DiagnosisDiagnostic tests are needed to verify the diagnosis of leptospirosis and exclude other causes of similar signs and optimally evaluate your pet for this disorder. Tests may include the following:
General blood and urine tests. Routine tests, such as a complete blood count, biochemistry panel and urinalysis will reveal the presence and severity of kidney damage and liver damage.
The microscopic agglutination test (MAT). The MAT is a blood test that looks for antibodies against the leptospirosis organism. A single high measurement may be diagnostic, although a more definite diagnosis is made if the antibody level increases fourfold, two to four weeks later.
Kidney biopsy. A silver stain looks for the leptospirosis organism, although this test often gives falsely negative results and may miss the diagnosis.
Therapy In-depth
Therapy for leptospirosis may include one or more of the following:
Antibiotic therapy is performed in two phases. Phase I is for killing the leptospirosis organisms in the bloodstream. Penicillin is the best antibiotic for this. Phase II is for killing the organism in the kidney to prevent the carrier state. (Doxycycline is thought to be the most effective.
Supportive care is directed at the other affected organ systems. Most pets are dehydrated from vomiting and diarrhea and require intravenous fluid therapy. Animals in acute kidney failure may need a diuretic, like furosemide (Lasix) or mannitol, to help restore urine production. If urine flow cannot be restored, dialysis should be considered. This requires referral to a specialty practice or university. Dialysis is expensive, but the acute kidney failure due to leptospirosis is usually reversible. Blood transfusions may be needed if bleeding disorders develop or persist and are causing active bleeding.
Follow-up
Optimal treatment for your pet requires a combination of home and professional veterinary care. Follow-up care can be critical, especially if your pet does not rapidly improve. Administer all prescribed medication as directed. Alert your veterinarian if you are experiencing problems treating your pet.
If your dog has permanent kidney damage as a result of the leptospirosis, you may need to feed him a special low-protein diet. Monitor your dog's food intake, water intake and body weight.
Blood and urine tests will need to be repeated and monitored frequently to assess the final extent of any kidney damage.
Consider vaccination for any other dogs in the household. There is a new vaccine (Duramune DA2P+Pv/LCI-GP) that immunizes dogs against four serovars of the leptospirosis organism. Previous vaccines only immunized against two serovars.
