Acute kidney injury due to Leptospira interrogans in 4 foals and use of renal replacement therapy with intermittent hemodiafiltration in 1 foal.
Abstract: Four 2-month-old foals were presented to an equine hospital with acute kidney injury caused by Leptospira interrogans infection. Clinical signs were nonspecific and included lethargy, fever, and unwillingness to nurse. The most important hematologic and clinicopathologic findings were azotemia, anemia, thrombocytopenia, hyponatremia, and hypochloremia. The diagnosis was based on urinary real-time PCR, serology using a microscopic agglutination test, or both. The most important serovars involved were L. interrogans serogroup australis serovar Bratislava and Australis. Treatment consisted of IV fluid therapy and antimicrobial treatment. Renal replacement therapy with hemodiafiltration was performed in 1 of the foals. All foals survived to discharge. This report highlights the importance of early diagnosis and treatment in foals with acute kidney injury caused by L. interrogans infection.
© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Publication Date: 2020-01-30 PubMed ID: 31999382PubMed Central: PMC7096627DOI: 10.1111/jvim.15713Google Scholar: Lookup
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Summary
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This research study focused on evaluating and treating four young horses (foals) that were suffering from acute kidney injury caused by infection with a bacterium known as Leptospira interrogans. One major component of the study was assessing the potential benefits of a specific treatment, renal replacement therapy with intermittent hemodiafiltration, in one of the foals.
Objective Study Background
- The study was conducted on four 2-month-old foals diagnosed with acute kidney injury, which was caused by the Leptospira interrogans infection.
- Leptospira interrogans is a type of bacterium that can cause serious infections in animals and humans. In these cases, it was causing kidney disease in the foals.
Key Symptoms and Diagnostics
- The symptoms of the foals were nonspecific, and included general signs of illness such as lethargy, fever and unwillingness to nurse.
- The key clinicopathologic findings leading to diagnosis were azotemia (high levels of nitrogen-containing compounds in the blood), anemia (lower than normal count of red blood cells), thrombocytopenia (low platelet count), hyponatremia (low sodium levels in the blood), and hypochloremia (low chloride levels in the blood).
- Diagnosis was confirmed through urinary real-time PCR (a genetic testing technique used to detect the bacterium’s DNA in the urine) and serology using a microscopic agglutination test (a blood test used to detect and measure the presence of antibodies to bacterial antigens). In some cases, both methods were used to ensure accurate diagnosis.
Treatment and Outcomes
- The primary methods of treatment involved intravenous (IV) fluid therapy and antimicrobial medication to combat the bacterial infection.
- Intriguingly, one of the foals also underwent a treatment known as renal replacement therapy with intermittent hemodiafiltration. This process involved pumping the foal’s blood through a machine that acts as an artificial kidney, filtering the blood before reinfusing it into the foal. The goal of this therapy was to help improve kidney function and alleviate the effects of the disease.
- All four foals successfully survived and were discharged from the equine hospital. This outcome suggests that prompt diagnosis and treatment can lead to positive outcomes in foals experiencing acute kidney injury caused by L. interrogans infection.
Cite This Article
APA
Fouché N, Graubner C, Lanz S, Schweighauser A, Francey T, Gerber V.
(2020).
Acute kidney injury due to Leptospira interrogans in 4 foals and use of renal replacement therapy with intermittent hemodiafiltration in 1 foal.
J Vet Intern Med, 34(2), 1007-1012.
https://doi.org/10.1111/jvim.15713 Publication
Researcher Affiliations
- Swiss Institute of Equine Medicine, University of Bern, and Agroscope, Bern, Switzerland.
- Swiss Institute of Equine Medicine, University of Bern, and Agroscope, Bern, Switzerland.
- Swiss Institute of Equine Medicine, University of Bern, and Agroscope, Bern, Switzerland.
- Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
- Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
- Swiss Institute of Equine Medicine, University of Bern, and Agroscope, Bern, Switzerland.
MeSH Terms
- Acute Kidney Injury / diagnosis
- Acute Kidney Injury / therapy
- Acute Kidney Injury / veterinary
- Animals
- Animals, Newborn
- Diagnosis, Differential
- Female
- Hemodiafiltration / veterinary
- Horse Diseases / diagnosis
- Horse Diseases / therapy
- Horses
- Leptospira interrogans
- Leptospirosis / diagnosis
- Leptospirosis / therapy
- Leptospirosis / veterinary
- Male
- Renal Replacement Therapy / veterinary
Conflict of Interest Statement
Authors declare no conflict of interest.
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