxTM has definitely increased
revenues in my practice, but more importantly, we
have more satisfied clients, because we can
identify disease states earlier. Dr. Fred
Metzger, DVM, ABVPMetzger Animal Hospital, State
College, PA