Case Study

Renal failure, Leptospirosis in a 9 year old MN English Bulldog

The patient is a canine English Bulldog, MN, 9 years, 67.5 lbs who was presented for vomiting and diarrhea. The patient is in renal failure. Urine specific gravity 1.017, 2+ protein, white count 11-20. Culture revealed E Coli. BUN 45, creatinine 3.6. Multiple, mild positives for Leptospirosis ( Leptospirosis titers positive. Pomona 1-200, Grippotyphosa 1-400. Autumnalis 1-200,

Sonographic Differential Diagnosis

Acute renal failure, chronic cystitis.

Image Interpretation

Mild chronic interstitial nephrosis pattern. CM junction and ratio maintained. Bladder presented minor micropolypoid changes at minor repletion. Suspect renal toxin, infectious (leptospirosis), UTI, Addisons or other cause of acute renal failure.Mild degenerative renal changes.. Chronic cystitis bladder pattern.

DX

Renal failure suspected sequelum to Leptospirosis

Outcome

None

Comments

Given the multiple, mild positives for Leptospirosis ( Leptospirosis titers positive. Pomona 1-200, Grippotyphosa 1-400. Autumnalis 1-200,) I would empirically treat for concurrent Leptospirosis in this case as it fits the profile. I would also treat E Coli infection. 72 hour IV fluid protocol, blood pressure measurements, IV Ampicillin, and IM Enrofloxacin would be a personal recommendation in this case. The antibiotics should be continued for at least 4 weeks with recheck culture at 3 weeks and continuation of antibiotics at least 10 days post negative culture and negative inflammatory sediment is recommended as well as reassessment of the clinical signs.

Clinical Differential Diagnosis

GI pathology – Gastroenteritis, GI foreign body/obstruction, neoplasia; pancreatic pathology – pancreatitis; Renal failure: Toxin, infectious, degenerative, obstructive urinary disease, Addisons.