Acute kidney injury in a dog diagnosed with leishmaniasis: case report

Abstract

A 3 years old, 40.8 kg, intact male American Bully, diagnosed with acute kidney injury in a private clinic in Serbia was referred for hemodialysis therapy. The dog was presented with the following symptoms: lethargy, appetite loss, vomiting, diarrhea, weight loss, dehydration (8-10%, Considerable loss of skin turgor), rectal temperature of 38.8oC and dry mucous membranes. Arterial blood pressure was elevated 218-220 mmHg systolic, using Doppler method. The biochemistry revealed elevated ALT 191 (RR: 10-118 U/L), AMY 1390 (RR: 200-1200 U/L), BUN 94 (RR: 7-25 mg/dL), CREA 3.6 (RR: 0.4-1.2 mg/dL), PHOS 9.8 (RR: 2.9-6.6 mg/dL), GLU 121 (RR: 60-110 mg/dL), K 3.3 (RR: 3.4-5.6 mmol/L). Urine analysis was performed with UPC 0.2-0.5 (borderline proteinuric), pH 5.5, microalbumin >25 mg/L, creatinine >26.4 mmol/L. The infestation with Leishmania infantum was confirmed using quantitative PCR. The patient was stabilized using fluid therapy and parenteral feeding. Hemodialysis was decided as an extracorporeal replacement therapy for sustaining renal function. A central venous catheter was placed under a light sedation with oxygen therapy. Hemodialysis was performed for three times in a period of 11 days. A key treatment for acute kidney injury in canine patients is represented by intensive care, fluid therapy and hemodialysis therefore, the values were reduced in BUN from 94 mg/dL to 30 mg/dL and CRE from 3.6 mg/dL to 1.8 mg/dL. The BUN and CREA reached normal values 39 days after that the patient was discharged.