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Leptospirosis (again! - sorry!)

3K views 14 replies 9 participants last post by  Mr Chi 
#1 ·
I found some good threads on this but I have a bit of a dilema. Winston's parents were vaccinated and this included the lepto shot. Winston is having his first shots tommorow and the vet was talking through the vaccinations he gives. This was last week when we were talking. I recently found the "dangers of leto shot" thread and phoned the surgery. He's happy to talk it over with me, he said bring along the thread so he can have a read. It was a bit too sciency for me so I was wondering how many people pass up what seems to be a very neccessary vaccination??!! I really dont know what to do about it! From what I can gather the problem stems from a reaction to the vaccine? If his parents were done I'm assuming the chances of complications are low. The vet lives above the surgery and said he would be happy to be on call any time if I was worried after the shots, but he was very confident that the course they use is very good. I've been with them with my other pets, but as this is a whole new ball park I find myself wavering. Please, any comments?
 
#2 ·
#5 ·
Oh dear :( This is the worst situation. I'm in the UK and dont need the rabies shot or heartworm or lyme disease shot....but what would you say is a high risk area? I see its carried by rats etc...the main thing is as chis seems to eat and lick every mucky thing they can find on their travels I just assumed it was important as it could be anywhere, although after what you've said I am really worried and confused. I obviously dont want him to come to harm, but oh I dont know. :( Thanks for your advice, I will talk through with the vet, I'm putting off his shots, this is all too confusing at the moment.
 
#6 ·
The person I got Chico from gave me a little paaper when i got Chico. it was a list of the very first vaccines chico had gotten and on there it said he got the "lepto" shot. Chico is just fine, but if the lepto shot has to be given yearly i'm not going to have him get it again...not taking any chances after reading up on what it can do to chi;s.
 
#7 ·
I too had read the article about lepto and discussed it with my vet. He told me because we live in a high risk area and have rats and mice (we live in a rural area). My other dogs and cats often kill them them and leave the bodies. My vet advised me that the risk to Pearl contracting lepto was much greater than the risk of a reaction. I nervously consented, and Pearl did fine with the shot.
 
#9 ·
i'm torn about this since there have been numerous cases in jersey lately. then again chiwi is such a spoiled royal diva she don't touch ground except my yard and even the she lays flat and won't move. so even though i take her places like parks and such she is always in my arms. but it is scarey. i worked in a vets office and this dog i had to clean up and take care of came back with a lepto positive test and even though i washed my hands after taking care of the dog, i had to get myself tested as well.....
 
#10 ·
When I have to make a decision like this, the first thing I want to know is how treatable is the disease itself.

The article says lepto is treated with anti-biotics. But, so is something serious like Parvo and something simple like a mild infection.

So, maybe someone could explain exactly what a dog goes through when they contract lepto?
 
#11 ·
Frasier's Mommy said:
When I have to make a decision like this, the first thing I want to know is how treatable is the disease itself.

The article says lepto is treated with anti-biotics. But, so is something serious like Parvo and something simple like a mild infection.

So, maybe someone could explain exactly what a dog goes through when they contract lepto?
here's what i found for ya:

Dogs become infected by leptospires when abraded skin comes into contact with the urine of an infected host. The organisms quickly spread through the bloodstream leading to fever, joint pain, and general malaise which can last up to a week. The organism settles in the kidneys and begins to reproduce, leading to further inflammation and then kidney failure. Depending on the type of leptospire involved, other organ failure (especially liver) can be expected as well. Make no mistake, leptospirosis is a life-threatening disease.

TYPICAL SYMPTOMS: Fever, depression, loss of appetite, joint pain, nausea, excessive drinking, jaundice, excess bleeding brought on by low platelet count.

PEOPLE CAN BECOME INFECTED, TOO!

The infection in humans
As the Centers for Disease Control and Prevention monitor leptospirosis cases in people it seems that one third come from contact with infected dogs and one third come from contact with rats (usually through field work). The same disease symptoms occur in humans as would be seen in a canine infection.

About the Organism
The species Leptospira interrogans has been classified into subtypes called SEROVARS. Over 200 serovars have been named.

Testing
Blood testing to detect antibodies against Leptospira interrogans (“microscopic agglutination testing”) can be performed. While a value of 1:800 or higher is supportive of a positive diagnosis, confirmation is not made until a second antibody level ( called a titer) is run between 2 & 4 weeks and shows a four fold increase. Vaccination may interfere with testing since obviously the entire point of vaccination is to generate antibodies. If the dog has been vaccinated in the last 3 months, testing will be difficult to interpret; however, a single titer of 1:800 or higher against a serovar for which there is no vaccine is considered a positive result. The PCR test, which amplifies small amounts of DNA, would be an excellent test if vaccination has been recent but PCR testing is not available in most reference laboratories.

Urine may be submitted for what is called Darkfield Microscopy. In this test, a dark background may offset the paler leptospire organisms rendering them visible. This sounds like a good way to make the diagnosis but the problems are

the urine sample must be fresh and most animal hospitals do not have the capability to do dark field microscopy

Leptospires are only shed in urine intermittently.
The kidney may be biopsied and special tissue stains may be used to detect leptospire organisms. Obviously this is an invasive procedure.

Treatment
Fortunately, Leptospira interrogans is sensitive to penicillin, a readily available antibiotic. After penicillin has been used to stop leptospire reproduction and limit bloodstream infection, tetracycline derivatives are used to clear leptospires from the kidneys. Since tetracyclines and penicillins are not a good concurrent combination, often a combination of a penicilin with a fluroquinolone type antibiotic (such as enrofloxacin) is used to cover both phases of the infection.

Intravenous fluids are crucial to support blood flow through the damaged kidneys so that recovery is possible. Any areas at home that have been contaminated with urine should be disinfected with an iodine based product and gloves should be warn in cleaning up any urine. Prognosis is guarded depending on the extent of organ damage.

HEMODIALYSIS? In a recent study from the University of California at Davis (JAVMA, Vol 216, No3, p271-5) dogs judged as having “mild to moderate” increases in renal parameters received traditional fluid therapy and 82% survived. Dogs having “moderate to severe” elevations tended to receive hemodialysis. Prognosis was worse for the severely affected that did not receive hemodialysis, while 86% of those receiving hemodialysis survived. In short, dogs with the most severe renal toxin build up probably need referral to a critical care facility that supports hemodialysis.

SO WHAT CONSISTITUTES A “MODERATE TO SEVERE” TOXIN BUILD UP? The parameters measured in the assessment of kidney function are called “BUN” (blood urea nitrogen - with normal levels around 25 mg/dl) and “creatinine” (normal levels less than 2.0 mg/dl). In the above study, the group termed “mild to moderate” had an initial BUN level ranging from 24 to 225 mg/dl and initial creatinine levels between 1.7 and 11.5 mg/dl. Again, 82% of these dogs survived with only traditional fluid therapy as can be performed in most veterinary practices. The “moderate to severe” group had initial BUN levels ranging from 97 to 365 mg/dl and initial creatinine levels ranging from 6.5-21.9 mg/dl. Obviously, there is some overlap.

VACCINATION REACTIONS ARE COMMON!

Vaccination options
Vaccination against Leptospira interrogans is only available for the serovars called canicola, grippotyphosa, pomona and icterohaemorragiae.. As a result of long standing use of this vaccine, it is hard to assess how important it is to vaccinate against leptospirosis. (As you might imagine, most recent outbreaks involve serovars for which vaccination does not exist.)

Vaccination against the four serovars mentioned is commonly included in the basic distemper shot (DHLPP - the “L” stands for “leptospirosis”). The vaccine can be made up to omit the leptospirosis portion. Of all the sera in this basic vaccine, it seems to be the leptospirosis portion that is associated with hives, facial swelling, and even life-threatening vaccination reactions much more than any of the other fractions. If there is any question of an animal having a vaccine reaction, leptospirosis vaccine is left out of the mix.

Vaccination will reduce the severity of disease but will not prevent infected dogs from becoming carriers.
 
#12 ·
Wow! Great article.

Cliff Notes by Nate for anyone who is ADD like me and can't get through the whole thing:

Leptospirosis is a family of bacteria that can infect pretty much all types of animals and humans by having an open wound contact an infected animal's urine, and less likely, by bite wounds and eating material from an infected animal . Vaccinated animals can also be carriers for short periods and shed the bacteria in their urine.

In the US, Florida, Alabama, Georgia, Massachusetts, Michigan, New Jersey, and New York have had outbreaks, but other states like California have also seen a few cases.

4-12 days following infection usually the dog has moderate fever, depression, vomiting, loss of appetite, and general pain.

Within 2 days body temperature may drop suddenly and signs of kidney failure begin including: urine color change, frequent urination, dehydration, frequent drinking.

In severe cases, difficulty breathing, muscular tremors, bloody vomit and feces are observed as the the liver and GI tract are affected. The severity of the symptoms does depend on which strain of Leptospirosis bacteria the animal was infected with, but often they are infected with multiple strains. Fun huh?

How do they test for lepto?
Initial blood tests will show signs of kidney and liver failure. If they suspect lepto, they will test the urine for the bacteria, test the blood serum or take a liver biopsy. Usually they will do more than one test or repeat tests if possible in case they recieve a false positive or false negative.

How do they treat lepto? Antibiotics to treat the infection, fluids to treat the kidney disease, and sometimes transfusions to compensate for liver failure. This works very well, and it is important the animal is in isolation. Only about 10% or less of the dogs that contract lepto die, and usually they are very young or very old and do not recieve prompt medical attention.

Should you vaccinate for lepto? The controversey has to do with 4 things:
1. Many dogs are allergic to the carrier in the lepto vaccine, it is the most common vaccine to cause of sudden life threatening allergic reaction.
2. It's only protecting against SOME bacteria. At most, the vaccine only protects against 4 strains (serovars) of Lepto bacteria. Usually animals are infected with multiple serovars, and although these 4 are the most common, it's far from ideal.
3. The vaccine gives a false sense of security to owners. Dogs who are vaccinated are very likely to still be infected, although the severity is reduced, during this time they shed the bacteria in their urine, making any animals and humans around them susceptible.
4. Duration sucks! The vaccine only lasts 6-8 months. This is twice a year, my dog could have an anaphylactic reaction.

Vets in high-risk areas have probably seen too many cases of lepto to not recommend the vaccine. Vets in low-risk areas have seen too few cases and heard of too many vaccine reactions to even give it a thought. In all situations their job is to weigh the pros and cons and do what is best for the animal.

For me personally, with Ritz going to Michigan, I will begin heartworm meds, but will not vaccinate for Lepto. He will be indoors most of the time and I will check his paws for open wounds before walking him. I've seen too many reports of allergic reaction to the vaccination to subject him to it. The math doesn't make sense to me: if 20-30% of dogs have allergic reactions (many of these fatal) to the vaccine, and less than 10% die from the infection itself, then Ritz has a better chance of living without the vaccine. I can decrease his risk of infection better by making sure his environment is clean, he doesn't walk with open sores, and he doesn't swim.

Hope that helps!
-Nate
 
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