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

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

2. Why test, you ask? Incidence is Growing Don’t 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

3. 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.

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

5. 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.

6. 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.

8. Testing for Heartworm only is not enough! Introducing a newconcept in screening: “The ParasiticDisease Screen” Test for Lyme, E. canisand Heartworm Disease.

9. 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…

10. 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 Subclinical Signs Lab Finding Duration Subclinical Signs Lab Finding Duration Chronic Signs Lab Finding Duration

11. 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 Subclinical Signs Lab Finding Duration Chronic Signs Lab Finding Duration

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

13. What’s 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: • 3diagnostics • Differentiationbetween vaccinated and naturally infected animals • Experts agree to routinely test for E. canis, Lyme and Heartworm

14. 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.

15. Don’t waitfor the disease to test. • SICK DOG TESTINGAwaiting clinical disease and sending off for confirming diagnosis? • TIMEIs the lag time to results excessive? • ACCURACYDo you understand the limitations of traditional testing methods? • SUBJECTIVITYDo results depend on who is reading the tests? Awaiting clinical disease and then testing? With SNAP® 3DxTM you’ll have the results in 8 minutes, allowing you to keep the dog in clinic and treat immediately if necessary.

16. 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 > > Dr. Johnny Hoskins, 2000

17. 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.

18. 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 don’t 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.

19. Benefits 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 don’t have to call clients with results or spend time filing results from lab, which saves you time and money!

20. 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

21. 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 doesn’t cross-react with currently available vaccines

22. 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 With Clinical Signs Without 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. 2001;184(7);870-878. Developed by: Steven Levy, VMD Roberta Relford, DVM, MS, PhD, DACVIM, DACVP Terri Wheeler, DVM

23. 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

24. 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 • CloselyMonitor 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

25. Don’t 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…

26. 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

27. 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!

28. What are youwaiting for? With over 6,000 clinics offering the SNAP® 3DxTM 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® 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