Most of the dogs with leptospirosis in southern Germany had sera reacting to serogroups other than icterohaemorrhagiae and canicola, which are contained in the vaccine. Thus, currently available vaccines in Europe do not protect against the most common Leptospira organisms associated with clinical disease.

A 5-month-old 1.8 kg (4 lb) female domestic short hair cat was examined for a 1-month history of generalized pain. A sibling of the cat in the same household was healthy and had a weight of 2.6 kg. Both cats had been adopted as strays 3 months before examination and were fed a commercial kitten food. The cat was examined by the referring veterinarian with generalized pain, a history of increasing reluctance to move, and intestinal constipation 3 days before initial presentation. The cat was treated with meloxicam, which only mildly improved its activity, and with lactulose and a sodium chloride enema to relieve constipation. The referring veterinarian noted reduced skeletal mineralization in a radiograph, and a serum biochemistry profile revealed hypocalcemia (total calcium 1.12 mmol/L; reference range 1. 46-3.16 On examination, the cat appeared growth retarded in comparison with its littermate, was lethargic, and moved only little. Touching and manipulating the vertebral column and the tail elicited a pain response. Inspection of the oral cavity revealed healthy deciduous teeth, but no evidence of second dentition. Nutritional condition and appetite were good, but defecation appeared to be painful. Radiographs were repeated and verified skeletal demineralization and abnormally wide growth plates of the long bones (Fig 1). The ionized calcium was low 0.69 (reference range 1.20-1.35 mmol/L). Test results for feline leukemia virus antigen and antibodies to feline immunodeficiency virus were negative. Urinalysis (cystocentesis) revealed a specific gravity of 1.034, traces of protein, and pyuria. On urine culture, no bacterial growth was detected.On the day after initial examination, the cat developed seizures caused by hypocalcemia. The cat was administered calcium gluconate 10% (1 mL/kg) slowly IV. This was continously montitored by ECG, and no arrhythmias were detected. The cat received a constant rate IV infusion of fentanyl (5 mg/kg/h). Because the cat had pyuria, amoxicillin/clavulanic acid was administered. Starting on Day 2, the cat received calcium gluconate (50 mg/kg PO q 24h). Ionized calcium concentrations were regularly rechecked but stayed low (0.69-0.79 mmol/L; reference range 1.2-1.35 mmol/L) despite PO calcium administration. The cat had no further seizures anymore and the pain improved.Hypocalcemia, hyperphosphatemia, and the skeletal abnormalities were indicative of rickets, which can develop after prolonged feeding of a diet deficient in calcium or vitamin D. Because the cats cannot synthesize vitamin D in the skin, exposure to sunlight does not contribute to vitamin D supply.1 A board-certified nutritionist was consulted and evaluated the food for calcium, phosphorus, and vitamin D concentration and considered the commercial diet to be well balanced. Because the sibling of the patient received the same food and showed no signs, nutritional deficiency seemed highly unlikely. Parathyroid hormone, measured in stabilized serum, was high (1,091 pg/mL, reference range 3-24 pg/mL). Total thyroxine (T...

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A 9-year-old female neutered domestic shorthair cat diagnosed with immune-mediated thrombocytopenia that was treated with prednisolone and cyclosporine, was presented for anorexia, vomiting, increased liver enzymes, and hyperbilirubinemia. Abdominal ultrasound revealed a markedly thickened gallbladder and common bile duct wall. Bile cytology detected severe neutrophilic inflammation and protozoal zoites. Suspected Toxoplasma gondii infection was confirmed by real-time PCR of bile. The cat was treated with clindamycin and ursodeoxycholic acid for 6 weeks, recovered and remained stable for 2 years despite ongoing immunosuppressive treatment. Thereafter, the cat was presented with suspicion of intestinal lymphoma, and recurrence of toxoplasmosis was diagnosed. Following treatment with clindamycin and prednisolone over 4 weeks the cat was euthanized. This is the first report of Toxoplasma gondii zoites detected in bile fluid from a cat with cholecystitis. Pathogenesis of toxoplasmosis in cats is still not fully understood. Although immunosuppression can represent a relevant predisposing factor, other factors, such as virulence of the parasite and genetic polymorphism of the host, can also play an important role. Toxoplasmosis should be included as a differential diagnosis in cats developing clinical signs of an inflammatory disease while receiving immunosuppressive treatment.

Zusammenfassung:Gegenstand und Ziel: Problemorientierte Aufarbeitung einer regenerate Anämie. Studiendesign: Fallbericht. Wie lautet Ihre Diagnose? Ergebnisse: Es handelte sich urn eine hochgradige normochrome, normozytäre Anämie durch eine chronische gastrointestinale Blutung aufgrund eines ulzerierten Adenokarzinoms des Magens mit sekundärem Eisenmangel. Die definitive Diagnose wurde durch Endoskopie mit Biopsie und histologischer Untersuchung gestellt. Schlussfolgerung: Patienten mit Magenerkrankungen müssen keinen Vomitus, Patienten mit einer gastrointestinalen Blutung kein Meläna zeigen, selbst wenn diese zu einer hochgradigen Anämie führt. Klinische Relevanz: Bei regenerativer Anämie mitZeichen eines Eisenmangels (Reti-kulozytenzahl ↑, MCV ↓) muss an eine gastrointestinale Blutung gedachtwerden.

In collaboration with the American College of Veterinary Pathologists

Zusammenfassung: Gegenstand: Da in den letzten Jahren Leptospirose bei Mensch und Hund in Deutschland wieder häufiger auftritt, wurde diese Studie durchgeführt, um festzustellen, welche Serovare bei Hunden in Süddeutschland vorwiegend vorkommen und ob es Rasse-, Geschlechtsoder Altersprädispositionen gibt. Material und Methoden: Als Grundlage der Studie wurden Krankenakten von 337 Hunden der Medizinischen Kleintierklinik der Ludwig-Maximilians-Universität München retrospektiv ausgewertet, die im Zeitraum 1990–2004 mittels Mikroagglutinationstest (MAT) auf Antikörper gegen acht verschiedene Leptospirenserovare getestet worden waren. Ergebnisse: 48% (162/337) der Hunde hatten Antikörpertiter gegen mindestens ein Leptospirenserovar. Neben Antikörpern gegen die in der Impfung enthaltenen Serovare copenhageni (114) und canicola (62) traten am häufigsten Antikörper gegen die Serovare grippotyphosa (54), bratislava (30) saxkoebing (16) und sejroe (13) auf. 42 der 337 Hunde waren an Leptospirose erkrankt. Das am häufigsten vorkommende Serovar bei den erkrankten Hunden war grippotyphosa (31%), gefolgt von saxkoebing (24%), copenhageni (17%), canicola (12%) und bratislava (7%). Bei vier Hunden konnte das ursächliche Agens nicht bestimmt werden. Berner Sennenhunde waren statistisch signifikant häufiger erkrankt und wiesen statistisch signifikant häufiger Antikörper auf. Schlussfolgerung und klinische Relevanz: Bei vielen Hunden lassen sich Antikörper gegen die Serovare copenhageni und canicola nachweisen, aber Erkrankungen treten vor allem durch die nicht in der Vakzine enthaltenen Serovare grippotyphosa und saxkoebing auf. Deshalb sollten neue Vakzinen produziert werden, die zusätzlich gegen die Serovare grippotyphosa und saxkoebing schützen.

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