Nebraska agencies and public health organizations collaboratively addressed cyanobacterial issues for the first time after two dogs died within hours of drinking water from a small private lake south of Omaha on May 4, 2004. A necropsy on one of the dogs revealed that the cause of death was due to ingestion of Microcystin toxins. Within two weeks after the dog deaths, state and local officials jointly developed strategies for monitoring cyanobacterial blooms and issuing public health alerts and advisories. Weekly sampling of public lakes for microcystin toxins and cyanobacteria was initiated during the week of May 17, 2004. ELISA laboratory equipment and supplies were purchased to achieve a quick turnaround time for measuring weekly lake samples for total microcystins so that public health advisories and alerts could be issued prior to each weekend's recreational activities. A conservative approach was selected to protect human health, pets, and livestock, which included collecting worst-case samples from cyanobacterial blooms; freezing and thawing of samples to lyse algal cells and release toxins prior to laboratory analysis; and using action levels of 15 ppb and 2 ppb of total microcystins, respectively, for issuing health alerts and health advisories. During 2004, five dog deaths, numerous wildlife and livestock deaths, and more than 50 accounts of human skin rashes, lesions, or gastrointestinal illnesses were reported at Nebraska lakes. Health alerts were issued for 26 lakes and health advisories for 69 lakes. Four lakes were on health alert for 12 or more weeks. The primary cyanobacterial bloomforming genera identified in Nebraska lakes were Anabaena, Aphanizomenon, and Microcystis. Preliminary assessments of lake water quality data indicated that lower lake levels from the recent drought and low nitrogen to phosphorus ratios may have contributed, in part, to the increased numbers of cyanobacterial complaints and problems that occurred in 2004.