Leptospirosis serovars

Re: Leptospirosis serovars

David Mills — Wed, 31 Oct 2012 23:06:20 GMT

Interesting isnt it how we reagrd lepto in different species?

Smal animals, hand ringing over antibiotics with little evidence for extended use of doxy (horribly expensive too) and how long to keep in.

Large animals - week of penicillin, isolate, then away.

Lepto is generally a crap bacterium in the face of antib's so most things will kill it. I cannot see for one minute how doxy would be superior apart from profit generation. We use plain old amoxicillin. Works fine.

Re: Leptospirosis serovars

Ruffles1849 — Wed, 31 Oct 2012 23:03:34 GMT

[quote user="Michael Woodhouse"]

[quote user="Rajat"]You could start Doxycycline alongside Synulox for a day or 2 before sending her home if the owner is insistent on having her home - mine was.[/quote]

Buy WHY would you? Amoxycillin should be fine and the dog is improving on treatment. IF there is any truth in the bacteriocidal/bacteriostatic antagonism is correct then why not complete one course before you start the other? I am genuinely not convinced there is any additional benefit to giving both but a small risk it could actually reduce the effectiveness. `

[/quote]

Hi there! I think the rationale for using Amoxycillin first followed by Doxycycline is that the former clears the bacteremia and a prolonged course of the latter prevents shedding in the urine.

Re: Leptospirosis serovars

Anthony Dennison — Wed, 31 Oct 2012 22:43:02 GMT

[quote user="Busybee"]

ps. forgive all the questions - at uni, lepto was one of those "You won't see a case of this so we won't go over it"!

[/quote]

Really?! We got warned about it a lot!

Re: Leptospirosis serovars

Michael Woodhouse — Wed, 31 Oct 2012 22:30:21 GMT

[quote user="Rajat"]You could start Doxycycline alongside Synulox for a day or 2 before sending her home if the owner is insistent on having her home - mine was.[/quote]

Re: Leptospirosis serovars

Rajat — Wed, 31 Oct 2012 22:09:28 GMT

[quote user="Busybee"]

Not been on IVFT since last Thursday (I think). Currently on oral antibs as not had GI signs since last week. Can hopefully get her on doxycycline - you start AFTER the end of the amoxyclav ? I'd love to send her home as she seems so well but am concerned about her risk to the other dogs at the owner's house and to the owner herself!

[/quote]

Hi no worries re questions

I did a bit of digging - so MAT test is poorly predictive of serovars and there can be ifnective and non infective leptospires in the same serovar due to gene transfer between them. Additionally, autumnalis has been reported to cause disease before.

All this is from the ACVIM consensus statement on Leptospirosis

Some answers and explanations in the abstract, page 1-4, 7, 10-11

But all this aside, the point is any dog that presents with those signs, positive on a pooled test(MAT) and other major obvious path ruled out and esp if it is responding to abs and tx has virulent Lepto for me ;)

How long has she been on abs now?

You could start Doxycycline alongside Synulox for a day or 2 before sending her home if the owner is insistent on having her home - mine was. She was asked to sign a lengthy consent form saying she'd been warned of all the risks and it was against our advice!

Re: Leptospirosis serovars

Busybee — Wed, 31 Oct 2012 21:37:25 GMT

ps. forgive all the questions - at uni, lepto was one of those "You won't see a case of this so we won't go over it"!

Re: Leptospirosis serovars

Busybee — Wed, 31 Oct 2012 21:36:15 GMT

Re: Leptospirosis serovars

Rajat — Wed, 31 Oct 2012 21:15:46 GMT

[quote user="Busybee"]How long should we be keeping her in? Amoxyclav good enough? [/quote]

Is she still on IVFT? I'd base it on initial bloods and need for IVFT - to maintain optimal hydration (but I don't like overhydrating or trying to 'flush the toxins'- can damage the kidneys that way, sure you wouldn't though!)

I usually use parenteral abs for 3-5 days then transition to oral. With GI signs, there is a possibility oral ab absorption may not be as good initially.

Amoxy clav is fine, doxycycline for 2-4 weeks after amoxy clav for 6 weeks is thought to help to reduce carrier status/shedding

I try to monitor bloods once in your dogs state once weekly-biweekly but really depends on how sick the dog is and what the last values were..

I am not very clued up on the serovar situation and cross protection so I'll defer to the manual on that one

Re: Leptospirosis serovars

Busybee — Wed, 31 Oct 2012 21:08:02 GMT

How long should we be keeping her in? Amoxyclav good enough? Will hopefully be repeating biochem tomorrow.

[quote user="Rajat"]Like one of my clients with several other dogs at home who still refused to vaccinate[/quote]

Unfortunately similar situation - pointer breeder, doesn't believe in vaccination. However in this case, would vaccination have helped? I read in the BSAVA Infectious Disease manual that there is very little chance of cross protection.

Re: Leptospirosis serovars

Rajat — Wed, 31 Oct 2012 21:02:46 GMT

That's fantastic news! Glad yours is doing well. mine too presented with jaundice and azotemia, one did have D+ as well. Annoying how some clients just don't get the benefits of vaccination!!Like one of my clients with several other dogs at home who still refused to vaccinate after spending >£1k on treatment over 2 months for her dog, thinking vaccinating will 'bring the disease out in them'.

Re: Leptospirosis serovars

Busybee — Wed, 31 Oct 2012 20:40:48 GMT

She came in looking like a HGE but 2 days later it was noticed she was jaundiced, bloods run showing elevated liver enzymes and severe azotaemia (sorry, can't remember the details), I remembered she wasn't vaccinated and so bloods were sent for lepto. Been on amoxyclav throughout and gastroprotectants until 3 days ago. Currently like a new dog - very bouncy (especially for an old pointer!), eating well, no V+/D+ and normal temp.

Re: Leptospirosis serovars

Rajat — Wed, 31 Oct 2012 20:22:48 GMT

sorry posted early!

both with very limited funds, and hence the panels weren't expanded and rising tires not run. I don't know enough about this to comment, but if I had a case with attributable clinical signs and a positive titre to the pool I'd treat 'em.

Luckily both of mine made it!

Re: Leptospirosis serovars

Rajat — Wed, 31 Oct 2012 20:21:05 GMT

Is the dog showing clinical signs of Leptospirosis?

I have had 2 cases this year. Both with