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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8 TESTING SHOULD BE PERFORMED KNOWING BENEFITS AND LIMITATIONS OF THE TESTS Right now, we have both MAT (microscopic agglutination testing) or antibody testing as well as PCR testing. Testing can be a bit confusing – please refer to my flow chart to help discern which test to choose and how to interpret the results. 9 TRANSMISSION CAN OCCUR THROUGH VARIOUS ROUTES The first line of therapy is antibiotics. I use Ampicillin at 20-30mg/kg IV q 6-8 hours with critical or vomiting patients – it does terminate bacteremia in the hospitalized patient. However, in stable patients, the gold standard currently is Doxycycline at 10mg/kg PO once daily for 14 days to clear the leptospires from the kidney – treat ALL dogs in the household to prevent transfer back and forth. For azotemic patients, fluid therapy is essential and aggressive. Make sure to monitor ins and outs and give clients the expectation of several days in the hospital ahead of time. Continue supportive care with antacids, anti-emetics and liver support if indicated. With prompt and
If Snap or MAT test is POSITIVE = check if vaccinated • if vaccinated, run PCR • if NOT vaccinated = POSITIVE test
If Snap or MAT test is NEGATIVE = NOT Leptospirosis or TOO early (needs 10 days)
If PCR is NEGATIVE = either NOT Lepto or not enough DNA for test
If PCR is POSITIVE = patient has Leptospirosis
vaccine specifically has label claims for prevention of leptospiremia, thrombocytopenia and prevention of mortality. Besides vaccination, encourage clients avoid contact with dog’s urine, wash hands after handling pets, clean up urinary accidents in the home with household disinfectants and minimize wild animal contact with fencing/rodent control. Let’s make a difference together in protecting our patients, families and teams!
aggressive care, survival rates are approximately 80% but many of these patients can develop chronic renal insufficiency with time. 10 VACCINATION IS KEY TO PREVENTION Screen your patients for environmental risk and, if indicated, utilize a vaccination that protects against the 4 most common serovars. There are still many misconceptions around vaccinations, reaction rates and other historical myths. Don’t hesitate to educate clients on how new protein diafiltration procedures have made these vaccines “smoother” and much less reactive. Patients who are vaccinated have much less kidney and liver disease, and the Nobivac
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