8 year old MN Shep mix with severely elevated liver values, severely icteric. Previous medical record indicated some elevated Lepto titers, but a convalescent sample had not risen enough to declare and infection (2021). The dog had been on Clavamox, doxy and Denamarin.
Could this liver appearance be chronic Lepto infection? I did a FNA, but came back hepatocellular vacuolation with moderate atypia and disorganization, marked cholestasis. No current Lepto test was ever submitted and the dog was eventually euthanized.
3 responses to “chronic leptospirosis?”
With the elevated liver enzymes, icterus, and the ultrasound appearance chronic-active hepatitis neoplasia (primary or infiltrative), and granulomatous disease would be likely etiologies. Tru-Cut or wedge biopsy often required for a diagnosis.
Generally leptospirosis causes acute hepatitis, which can with time as there can be self perpetuating changes within the liver (oxidative changes, immune-mediated, accumulation of copper and iron, etc) result in chronic hepatitis but usually is not of a chronic-active process.
Thank you very much for the input. For granulomatous disease, could Lepto be an underlying cause? How would I expect it’s appearance to differ from this image? For a chronic Lepto case, what are the typical characteristics on ultrasound?
Unfortunately there are no typical abdominal ultrasound findings for leptospirosis.