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Small Animal Medicine > Infectious Dz - Lepto > Flashcards

Infectious Dz - Lepto Flashcards

1
Q

What type of bacteria is Leptospira?

A

a gram negative spirochete

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2
Q

What are the two main pathogenic Leptospira species in dogs?

A

L. interrogans and L. kirschneri

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3
Q

What are the specific reservoir hosts for Leptospires?

A

Rats, mice, muskrats, opossums, and squirrels

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4
Q

What can kill Leptospira?

A

frost, disinfectants, and UV radiation

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5
Q

Where can Leptospira survive for long periods of time?

A

water and wet soil

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6
Q

True or False: Seasonality of Leptospirosis outbreaks are associated with rainfall

A

True

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7
Q

Where is Leptospirosis distributeed?

A

Across the US but here are high incidences around the great lakes, in the Mississippi and Ohio river valley

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8
Q

When do Leptospirosis outbreaks most commonly occur?

A

In the fall

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9
Q

How does infection with Leptospirosis happen?

A

Infection is by ingestion or contact with contaminated water/urine
also transplacental and venereal

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10
Q

What is the rout of entry of Leptospira?

A

intact mucosal surfaces or skin abrasions

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11
Q

In a recent study, what dogs have the highest prevalence of Leptospirosis?

A

In dogs less than 15 pounds

Yorkies are the highest prevalence breed

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12
Q

Bottom line, what dogs can get Leptospirosis?

A

Any dog

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13
Q

Explain the infection timeline of Leptospirosis?

A

Day 0 - mucosal penetration, multiplication in vasculature
Day 3-4 - Multiplication
Day 5-6 - Vascular damage and thrombocytopenia
Day 7-8 - Clinical disease
Day 10 - Antibody titer increases
Day 12 - renal colonization
Day 14-15 - Leptospiruria

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14
Q

What clinical feature is often overlooked in patients with Leptospirosis?

A

a transient fever

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15
Q

What other clinical features do patients with Leptospirosis have?

A 
Renal injury (50-80%)
Hepatic injury (14-47%)
Lung injury (2%)
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16
Q

What clinical signs are associated with Leptospirosis?

A

PU/PD, uremia, icterus, tachypnea, cough, harsh lung sounds, uveitis and bleeding tendencies

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17
Q

How can you diagnose Leptospirosis?

A

Minimum database, coagulation panel, imaging, dark field microscopy, culture, PCR, and serology

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18
Q

What will you find on minimum database in patients with Leptospirosis?

A

Thrombocytopenia, azotemia, increased ALT/ALP, hyperbilirubinemia, and signs of tubular damage (glucosuria and proteinuria)

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19
Q

What may you find on a coagulation panel in patients with Leptospirosis?

A

Increased PT/PTT

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20
Q

What may you see on thoracic radiographs in patients with Leptospirosis?

A

Interstitial to nodular pattern

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21
Q

What may you see on ultrasound in patients with Leptospirosis?

A

Perirenal, abdominal fluid, pyelectasia, and hepatic changes

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22
Q

Why would you want to use dark-field microscopy to diagnose Leptospirosis?

A

To examine live organisms in urine

23
Q

Why is culture not commonly performed to diagnosis Leptospirosis?

A

because it is a long process

24
Q

What does PCR detect?

A

DNA of the organism

25
Q

Why would you want to do PCR for Leptospirosis diagnosis?

A

because it can allow for an earlier diagnosis over serology

26
Q

Does a negative PCR result rule out Leptospirosis?

A

no

27
Q

What can cause a false-negative Leptospirosis?

A

Administration of 1-2 doses of antibiotics

28
Q

What serologic tests can be done to diagnose Leptospirosis?

A

Microscopic agglutination test (MAT), SNAP Lepto, and Witness Lepto

29
Q

What does the Microscopic Agglutination Test based on?

A

Agglutination of live cultures in contact with serial dilutions of the patients serum

30
Q

What is a positive MAT result?

A

Titer of >1:1600 or 4-fold increase in convalescent antibody titers

31
Q

What should always be done if you chose MAT to diagnose Leptospirosis?

A

You always need to do a convalescent titer (second titer) with >10-14 days in between

32
Q

What can cause false positives in a MAT test?

A

previous exposure and vaccination

33
Q

What can cause false positives in a MAT test?

A

Serovar not included on the test panel and early testing

34
Q

What does SNAP Lepto detect?

A

LipL32 proteins

35
Q

Can vaccination affect SNAP Lepto results?

A

yes - cross reactions with vaccine antibodies is reported in 24% of cases

36
Q

If a patient has Leptospirosis, why can they get a negative SNAP Lepto result?

A

because it is early in the infection

37
Q

What does Witness Lepto detect?

A

IgM antibodies against whole-cell extracts

38
Q

Does Witness Lepto cross-react with vaccination?

A

It can, but it is less likely

39
Q

If a patient has Leptospirosis, why can they get a negative Witness Lepto result?

A

because it is early on in the infection

40
Q

How long can vaccination titers persist in patients?

A

up to 1 year post vaccination

41
Q

Which test is the best one?

A

Each test has its own advantages/disadvantages

Consider using a combination of tests as well as your clinical assessment

42
Q

What is the gold standard treatment for leptospirosis?

A

Doxycycline for 2 weeks

43
Q

Aside from doxy, what is used to treat leptospirosis?

A

Ampicillin/amoxicillin

44
Q

Why would you want to use Ampicillin/amoxicillin?

A

it clears bacteremia

45
Q

What is the prognosis for Leptospirosis?

A

Good if treatment is initiated early - antibiotics, IV fluids, and supportive care

46
Q

What serovars are there Lepto vaccines for?

A

Icterohemorrhagiae, canicola, grippotyphosa, and pomona

47
Q

Ideally, when should a Lepto vaccine be performed?

A

a few months prior

48
Q

What is the efficacy of the Lepto vaccine?

A

It has been shown to decrease shedding and protect against disease when challenged with vaccinated serovar

49
Q

What are the public health risks with Leptospirosis?

A

It is zoonotic - special precautions should be taken with all dogs with AKI or acute hepatopathy of unknown etiology

50
Q

What precautions can be taken when dealing with a patient with suspect Leptospirosis?

A

Inform clients and personnel
Wear gloves at all times
Disinfect urine and sides of urination with iodine or bleach
Have designated areas for Lepto patients

51
Q

Can cats get Leptospirosis? How?

A

Infection is possible by ingestion of prey and contact with infected dogs

52
Q

In most cases, cat infection is _______.

A

subclinical

53
Q

Is vaccination in cats recommended?

A

no

Small Animal Medicine (100 decks)

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