What do lepto lungs look like radiographically?

JVIM 2010

B. Kohn, K. Steinicke, G. Arndt, A.D. Gruber, B. Guerra, A. Jansen, B. Kaser-Hotz, R. Klopfleisch, F. Lotz, E. Luge, K. Nöckler

Background
Leptospirosis in dogs is a zoonotic disease primarily affecting the kidneys and liver. Pulmonary manifestations, though less studied in veterinary medicine, are increasingly recognized as significant contributors to morbidity and mortality. This study aimed to assess the prevalence and characteristics of pulmonary abnormalities in dogs with leptospirosis, focusing on clinical and radiological signs, laboratory differences between affected and unaffected dogs, and the correlation of respiratory distress severity with outcomes.

Methods
The study retrospectively reviewed medical records of 50 dogs diagnosed with leptospirosis at the Small Animal Clinic, Berlin, from 2006 to 2009. Diagnostic methods included the microscopic agglutination test (MAT), polymerase chain reaction (PCR), and histopathology. Dogs were grouped into two categories based on the presence (Group 1) or absence (Group 2) of lung abnormalities. Severity of respiratory distress and radiological changes were graded, and laboratory findings were compared between groups.

Results
Pulmonary abnormalities were present in 70% of the dogs (35/50).


Among these, 62% displayed respiratory distress, classified as mild to moderate (42%) or severe (58%).


Radiological findings included caudal interstitial patterns (Grade 1), generalized reticulonodular patterns (Grade 2), and severe patterns with alveolar consolidations (Grade 3).


Thrombocytopenia was significantly associated with pulmonary signs, observed in 83% of Group 1 versus 53% of Group 2 dogs.


Mortality was high among dogs with severe dyspnea (67%), with respiratory distress being the leading cause of euthanasia.


Histopathology revealed diffuse pulmonary hemorrhage and alveolar damage in affected dogs, even in some without clinical signs.


Limitations
The study was retrospective, relying on available records which might have introduced selection bias. The absence of standardized diagnostics across cases limited comparability, and some potentially relevant data, such as detailed immune and coagulation profiles, were incomplete.

Conclusions
Pulmonary abnormalities are frequent and severe complications in canine leptospirosis, significantly increasing mortality risk. The findings highlight the need for prompt recognition and management of respiratory involvement in affected dogs to improve outcomes. Further research is necessary to elucidate pathophysiological mechanisms and optimize treatment strategies.

Fig 1. Lateral thoracic radiograph of a 7-year-old female mixed-breeddog with leptospirosis and severe dyspnea: generalized severe reticulo-nodular interstitial lung pattern with patchy alveolar consolidations.

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