canis - Articles
Leptospirosis
Introduction
- Epidemiology: Leptospirosis can be caused by pathogenic serovars of Leptospira interrogans sensu lato.
- Prevalence: acute disease has a low reported prevalence but is likely underdiagnosed. Disease caused by the serovars Canicola and Icterohaemorrhagiae is almost eradicated in dogs due to vaccination. Other serovars are much more common today in dogs with clinical disease.
- Signs: signs include sudden onset of fever, vomiting, jaundice, depression, dehydration, and renal failure. Death can occur within as early as 2 days (or later) after onset of clinical signs.
- Treatment: treatment consists of antibiotic therapy, fluid therapy, supportive treatment, if necessary hemodialysis in renal failure, or mechanical ventilation in pulmonary forms.
- Prognosis: depends on treatment and is good with intensive care.
- Zoonosis: Leptospira spp are shed in urine of infected dogs, both in acute and chronic infections.
Precautions to protect veterinary staff and owners is important if leptospirosis is suspected.Print off the owner factsheet Leptospirosis Leptospirosis to give to your client.
Acute presentation
- Signs are related to the presence of acute renal failure, liver or lung disease.
- Presentation depends on age and immune response of the host as well as on virulence of the pathogen.
- Regional differences exist.
Public health considerations
- Leptospiral infections of humans occur through contact with infected dogs or contaminated water.
- Hospitalized dogs should be handled with gloves.
- Owners should be informed of human health risks, and the potential for urinary shedding of their animals.
Pathogenesis
Etiology
- Infection with pathogenic Leptospira Leptospira spp serovars. Several different serovars reported in canine disease.
- Leptospira spp have worldwide distribution.
- Leptospira spp are inactivated by acidic urine, direct sunlight, temperatures above 30°C, desiccation and disinfection. They survive in contaminated water, stagnant or slow-moving water, moist soil; they prefer alkaline pH. Freezing can decrease the survival. Consequently, the disease occurs more common in summer and autumn/fall.
- Each serovar is believed to have a reservoir or maintenance host in which it can cause a chronic infection without overt clinical signs.
- Leptospira spp commonly sequestered in the renal tubules and voided in the urine.
Predisposing factors
General
- Large breed, male adult, outdoor dogs are most commonly infected.
- Infection occurs commonly through urine-contaminated water.
- Likelihood of infection increases in persistent rainfall and areas of poor drainage or contact with slow-flowing water.
- High density of reservoir animals (rodents), or other wildlife are risk factors.
- Herding dogs, hunting dogs, and working dogs are predisposed.
- Skin trauma allows organism to penetrate easier.
Specific
- Unvaccinated dogs have a higher risk of infection.
Pathophysiology
- Infection occurs through ingestion of infected rodents or penetration of mucosae or traumatized skin. Leptospiremia occurs within 1 week. Leptospires spread to other organ systems (kidneys, liver, spleen, endothelial cells, lungs, uvea/retina, skeletal and heart muscles, pancreas, and genital tract) and cause tissue damage, visceral and vascular inflammation.
- Leptospiral pulmonary hemorrhage syndrome (LPHS) can occur as severe manifestation of acute leptospirosis.
- Leptospires can persist in immune privileged site (eg, renal tubes, eye).
- In the presence of adequate antibody titers, leptospires are eliminated from most organs. In the presence of low antibody titers mild leptospiremia can continue with a subclinical course of disease.
Timecourse
- Time course varies according to immunocompetence of the host, infecting dose, and serovar.
- Incubation period lasts approximately 7 days after experimental infection.
- Initial leptospiremia lasts 4-12 days.
- Usually clinical signs have acute onset.
- Death can occur within 2 days (or later).
- Surviving animals can shed the organism in urine for up to 3 months (or longer).
- Chronic renal sequelae are possible in recovered dogs.
Epidemiology
- Infected reservoir hosts shed leptospires with urine. This leads to infection of further reservoir hosts or infection of accidental hosts, such as dogs and humans.
- Cats can be infected and also shed leptospires and thus, can potentially infect dogs or humans.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Lizer J, Grahlmann M, Hapke H, Velineni S, Lin D, Kohn B (2017) Evaluation of a rapid IgM detection test for diagnosis of acute leptospirosis in dogs. Vet Rec 180 (21), 517 PubMed.
- Schuller S, Francey T, Hartmann K, Hugonnard M, Kohn B, Nally J E & Sykes J (2015) European consensus statement on leptospirosis in dogs and cats. JSAP 56 (3), 159-179 PubMed.
- Fraune C K, Schweighauser A & Francey T (2013) Evaluation of the diagnostic value of serologic microagglutination testing and a polymerase chain reaction assay for diagnosis of acute leptospirosis in dogs in a referral center. J Am Vet Med Assoc 242 (10), 1373-1380 PubMed.
- Hartmann K, Egberink H, Pennisi M G, Lloret A, Addie D, Belák S, Boucraut-Baralon C, Frymus T, Gruffydd-Jones T, Hosie M J, Lutz H, Marsilio F, Möstl K, Radford A D, Thiry E, Truyen U, Horzinek M C (2013) Leptospira species infection in cats: ABCD guidelines on prevention and management. J Feline Med Surg 15 (7), 576-581 PubMed.
- Abdoel T H, Houwers D J, van Dongen A M, Adesiyun A A, Jimenez-Coelloe M, Cardoso L, Suepaul S M, Ortega-Pacheco A & Smits H L (2011) Rapid test for the serodiagnosis of acute canine leptospirosis. Vet Microbiol 150 (1-2), 211-213 PubMed.
- Michel E, Kook P H, Voss K, Boretti F & Reichler I M (2011) Generalized metastatic intestinal and cutaneous calcinosis in a Hovawart puppy with leptospirosis. Schweiz Arch Tierheilkd 153 (1), 27-31 PubMed.
- Sykes J E, Hartmann K, Lunn K F, Moore G E, Stoddard R A & Goldstein R E (2011) 2010 ACVIM small animal consensus statement on leptospirosis: diagnosis, epidemiology, treatment, and prevention. J Vet Intern Med 25 (1), 1-13 PubMed.
- Kohn B, Steinicke K, Arndt G, Gruber A D, Guerra B, Jansen A, Kaser-Hotz B, Klopfleisch R, Lotz F, Luge E & Nockler K (2010) Pulmonary abnormalities in dogs with leptospirosis. J Vet Intern Med 24 (6), 1277-1282 PubMed.
- Burr R D, Lunn K, Yam P S (2009) Current perspectives on canine leptospirosis. In Practice 31 (3), 98-102 VetMedResource.
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- Greenlee J J, Bolin C A, Alt D P, Cheville N F & Andreasen C B (2004) Clinical and pathologic comparison of acute leptospirosis in dogs caused by two strains of Leptospira kirschneri serovar grippotyphosa. Am J Vet Res 65 (8), 1100-1107 PubMed.
- Nally J E, Chantranuwat C, Wu X Y, Fishbein M C, Pereira M M, Da Silva J J, Blanco D R & Lovett M A (2004) Alveolar septal deposition of immunoglobulin and complement parallels pulmonary hemorrhage in a guinea pig model of severe pulmonary leptospirosis. Am J Pathol 164 (3), 1115-1127 PubMed.
- Ward M P, Guptill L F & Wu C C (2004) Evaluation of environmental risk factors for leptospirosis in dogs: 36 cases (1997-2002). JAVMA 225 (1), 72-77 PubMed.
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