Serial evaluation of clinical, functional, and structural pulmonary changes in 10 dogs with leptospirosis.

CT lung densitometry better reflects clinical pulmonary improvement in canine leptospirosis than arterial blood gas analyses.

This prospective case series evaluated serial clinical, functional, and structural pulmonary changes in 10 client-owned dogs diagnosed with leptospirosis over the first 8 days of hospitalization. Assessment tools included daily clinical examination, arterial blood gas (ABG) analyses on days 1–4, 6, and 8, and thoracic computed tomography (CT) with pulmonary segmentation and lung densitometry on days 1, 4, and 8. The majority of dogs exhibited clinical respiratory impairment, with one dog succumbing to fatal pulmonary hemorrhage syndrome. Hypoxemia was documented in 5 of 10 dogs, characterized by reduced arterial PO2 (median 56.6 mmHg) and elevated alveolar-arterial (A-a) PO2 gradients (median 37.9 mmHg), indicating ventilation-perfusion mismatch or intrapulmonary shunting. Alveolar ventilation was relatively preserved, with arterial PCO2 values near normal. Quantitative CT analysis revealed increased mean lung attenuation (MLA) in all dogs at admission, consistent with pulmonary consolidation or hemorrhage, with progressive improvement in MLA over the study period in most dogs. Notably, clinical scores and CT-derived structural parameters improved in parallel, while ABG results demonstrated a more variable, fluctuating pattern. These findings suggest that CT-based lung densitometry may more reliably reflect the clinical trajectory of pulmonary leptospirosis than functional blood gas parameters. This study highlights the value of serial CT evaluation in monitoring pulmonary involvement in canine leptospirosis and underscores the importance of recognizing pulmonary hemorrhage syndrome as a potentially fatal complication requiring vigilant monitoring.

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