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CASE STUDY: ZEKE

Clinical Presentation: Fever, Progressive Anorexia, and Vomiting

Zeke, a neutered 6-year-old male Boston Terrier

Zeke had been a happy, playful dog until shortly before presenting with a fever (104.4°F), progressive anorexia with vomiting, polyuria, and discolored urine. He had been previously well-vaccinated including 2-way leptospira vaccines containing L. canicola and L.icterohaemorrhagiae.
Blood tests indicated elevated BUN and creatinine and neutrophilia with a left shift. Pyuria, proteinuria, hematuria, and bacteriuria with isosthenuria also were confirmed by urinalysis. The veterinarian considered a urinary tract infection or renal disease as differential diagnoses.
Zeke was hospitalized and treated with IV fluids and enrofloxacin. His fever resolved; however, bloody diarrhea developed, his BUN continued to climb, and urine output decreased. Zeke was transferred to a referral institution and received aggressive therapy. Despite therapy, Zeke developed aspiration pneumonia and was euthanized.
Serology testing indicated titers for the following: L. grippotyphosa, 1:3200; L. pomona, 1:1600; L. bratislava, 1:3200; L. canicola, <1:100; and L. icterohaemorrhagiae, <1:100.

CASE NOTE: Zeke presented with clinical signs highly suggestive of kidney disease rather than cystitis (which normally does not result in elevated BUN and creatinine). Leptospirosis should be very high on a list of differential diagnoses for all cases of acute renal failure. Amoxicillin, ampicillin, and doxycycline are the antibiotics of choice for treating leptospirosis, whereas fluoroquinolones (a reasonable choice for cystitis) generally are not recommended. This case also demonstrates that leptospirosis can and does occur in small breed dogs. Any dog with even limited exposure to wildlife is at risk of developing leptospirosis.

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CASE STUDIES


Read about real pets that were diagnosed with leptospirosis.