First report of Lyme borreliosis leading to cardiac bradydysrhythmia in two cats

Case series summary Two cats presented for investigation of bradyarrhythmia detected by their referring veterinarians during routine examination. Both cats had extensive investigations including haematology, serum biochemistry with electrolytes and thyroxine concentrations, systolic blood pressure measurement, echocardiography, electrocardiography and infectious disease testing. Infectious disease testing included serology for Toxoplasma gondii, Ehrlichia canis, Anaplasma phagocytophilium and Borrelia burgdorferi (B burgdorferi), and polymerase chain reaction (PCR) test for B burgdorferi antigen in both cats. Case 1 was also assessed by PCR test for Bartonella henselae antigen and Case 2 was assessed for Dirofilaria immitis by serology. All infectious disease tests, other than for B burgdorferi, were negative. Case 1 was diagnosed with Lyme carditis based on marked bradydysrhythmia, positive B burgdorferi serology, a structurally normal heart and clinical resolution with appropriate treatment with a four-year follow up. Case 2 was diagnosed with Lyme carditis based on marked bradydysrhythmia and positive B burgdorferi PCR test; however, this cat had structural heart disease that did not resolve with treatment.
Relevance and novel information This small case series describes two B burgdorferi positive cats presenting with newly diagnosed cardiac abnormalities consistent with those found in humans and dogs with Lyme carditis. Both cats were asymptomatic as perceived by their owners; the arrhythmia was detected by their veterinarians.