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PEER REVIEWED 76 FOCUS ON LEPTOSPIROSIS Scant peritoneal and retroperitoneal effusion was also present. Aerobic culture of urine was reported as "no growth" after 3 days of incubation. Blood and urine samples were submitted for leptospirosis polymerase chain reaction (PCR) testing and microscopic agglutination test (MAT) titers. PCR results were negative in blood and positive in urine for leptospirosis. MAT titers were strongly supportive of natural leptospirosis infection ( TABLE 3 ). THERAPY FOR LEPTOSPIROSIS Supportive Care The patient was treated supportively with IV fluid therapy, maropitant, famotidine, and buprenorphine. Antibiotics IV ampicillin and sulbactam was initiated due to the high suspicion for leptospirosis. The patient improved clinically with these therapies within a few days. Once leptospirosis MAT titers and PCR results were received, he was transitioned to oral doxycline. Patient Monitoring The patient was hospitalized for 8 days. Serial biochemical profiles supported a positive response to therapy ( TABLE 4 ). FOLLOW-UP A week after discharge from the hospital, blood work performed by the referring veterinarian revealed no abnormalities, and creatinine had remained within the normal reference range (1.4 mg/dL). Convalescent FIGURE 1. This ultrasound image depicts a subjectively enlarged right kidney, measuring 4.9 cm in length. There is mild pyelectasia, the cortex is mildy hyperechoic, and the corticomedillary junction is slightly indistinct. TABLE 3 Microscopic Agglutination Test Titers SEROVAR TITER Pomona 1:400 Icterohaemorrhagiae Negative Canicola 1:200 Grippotyphosa 1:1600 Hardjo Negative Bratislava 1:200 Autumnalis 1:200 Sejroe Negative TABLE 4 Serial Biochemical Profile Abnormalities VALUE REFERENCE RANGE RESULT DAY OF HOSPITALIZATION 1 3 4 5 6 7 8 9 Alkaline phosphatase (U/L) 24−147 473 323 392 308 374 468 463 504 Blood urea nitrogen (mg/dL) 5−29 69 40 68 67 34 31 23 43 Cholesterol (mg/dL) 120−247 394 353 358 316 292 * * * Creatinine (mg/dL) 0.3−2.0 2.09 1.3 2.87 2.94 1.56 1.26 1.14 1.4 Phosphorus (mg/dL) 2.9−6.2 8.3 5.9 7.6 6.7 5.7 * * * *Value not measured