Its the only way to screen dogs quickly

It’s the only way to screen dogs quickly and easily for Lyme, Ehrlichia canis and Heartworm in your clinic!

Why test, you ask? Don’t have ticks or tickborne diseases in your area? Think again! Incidence is Growing 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

Believe it! Tick-borne disease is 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, Ph. D, 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.

What do you think are the two most common canine infectious diseases in the United States?

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.

Isn’t 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.

Testing for Heartworm only is not enough! Introducing a new concept in screening: “The Parasitic Disease Screen” Test for Lyme, E. canis and Heartworm Disease.

Why screen for these diseases? Why not just test dogs you suspect are infected? If you’re not testing, you won’t 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…

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 Subclinical Chronic Signs Lab Finding Duration Fever, lethargy, joint swelling, arthritis, shifting leg lameness +/- Positive serology Bloodwork — unremarkable Urinalysis — proteinuria, cells , 7 - 21 days Signs Lab Finding Duration No symptoms + Positive serology Bloodwork — unremarkable 1 - 3 years Signs Lab Finding Duration Shifting leg lameness, arthritis, neurological signs, renal failure, cardiac arrhythmia, myocarditis + Positive serology Organ systemspecific Could be fatal casts

Canine Ehrlichiosis Disease 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 Lab Finding Duration No symptoms +/- Positive serology Thrombocytopenia Variable leukocyte counts Anemia 40 to 120 days (may last several years) 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 Subclinical Signs Chronic

Can a dog be infected with Lyme disease, E. canis and Heartworm all at once?

What’s the defense against these deadly diseases? Early Detection Prevention Client Education The Parasitic Disease Screen The Canine SNAP® 3 Dx. TM 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

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.

Don’t wait for 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® 3 Dx. TM you’ll have the results in 8 minutes, allowing you to keep the dog in clinic and treat immediately if necessary.

Know for sure. Know right now. What are the drawbacks with the way you may be testing now? Sample # Disadvantages of current assays: IFA Specificity is poor, resulting in questionable results. Disadvantages • Sick Dog Testing • Time • Accuracy • Subjectivity Laboratory A Titer Laboratory B Titer 4453 1: 1600 1: 320 8946 1: 1600 1: 1280 1: 100 2212 1: 1600 1: 640 1: 400 1: 2560 1: 400 0367 Dr. Johnny Hoskins, 2000 > = 1: 3200 Laboratory C Titer > = 1: 3200

Know for sure. Know right now. Dog A What are the drawbacks with the way you may be testing now? Dog B Disadvantages of current assays: Western Blot Used to distinguish between vaccinated dog and infected dog BUT is highly subjective, costly and takes 3 -7 days to run. Disadvantages • Sick Dog Testing • Time • Accuracy • Subjectivity Vaccines generate numerous bands on the Western Blot, obscuring the ability to interpret the bands needed to determine exposure/infected status.

Why should you use SNAP® 3 Dx. TM as an annual screening 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 don’t interfere with the Lyme test results of SNAP® 3 Dx. TM 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.

Benefits of testing in-house with SNAP® 3 Dx. TM • 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 don’t have to call clients with results or spend time filing results from lab, which saves you time and money!

How does SNAP® 3 Dx. TM 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

The Lyme Diagnostic The Technology Lyme Disease C 6 identifies infection C 6 wanes post-treatment C 6 doesn’t cross-react with currently available vaccines SNAP® 3 Dx. TM makes all the difference because the revolutionary C 6 ELISA technology is unique. With all of the advantages of C 6 diagnostic technology, you can identify Lyme infection in clinically and subclinically infected dogs by using the SNAP® 3 Dx. TM test.

Recommended protocol for Lyme disease The SNAP® 3 Dx. TM 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 Without Clinical Signs • 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 With Clinical Signs • 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 Negative Result Without Clinical Signs With Clinical Signs • Patient is • Lyme not infected • Treatment is not indicated infection is unlikely; pursue an alternative diagnosis • Retest with SNAP® 3 Dx. TM test after one month. Dog may not have developed a detectable serum titer * Philipp M. , et al. Antibody response to IR 6, a conserved immunodominant region of the VIs. E lipoprotein, wanes rapidly after antibiotic treatment of Borrelia burgdorferi infection in experimental animals and in humans. J. Infect. Dis. 2001; 184(7); 870 -878. Developed by: Steven Levy, VMD Roberta Relford, DVM, MS, Ph. D, DACVIM, DACVP Terri Wheeler, DVM

E. canis Diagnostic The Technology E. canis SNAP® 3 Dx. TM 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

Recommended protocol for Ehrlichiosis (E. canis) E. canis Result Positive Result Clinical signs† and laboratory data** support ehrlichiosis Clinical signs† and laboratory data** DO NOT support ehrlichiosis Treat & Monitor Options • Tetracycline • Doxycycline • Imidocarb • Monitor CBC Suspect subclinical phase infection. Monitor CBC every 3 -6 months for consistent hematologic changes. for correction of the hematologic abnormalities (3 -6 months) • Review tick control protocol • Educate clients Negative Result Clinical signs† and laboratory data** support ehrlichiosis Clinical signs† and laboratory data** DO NOT support ehrlichiosis Options No Action • Serum titer by IFA* • PCR • Treat • Closely Monitor 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, Ph. D, DACVIM, DACVP

Don’t let your guard down Now that we have covered the facts, here is how SNAP® 3 Dx. TM can protect your clients’ pets and benefit your business…

Educate your clients on the importance of a Parasitic Disease 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

How can the SNAP® 3 Dx. TM test help build your practice? Diagnose, Prevent and Treat Use the SNAP® 3 Dx. TM 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!

What are you waiting for? With over 6, 000 clinics offering the SNAP® 3 Dx. TM test to their customers, and over 3 million tests used, there’s never been a better time to increase the value of an annual visit. Better medicine. Better business. “The test [SNAP® 3 Dx. TM] 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, ABVP Metzger Animal Hospital, State College, PA