CVC Central 2007 Highlights: A tip for interpreting Leptospira species titers

CVC Central 2007 Highlights: A tip for interpreting Leptospira species titers

There's no easy way to definitively diagnose leptospirosis quickly in dogs—yet. But obtaining a negative result initially doesn't mean you should stop antibiotic therapy. Here's how to best interpret the titers.



To help confirm a diagnosis of canine leptospirosis, veterinarians today must rely on serologic testing with the microscopic agglutination test (MAT). The highest dilution of serum that agglutinates 50% of the Leptospira organism is the titer. Interpreting the test can be problematic, though, especially early on in the disease or in a recently vaccinated dog.

AN EARLY NEGATIVE TITER SHOULDN'T DISSUADE YOU

A low MAT titer could indicate previous vaccination against Leptospira species or possibly infection with another type of spirochete because cross-reactivity occurs. However, a titer ≥ 800 for a nonvaccinal serovar along with appropriate clinical signs is suggestive of active disease. Also, a fourfold increase in titer in a convalescent serum sample indicates a recent Leptospira species infection.1

For example, you're treating a sick dog (dogs with leptospirosis may have acute renal failure, vasculitis, disseminated intravascular coagulation, or hepatic disease) that has a titer ≥ 800 for Leptospira pomona, but the dog was vaccinated two months earlier against L. pomona. You submit another serum sample seven to 10 days later, and the titer is now ≥ 3,200. This fourfold increase in titer indicates infection, most likely due to L. pomona during the illness.

Keep in mind that because titers may decline quickly after antibiotic therapy, you may miss rapidly rising titers if a convalescent titer is drawn after the typical three-week interval. So if you suspect leptospirosis, don't let an early negative titer result dissuade you; start treating and submit another sample for an MAT within seven to 10 days.

HOW LONG DO VACCINAL TITERS LAST?

Leptospira species vaccinal titers may last six months to a year or longer. However, antibody testing may not be a good way to assess protection because at least one study has shown that dogs were well-protected from a challenge with Leptospira organisms a full year after vaccination despite low serum MAT titers.2

A TEST ON THE HORIZON

Veterinarians may someday have a better diagnostic test that will allow earlier diagnosis of canine leptospirosis. In people, ELISA tests are used as screening tools for leptospirosis, and similar types of tests are currently being evaluated in dogs.

Richard E. Goldstein, DVM, DACVIM (small animal internal medicine), DECVIM-CA, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

REFERENCES

1. Greene CE, Sykes JE, Brown CA, et al. Leptospirosis. In: Greene CE, ed. Infectious diseases of the dog and cat. 3rd ed. Philadelphia, Pa: WB Saunders Co, 2006;402-417.

2. André-Fontaine G, Branger C, Gray AW, et al. Comparison of the efficacy of three commercial bacterins in preventing canine leptospirosis. Vet Rec 2003;153(6):165-169.