Dear Dr. John,

As I write, my four-year-old dog is in an ICU at an emergency veterinary hospital. He has been diagnosed with Leptospirosis and is in organ failure. He is not even urinating or eating but seems happy when I visit. They are doing all that they can for him with fluids and supportive care, but they have told me to prepare for the strong possibility that he may not survive or may need to be put down. Apparently, his renal values are very high, for example, his creatinine is 10. How high is that value compared to normal? My dog was unfortunately not vaccinated for Leptospirosis because he has had a history of SRMA. He had not been on his prednisone for over a year and the emergency hospital said they have seen 15 cases of Leptospirosis in the last month! They also said that only 50% of those dogs presenting with it have survived.  R.M.

Dear R.M.,

I am sorry to hear of what you are facing and given the numbers reported to you of 15 cases of leptospirosis being seen in one month, I am happy to alert dog owners of these numbers being seen in our area, which strike me as significantly high. I believe this is reason for concern and another good reason why I always recommend vaccination for leptospirosis unless there are significant reasons not to, such as is the case with your dog.

Unfortunately, leptospirosis does have a fairly high mortality rate, so the reported numbers of 50% survival seem correct. A creatinine of 10 is very high with a normal range of 0.5-1.5 mg/dl. I fear that your dog has a lesser chance of successfully pulling through due to this high value suggestive of renal failure and a history of health issues with the SRMA, or steroid responsive meningitis-arteritis. Long-term use of the treatment for SRMA with high doses of corticosteroids can cause various overall health challenges.

If he is currently not urinating, they may be limited in fluid administration since they do not want to overload the body and kidneys. By the time this letter is published, I fear you may have lost your dog. If so, I’m sorry for your loss and if he pulled through, your dog is very lucky. Fingers crossed!

Dr. John de Jong is President of the World Veterinary Association. He owns and operates the Boston Mobile Veterinary Clinic and can be reached at 781-899-9994.