Leptospirosis in Bull terriers.

Juan Pablo Atencio Lobo, Abraham David Castaño

University of Córdoba, Faculty of Veterinary Medicine and Zootechnics, Montería,

Colombia.

Jpat0690@gmail.com, abrahandavidcd@gmail.com

Resumen.

Leptospirosis is a zoonotic disease caused by infection with any of the more than 250
serovars of a Gram-negative spiral-shaped bacterium called Leptospira. Leptospirosis in
dogs was first described in 1899 and has recently received attention as a major cause of
liver and kidney disease. The disease in dogs can be acute, chronic, or subacute; the most
frequent presentation is acute infection, which is characterized by the presence of anemia,
jaundice, diarrhea, fever, and dehydration, affecting the renal and hepatic systems.
Treatment in dogs focuses on avoiding irreparable damage caused by Leptospira, but does
not guarantee that the patient will make a full recovery and that is why vaccination plays an
important role in disease prevention.

Key words: leptospirosis, jaundice, acute infection, serovar, zoonotic.

Introduction.

Canine leptospirosis is a highly infectious disease, known as dog typhus. Although it also
affects cats, dogs are much more likely to suffer from this disease that mainly affects the
kidneys and liver. The most common mode of infection is by contamination of standing
water due to the urine of an infected animal. The simple contact of that water with any
wound that our dog has on the skin is more than enough reason to contract the disease.
You have to be very careful, because we can also get infected if we come into contact with
contaminated water, urine or food. One of the most common ways is through the ground if
it is infected and we usually walk barefoot.

Leptospirosis in dogs was first described in 1899 and recently received attention because it
is a major cause of kidney and liver disease (Bolin, 2002). The main reservoirs of
Leptospira in the urban environment are canines and rodents, as well as cattle, pigs and
horses in the field. Of the rodents as wild animals in urban settings, the species Rattus
rattus, (black rat), Mus musculus (mouse) and Rattus norvegicus (rat of
sewer). Leptospira was also adapted to reservoir hosts, which are commonly wild animals
that make its control more difficult and increase the prevalence of this disease. Infection in
humans and animals occurs by direct contact with infected urine, fetal and placental fluids,
uterine discharges or by contact with the contaminated environment (Berdasquera & Cruz,
2009).

Case report.

Anamnesis

A female canine, a Bull Terrier, 6 years and 6 months old, weighing 21.6 kg and body
condition 3/5, was presented to the El Poblado Veterinary Clinic, with a history of
consumption of foreign materials from sites visited by rodents. The patient presented signs
of lethargy, several episodes of emesis of a nutritional characteristic, and also presented
inappetence. The owner also reported that his pet did not have the complete vaccination
plan, it had only been vaccinated once during its puppy stage with an unknown product and
it was never revaccinated, the owner had also recently noticed the presence of ectoparasites
(ticks).
 
Clinical findings

The clinical examination revealed the depressed patient but responding to external stimuli.
The patient presented fever (40 ° C), her respiratory pattern was eupneic, and her heart rate
was also within normal limits. On cardiopulmonary auscultation the sounds were normal.
The physical evaluation revealed the gingival and scleral mucosa and the skin of the
abdominal, inguinal, axillary and perineal regions with a marked jaundice dye (Figures 1
and 2). Her capillary fill time was at 1 second, there were no apparent signs of dehydration.
Lymph nodes were found to be normal on palpation. And her femoral pulse was strong and
consistent. Abdominal palpation did not find discomfort or distention. The patient was
transferred to the hospitalization area to start fluid therapy for maintenance and to carry out
diagnostic approaches, the recommendation at the time of hospitalization is that it be
handled with gloves.
Results.

Diagnostic aids

Blood tests for hemogram, alanine aminotransferase (ALT), albumin and creatinine were
taken on the first day of hospitalization and after four days. In the first blood count the only
altered line was platelets, the patient presented thrombocytopenia with platelets at 154,000
Pl / µl (reference values 200,000–500,000). Thrombocytopenia is a sign that may or may
not be present in the disease. Albumin and creatinine were within normal ranges, and ALT
represented the most altered value in the first examinations, it had a result of 1,431 U / L,
the reference values are 15-60 U / L although the range of normality varies according to
laboratories. ALT is a cytoplasmic locating enzyme in the liver. Its increase is associated
with hepatic (reversible) inflammatory processes and also with necrosis processes.

A slight elevation of liver transaminases is sometimes the only finding that guides the
presence of liver disease in an asymptomatic patient; however, this finding will inform
nothing about the severity or etiology of the liver disease. When the alanine
aminotransferase (ALT) is elevated 10 or more times the upper limit of reference, the
existence of acute liver injury can be diagnosed and, in these cases, the etiological study
should be started immediately.

A rapid haemoparasite test was also performed because the patient had a history of
ectoparasites, a test was performed to detect Dirofilaria immitis Antigens (Ag), Antibodies
(Ac) against Anaplasma platys-phagocytophilum, Ac Borrelia burgdorferi, Ac Erlichia
canis -ewingii. The test has a specificity of 100% and a sensitivity of 96.2% to 99.2%
depending on the hemoparasite, the result for this test was negative.

On the second day of hospitalization, a sample was taken for direct and total bilirubin
examination using the colorimetric enzymatic technique, the result was 9.56 mg / dl
(reference values 0.06-0.12), and 13.98 mg / dl. dl (reference values 0.1-0.3) respectively.
Approximately 15% of animals with leptospirosis have bilirubinemia greater than 2 mg / dl,
due to obstructive hepatocellular degeneration and intrahepatic cholestasis and not to
hemolysis as is often thought.
 
Due to the laboratory findings accompanied by the clinical signs of the patient, it was
decided to perform a rapid Leptospira test using the ImmunoComb ELISA test, the result
was S2 and the values for interpretation are: S0: negative reaction to Leptospira,> S5
positive reaction high to Leptospira, S1-2 low positive reaction to Leptospira and> = S3
positive reaction to Leptospira.

Due to the result, it was decided to take a sample for microagglutination serology for
Leptospira, which is considered by the Pan American Health Organization (PAHO) and the
International Organization of Epizootics (OIE) as the test with the highest diagnostic
validity for the disease.

The microscopic agglutination test (MAT) is carried out by incubating patient serum with
various serovars of Leptospiras. Titres are obtained by testing various dilutions of serum
with the serotype positive. The serovar that reacts with the patient's serum is suggested to
be the infecting serovar. The test identifies results for 8 serovars, and it was positive for
Leptospira Patoc and Hardjo, the results can be seen in table 1.

The criteria for interpreting the test indicate that titers of 1:50 are suspicious and 1: 100 or
higher are positive. Titers from 1: 100 to 1: 200 are of importance mainly in unvaccinated
animals, higher titers with a single sample (= 1: 800) are usually indicative of infection and
are of diagnostic value as long as there are data compatible with the clinical picture
(Srivastava, 2010).

After the positive diagnosis of leptospirosis, it was decided to perform a hemogram, ALT,
albumin and control creatinine, in the hemogram the hematocrit was found in 37.8%
(reference values: 39.2-58.8%), hemoglobin was present in 12 g / dl (reference values:
12.7-16.3 g / dl), platelets were at 197,000, and the patient also presented leukocytosis of
21,400 Leu / µl (reference values: 6,000-15,000 Leu / µl). Moderate leukocytosis has been
reported after four to five days of illness, as well as low hemoglobin and moderate to severe
regenerative anemia (Luna et al., 2008). ALT decreased to 436 U / L, albumin and
creatinine remained within normal ranges.

Discussion

Symptoms associated with canine leptospirosis, documented in our case, reports signs of
decay, vomiting, and fever. One of the most striking signs is jaundice, the presence of this
in canine leptospirosis is not a pathognomonic sign, in clinical cases a frequency of 10% is
mentioned. In the literature consulted, there is controversy regarding the clinical sinology
of leptospirosis. The clinical manifestation of leptospirosis is highly complex and variable,
depending on both the pathogenicity of the serovar, the host's immune response, and the
number of bacteria present. Leptospira is transmitted by direct contact (water, urine,
contaminated soil, bites, placenta) and by ingestion of infected tissues (rodents). Bacteria
multiply in the host's blood on the first day after infection and colonize the liver, kidney,
lungs, spleen, central nervous system, and eyes. Symptoms range from mild to severe
depending on the condition of the affected organs.

In the present case, the progression was rapid and mild, showing only signs such as
jaundice, vomiting, and decay. As the therapeutic plan was established, the patient
presented marked improvement, laboratory tests guided the diagnostic approach and
focused the case on acute liver disease. signs and findings generated suspicion of canine
leptospirosis, and after confirmation by the microscopic agglutination test (MAT), which
has been widely used as a reference test for the detection of antibodies to the disease, its
specific therapeutic protocol and the evolution was favorable. For the diagnosis of canine
leptospirosis, other techniques such as ELISA have also been developed, the polymerase
chain reaction (PCR) in dog urine identifies the DNA of several serovars from 100
Leptospires per milliliter of sample.

Leptospirosis is a disease of clinical urgency, in which it is necessary to perform

complementary tests in order to differentiate it from other disorders that could cause
jaundice.
As it is a high-risk zoonotic disease, in professional practice it is convenient to inform pet
owners about the risks of daily living with their animals, the handling and hygiene
measures, as well as minimal veterinary medical care.
Conclusions

Canine leptospirosis is a growing disease, it is important to note that any patient with signs
and findings of acute hepatitis should be included in the differential diagnosis of this
pathology. Vaccination is the most efficient preventive method; the first immunization must
be carried out in at least 3 doses and later revaccination annually. The low specificity of the
signs of the disease forces the clinician to investigate the etiology of the disorder through
laboratory tests and complementary examinations. The diagnosis of leptospirosis is an
affordable tool in today's medicine and should be done whenever you have suspected the
presence of this. Treatment is aimed at attenuating the signs that the case produces and
eliminating the infection with specific antibiotics. Canine leptospirosis is a disease to be
considered due to the increase in current clinical symptoms and the severe compromise and
morbidity and mortality that it can trigger.

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