Duration of immunity of a multivalent (DHPPi/L4R) canine vaccine against four Leptospira serovars

Updated ACVIM consensus statement on leptospirosis in dogs

Since publication of the last consensus statement on leptospirosis in dogs, there has been revision of leptospiral taxonomy and advancements in typing methods, widespread use of new diagnostic tests and vaccines, and improved understanding of the epidemiology and pathophysiology of the disease. Leptospirosis continues to be prevalent in dogs, including in small breed dogs from urban areas, puppies as young as 11 weeks of age, geriatric dogs, dogs in rural areas, and dogs that have been inadequately vaccinated for leptospirosis (including dogs vaccinated with 2-serovar Leptospira vaccines in some regions). In 2021, the American College of Veterinary Internal Medicine (ACVIM) Board of Regents voted to approve the topic for a revised Consensus Statement. After identification of core panelists, a multidisciplinary group of 6 experts from the fields of veterinary medicine, human medicine, and public health was assembled to vote on the recommendations using the Delphi method. A draft was presented at the 2023 ACVIM Forum, and a written draft posted on the ACVIM website for comment by the membership before submission to the editors of the Journal of Veterinary Internal Medicine. This revised document provides guidance for veterinary practitioners on disease in dogs as well as cats. The level of agreement among the 12 voting members (including core panelists) is provided in association with each recommendation. A denominator lower than 12 reflects abstention of ≥1 panelists either because they considered the recommendation to be outside their scope of expertise or because there was a perceived conflict of interest.

A Canine Leptospirosis Clinical Case Due to Leptospira interrogans (Serogroup Icterohaemorrhagiae) in a Dog Kennel in Castelvetrano (Western Sicily, South Italy)

Leptospirosis is a worldwide widespread zoonosis caused by Leptospira genus. We report an acute leptospirosis case in a puppy housed at a municipal kennel and the subsequent diagnostic investigations carried out on all dogs housed in the kennel. Laboratory investigation included mainly a microagglutination test, real-time PCR, and multi-locus sequence typing (MLST) for Leptospira genus. Other agents of infection were excluded. The puppy resulted positive for Leptospira interrogans Icterohaemorrhagiae both with serological and molecular assays. All of the other 66 dogs in the kennel underwent clinical and laboratory investigations twice, 15 days apart. No other dog showed leptospirosis clinical signs. At the first sampling, eight dogs (12%) showed antibodies against Leptospira interrogans serogroup Icterohaemorragiae serovar Copenhageni. Real-time PCR on urine samples of seropositive dogs detected Leptospira spp. DNA in one sample, then identified as Leptospira interrogans serogroup Icterohaemorragiae by MLST. Fifteen days after, four of the previous seropositive dogs still showed antibodies against Leptospira spp. All urine samples collected from seropositive dogs were negative at real-time PCR. The study allowed the early confirmation of a Leptospirosis case and the identification of at least one asymptomatic carrier of pathogenic Leptospira spp. The prompt activation of all appropriate management measures allowed limiting and extinguishing the infection.

Cellular and humoral immune responsiveness to inactivated Leptospira interrogans in dogs vaccinated with a tetravalent Leptospira vaccine

Vaccination is commonly used to protect dogs against leptospirosis, however, memory immune responses induced by canine Leptospira vaccines have not been studied. In the present study, antibody and T cell mediated responses were assessed in dogs before and 2 weeks after annual revaccination with a commercial tetravalent Leptospira vaccine containing serogroups Canicola and Australis. Vaccination significantly increased average log₂ IgG titers from 6.50 to 8.41 in year 1, from 5.99 to 7.32 in year 2, from 5.32 to 8.32 in year 3 and from 5.32 to 7.82 in year 4. The CXCL-10 levels, induced by in vitro stimulation of PBMC with Canicola and Australis, respectively, significantly increased from 1039.05 pg/ml and 1037.38 pg/ml before vaccination to 2547.73 pg/ml and 2730.38 pg/ml after vaccination. IFN-γ levels increased from 85.60 pg/ml and 178.13 pg/ml before vaccination to 538.62 pg/ml and 210.97 pg/ml after vaccination. The percentage of proliferating CD4⁺ T cells in response to respective Leptospira strains significantly increased from 1.43 % and 1.25 % before vaccination to 24.11 % and 14.64 % after vaccination. Similar responses were also found in the CD8⁺ T cell subset. Vaccination also significantly enhanced the percentages of central memory CD4⁺ T cells from 12 % to 26.97 % and 27.65 %, central memory CD8⁺ T cells from 3 % to 9.47 % and 7.55 %, and effector CD8⁺ T cells from 3 % to 7.6 % and 6.42 %, as defined by the expression of CD45RA and CD62L, following stimulation with Canicola and Australis, respectively. Lastly, enhanced expression of the activation marker CD25 on T cells after vaccination was found. Together, our results show that next to IgG responses, also T cell responses are induced in dogs upon annual revaccination with a tetravalent Leptospira vaccine, potentially contributing to protection.

2022 AAHA Canine Vaccination Guidelines

These guidelines are an update and extension of previous AAHA peer-reviewed canine vaccination guidelines published in 2017. Vaccination is a cornerstone of canine preventive healthcare and one of the most cost-effective ways of maintaining a dog's health, longevity, and quality of life. Canine vaccination also serves a public health function by forming a barrier against several zoonotic diseases affecting dogs and humans. Canine vaccines are broadly categorized as containing core and noncore immunizing antigens, with administration recommendations based on assessment of individual patient risk factors. The guidelines include a comprehensive table listing canine core and noncore vaccines and a recommended vaccination and revaccination schedule for each vaccine. The guidelines explain the relevance of different vaccine formulations, including those containing modified-live virus, inactivated, and recombinant immunizing agents. Factors that potentially affect vaccine efficacy are addressed, including the patient's prevaccination immune status and vaccine duration of immunity. Because animal shelters are one of the most challenging environments for prevention and control of infectious diseases, the guidelines also provide recommendations for vaccination of dogs presented at or housed in animal shelters, including the appropriate response to an infectious disease outbreak in the shelter setting. The guidelines explain how practitioners can interpret a patient's serological status, including maternally derived antibody titers, as indicators of immune status and suitability for vaccination. Other topics covered include factors associated with postvaccination adverse events, vaccine storage and handling to preserve product efficacy, interpreting product labeling to ensure proper vaccine use, and using client education and healthcare team training to raise awareness of the importance of vaccinations.

Detection of New Leptospira Genotypes Infecting Symptomatic Dogs: Is a New Vaccine Formulation Needed?

Leptospirosis in dogs has been largely described worldwide, and epidemiological studies have been mainly based on serological data. This study aims to detect and genotype leptospires affecting symptomatic dogs in Northeast Italy between 2013 and 2019. Overall, 1631 dogs were tested using real-time PCR, and leptospires from 193 dogs were subjected to Multilocus Sequence Typing and a Multiple Loci Variable-number Tandem Repeat Analysis. Leptospires were successfully isolated from 15 symptomatic dogs. Six distinct Sequence Types (STs) were found for 135 leptospires, with 3 STs characterizing Leptospira interrogans (ST17, ST198 and ST24), 2 STs characterizing Leptospira kirschneri (ST117 and ST289) and 1 ST characterizing Leptospira borgpetersenii (ST155), revealing the circulation of the serogroups Icterohaemorrhagiae, Australis, Sejroe and Pomona. The Multiple Loci Variable-number Tandem Repeat Analysis of 17 samples did not result in any additional discrimination. Genotypes were compared with those of strains present in the historical internal database, and possible transmission chains were identified from rat, mouse, hedgehog and pig. This work highlights the importance of molecular methods in revealing and identifying circulating Leptospira strains, and it also encourages the evaluation of the ability of commercially available vaccines to reduce the disease burden among dogs.

Development of antibody ELISA specific of Leptospira interrogans serovar Grippotyphosa, Canicola, and Icterohaemorrhagiae to monitor vaccine immunogenicity

The antibody response after primary vaccination and annual revaccination with a multivalent DAPPi-L vaccine was assessed respectively in SPF dogs and in client owned dogs against the Grippotyphosa (Lg), Canicola (Lc) and Icterohaemorrhagiae (Li) Leptospira serovars. To overcome limitations of the microscopic agglutination test (MAT), we developed serovar-specific and sensitive blocking ELISA assays. Serovar-specific antibodies against Lg, Lc and Li were detected in 100%, 45% and 91% of dogs, respectively, after the first dose of vaccine, and in 100% of dogs for all serovars after the second dose. In addition, mean ELISA antibody titers increased 14 days after annual revaccination with most dogs remaining ELISA antibody positive against Lg (85.3%), Lc (90%) and Li (100%). Parallel testing of sera from the annual revaccination study in the MAT and ELISA assays resulted in an overall agreement of 72%, 67%, 77% of samples for Lg, Lc and Li serovars, respectively. More sera tested positive by ELISA than by MAT, suggesting that the ELISA assay is more sensitive than the MAT. These three new antibody-based assays are the first suitable and reliable ELISA assays for the assessment of the canine antibody response following vaccination and an attractive alternative to the MAT.

Outpatient Clinical Trial in Dogs With Leptospirosis Treated With Enrofloxacin Hydrochloride-Dihydrate (ENRO-C)

Pharmacokinetics of enrofloxacin HCl-2H2O (enro-C) in dogs and Monte-Carlo simulations against Leptospira spp. prompted a clinical study to treat the clinically apparent phase of this disease. Leptospirosis was diagnosed by real-time PCR from blood, micro-agglutination titers (MAT), clinical signs and blood parameters of the liver and kidney. In order to determine the clinical ability of the participants to diagnose leptospirosis on the first exam and establish an early treatment to avoid excessive organ damage, patients were clinically classified as: high-risk or medium-risk. Forty-five dogs were included in this trial (from 2017 to early 2019). The treatment consisted of IM injections of a 5% aqueous enro-C suspension (10 mg/kg/day) for 10 days, and subsequently enro-C was administered orally for another 7 days in gelatin capsules. Thirty-four high-risk and 11 medium-risk dogs were treated, including 6 puppies (4 high-risk with ages between 6 to 10 months and 2 medium-risk dogs with an average age of 6 and 7 months). Other ages ranged from 1 to 5 years. Fifteen cases had a history of having received prior treatment with other antibiotics, including all puppies. The clinical diagnostic error was 13.5% (7/52 cases), and only one of the misdiagnosed dogs had been classified as a high-risk patient. Three to 5 days after finishing treatment with enro-C, 82.2% of the dogs were negative to real-time PCR from urine samples and 100% negativity was observed on day 30 after treatment, when antibody titrations dropped to 1:100-1:200. Based on the absence of clinical signs, real-time PCR, and MAT titers, all treated dogs were considered as successful treatments. Within 6-24 months of clinical follow-up, no relapses were recorded. Adverse effects were inconsequential. This study represents the first report of a successful treatment of canine leptospirosis using a fluoroquinolone, and due to its efficacy, it is suggested that enro-C be considered as a viable option for the treatment of this disease.

Hepatic leptospiral infections in dogs without obvious renal involvement

Background

Reports of chronic hepatitis in dogs caused by Leptospira spp. are confined to small case series. Fluorescence in situ hybridization (FISH) allows the identification of spirochetes in liver samples. Consequently, this technique may help elucidate the role of Leptospira spp. in cases of chronic hepatitis.

Objectives

To describe cases of hepatic leptospirosis in dogs diagnosed by FISH and subsequent polymerase chain reaction (PCR) speciation, with the absence of clinically relevant renal involvement.

Animals

Ten client‐owned dogs.

Methods

Retrospective case series from the University of Cambridge presented between 2013 and 2016 or cases consulted by telephone advice during this time period. Cases were selected based on histopathologically confirmed granulomatous hepatitis and leptospiral organisms identified by FISH and PCR speciation (Leptospira interrogans/kirschneri).

Results

All cases had increased liver enzyme activities, and FISH in combination with PCR speciation‐confirmed infection with L. interrogans/kirschneri. Four dogs underwent repeat liver biopsy, FISH and PCR speciation 4‐15 months after initial presentation and doxycycline treatment with 1 dog undergoing repeat sampling at necropsy. Three dogs that underwent repeat biopsy remained positive for L. interrogans/kirschneri infection. Six dogs were alive at the time of manuscript preparation and 4 dogs were euthanized as a result of progressive liver disease.

Conclusions and Clinical Importance

The presence of hepatic leptospiral organisms may be associated with chronic granulomatous hepatitis without clinical evidence of renal involvement. Further studies are necessary to elucidate the etiological role of these organisms in the disease.

Leptospira interrogans serovars Bratislava and Muenchen animal infections: Implications for epidemiology and control

Strains of Leptospira interrogans belonging to two very closely related serovars - Bratislava and Muenchen - have been associated with disease in domestic animals, in particular pigs, but also in horses and dogs. Similar strains have also been recovered from various wildlife species. Their epidemiology is poorly understood. Two hundred and forty seven such isolates, from UK domestic animal and wildlife species, were examined by restriction endonuclease analysis in an attempt to elucidate their epidemiology. A representative sub-sample of 65 of these isolates was further examined by multiple-locus variable-number tandem repeat analysis and 22 by secY sequencing. Ten restriction pattern types were identified. The majority of isolates fell into one of three restriction endonuclease analysis pattern types designated B2a, B2b and M2a. B2a was ubiquitous and was isolated from 10 species and represented the majority of the horse and all dog isolates. B2b was very different, being isolated only from pigs, indicating that this type was maintained by pigs. The pattern M2a was reported for the majority of isolates from pigs but also was common in small rodents isolates. Five restriction pattern types were found only in wildlife suggesting that they are unlikely to pose a disease threat to domestic animals. Multiple-locus variable-number tandem repeat analysis identified six clusters. The REA types B2a and B2b were all found in one MLVA cluster while the majority of the M2a strains examined occurred in another cluster. The secY sequencing detected only one sequence type, clustered with other serovars of Leptospira interrogans.