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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 25127
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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I almost lost my dog this week to leptospirosis. Came home

Customer Question

Hi. I almost lost my dog this week to leptospirosis. Came home from work and he was near death. Luckily my vet has had recent experience with leptospirosis in his practice and recognized the signs. His leptospirosis test came back yesterday as having 4 of the 7 strains tested. So I have been doing a lot of research online and came across this site. I would appreciate your opinion on some things. 1) in the 2 weeks before the acute symptoms showed up my dog started urinating in the house and the day of the acute illness he threw up all over the house. From everything I have read online it doesn't seem I have anything to worry about these areas in my carpet any more because it has dried. But my vet is concerned that this carpet could still be toxic. Your opinion? I do understand now that if he vomits or urinates in the house I need to start cleaning with rubber gloves. I am just really concerned about the carpet because I have grandkids that come over to play and want to know if I need to worry about the dried spots. 2) The vet gave my dog a Convenia injection the day of emergency care and then yesterday he started him on Clavamox after we got the test results. He said Clavamox is one of the antibiotics shown to be good at killing the leptospirosis that hide in the kidneys. But I am not finding supporting evidence that Clavamox is a preferred antibiotic for leptospirosis. Your opinion on this? 3) I am very concerned about my dog now being a carrier. From what I have read it ranges from that he will probably be OK and not shedding in the urine after he completes his antibiotics, to 'be careful' for about 6 month but you should be fine after that, to he can be a carrier for life. Is there any reliable tests to ensure he is no longer a carrier? Right now I am afraid I can never take him on walks, to parks, or doggy day care ever again for fear of spreading the disease. Thanks for your advise.
Submitted: 11 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 11 months ago.

I'm sorry to hear of this with Baxter. I'll address your concerns as you presented them...

1) Theoretically, drying kills leptospires quickly. I would be more comfortable, however, if the carpet were steam cleaned and bedding laundered which will inactive leptospires; however, those handling soiled laundry should wear personal protective equipment.

2) Whenever possible, doxycycline should be used as the initial antimicrobial because it both treats the leptospiremia and clears the carrier state that leads to environmental shedding. However, doxycycline concentrates in bile and is excreted in the feces and supraphysiologic serum concentrations may occur in patients with liver disease. In such patients, beta-lactam antibiotics (e.g., penicillin, ampicillin, amoxicillin-clavulanic acid/Clavamox) should be used initially to clear the leptospiremia. This must be followed with 2 weeks of doxycycline to clear the carrier state.

3) No, we can clear the carrier state when treating as noted above. PCR (DNA-based testing) on urine is the most sensitive and specific manner in which to test for the carrier state. The concentration of leptospires is highest in urine.

Please respond with further questions or concerns if you wish.

Customer: replied 11 months ago.
1) Do I need to warn the company that I hire to clean the carpets that they are dealing with carpet exposed to lepto?
2) The vet did comment that the blood work shows it attacked his liver and so if I am interpreting what you are saying correctly, this is probably why he prescribed Clavamox right now instead of doxycycline? But after he finishes the Clavamox and his liver indicators are back to normal, then I should ask my vet for a prescription of doxycycline, correct?
3) So after he has finished all of his treatments and Baxter has a PCR test that comes out positive to not being a carrier, I would be able to begin taking him for walks, to parks, and to doggy daycare and not be fearful of passing it on to other dogs? Plus if he urinates in the house after a PCR test that shows he is not a carrier (while I will always clean/disinfect with gloves now that I know about lepto) I don't have to fear that he will pass to me? Or for another example, if he urinates in the yard and one of my grandchildren accidentally comes in contact with the wet urine, I don't have to fear that he will pass to them?
Expert:  Dr. Michael Salkin replied 11 months ago.

1) Yes, that would be appropriate.

2) Correct! Correct!

3) Correct! Correct! Correct!

Please continue our conversation if you wish.

Customer: replied 11 months ago.
Thank you so much. It has really helped me to get more information and a 2nd 'live' opinion (vs. just reading pages and pages of sometimes conflicting information on the internet). A couple of more questions. I have read lots on the span of time from exposure to signs of acute illness anywhere from 1 day to 30 days I think on the max end. He started urinating in the house (which he has done in the past but not in over a year) about 2 weeks prior to showing acute signs of illness. Is it likely that the disease was incubating so to speak and causing him to urinate more frequently? And would that urine (prior to showing signs of acute illness) have the lepto bacteria in it that could be transmitted to humans? The primary reason for asking is that I did have my grandchildren in the house approx. 2 weeks prior to the acute attack and they could have come in contact with the urine. Additionally, the day before the acute attack (and actually he was showing his first signs of illness that day by vomiting a small amount that morning) he had been around them and licking them. (I have read conflicting information as to whether it can be passed through saliva). Should I be very concerned about either of those 2 contacts they had with the dog?
Expert:  Dr. Michael Salkin replied 11 months ago.

That's a tougher question to answer with accuracy because the presentation is highly variable. Dogs may demonstrate no obvious signs and presenting signs may be dependent on the infecting strain, geographic location, and host immune response. Once exposed, leptospiremia is expected within 7-10 days, however.

Yes, asymptomatic dogs can infect people through contaminated urine or other body fluids except saliva. Please see here: http://www.cdc.gov/leptospirosis/infection/ For additional information concerning leptospirosis in people I have to refer you to your doctor(s). I'm not qualified to discuss any more than the zoonotic potential of infectious agents.

Expert:  Dr. Michael Salkin replied 11 months ago.

Oh my goodness. My condolences for your loss of Merrie, Teri. Such an unexpected death with hematemesis (blood in the vomitus) suggests poisoning with an anticoagulant rodenticide such as d-CON which can occur by ingesting not only the poison itself but also by by ingesting a poisoned rodent, acute thrombocytopenia (lack of blood platelets), or perhaps acute hepatic or renal failure due to a number of infections or toxins.

Expert:  Dr. Michael Salkin replied 11 months ago.

My apologies. A bug in the system allowed posting of this inappropriate post in our conversation.