LEPTOSPIROSIS: WHY AWARENESS AND DIAGNOSIS IS CRUCIAL TO THE HEALTH OF YOUR PATIENTS, CLIENTS AND PRACTICE DR. NATALIE MARKS, DVM, CVJ
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5 DOGS WITH LEPTOSPIROSIS CAN HAVE SOME UNUSUAL CLINICAL SIGNS While we’ve talked about the acute and chronic presentations, don’t forget that some dogs with conjunctivitis and uveitis are actually Leptospirosis patients! Remember, this is a spirochete, and very similar to other tick transmitted diseases with spirochetes, this organism can enter the eye and cause inflammatory change. We can also see abnormal bleeding patterns in these patients, and in rare instances, a recently recognized pulmonary hemorrhagic syndrome has been recognized.
These serovars can help steer towards the reservoir host. Remember, ‘urban wildlife’ like rats, raccoons, opossums and skunks aren’t the only sources – cows and pigs can also act as reservoirs for other important serovars. This is important to consider when screening a patient for environmental risk factors. 4 TRANSMISSION CAN OCCUR THROUGH VARIOUS ROUTES Urine is shed in the urine of the host (this bacterium is in almost 90% of urban rat urine!) and infection occurs after ingestion of contaminated water or contact with mucous membranes most commonly. However, dogs can become infected after direct penetration of infected skin through bite wounds or through indirect transmission through contact with water sources, soil, food and contaminated bedding. This is incredibly important to remember as our team members fall into this last category. The website www.stoplepto.com has invaluable resources to make sure all team members understand risk factors and how to keep themselves safe when obtaining diagnostics and performing treatments on suspect Leptospirosis cases in hospital.
have predilection for the liver and, if liver values are the only enzymes elevated, don’t exclude Leptospirosis immediately. Some dogs will also be hyperbilirubinemic in these cases. However, a newer discovery that is very helpful with screening our patients is that up to 58% of patients will be thrombocytopenic, and I encourage new associates to think Lepto and Lyme (and other tick diseases) with mildly thrombocytopenic cases. And, on urinalysis, not only will our patients have less concentrated urine due to most being polyuric/polydipsic at first, over 50% of our patients will have glucosuria from proximal tubular damage. (continued)
6 KEEP MY CHEESY PNEUMONIC IN MIND! When to suspect Lepto: L iver/Kidney E nzyme elevations P olyuria/polydipsia T hrombocytopenia O liguria 7 THERE ARE A FEW KEY
CLINICAL PATHOLOGY FINDINGS TO TRIGGER LEPTOSPIROSIS TESTING AND TREATMENT More than 80% of canines will be azotemic with this disease. But, keep in mind, there are some serovars that
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