Hola a todos,
gostaria de saber qual es lo melhora tratamento para a leptospira, la penicilina G com estreptomicina ou doxicilina, qual a doses e frequencia.
Tengo 2 perros vacunados na clinica, un deles es mio com leptospirose.
muchas gracias
isabel
Esto es lo que tengo sobre tratamiento de Lepto
Saludos
Leonardo
_______________________________________________________________________
Canine leptospirosis
Frederic Gaschen Dr.med.vet., Dr.habil., DACVIM, DECVIM-CA
Veterinary Clinical Sciences School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA. fgaschen@vetmed.lsu.edu
Proceedings of the 33rd World Small Animal Veterinary Congress 2008 - Dublin, Ireland
Therapy
In canine leptospirosis, renal and liver failures are potentially reversible and should be treated as early and aggressively as possible. The affected dogs are treated symptomatically with antiemetics and gastric protectants, and particular attention is paid to adequate urine production after the animals have been properly rehydrated. The placement of a sterile urinary catheter can be helpful in assessing urine production as well as containing potentially infective waste. Urine production minor to 2 ml/kg/hr in an adequately hydrated dog indicates oliguria and must be treated aggressively.
In animals that are not fluid overloaded, mannitol is usually considered the treatment of choice. It is initially given as a bolus, (0.5 g/kg over 30-60 min) and then followed as a constant rate infusion (1-2 mg/kg/min) if urine production responds appropriately. Alternatively, furosemide can also be administered. It is initially given as a bolus (2-4 mg/kg) and then followed as a constant rate infusion (0.25 - 1 mg/kg/hour) if urine production increases appropriately. Urine production should be followed closely and over-hydration of the patient avoided. Antibiotic therapy is usually given in 2 phases: ampicillin or amoxicillin can be administered parenterally (20-25 mg/kg i.v. TID) during the initial, critical phase. It is important to note that the kidneys clear these drugs and blood concentrations can become inappropriately high in patients with renal dysfunction. A common method of adjusting these antibiotic dosages is to multiply the normal dose by 1/serum creatinine. When the dogs are recovered, doxycycline (10 mg/kg p.o. daily in 1 or 2 doses) is the antibiotic of choice and is prescribed for a minimum of 3 weeks to prevent persistent renal shedding. The prognosis of canine leptospirosis is fair; depending on the case series, between 50 and 90% of dogs can be discharged from the hospital after a stay of up to 7-10 days. Oliguric/anuric renal failure is a strong negative prognostic factor in most reports. However, dogs affected with this complication do benefit from hemodialysis or continuous renal replacement therapy.
Both procedures may significantly decrease mortality, and are currently available in many teaching hospitals and large referral centers.
_____________________________________________________________________________
LEPTOSPIROSIS STILL A PROBLEM IN DOGS
Katrin Hartmann, Prof., Dr. vet. med., Dr. vet. med. habil., Diplomate ECVIM-CA Medizinische Kleintierklinik Ludwig Maximilians University, Munich, Germany
Proceeding of the NAVC North American Veterinary Conference Jan. 13-27, 2007, Orlando, Florida
TREATMENT
Supportive therapy for animals with leptospirosis depends on the severity of clinical signs and the presence of renal or hepatic dysfunction and other complicating factors. Antimicrobial therapy is essential in the treatment of leptospirosis to terminate the bacteremia. There are two stages of treatment. The first stage is aimed to immediately inhibit replication of the organism and rapidly reduce fatal complications of infection such as hepatic and renal failure. Penicillin and its derivatives are the antibiotics of choice for terminating leptospiremia. Initially, ampicillin (22 mg/kg every 8 hours IV) or preferentially amoxicillin (22 mg/kg every 12 hours IV) should be given parenterally to the vomiting, uremic, or hepatically compromised animal. These drugs prevent shedding and transmission of the organism within 24 hours of initiation of therapy. They are, however, neither able to clear infection from the kidneys nor to eliminate the carrier state and prevent chronic shedding.
Thus, in the second stage other drugs should be used after the penicillins to eliminate the carrier state.
Doxycycline (5 mg/kg every 12 hours PO for 3 weeks) is the drug of choice. Doxycycline treatment should start as soon as the clinical condition allows initiation of its oral application. Doxycycline is usually given orally as intravenous application can cause shock and vomiting, and subcutaneous injection leads to abscessation. Oral administration, however, can cause gastrointestinal side effects. Doxycycline can be given regardless of the degree of renal dysfunction. The doxycycline dose does not need to be adjusted in animals with renal failure because it is predominantly excreted in the feces.
However, doxycycline can lead to liver toxicity. It should only be started after the animal stops vomiting and liver enzymes are in the reference range. In animals without or only mild clinical signs, doxycycline can be used for both initial and elimination therapy.
Saludos
Leonardo
_______________________________________________________________________
Canine leptospirosis
Frederic Gaschen Dr.med.vet., Dr.habil., DACVIM, DECVIM-CA
Veterinary Clinical Sciences School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA. fgaschen@vetmed.lsu.edu
Proceedings of the 33rd World Small Animal Veterinary Congress 2008 - Dublin, Ireland
Therapy
In canine leptospirosis, renal and liver failures are potentially reversible and should be treated as early and aggressively as possible. The affected dogs are treated symptomatically with antiemetics and gastric protectants, and particular attention is paid to adequate urine production after the animals have been properly rehydrated. The placement of a sterile urinary catheter can be helpful in assessing urine production as well as containing potentially infective waste. Urine production minor to 2 ml/kg/hr in an adequately hydrated dog indicates oliguria and must be treated aggressively.
In animals that are not fluid overloaded, mannitol is usually considered the treatment of choice. It is initially given as a bolus, (0.5 g/kg over 30-60 min) and then followed as a constant rate infusion (1-2 mg/kg/min) if urine production responds appropriately. Alternatively, furosemide can also be administered. It is initially given as a bolus (2-4 mg/kg) and then followed as a constant rate infusion (0.25 - 1 mg/kg/hour) if urine production increases appropriately. Urine production should be followed closely and over-hydration of the patient avoided. Antibiotic therapy is usually given in 2 phases: ampicillin or amoxicillin can be administered parenterally (20-25 mg/kg i.v. TID) during the initial, critical phase. It is important to note that the kidneys clear these drugs and blood concentrations can become inappropriately high in patients with renal dysfunction. A common method of adjusting these antibiotic dosages is to multiply the normal dose by 1/serum creatinine. When the dogs are recovered, doxycycline (10 mg/kg p.o. daily in 1 or 2 doses) is the antibiotic of choice and is prescribed for a minimum of 3 weeks to prevent persistent renal shedding. The prognosis of canine leptospirosis is fair; depending on the case series, between 50 and 90% of dogs can be discharged from the hospital after a stay of up to 7-10 days. Oliguric/anuric renal failure is a strong negative prognostic factor in most reports. However, dogs affected with this complication do benefit from hemodialysis or continuous renal replacement therapy.
Both procedures may significantly decrease mortality, and are currently available in many teaching hospitals and large referral centers.
_____________________________________________________________________________
LEPTOSPIROSIS STILL A PROBLEM IN DOGS
Katrin Hartmann, Prof., Dr. vet. med., Dr. vet. med. habil., Diplomate ECVIM-CA Medizinische Kleintierklinik Ludwig Maximilians University, Munich, Germany
Proceeding of the NAVC North American Veterinary Conference Jan. 13-27, 2007, Orlando, Florida
TREATMENT
Supportive therapy for animals with leptospirosis depends on the severity of clinical signs and the presence of renal or hepatic dysfunction and other complicating factors. Antimicrobial therapy is essential in the treatment of leptospirosis to terminate the bacteremia. There are two stages of treatment. The first stage is aimed to immediately inhibit replication of the organism and rapidly reduce fatal complications of infection such as hepatic and renal failure. Penicillin and its derivatives are the antibiotics of choice for terminating leptospiremia. Initially, ampicillin (22 mg/kg every 8 hours IV) or preferentially amoxicillin (22 mg/kg every 12 hours IV) should be given parenterally to the vomiting, uremic, or hepatically compromised animal. These drugs prevent shedding and transmission of the organism within 24 hours of initiation of therapy. They are, however, neither able to clear infection from the kidneys nor to eliminate the carrier state and prevent chronic shedding.
Thus, in the second stage other drugs should be used after the penicillins to eliminate the carrier state.
Doxycycline (5 mg/kg every 12 hours PO for 3 weeks) is the drug of choice. Doxycycline treatment should start as soon as the clinical condition allows initiation of its oral application. Doxycycline is usually given orally as intravenous application can cause shock and vomiting, and subcutaneous injection leads to abscessation. Oral administration, however, can cause gastrointestinal side effects. Doxycycline can be given regardless of the degree of renal dysfunction. The doxycycline dose does not need to be adjusted in animals with renal failure because it is predominantly excreted in the feces.
However, doxycycline can lead to liver toxicity. It should only be started after the animal stops vomiting and liver enzymes are in the reference range. In animals without or only mild clinical signs, doxycycline can be used for both initial and elimination therapy.
Muchas gracias leonardo, vou intentar la amoxicilina injectavel
outra pergunta,la zoonosis
hablei com una medica de infectocontagiosas que me dice que para nosoutros no es mucho grave apenas para persona imunocomprometidas (diabeticos, alcoolicos etc) para vigiar signos de gripe.
que cuidados hay que tener com personal de la clinica, alem de lavar bien com detergente e despues lexivia, usar guantes.
vosoutros usam mascarilhas?
gracias
isabel
outra pergunta,la zoonosis
hablei com una medica de infectocontagiosas que me dice que para nosoutros no es mucho grave apenas para persona imunocomprometidas (diabeticos, alcoolicos etc) para vigiar signos de gripe.
que cuidados hay que tener com personal de la clinica, alem de lavar bien com detergente e despues lexivia, usar guantes.
vosoutros usam mascarilhas?
gracias
isabel
Potencial Zoonótico
Para los humanos la orina de los animales es el vehículo más importante de la infección zoonótica de la leptospirosis. El contacto directo con los animales infectados, el suelo contaminado, tejidos corporales o piscinas puede dar origen a la transmisión. En humanos, la leptospirosis es una enfermedad de reporte obligatorio ante el departamento estatal de salud.
En los últimos 24 meses en Long Island no ha habido informes de leptospirosis humana, pero se han reportado diversos casos anualmente en Estados Unidos ante los Centros Para el Control y Prevención de Enfermedades en Atlanta. Es necesario advertir a los propietarios de los perros infectados acerca del potencial zoonótico y de los riesgos para la salud humana, además del hecho de que los microorganismos que se diseminan en la orina se pueden presentar hasta por tres meses después de la infección. Se les debe aconsejar mantener a los perros fuera de las áreas donde juegan los niños como jardines, areneros, piscinas y chapoteaderos.
Cualquier animal sospechoso o infectado que visite el hospital se le debe aislar para prevenir la exposición a otros animales. El personal que maneje a estos pacientes debe usar guantes y ser extremadamente cuidadoso al manipular sangre, orina y tejidos de animales infectados. Se puede pasear a los perros en un área confinada y las zonas contaminadas con orina infectada se deben lavar y desinfectar con una solución de cloro o yodo.
Los síntomas de la leptospirosis en humanos son fiebre, dolor de cabeza, temblores, vómito, ictericia y anemia. Aún cuando los síntomas entre las personas pueden ser leves, cuando tienen leptospirosis con frecuencia se ven muy enfermos y requieren hospitalización. Cualquier persona que desarrolle una enfermedad similar a la influenza (gripa) después de haber tenido contacto con un perro infectado, deberá consultar al médico y mencionar su exposición a la leptospirosis.
________________________________________________________________________________
Helena nostros tenemos precaucion pero sin asustarnos, ni bien comenzas con la administarcion de antibioticos la eliminacion de Leptospiras por orina deberia parar.
Por otro lado depende del serovar involucrado y su patogenicidad para afectar al humano.
Además y para que te quedes mas tranquila o no :-), algunos perros que no tienen Leptospirosis clinica, y que atendes rutinariamente en la clinica, sin tomar demasiadas precauciones, podrían estar eliminando Leptospiras por orina, estos son los potadores renales cronicos asintomaticos, y la variedad involucrada es la Canicola.
Saludos
Leonardo
Para los humanos la orina de los animales es el vehículo más importante de la infección zoonótica de la leptospirosis. El contacto directo con los animales infectados, el suelo contaminado, tejidos corporales o piscinas puede dar origen a la transmisión. En humanos, la leptospirosis es una enfermedad de reporte obligatorio ante el departamento estatal de salud.
En los últimos 24 meses en Long Island no ha habido informes de leptospirosis humana, pero se han reportado diversos casos anualmente en Estados Unidos ante los Centros Para el Control y Prevención de Enfermedades en Atlanta. Es necesario advertir a los propietarios de los perros infectados acerca del potencial zoonótico y de los riesgos para la salud humana, además del hecho de que los microorganismos que se diseminan en la orina se pueden presentar hasta por tres meses después de la infección. Se les debe aconsejar mantener a los perros fuera de las áreas donde juegan los niños como jardines, areneros, piscinas y chapoteaderos.
Cualquier animal sospechoso o infectado que visite el hospital se le debe aislar para prevenir la exposición a otros animales. El personal que maneje a estos pacientes debe usar guantes y ser extremadamente cuidadoso al manipular sangre, orina y tejidos de animales infectados. Se puede pasear a los perros en un área confinada y las zonas contaminadas con orina infectada se deben lavar y desinfectar con una solución de cloro o yodo.
Los síntomas de la leptospirosis en humanos son fiebre, dolor de cabeza, temblores, vómito, ictericia y anemia. Aún cuando los síntomas entre las personas pueden ser leves, cuando tienen leptospirosis con frecuencia se ven muy enfermos y requieren hospitalización. Cualquier persona que desarrolle una enfermedad similar a la influenza (gripa) después de haber tenido contacto con un perro infectado, deberá consultar al médico y mencionar su exposición a la leptospirosis.
________________________________________________________________________________
Helena nostros tenemos precaucion pero sin asustarnos, ni bien comenzas con la administarcion de antibioticos la eliminacion de Leptospiras por orina deberia parar.
Por otro lado depende del serovar involucrado y su patogenicidad para afectar al humano.
Además y para que te quedes mas tranquila o no :-), algunos perros que no tienen Leptospirosis clinica, y que atendes rutinariamente en la clinica, sin tomar demasiadas precauciones, podrían estar eliminando Leptospiras por orina, estos son los potadores renales cronicos asintomaticos, y la variedad involucrada es la Canicola.
Saludos
Leonardo