Case Study

Leptospirosis in a 12 year old FS mixed dog

The patient is a canine mix, FS, 12 ½ years. The patient is anorexic and lethargic. The patient has a tense abdomen. Anemic. BUN and creatinine were elevated. ALKP, bilirubin, GGT elevated. The patient was treated and then BUN was 48 and creatinine 2.9.

Sonographic Differential Diagnosis

Suspicion for leptospirosis or similar acute hepatic insult.

Image Interpretation

Kidneys presented minor interstitial nephrosis pattern with slightly thickened cortices. Pericapsular fluid was noted around the left kidney. The liver was mildly swollen in contour with a mildly hypoechoic parenchyma. The hepatic veins were mildly dilated likely owing to fluid therapy. The gallbladder and common bile duct were normal

DX

Leptospirosis

Outcome

Patient was hospitalized for 1 week. Initially was treated with IV fluids, parenteral ampicillin and baytril, along with famotidine. He also had an infusion of fresh frozen plasma.

At discharge he was sent home on oral amoxicillin until his liver values improved. At the 1- week recheck his liver values had improved and he was switched to oral doxycycline for 3 weeks.

At recheck 1 week later his Lepto titer and PCR were both negative.

3 weeks after that he was clinically normal and received vaccination for Lepto which was then again boostered after 3 weeks.

He is currently normal.

Clinical Differential Diagnosis

Liver pathology – neoplasia, abscess, granuloma, hepatitis (viral/bacterial/fungal);
Gall bladder pathology- cholecystitis, mucocele;;
Renal pathology- acute kidney injury, renolith, neoplasia, hydronephrosis
Pancreatic pathology – pancreatitis, neoplasia;
Splenic pathology- neoplasia, torsion
Peritonitis