Diagnosis and Treatment
Recommended Treatment
The prime objective in acute cases is to eradicate the leptospiremia and supress leptospiruria, which will prevent shedding and disease transmission. Early detection and treatment will improve prognosis for recovery and prevent progressive kidney and/or liver disease.
Acute cases require appropriate antibiotics and supportive care including fluid therapy.
Initial antimicrobial therapy includes the use of:
- Ampicillin or amoxicillin initiated for two weeks; or alternately penicillin or until kidney function returns.
- Doxycycline, administered orally for two weeks to eliminate leptospires from the dog’s renal interstitial tissues to control the carrier state.
- The ideal approach may be administration of ampicillin or amoxicillin for five to seven days followed by doxycycline for two weeks. Since these antibiotics are excreted through the kidneys, they will ensure the organisms are rapidly removed from this site.
Aminoglycosides should not be used in patients until kidney function has been restored. Fluoroquinolones generally are not recommended.
Leptospires that have localized in the kidney tubules, eyes, liver, lungs, or the reproductive tract are sheltered from the bactericidal effects of serum antibody.
A successful outcome for infected dogs depends on:
- The robustness of an antibody response,
- How promptly treatment is initiated, and
- How much organ damage has occurred.