Kidney Failure - Leptospirosis

Four of my dogs have died of kidney failure this year. I have no idea of what to do. I discussed this with Ingrid Newkirk of PETA who dropped in to Delhi for one evening and she immediately said Leptospirosis. Then two days later this opinion was reinforced by two other foreign vets, visiting India. If I don’t know about it, I am fairly sure no one else does. So this is a technical article.

The largest killer of dogs in India is kidney failure and no one can explain it. It stretches across dogs that are fed badly or well, fat and thin, pet or stray, young or old. Scientists are coming to the opinion that a little known but very rampant disease called Leptospirosis may be the killer. Through this article I would like to address anyone who has pets or runs a shelter or has a vet friend. Please cut this out and send it to all such people.

How Would a dog catch Leptospirosis?

Leptospirosis affects many kinds of animals besides dogs. The organism that causes leptospirosis belongs to a group of organisms called spirochetes.

Dogs and cats pick this up from rats, wildlife as well as domestic livestock. More cases occur after heavy rainfall. Leptospira persist in standing water, dampness, mud and alkaline conditions.

Most infected animals that spread leptospirosis do not appear ill. In these animals, the leptospira have taken up residence in their kidneys. When they urinate they contaminate their environment with living leptospira. Animals can become infected by sniffing this urine. The leptospira are washed by rains into standing water. Animals wading, swimming or drinking the contaminated water develop the disease. They can also enter through a bite wound or through the pets eating infected materials.

What Happens A Dog Catches Leptospirosis ?

Not all dogs that are exposed to leptospirosis become visibly ill. Chronic kidney inflammation is a leading cause of kidney failure and death in dogs. This form of kidney damage can be one outcome of leptospirosis.

When leptospirosis does cause sudden disease in dogs, it tends to be most severe in dogs that are younger than 6 months old. These are the pets most likely to suffer life-threatening liver and kidney damage. It takes about 4-12 days after exposure for the pet to feel ill.

In dogs that become ill, the leptospira spread rapidly through the pet’s blood stream, usually causing high fevers, depression and joint pain. Leptospira produce powerful toxins that attack the liver and kidneys, leading to failure of these organs. Some varieties primarily cause liver damage, while others concentrate in the kidneys. In other pets, blood fails to clot normally - leading to bleeding.

What Are The Signs To See In The Dog?

The most common signs are fever and depression. These pets are cold, shivery, and stiff. They may carry their tummies tucked up due to pain. Some drool and vomit and most lose their appetite. Fever causes many dogs to drink excessively.

Later in the disease, a few pets will develop eye inflammations (uveitis), nervous system abnormalities, or pass red-tinged urine. As the disease progresses, the pet may become dehydrated due to the fever, vomiting and disinterest in drinking. A drop to subnormal body temperature is a very grave sign. A few dogs, particularly pups, will die suddenly before many of these signs occur.

When the liver has been damaged, the pet’s skin may take on a yellowish tinge and show all the symptoms of hepatitis. When the kidneys have been severely damaged, the pet may show the signs of uremia.

How Would A Veterinarian Diagnose Leptospirosis In The Dog ?

Most vets fail to diagnose the disease on the first examination.

What has to be done are blood tests (CBC and blood chemistry). One of the typical signs found in blood tests, as leptospirosis progresses, is an elevation in the number of white blood cells in the blood. The cells that tend to go up in leptospirosis are the neutrophils. However, very early in the infection, white blood cell numbers can be lower than normal. There are other chemical abnormalities that suggest leptospirosis – changes in liver enzymes, blood-clotting cells (thrombocytes) and kidney health values (BUN and creatinine). Evidence of damage to the pet’s kidneys would also be reflected in abnormal urine analysis results.

Vets often confuse the disease with ehrlichiosis, babesiosis, autoimmune disease, infectious canine hepatitis, canine herpes virus, canine brucellosis and certain poisonings. Because of this, your veterinarian may place your pet on antibiotics while another test is run. This is the leptospirosis PCR test. This test is extremely sensitive in finding the presence of leptospira and the results can be obtained rapidly from urine and blood samples. After the first ten days of infection, antibodies against leptospirosis can be detected in your pet’s blood if it has encountered leptospira. However, antibody detections is not as valuable as a positive PCR test in dealing with leptospirosis. Occasionally the diagnosis can be made by seeing leptospira microscopically in the pet’s urine.

How Can Other Dogs Be Prevented From Catching It?

You have to find a way to deal with the urine of an infected dog so that it does not infect others. Because recovered pets can shed leptospira in their urine for months, this has to be monitored even after the animal has recovered.

Confine the animal to an easily-sanitized area of your house. Take your dog out on a leash frequently to urinate. Only allow the pet to urinate on dry concrete surface that can be easily sanitized with bleach.

How Will The Vet Treat Leptospirosis?

The treatment of leptospirosis is much easier than the diagnosis. Many common antibiotics kill leptospira - ordinary penicillin, tetracycline and erythromycin all work well. Most vets keep infected pets on a tetracycline-class antibiotic for an extended period after recovery to prevent a carrier state from developing.

Sick pets require intense supportive care to get them through the early severe stage of the disease. Dogs with stomach involvement need anti-emetic medications to lessen vomiting. Dogs that vomit need intravenous fluids to stem dehydration and correct blood acid / base balance. Rigorous fluid therapy also helps flush out the pet’s kidneys. Some animals recover. Some go on to suffer chronic renal failure or develop chronic active hepatitis – neither of which is curable.

How Can A Pet Be Prevented From Catching Leptospirosis ?

Vaccination is one option. It is one of the 7-in-one vaccinations that are commonly given when the pup is a few months old.

There are two problems with this :

1. The 7-in-one does not work for leptospirosis . You need to give it as an independent injection, and not in a combination vaccine or multiple vaccines given on the same day. First get your dog immunized against parvo and distemper virus. Then let several weeks pass before the leptospirosis vaccination. This is because adding leptospirosis ingredients to combination vaccines reduces the effectiveness of the other ingredients

Secondly, the vaccination has side effects. Most foreign vets do not recommend that pets receive it unless there is a good chance they will be exposed to leptospirosis. They see more vaccination reactions than from any other vaccines. These range from pain at injection site, facial swelling and hives to a fatal anaphylactic reaction. Reactions seem to occur more frequently in smaller breeds than larger ones.

Third, the immunity that leptospirosis vaccinations give is short lasting – perhaps a year, perhaps less. Occasionally, the vaccine does not protect at all. Vaccine manufacturers have known the drawbacks of their leptospirosis vaccines for years.

Fourth, vaccination does not always prevent infection – but it makes the disease much milder. However vaccinated dogs can become long-term carriers of leptospirosis. Some long-term carriers have a frequent incidence of reproductive failure and stillbirths.

In 2004, Wyeth Pharmaceuticals came out with a multi-strain leptospirosis vaccine which is supposed to be safer. I do not know whether it is available in India. But considering the epidemic, we should make all efforts to get it.

The first vaccination is at 14-16 weeks of age. It can be given as early as 12 weeks of age if the pup's exposure risk is high. But no other vaccinations are to be given that week. As of now, obtaining a blood sample and checking the dog for protective levels of antibody is a safer option.

How Long Do Leptospirosis Organisms Survive In The Environment ?

Leptospira are very dependent on water, mud or damp clay soils to survive. They die almost immediately on dry surfaces - even if those surfaces could be contaminated with urine from other infected animals. Temperatures at or above 131 deg.F (42 deg.C) kill leptospira as well. All common household disinfectants (bleaches, alcohol based products, vinegar, lemon juice etc.) kill leptospira quickly; as does a liberal application of detergent or boiling for 5 minutes. Standing water can be disinfected using swimming pool chlorine tablets.

 

Maneka Sanjay Gandhi
Pl. add: To join the animal welfare movement contact gandhim@nic.in, www.peopleforanimalsindia.org

*Proper wildlife rehabilitation is an extremely biologically and ecologically responsible attitude toward all living things.*