Renal presentation of Leptospirosis in a 1 year old MI Giant Schnauzer

History

A 1-year-old intact male Giant Schnauzer dog with a 1-month history of lethargy and slightly decreased appetite was presented for evaluation of anorexia and uremic breath. The dog had been noted to be PU/PD since 4 months of age. Isosthenuria and mild proteinuria were present on urinalysis. Abnormalities on CBC and serum biochemistry included anemia, azotemia, and hyperphosphatemia.

A 1-year-old intact male Giant Schnauzer dog with a 1-month history of lethargy and slightly decreased appetite was presented for evaluation of anorexia and uremic breath. The dog had been noted to be PU/PD since 4 months of age. Isosthenuria and mild proteinuria were present on urinalysis. Abnormalities on CBC and serum biochemistry included anemia, azotemia, and hyperphosphatemia.

Clinical Differential Diagnosis

Renal dysplasia, chronic kidney disease from prior renal insult (infectious, trauma, toxins, hypoxia), pyelonephritis, nephroblastoma.

DX

Renal presentation of Leptospirosis

Sampling

None. Cortical renal biopsy is necessary for a definitive diagnosis.

Sonographic Differential Diagnosis

The images show a chronic interstitial nephrosis pattern. Given the patient’s age and history, primary renal dysplasia is possible. Amyloidosis, chronic Leptospirosis or toxin exposure are all possible. ACTH stimulation would be recommended to ensure an underlying Addisonian crisis is not playing a role in this patient and complicating the renal presentation.

Image Interpretation

The kidneys in this patient presented an interstitial nephrosis pattern, disrupted corticomedullary definition and collapse of the cranial pole of the left cortex. Cortical infarcts were also present. The left kidney size appeared relatively normal to slightly subnormal depending on the weight of the patient. The left kidney measured approximately 6.0 cm. The right kidney revealed similar changes and measured approximately 6.0 cm.

Outcome

Patient tested positive for Leptospirosis.

Video

Patient Information

Patient Name : Bear O
Age : 1 Year
Gender : Male, Intact
Species : Canine
Liz Wuz Here : Yes
Status : Complete
Code : 06_00242

Blood Chemistry

  • Azotemia

CBC

  • RBC, Low

Clinical Signs

  • Anorexia
  • Halitosis
  • Lethargy
  • PU-PD

Urinalysi

  • Isosthenuria Present
  • Protein Present

Images

2014111018172120141110181844

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