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CANINE LEPTOSPIROSIS | as first-line therapy for dogs in acute renal failure. It is effective at resolving the leptospiremic phase (pres- ence of leptospires in the blood), but not the lepto- spiruric phase (presence of leptospires in the urine). For that reason, dogs should be transitioned to doxy- cycline once they can tolerate oral antibiotics. Editor's Note: Intravenous doxycycline can be substituted for ampicillin as initial therapy (10 mg/ k}Ê 6Ê+ÊÓ{Ê ]Ê`ilÕÌi`Ê>n`Ê>`miniÃÌiÀi`Ê>ÃÊ>ÊÃloÜÊ infusion).—Dr. Lesley King, Editor in Chief UÊDoxycyclineÊ xÊ m}Ék}Ê *"Ê +Ê £ÓÊ ®Ê ÃhoÕl`Ê LiÊ administered to the dogs mentioned above as well as those that are eating, such as dogs with nonazo- temic PU/PD. » I recommend a 3- to 4-week course of doxycycline. » In dogs in which azotemia does not resolve com- pletely after 2 weeks of doxycycline, I recommend performing a PCR assay to determine if the organ- ism has been cleared. » If PCR is positive, the dog should be treated with a fluoroquinolone.28,29 Management of Organ Failure Supportive care for dogs with acute kidney injury is focused on adequate fluid therapy. Most dogs with acute kidney injury have polyuric renal failure. Adequate fluid therapy can be ensured by estab- lishing an acceptable weight range following rehydration; then weighing the dog every 4 to 6 hours to monitor for marked deviation from this target weight. For patients that are oliguric, the placement of a uri- nary catheter and closed collection system may be nec- essary for accurate measurement of urine production. A central venous catheter may also be necessary to ensure that overhydration does not occur. Additional management strategies, such as use of diuret- ics in oliguric dogs and guidelines for anti-emetics and gastroprotectants, can be found in reference textbooks. Complications UÊPersistent vomiting should be initially managed with maropitant or metoclopramide (however, not in the presence of intussusception). UÊ nÊ «>ÌiinÌÃÊ ÜiÌhÊ abdominal pain and vomiting caused by renal pain, which can be intense, the administration of an opioid, such as buprenorphine or fentanyl, is recommended. UÊ nÊ ÌhiÊ«ÀiÃinViÊovÊ renal or hepatic failure, gas- tric hyperacidity may also contribute to vomiting; >nÊ Ó-ÀiVi«ÌoÀÊLloVkiÀÊ i}]Ê v>moÌi`ini®Ê ÃhoÕl`ÊLiÊ administered. Referral to a center that can perform hemodialysis or peritoneal dialysis is recommended for dogs that: UÊ,im>inÊoli}ÕÀiVÊoÀÊ >nÕÀiVÊ voÀÊ lon}iÀÊ Ìh>nÊÓ{ÊhoÕÀÃ]Ê presuming that they have been adequately hydrated Website: medical.konicaminolta.us 1 (800) 934-1034, ext. 1354 July/August 2012 Today's Veterinary Practice 31 Only ImagePilot With Informity Brings You So Much For So Little! Designed and developed by Konica Minolta, the proven leader in digital radiography, the ImagePilot Sigma is the affordable solution for all your radiography needs. This easy- to-use desktop system is fully featured and offers you superior image quality and optimal workflow. Informity is Konica Minolta's "Cloud Based" service offer ing the ultimate solution to meet your ImagePilot data storage and collaborative needs. Simple to use, Informity protects your valuable data from cata- strophic loss and allows you to share images online instantly with colleagues. ImagePilot Sigma and Informity… from the #1 rated manufacturer in Customer Satisfaction, Reliability and Value! Hey doc, did you hear the news from Konica Minolta?