Persistent Leptospiruria in Five Dogs Despite Antimicrobial Treatment (2000–2017)

Abstract

In dogs with leptospirosis, doxycycline therapy is recommended as the preferred therapy for its ability to eliminate the organism from all tissues, including the renal tubules. Elimination of organisms from the renal tubules terminates leptospiruria and prevents transmission of the organism. This report describes the discovery of persistent leptospiruria in the face of therapy with doxycycline in four dogs and enrofloxacin in one dog. Leptospiruria was confirmed by polymerase chain reaction testing for pathogenic leptospires in all five dogs. In two dogs, leptospiruria resolved after a change in therapy to enrofloxacin. In three dogs, doxycycline and/or enrofloxacin were ineffective at eliminating leptospiruria, which then resolved after therapy with clarithromycin. Pet owners could be at risk as persistent leptospiruria poses a potential zoonotic risk. The potential reasons for persistent leptospiruria as demonstrated by polymerase chain reaction testing are discussed.

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

“…in the urine of infected dogs was reported as ≥7 d of clinical illness. 9,27,36 Therefore, the detection of leptospiral DNA from blood rather than urine should be considered a more reliable strategy to diagnose leptospirosis in dogs presented with both kidney and liver disease.…”

Pharmacokinetics of enrofloxacinHCl‐2H2O (ENRO‐C),PK/PD, and Monte Carlo modeling vs. Leptospiraspp. in cows

“…The existence of a high probability of failure to achieve bacteriological cure with streptomycin, the preference drug to date, has been recognized (Gerritsen, Koopmans, Dekker, De Jong, & Olyhoek, ; Gerritsen, Koopmans, & Olyhoek, ). Other antimicrobial drugs such as amoxicillin (Smith et al., ), oxytetracycline, tilmicosin, and ceftiofur (Alt et al., ) have been tested, in which low efficiencies have been reported and, as indicated above, fluoroquinolones are not particularly effective in the treatment of leptospirosis in veterinary medicine (Griffith et al, ; Mauro & Harkin, ; Wu et al., ). Considering this global scenario, it is tempting to think that it would be useful to carry out both an efficacy study in the face of a controlled challenge of leptospirosis, as well as a clinical study of outbreaks in the field, using Enro‐C.…”

“…For example, given the low apparent volume of distribution/area under the curve (Vd AUC ) of streptomycin, this drug is only useful to treat the acute phase of leptospiremia. Similarly, beta‐lactamic antibacterial drugs exhibit limited success to treat this disease and doxycycline is an option difficult to administer in bovine medicine (Alt, Zuerner, & Bolin, ; Mauro & Harkin, ). Often, many animals remain as carriers, causing great economic losses, even when vaccination is implemented in the farm (Martins & Lienbaum, ).…”

Investigating the Immunological and Biological Equilibrium of Reservoir Hosts and Pathogenic Leptospira: Balancing the Solution to an Acute Problem?

“…This is evident not only in animals, but also in humans. Case reports demonstrate the ability of dogs to persistently shed leptospires even after antibiotic treatment (Juvet et al, 2011;Mauro and Harkin, 2019). Unique human cases have also been described, where asymptomatic shedding can occur for extended periods of time (Ganoza et al, 2010;Chow et al, 2012).…”