No results found.
Shawn Kearns, DVM, DACVIM (SAIM), Angell Animal Medical Center, Boston, Massachusetts
Sign in to Print/View PDF
This is a filled error message
To access full articles on www.cliniciansbrief.com, please sign in below.
Create an account for free
Want free access to the #1 publication for diagnostic and treatment information? Create a free account to read full articles and access web-exclusive content on cliniciansbrief.com.
Passwords do not match
Where are you from?
AG|Antigua and Barbuda
BA|Bosnia and Herzegovina
IO|British Indian Ocean Territory
CF|Central African Republic
CC|Cocos (Keeling) Islands
CD|Congo, the Democratic Republic of the
FK|Falkland Islands (Malvinas)
TF|French Southern Territories
HM|Heard Island and McDonald Islands
VA|Holy See (Vatican City State)
KR|Korea, Republic of
LY|Libyan Arab Jamahiriya
MK|Macedonia, the former Yugoslav Republic
FM|Micronesia, Federated States of
MD|Moldova, Republic of
MP|Northern Mariana Islands
PG|Papua New Guinea
KN|Saint Kitts and Nevis
VC|Saint Vincent and the Grenadines
ST|Sao Tome and Principe
GS|South Georgia and the South Sandwich Islands
PM|Saint Pierre and Miquelon
SJ|Svalbard and Jan Mayen
SY|Syrian Arab Republic
TW|Taiwan, Province of China
TZ|Tanzania, United Republic of
TT|Trinidad and Tobago
TC|Turks and Caicos Islands
AE|United Arab Emirates
UM|United States Minor Outlying Islands
VG|Virgin Islands, British
VI|Virgin Islands, U.S.
WF|Wallis and Futuna
DC|District of Columbia
Micronesia (Federated States Of)
US Minor Outlying Islands
Armed Forces Africa
Armed Forces Americas Aa (except Canada)
Armed Forces Canada
Armed Forces Europe Ae
Armed Forces Middle East Ae
Armed Forces Pacific Ap
PE|Prince Edward Island
Tell us about yourself
Choose the category that describes your business/professional activity
What best describes your position? (question 1 of 2)
Veterinarian Role: (question 2 of 2)
Non-Veterinarian Role: (question 2 of 2)
Yes, I would like to receive updates about products & services, promotions, special offers, news & events from Brief Media.
Already have an account? Sign in here.
Acceptance to the GDPR regulations is required.
Leptospira spp of various serovars are responsible for human and animal leptospirosis infections worldwide. Leptospirosis remains an important zoonotic disease. Clinical signs vary depending on geographic region and predominating serovar(s). Disease should be suspected in patients with presence of common serum chemistry findings, including azotemia, increased liver enzymes, and/or hyperbilirubinemia. Leukocytosis, anemia, and thrombocytopenia are often found on CBC. Disease is confirmed with single microscopic agglutination titers ≥1:800 for nonvaccinal serovars, a 4-fold increase in microscopic agglutination titers over 2 to 3 weeks, or urine and blood PCR testing. Blood-based PCR can detect organisms in the first 10 days of infection, after which concentrations are highest in urine.1 PCR tests are not influenced by vaccination,2 but prior antibiotic administration can decrease sensitivity. Use of an immunoglobulin M-based screening test may also be useful for earlier detection.3
Although renal and hepatic involvement are most frequently reported, clinicians should be aware of potential for mild-to-severe pulmonary involvement. Multiorgan involvement of various combinations is common. Signs associated with lung involvement may be present at various times during disease progression. Thoracic radiographs should be obtained at initial presentation and if respiratory signs change during hospitalization. In this retrospective study, the medical records of 99 dogs with leptospirosis showed that 49% had pulmonary abnormalities detected on admission; nonsurviving patients more often had severe radiographic changes.
Treatment of leptospirosis includes amoxicillin-based drugs and doxycycline. Most patients require additional supportive care with IV fluids, gastroprotectants, and antiemetics. Those with pulmonary involvement may require oxygen therapy, and those with severe azotemia, those with significant metabolic abnormalities, or those progressing to oliguria or anuria may require hemodialysis. Patients requiring hemodialysis have a more favorable outcome than do patients receiving hemodialysis for other known or unknown causes.4,5 Although many patients with leptospirosis can respond to treatment, the mortality rate can still be high, as represented by the 32% mortality rate in this study. Owners should be aware that multiorgan involvement, particularly in dogs with pulmonary manifestations, and more severe azotemia are factors associated with nonsurvival.
Article continues after advertisement
Key pearls to put into practice:
Because timing of Leptospira spp infection is often unknown, a combination of serologic and PCR testing at initial presentation may increase the likelihood of diagnosis.
Prognosis is more guarded for patients with more severe azotemia, multiorgan involvement, and pulmonary involvement.
If financially and geographically feasible, early referral for hemodialysis should be considered in patients not responding to conventional medical management.
Material from Clinician’s Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.
Clinician's Brief provides relevant diagnostic and treatment information for small animal practitioners. It has been ranked the #1 most essential publication by small animal veterinarians for 9 years.*
*2007-2017 PERQ and Essential Media Studies
It's Free & Simple
Delivered to Your Inbox
Join the Conversation
Follow us @CliniciansBrief
© 2018 Educational Concepts, L.L.C. dba Brief Media ™ All Rights Reserved.