An emerging pulmonary haemorrhagic syndrome in dogs: similar to the human leptospiral pulmonary haemorrhagic syndrome?

Exudative glomerulonephritis associated with acute leptospirosis in dogs

In the past 20 years in Switzerland, dogs with suspect acute leptospirosis frequently showed severe glomerular changes that had not been previously reported. These features were characterized by abundant extravasated erythrocytes and fewer neutrophils accompanied by marked fibrin exudation into the urinary space that was interpreted as an exudative glomerulonephritis (GN). This retrospective study describes this significant glomerular pathological change and investigates the association with leptospirosis. Tissues from 50 dogs with exudative GN, retrieved from 2 pathology archives in Switzerland were reviewed using hematoxylin and eosin, periodic acid-Schiff, phosphotungstic acid-hematoxylin, and Warthin and Starry stains. Clinical and postmortem data were collected for each case. Immunohistochemistry (IHC) and/or polymerase chain reactions were used as confirmatory tests for leptospirosis. While all 50 cases had clinical and pathological features supporting a diagnosis of leptospirosis, 37 cases were confirmed for the disease. Using a LipL32 antibody in addition to the OMV2177 antibody raised against the lipopolysaccharide of Leptospira interrogans serovar Copenhageni increased the detection rate of Leptospira by IHC in exudative GN from 24% to 62%. Signalment, seasonality, clinical signs, blood results, and pathological changes in dogs with exudative GN were similar to those reported for dogs without GN and confirmed infection by Leptospira spp.. Exudative GN was common among Swiss dogs with leptospirosis where it caused acute severe disease. Leptospirosis should be considered as a cause of this new pathologic feature by the pathologist. The pathogenesis remains unclear, but involvement of a geographic-specific serovar with unique virulence factors is suspected and warrants further investigation.

Nephrology in Veterinary Medicine

Veterinary nephrology is a specialized field of veterinary medicine providing a high level of care for animals with all types of kidney disease. Veterinarians complete extensive training to become board-certified in veterinary nephrology-urology. Companion animal nephrology is the most advanced field; however, all species are afflicted by a variety of renal disorders. Most naturally occurring animal kidney diseases have similar disorders found in people; where veterinary research is lacking, clinical management is often modified from standard of care in people. Veterinarians have become adept at scaling down procedures to safely perform them on dogs and cats weighing only a few kilograms. Advanced diagnostics (renal biopsy, cystoscopy, fluoroscopic studies, etc. ) and therapeutics (renal replacement therapy, interventional endourology, etc. ) are commonly performed within the practice of veterinary nephrology-urology. Collaboration between veterinary and human nephrologists may advance both disciplines and improve care for people and animals alike.

Sph2(176-191) and Sph2(446-459): Identification of B-Cell Linear Epitopes in Sphingomyelinase 2 (Sph2), Naturally Recognized by Patients Infected by Pathogenic Leptospires

Sphingomyelin is a major constituent of eukaryotic cell membranes, and if degraded by bacteria sphingomyelinases may contribute to the pathogenesis of infection. Among Leptospira spp., there are five sphingomyelinases exclusively expressed by pathogenic leptospires, in which Sph2 is expressed during natural infections, cytotoxic, and implicated in the leptospirosis hemorrhagic complications. Considering this and the lack of information about associations between Sph2 and leptospirosis severity, we use a combination of immunoinformatics approaches to identify its B-cell epitopes, evaluate their reactivity against samples from leptospirosis patients, and investigate the role of antibodies anti-Sph2 in protection against severe leptospirosis. Two B-cell epitopes, Sph2_(176-191) and Sph2_(446-459), were predicted in Sph2 from L. interrogans serovar Lai, presenting different levels of identity when compared with other pathogenic leptospires. These epitopes were recognized by about 40% of studied patients with a prevalence of IgG antibodies against both Sph2_(176-191) and Sph2_(446-459). Remarkably, just individuals with low reactivity to Sph2_(176-191) presented clinical complications, while high responders had only mild symptoms. Therefore, we identified two B-cell linear epitopes, recognized by antibodies of patients with leptospirosis, that could be further explored in the development of multi-epitope vaccines against leptospirosis.

Leptospirosis

Leptospirosis is a blood infection caused by the bacterium Leptospira. Signs and symptoms can range from none to mild (headaches, muscle pains, and fevers) to severe (bleeding in the lungs or meningitis). Weil's disease, the acute, severe form of leptospirosis, causes the infected individual to become jaundiced (skin and eyes become yellow), develop kidney failure, and bleed. Pulmonary hemorrhage in association with leptospirosis is known as "severe pulmonary haemorrhage syndrome". More than ten genetic types of Leptospira, which are a type of a spirochaete, cause disease in humans. Both wild and domestic animals can spread the disease, most commonly rodents. The bacteria are spread to humans through animal urine, or water and soil contaminated with animal urine, coming into contact with the eyes, mouth, nose or breaks in the skin. In developing countries, the disease occurs most commonly in farmers and low-income people who live in areas with poor sanitation. In developed countries, it occurs during heavy downpours and can affect those involved in outdoor activities in warm and wet areas. Diagnosis is typically by testing for antibodies against the bacteria or finding bacterial DNA in the blood. Efforts to prevent the disease include protective equipment to block contact when working with potentially infected animals, washing after contact, and reducing rodents in areas where people live and work. The antibiotic doxycycline is effective in preventing leptospirosis infection. Human vaccines are of limited usefulness; vaccines for other animals are more widely available. Treatment when infected is with antibiotics such as doxycycline, penicillin, or ceftriaxone. The overall risk of death is 5–10%. However, when the lungs are involved, the risk of death increases to the range of 50–70%. It is estimated that one million people worldwide are infected by leptospirosis every year, causing approximately 58,900 deaths. The disease is most common in tropical areas of the world but may occur anywhere. Outbreaks may arise after heavy rainfall. The disease was first described by physician Adolf Weil in 1886 in Germany. Infected animals may have no, mild or severe symptoms. These may vary by the type of animal. In some animals Leptospira live in the reproductive tract, leading to transmission during mating.

Detection and characterization of Leptospira spp. in dogs diagnosed with kidney and/or liver disease in Selangor, Malaysia

Leptospirosis is a serious bacterial disease that affects both humans and animals. A wide range of symptoms have been described in humans; the disease in dogs is commonly associated with kidney and/or liver disease. In Malaysia, information about the common serovars infecting dogs is limited. Therefore, we investigated the occurrences of leptospirosis in 124 pet dogs diagnosed with kidney and/or liver disease. Blood, urine, abdominal effusion, and/or kidney and liver were collected from the dogs. Based on microscopic agglutination testing, 53 of 124 (42.7%) dogs were seropositive for leptospiral exposure. Sera were frequently positive to serovars Bataviae (n = 12), Javanica (n = 10), and Icterohaemorrhagiae (n = 10). Direct detection using PCR showed that 42 of 124 (33.9%) of the whole blood and 36 of 113 (31.9%) urine samples were positive for pathogenic Leptospira spp. By PCR, 2 of 23 (9.1%) kidney and 2 of 23 (9.1%) liver were positive for pathogenic Leptospira spp. Abdominal effusion from 4 dogs were PCR-positive for pathogenic Leptospira spp. The species detected were L. interrogans, L. borgpetersenii, L. kirschneri, and L. kmetyi by partial 16S rRNA sequencing. We further identified and characterized 11 Leptospira spp. isolates from 8 dogs as serovars Bataviae, Javanica, and Australis. The mortality rate of the Leptospira-infected dogs was high (18 of 53; 34%).

Predictors of Fatal Pulmonary Haemorrhage in Dogs Affected by Leptospirosis Approaching Haemodialysis

A retrospective case control study, which aimed to evaluate potential clinical, laboratory and imaging predictors of fatal pulmonary haemorrhage in dogs with Leptospirosis submitted to haemodialysis. The study population was divided in two groups according to the presence (PH) or absence (nPH) of pulmonary haemorrhage. A statistical comparison was performed at hospital admission for clinical (spontaneous bleeding, icterus, and respiratory distress), laboratory (serum creatinine, urea, phosphate, calcium, bicarbonate, bilirubin, AST, ALT, ALKP, GGT, total protein, albumin, glycaemia, sodium, potassium, CRP, RBC, HCT, HGB, WBC, PLT, PT, aPTT, fibrinogen), and pulmonary radiographic findings between the two groups of dogs. At hospital admission, dogs developing pulmonary haemorrhage were more likely to have respiratory distress (p = 0.002), severely elevated serum bilirubin (p = 0.002), AST (p = 0.04), ALT (p = 0.012), ALKP (p = 0.002), reduced serum glycaemia (p = 0.014), and thrombocytopenia (p = 0.04). Respiratory distress and elevated serum bilirubin (≥11.5 mg/dL) were independently associated with increased risk of pulmonary haemorrhage. In conclusion, the presence of respiratory distress at hospital admission is strongly associated (OR 40.9) with increased risk of pulmonary haemorrhage, even though no abnormalities are found at chest radiography.

First report of fatal autochthonous angiostrongylosis in a dog in Greece

Canine angiostrongylosis caused by Angiostrongylus vasorum is a life-threatening disease which is emerging in regions of Europe. Thus, there is the merit for a continuous epidemiological surveillance in dog populations. This is the first description of a clinical autochthonous case of canine angiostrongylosis in Greece. A 7-month-old, male, mixed-breed dog was presented with progressively worsening anorexia, respiratory distress, coughing, bleeding diathesis and succumbed four days post admission. Gross post mortem examination revealed numerous nodular fistulated lesions in the lungs, and pulmonary cytology and histopathology showed a verminous pyogranulomatous pneumonia. The definitive diagnosis was based on the morphological identification of first stage larvae (L1) retrieved in the feces by the Baermann method, the detection of the circulating antigen by an in-clinic test and the molecular identification of L1. This report underlines the epidemiological and clinical implications, as well as the infection risks when the index of clinical suspicion is low and the disease is unexpected in a country.

Unusual case of polyarthritis and hepatorenal syndrome associated with Leptospira interrogans infection in a dog: A case report

Leptospirosis is a zoonotic disease caused by spirochetal bacterial of the genus Leptospira affecting virtually all mammals. The infection has a broad range of effects, from mild clinical manifestation to multiple organ failure, and ultimately death. A 5-months-old male unvaccinated dog was admitted to the University Veterinary Teaching Hospital presenting dullness, dehydration, jaundiced mucous, bloody diarrhea, vomiting, and hyporexia. Microscopic agglutination test (MAT) detected serological titers of 1:1.600 for serogroup Canicola. After five days of monitoring by the medical team he developed fever and swelling of carpal and tarsal joints, accompanied by functional limitation. Initial antimicrobial treatment was instituted for leptospirosis. Polyarthritis responsiveness to glucocorticoid therapy was observed through decreasing signs of inflammation of the affected joints. The diagnosis of leptospirosis was further confirmed by molecular investigation for Leptospira spp. on blood and synovial fluid samples. Amplification and sequencing of the secY partial gene characterized the infective bacterial as Leptospira interrogans. From the 7th day the respiratory condition worsened and on Day 14 the patient evolved to death, when necropsy and histological evaluation were performed. Prominent anatomopathological findings included: fibrinous polyarthritis, bronchointerstitial pneumonia, intense hepatocyte dissociation, cholestasis, and periportal multifocal hepatitis, diffuse acute tubular necrosis, and significant dystrophic mineralization in the renal parenchyma, lungs, and atrial endocardium. Here, we present a case report of systemic clinical manifestations polyarthritis associated with the presence of leptospiras in the synovial fluid. We highlight the need for richer knowledge about the different clinical manifestations of leptospirosis.

Interstitial lung diseases in dogs and cats part II: Known cause and other discrete forms

In addition to idiopathic interstitial pneumonias, interstitial lung diseases (ILDs) can occur secondary to known causes or be classified as discrete syndromes. Also known as diffuse parenchymal lung diseases, the ILDs represent a heterogenous group of non-infectious, non-neoplastic disorders characterized by varied patterns of inflammation and fibrosis. Characteristically associated with the true interstitium (i.e. the anatomic space lined by alveolar epithelial cells and capillary endothelial cells and the loose-binding connective tissue), it is important to understand ILDs are associated with pathology of the distal lung parenchyma and thus lesions can be bronchiolocentric or resemble alveolar filling disorders. Injury to the distal lung can occur via inhalation or hematogenous routes. This review will build on a proposed classification scheme adapted from human medicine to describe known cause and discrete forms of ILDs in dogs and cats.

MAT cross-reactions or vaccine cross-protection: retrospective study of 863 leptospirosis canine cases

Dogs are naturally exposed to numerous pathogenic serogroups. Leptospirosis vaccines are claimed to afford a clinical protection restricted to the serogroups of which they are composed.

Objectives

Dogs exhibiting liver and kidney injury were suspected of having leptospirosis. The purpose of this study was to compare the microscopic agglutination test (MAT) results in naive and vaccinated dogs experiencing leptospirosis outcomes. Only MAT-positive animals were included in the study.

Methods

Over five years, 3 512 dogs were suspected of having leptospirosis. For each case, biochemical parameter results were recorded. Leptospirosis involvement was investigated by MAT performed against 6 major serogroups (Icterohaemorrhagiae, Canicola, Australis, Autumnalis, Grippotyphosa and Sejroë). MAT-positive results confirmed leptospirosis cases in 147 naïve dogs and in 580 fully vaccinated dogs. Serological titres of agglutinating antibodies were related to the severity of liver and kidney failure.

Results

The most prevalent outcome of leptospirosis in unvaccinated dogs was liver failure (57.8%) compared to 51.7% for kidney disease, but the most severe onset (90.8%) was found among the cases of acute kidney injury compared to the severe (42.3%) hepatitis cases. In dogs vaccinated by bivalent Icterohaemorrhagiae and Canicola bacterins, hepatitis decreased from 57.8 to 46.5% and acute kidney injury from 51.7 to 21.6%. The decrease was shown in leptospirosis cases induced by field strains belonging to the six most prevalent serogroups, including the 4 serogroups heterologous to the vaccine.

Conclusion

Common vaccination was efficient in decreasing hepatitis and kidney failure induced by field Leptospira spp infection regardless of the MAT-prominent serogroup and limited the disease severity in the remaining cases.

Urinary shedding of pathogenic Leptospira in stray dogs and cats, Algiers: A prospective study

Background

Leptospirosis is an important worldwide zoonosis. This disease is caused by pathogenic species of the genus Leptospira which are maintained in the environment via chronic renal infection of carrier animals which can be asymptomatic excretors of the organisms in their urines and become a source of infection for humans and other hosts. The prevalence of animal leptospirosis in Algiers, Algeria, is unknown.

Methodology/principal findings

Real-time PCR and standard PCR and sequencing were used to detect pathogenic Leptospira organisms in the urines of stray dogs and cats in Algiers. In the presence of appropriate controls, none of the 107 cat urine samples were positive while 5/104 (4.8%) canine urine samples (asymptomatic mixed-breed dogs, three females and two males) were positive in two real-time PCR assays targeting the rrs and hsp genes. The positivity of these samples was confirmed by partial PCR-sequencing of the rpoB gene which yielded 100% sequence similarity with Leptospira interrogans reference sequence. In this study, L. interrogans prevalence was significantly higher in dogs aged < one year (16.46% - 29.41%) than in adults (0%) (P value = 0.0001) and then in the overall dog population (2.68% - 4.8%) (P = 0.0007).

Conclusions/significance

These results suggest that dogs are maintenance hosts for zoonotic leptospirosis in Algiers, Algeria. To face this situation, effective canine vaccination strategies and raising public health awareness are mandatory. Further investigations incorporating a larger sample in more localities will be undertaken to document the epidemiology of urban animal leptospirosis in Algeria at large.

Evaluation of a new chest physiotherapy technique in dogs with airway fluid accumulation hospitalized in an intensive care unit

OBJECTIVE

To evaluate the feasibility, benefits, and adverse effects of prolonged slow expiration (PSE) and assisted cough (AC) as chest physiotherapy (CP) techniques in dogs with airway fluid accumulation.

DESIGN

Prospective interventional study.

SETTINGS

University teaching hospital.

ANIMALS

Intervention group of 30 client-owned dogs and retrospective control group of 71 client-owned dogs.

INTERVENTIONS

PSE was performed on dogs with evidence of airway fluid accumulation, identified based on physical examination and thoracic radiographs. AC was performed if spontaneous cough or swallowing were not evident. The PSE treatment was performed every 6 hours until normalization of respiratory status or hospital discharge. Animals were monitored for respiratory distress, discomfort, and SpO₂ during the procedure. A retrospective control group was identified by computer search.

MEASUREMENTS AND MAIN RESULTS

One hundred thirty-three sessions of CP were performed on 30 dogs. Discomfort frequency during physiotherapy was low (9%). The most commonly used position for CP was in lateral recumbency (95%) and this was well tolerated in most cases. There was no significant difference in the median SpO₂ before and after CP sessions (P = 0.24). Sixty percent of sessions had a spontaneous cough or swallowing evident, 21% had successful AC performed, and no cough or swallowing occurred in the remaining (19%) sessions despite attempts of AC being made. The length of hospitalization was significantly longer in the intervention group (6 days vs 4) (P = 0.02). There was no difference in survival between the intervention (76.7%) and the control (57.7%) group (P = 0.055).

CONCLUSIONS

PSE associated with AC are easily adaptable, well-tolerated techniques in dogs. The benefit of CP in dogs with airway fluid accumulation remains to be determined and it is hoped that future randomized controlled prospective studies may help answer this line of inquiry.

Isolation and characterization of Leptospira interrogans serovar Copenhageni from a dog from Saint Kitts

Introduction. Leptospirosis is a zoonotic bacterial disease of global distribution affecting humans and animals. The initial phase of leptospirosis resembles many other febrile illness and due to its broad and biphasic clinical manifestations, selection and implementation of appropriate diagnostic tests can be challenging.

Case presentation. This report describes a case investigation of a 14 weeks old male, orphan puppy, presented with generalised jaundice, anemia, weakness, and anorexia. Clinical abnormalities included the evidence of renal and hepatic failure. Antemortem and postmortem diagnostic investigations were conducted to identify the cause of illness. PCR testing and culture of blood was positive for Leptospira sp. Necropsy followed by histopathology evaluation revealed lesions compatible with liver and kidney damage consisting of marked diffuse hepatocellular dissociation, acute renal tubular necrosis, and mild interstitial nephritis.

Conclusion. Multiple diagnostic techniques including bacterial isolation confirmed Leptospira infection in this puppy. Whole genome sequencing and analysis identified the Leptospira sp. isolated from this puppy as Leptospira interrogans serovar Copenhageni. To our knowledge, this case report describes the first isolation of Leptospira from Saint Kitts. This case highlights the usefulness of including multiple diagnostic tests for the diagnosis and epidemiological investigation of Leptospira infection. Accurate diagnosis followed by timely intervention can prevent case fatality and mortality in infected patients.

Expression Profile of Cytokines and Enzymes mRNA in Blood Leukocytes of Dogs with Leptospirosis and Its Associated Pulmonary Hemorrhage Syndrome

Background

Dogs with leptospirosis show similar organ manifestations and disease course as human patients, including acute kidney injury and pulmonary hemorrhage, making this naturally-occurring infection a good animal model for human leptospirosis. Expression patterns of cytokines and enzymes have been correlated with disease manifestations and clinical outcome in humans and animals. The aim of this study was to describe mRNA expression of pro- and anti-inflammatory mediators in canine leptospirosis and to compare it with other renal diseases to identify patterns characterizing the disease and especially its pulmonary form.

Methodology and Principal Findings

The mRNA abundance of cytokines (IL-1α, IL-1β, IL-8, IL-10, TNF-α, TGF-β) and enzymes (5-LO, iNOS) was measured prospectively in blood leukocytes from 34 dogs with severe leptospirosis and acute kidney injury, including 22 dogs with leptospirosis-associated pulmonary hemorrhages. Dogs with leptospirosis were compared to 14 dogs with acute kidney injury of other origin than leptospirosis, 8 dogs with chronic kidney disease, and 10 healthy control dogs. Canine leptospirosis was characterized by high 5-LO and low TNF-α expression compared to other causes of acute kidney injury, although the decreased TNF-α expression was also seen in chronic kidney disease. Leptospirosis-associated pulmonary hemorrhage was not characterized by a specific pattern, with only mild changes noted, including increased IL-10 and decreased 5-LO expression on some days in affected dogs. Fatal outcome from pulmonary hemorrhages was associated with low TNF-α, high IL-1β, and high iNOS expression, a pattern possibly expressed also in dogs with other forms of acute kidney injury.

Conclusion

The patterns of cytokine and enzyme expression observed in the present study indicate a complex pro- and anti-inflammatory response to the infection with leptospires. The recognition of these signatures may be of diagnostic and prognostic relevance for affected individuals and they may indicate options for newer therapies targeting the identified pathways.

European consensus statement on leptospirosis in dogs and cats

Leptospirosis is a zoonotic disease with a worldwide distribution affecting most mammalian species. Clinical leptospirosis is common in dogs but appears to be rare in cats. Both dogs and cats, however, can shed leptospires in the urine. This is problematic as it can lead to exposure of humans. The control of leptospirosis, therefore, is important not only from an animal but also from a public health perspective. The aim of this consensus statement is to raise awareness of leptospirosis and to outline the current knowledge on the epidemiology, clinical features, diagnostic tools, prevention and treatment measures relevant to canine and feline leptospirosis in Europe.

Recent advances in canine leptospirosis: focus on vaccine development

Leptospirosis is a global infection of humans and animals caused by pathogenic Leptospira spp. Leptospirosis is a major zoonosis, with infection acquired from wild and domestic animals. It is also a significant cause of morbidity, mortality, and economic loss in production and companion animals. Leptospirosis in dogs is prevalent worldwide and as well as a cause of canine disease, it presents a zoonotic risk to human contacts. Canine leptospirosis does not differ greatly from the syndromes seen in other animal species, with hepatic, renal, and pulmonary involvement being the main manifestations. While the pathogenesis of disease is well documented at the whole animal level, the cellular and molecular basis remains obscure. Killed, whole-cell bacterin vaccines are licensed worldwide and have not changed greatly over the past several decades. Vaccine-induced immunity is restricted to serologically related serovars and is generally short-lived, necessitating annual revaccination. The appearance of new serovars as causes of canine leptospirosis requires constant epidemiological surveillance and tailoring of vaccines to cover emerging serovars. At the present time, there is no realistic prospect of alternative, non-bacterin vaccines in the foreseeable future.

Biology and Diseases of Dogs

Historically, the dog played an important role as a laboratory animal in biomedical research. Although numbers are declining, the use of dogs continues to be common in pharmacokinetics and cardiovascular studies. The normal biology of the dog as both a laboratory and a companion animal has been well studied and reference values are presented here as a clinical and experimental resource. This provides the necessary background to discuss the spontaneous diseases, including infectious and neoplastic conditions, prevalent in purpose bred as well as random source dogs used in biomedical research. In addition, diseases and conditions that arise secondary to the housing and experimental manipulation of dogs is discussed with emphasis on treatment and prevention.

Recombinant antigens rLipL21, rLoa22, rLipL32 and rLigACon4-8 for serological diagnosis of leptospirosis by enzyme-linked immunosorbent assays in dogs

Animal leptospirosis is one of the most common zoonotic diseases in the United States and around the world. In a previous study, we applied four recombinant antigens, rLipL21, rLoa22, rLipL32 and rLigACon4-8 of Leptospira interrogans (L. interrogans) for the serological diagnosis of equine leptospirosis (Ye et al, Serodiagnosis of equine leptospirosis by ELISA using four recombinant protein markers, Clin. Vaccine. Immunol. 21:478–483). In this study, the same four recombinant antigens were evaluated for their potential to diagnose canine leptospirosis by ELISA. A total of 305 canine sera that were Leptospira microscopic agglutination test (MAT)-negative (n = 102) and MAT-positive (n = 203) to 5 serovars (Pomona, Grippotyphosa, Icterohaemorrhagiae, Canicola and Hardjo) were tested. When individual recombinant antigens were used, the sensitivity and specificity of ELISA were 97.5% and 84.3% for rLigACon4-8; 89.7% and 81.4% for rLoa22; 92.6% and 84.3% for rLipL32 and 99.5% and 84.3% for rLipL21, respectively compared to the MAT. The sensitivity and specificity of ELISA were, 92.6% and 91.2% for rLigACon4-8 and rLipL32, 97.5% and 84.3% for rLigACon4-8 and rLipL21, 89.7% and 87.3% for rLigACon4-8 and rLoa22, 89.7% and 87.3% to rLipL21 and rLoa22, 92.6% and 91.2% for rLipL21 and rLipL32 and 89.2% and 94.1% for rLoa22 and rLipL32 when one of the two antigens was test positive. The use of all four antigens in the ELISA assay was found to be sensitive and specific, easy to perform, and agreed with the results of the standard Leptospira Microscopic Agglutination test (MAT) for the diagnosis of canine leptospirosis.

[Leptospirosis with necro-haemorrhagic cholecystitis in a Boxer puppy]

A Boxer puppy from the island of Rügen, which was properly vaccinated according to its age, was presented with acute gastrointestinal symptoms. The presumptive diagnosis of leptospirosis with acute renal failure, hepatic damage, and jaundice was confirmed by seroconversion (increased titre to 1 : 800 in a non-vaccine serogroup 4 weeks after disease onset). Cholecystitis was diagnosed based on clinical symptoms and sonographic results. After an initial improvement, the puppy's condition deteriorated and cholecystectomy was performed. Histopathological diagnosis indicated a haemorrhagic necrotizing cholecystitis.

Diagnostic features in 10 naturally occurring cases of acute fatal canine leptospirosis

The current report describes the diagnostic features in 10 cases of acute fatal canine leptospirosis with minimal renal and hepatic changes that may present a diagnostic challenge for the pathologist. Most affected dogs were less than 6 months of age and had a biochemical profile consistent with hepatorenal dysfunction. Clinical signs consisted of vomiting, depression, icterus, dehydration, diarrhea, and anorexia. All dogs died or were humanely euthanized within 3–7 days after the onset of clinical disease. Necropsy findings included pulmonary edema with hemorrhages, icterus, renal and hepatic pallor and swelling, and gastric edema with hemorrhage. Despite severe azotemia, histological changes in the kidneys were subtle in all dogs, and included mild renal tubular simplification, with single-cell necrosis and attenuation, along with minimal interstitial lymphoplasmacytic inflammation, edema, and hemorrhage. Hepatic lesions included scattered hepatocellular single-cell necrosis and hepatocellular dissociation. Prominent extrarenal lesions typically associated with uremia including vascular fibrinoid necrosis in multiple organs, pulmonary mineralization with occasional fibrinosuppurative exudation, and gastric mineralization were also present. Postmortem diagnostic confirmation was based on the detection of leptospiral antigen on fresh renal samples by fluorescent antibody test and on the demonstration of intact spirochetes in sections of kidneys using immunohistochemical staining. Acute fatal canine leptospirosis occurred as a fulminant hepatorenal disease affecting mainly young dogs, and the diagnosis was dependent on the recognition of the subtle renal changes with confirmation via fluorescent antibody testing or immunohistochemical staining.

Increasing incidence of canine leptospirosis in Switzerland

A marked increase in canine leptospirosis was observed in Switzerland over 10 years with a peak incidence of 28.1 diagnosed cases/100,000 dogs/year in the most affected canton. With 95% affected dogs living at altitudes <800 m, the disease presented a seasonal pattern associated with temperature (r² 0.73) and rainfall (r² 0.39), >90% cases being diagnosed between May and October. The increasing yearly incidence however was only weakly correlated with climatic data including number of summer (r² 0.25) or rainy days (r² 0.38). Serovars Australis and Bratislava showed the highest seropositivity rates with 70.5% and 69.1%, respectively. Main clinical manifestations included renal (99.6%), pulmonary (76.7%), hepatic (26.0%), and hemorrhagic syndromes (18.2%), leading to a high mortality rate (43.3%). Similar to the human disease, liver involvement had the strongest association with negative outcome (OR 16.3). Based on these data, canine leptospirosis presents similar features and severity as the human infection for which it therefore can be considered a model. Its re-emergence in a temperate country with very high incidence rates in canines should thus be viewed as a warning and emphasize the need for increased awareness in other species.

Pulmonary abnormalities in dogs with renal azotemia

BACKGROUND

Clinical signs associated with respiratory tract disease are regularly encountered in people with kidney failure, and have been anecdotally reported in dogs.

OBJECTIVES

To compare clinical signs indicative of pulmonary disease, clinicopathologic findings, radiographic abnormalities, and histologic findings in dogs with acute kidney injury (AKI) or International Renal Interest Society Stage 3 or 4 chronic kidney disease (CKD) to nonazotemic dogs. To determine associations between abnormalities indicative of pulmonary disease and outcome in azotemic dogs.

ANIMALS

One hundred sixty-seven pet dogs (54 AKI dogs, 50 CKD dogs, 63 nonazotemic control dogs diagnosed with intracranial disease).

METHODS

Retrospective cohort study comparing signalment, clinical signs, clinicopathologic variables, prevalence, and severity of pulmonary radiographic patterns, histopathologic findings, and survival times in AKI, CKD, and control dogs.

RESULTS

Clinical signs of pulmonary disease were significantly more common in AKI dogs. Prevalence of an alveolar lung pattern was greater in AKI and CKD dogs. Alveolar mineralization was the most common pulmonary histologic lesion in AKI dogs (6 of 8 dogs), with concurrent alveolar concretions or mineralization of pulmonary vessels or bronchioles noted in 1 dog each; mineralization of lung tissues was not noted in control dogs. Neither clinical signs nor presence of an alveolar pattern were associated with likelihood of survival to discharge or median number of days from discharge until death.

CONCLUSIONS AND CLINICAL IMPORTANCE

Abnormalities indicative of pulmonary disease are more common in azotemic dogs than in control dogs; however, prognosis is not associated with presence of clinical or radiographic pulmonary dysfunction.

Structural analysis of the Leptospiral sphingomyelinases: in silico and experimental evaluation of Sph2 as an Mg-dependent sphingomyelinase

BACKGROUND

Leptospiral sphingomyelinases are candidate virulence factors present only in pathogenic Leptospira spp. Leptospira interrogans serovar Lai encodes Sph1, Sph2, Sph3, Sph4 and SphH. Except for Sph4, they all possess the exo-endo-phosphatase domain that groups them under the DNase I superfamily.

METHODS, RESULTS AND CONCLUSIONS

Modeling of exo-endo-phosphatase domains reveals high-level structural similarity of Sph2 with the crystal structure of SmcL and BC SMase sphingomyelinases from Listeria ivanovii and Bacillus cereus, respectively. A β-hairpin loop, essential for host cell membrane interaction, is absent in leptospiral sphingomyelinases. Instead, several aromatic amino acids were oriented outward from the surface of these molecules and formed clusters of hydrophobic regions that possibly enables the anchoring of these molecules into the host cell membrane, as demonstrated in Sph2 and Sph3. Sph2 is unique and possesses the Mg(++)-binding Glu53 residue in the metal-binding site and two His residues (His151 and His286) in the catalytic site. We demonstrate experimentally the Mg(++)-dependent hemolysis of erythrocytes by rSph2 and its ability to cleave sphingomyelin to ceramide. Anti-Sph2 antibodies neutralized the hemolytic activity of Sph2. In conclusion, we provide evidence showing that Sph2 is a Mg(++)-dependent hemolysin with both sphingomyelinase and hemolytic activities.