Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Beats — Mon, 11 Oct 2021 18:56:01 GMT

[quote userid="2186" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29966/diagnostic-of-lepto-or-not-in-dog-vaccinated-mid-may-with-nobivac-l4/233542#233542"]Odd that the panel didn't include L. icterohaemorrhagiae, or is there cross reactivity with one of the other serovars?[/quote]

I believe that icterohaemorrhagiae is the serogroup, and copenhageni is (presumably the most relevant) serovar of that serogroup

https://leptospira.amsterdamumc.org/filters/serogroup/icterohaemorrhagiae/

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Virginia Campbell — Mon, 11 Oct 2021 17:06:05 GMT

this case was hepatic lymphoma,

Unlucky! Odd that the panel didn't include L. icterohaemorrhagiae, or is there cross reactivity with one of the other serovars? It's ages since I've done a lepto panel!

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Beats — Fri, 17 Sep 2021 19:09:01 GMT

this case was hepatic lymphoma, and is now decesased, for those interested. The lepto PCRs were negative on blood and urine.

[quote userid="24356" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29966/diagnostic-of-lepto-or-not-in-dog-vaccinated-mid-may-with-nobivac-l4/233061#233061"]those of you seeing lepto cases - what strains are you seeing?[/quote]

Last confirmed case I typed by MAT was suggestive of Lepto hebdomadis. Farm puppy.

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Elizabeth — Fri, 17 Sep 2021 18:19:33 GMT

those of you seeing lepto cases - what strains are you seeing?

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Anthony Dennison — Fri, 17 Sep 2021 14:52:28 GMT

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29966/diagnostic-of-lepto-or-not-in-dog-vaccinated-mid-may-with-nobivac-l4/232657#232657"]Maybe area and type of practice dependant[/quote]

Agreed. We see a similar number of cases a year. Nearly always unvaccinated farm dogs.

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Michael Woodhouse — Fri, 27 Aug 2021 11:04:09 GMT

[quote userid="3213" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29966/diagnostic-of-lepto-or-not-in-dog-vaccinated-mid-may-with-nobivac-l4/232627#232627"]Lepto didtn't really feature in the differential diagnosis list at all.[/quote]

If we are talking dogs with clinically obvious jaundice then I've had more of them positive for lepto than all the other diagnoses put together.

Maybe area and type of practice dependant

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Beats — Thu, 26 Aug 2021 06:32:33 GMT

[quote userid="3213" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29966/diagnostic-of-lepto-or-not-in-dog-vaccinated-mid-may-with-nobivac-l4/232627#232627"]Why is lepto the front runner re diagnosis particularly?[/quote]

Other than a 1:1600 titre, currently no particular reason.

[quote userid="3213" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29966/diagnostic-of-lepto-or-not-in-dog-vaccinated-mid-may-with-nobivac-l4/232627#232627"]biopsy and chronic active hepatitis was the top diagnosis.[/quote]

I don't tend to jump to liver biopsy unless the patient isn't getting better. The different treatment options based on biopsy seem limited?

That said I had a 2 year old Labrador with ascites this week that had portal hypertension due to a very shrunken and nobbly liver. Considered biopsy, but euthanased instead.

[quote userid="3213" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29966/diagnostic-of-lepto-or-not-in-dog-vaccinated-mid-may-with-nobivac-l4/232627#232627"] I asked about lepto being in differential mix and this seemed to be generally dismissed as a differnital.[/quote]

I'm not sure why lepto is not a differential for liver disease, but I guess it does vary geographically. I guess relevance as a differential to me is you may wish to treat it differently (a week or more of doxycycline).

Furthermore, I feel a need to screen patients for lepto given that a significant part of my time is spent giving lepto vaccines - if I don't do surveillance to see the local need for this then it is rather speculative. Doing testing on unwell young animals with liver, renal or pulmonary lesions seems the most reasonable surveillance.

"upper reference limit"

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

mel kavanagh — Wed, 25 Aug 2021 22:22:38 GMT

Why is lepto the front runner re diagnosis particularly? I did a short medical course last year and one of the modules looked at hepaitits in dogs. Lepto didtn't really feature in the differential diagnosis list at all. II was all raised liver chemistry, biopsy and chronic active hepatitis was the top diagnosis. I asked about lepto being in differential mix and this seemed to be generally dismissed as a differnital. Lots of dogs are a bit off and might or might not have raised liver chemiistry. What does the URL thing refer to please? presumabley xnormal levels?

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Michael Woodhouse — Wed, 25 Aug 2021 08:08:42 GMT

[quote userid="12930" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29966/diagnostic-of-lepto-or-not-in-dog-vaccinated-mid-may-with-nobivac-l4/232578#232578"]Do you get many cases that are PCR positive in your experience?[/quote]

Yes. We see clinical cases 2-4 times per year. Yellow, sick. Most die.

Suspect much more mild disease passes by un-noticed.

With a PCR it's so sensitive that I'd be surprised if a shot of Betamox was enough to give a false negative.

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Beats — Wed, 25 Aug 2021 07:19:42 GMT

It was the copenhageni titre that I was wondering about. I can take another sample in a couple of weeks and compare titres, but that is somewhat retrospective re treatment decisions now. Dog is on amoxicillin, but responds clinically best to dexafort injections it would seem. I would go light on steroid use at this point if results were highly suggestive of lepto.

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Beats — Wed, 25 Aug 2021 07:13:53 GMT

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29966/diagnostic-of-lepto-or-not-in-dog-vaccinated-mid-may-with-nobivac-l4/232575#232575"]PCR[/quote]

Results pending. I've never had a positive on this. Whether this is because the incidence of lepto is very low where I am, because folks have often given them a shot of betamox LA before taking samples, or because the sensitivity is poor generally, I am not sure.

Do you get many cases that are PCR positive in your experience?

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Dinu Catilina — Wed, 25 Aug 2021 06:38:40 GMT

[quote userid="12930" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29966/diagnostic-of-lepto-or-not-in-dog-vaccinated-mid-may-with-nobivac-l4"]

L. canicola

1:400

[/quote]

This can happen in vaccinated dogs without disease, we get it occasionally when we test healthy dogs to export their semen to Australia.

I would do a PCR

RE: Diagnostic of Lepto or not in dog vaccinated mid-May with Nobivac L4?

Michael Woodhouse — Tue, 24 Aug 2021 22:45:41 GMT

Dunno, if I suspect clinical disease I'd do the PCR