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History and Physical Exam:
This case involves “Jensen”, a 5-month old, intact male Golden Retriever puppy. Jensen was adopted 5 weeks earlier from a breeder and was not currently vaccinated for leptospirosis, but was up to date on his DA2PP and Rabies vaccines and on monthly heartworm preventative. He presented after hours to the local emergency clinic for lethargy, anorexia and a few episodes of bilious vomiting earlier in the day.
On physical exam he was very depressed and reluctant to move, mildly dehydrated, mildly icteric, with a normal temperature of 100.9°F, and fluid-filled intestines were noted on abdominal palpation.
Laboratory & Diagnostic Test Results:
Preliminary diagnostics included abdominal radiographs, CBC, chemistry panel and complete urinalysis. Abdominal radiographs revealed a slightly enlarged liver and gas-filled intestines. No foreign bodies or obstructive pattern were noted. On his CBC a mild anemia was noted, with a concurrent leukocytosis, neutrophilia, lymphocytosis, monocytosis and mild thrombocytopenia. The chemistry panel demonstrated severe azotemia, and increased ALT, GGT and hyperbilirubinemia . The urinalysis showed mild proteinuria, isosthenuria ,with an inactive sediment. Leptospirosis was considered the primary differential due to lack of leptospirosis vaccination, clinical signs, physical exam findings and preliminary diagnostic abnormalities, and lack of history of jerky treat or other toxin exposure.
Diagnosis: Leptospirosis
Additional samples were submitted for leptospirosis testing at IDEXX reference laboratories, both serology and PCR testing was performed. Antibodies were detected on the Leptospira spp Antibody by ELISA, also available as the in-clinic SNAP® Lepto test. The Leptospira spp RealPCR™ test was also positive, aiding in the confirmation of leptospirosis as a diagnosis in this patient. Jensen was treated with antibiotics and supportive therapy and recovered fully from the infection.
This case highlights the importance of a timely diagnosis in cases of acute canine leptospirosis. For the most complete diagnostic workup, it is important to consider both serology and PCR when a patient presents with clinical signs consistent with leptospirosis. A particular challenge with diagnosing leptospirosis is that the signs are nonspecific and may resemble many other conditions. It is important to keep leptospirosis on your differential diagnosis list for dogs presenting with any of a wide range of problems, including fever, lethargy, anorexia, dehydration, vomiting, diarrhea, abdominal pain, muscle pain, and stiffness1. When diagnosed early, the disease can be appropriately treated and the pet owners and staff better protected against this potentially zoonotic infection.
The SNAP Lepto Test tests for antibodies to canine leptospirosis pet-side in 10 minutes.
References:
- Sykes JE, Hartmann K, Lunn KF, Moore GE, Stoddard RA, Goldstein RE. 2010 ACVIM small animal consensus statement on leptospirosis: diagnosis, epidemiology, treatment, and prevention. J Vet Intern Med. 2011;25:1–13.
