This case involves a 7-year-old spayed Labrador Retriever who was referred for endoscopy due to significantly elevated liver parameters. Prior to this, she had undergone multiple investigations at a tertiary referral hospital, including an ultrasound, but all results were considered relatively normal. Based on these findings, she was diagnosed with idiopathic hepatitis of unknown origin and was discharged with hepatic support supplements.

However, Dr. Elise was not completely satisfied with this diagnosis. She understood the importance of liver pathology, particularly laparoscopic biopsies, because Labradors are prone to copper hepatopathy (an abnormal accumulation of copper in the liver cells, which can silently lead to chronic hepatitis and eventually cirrhosis). Therefore, Dr. Elise decided to proceed with a liver biopsy.

The results were surprising—the biopsy revealed an inflammatory reaction pattern typically associated with bacterial infection, which was entirely different from the initial diagnosis of idiopathic hepatitis. Additionally, the liver's appearance and texture under endoscopy were markedly abnormal, presenting a stark contrast to the ultrasound findings.

To further pinpoint the cause, Dr. Elise utilized FISH (fluorescence in-situ hybridization) technology, an advanced technique that can identify bacterial DNA. Given the dog’s chronic hepatitis background, she suspected Leptospira as the potential pathogen. The FISH test confirmed this, revealing a hidden case of leptospirosis.

The Labrador is now undergoing treatment with doxycycline and will continue on hepatic support supplements for life to maintain liver health.

This case serves as a reminder that even if imaging results appear normal, we must not become complacent. Every diagnostic method has its limitations, requiring us to integrate clinical judgment, experience, and intuition. Fortunately, Dr. Elise, with her sharp professional acumen, identified the underlying problem in time, paving the way for an appropriate treatment plan for this dog.

We hope this case inspires others to maintain an open mind when faced with similar cases, relying not only on individual test results but also on the entire clinical picture to make the most appropriate treatment decisions.

We are pleased to announce that Dr. Elise Robertson will be consulting at Concordia Pet Care from 16 to 18 September 2024.

Dr. Elise Robertson is not only a board-certified specialist in feline medicine with ABVS® certification but also a renowned specialist in endoscopy, laparoscopy, and endoscopic laser surgery for both canines and felines. With over twenty years of clinical experience, she has accumulated a wealth of expertise.

For more info: https://www.facebook.com/photo?fbid=929713682504381&set=a.447150904093997

Please note that Dr. Robertson’s availability is limited to these three days only. Spaces are limited, so we encourage you to schedule an appointment as soon as possible if your pet requires specialised care.

For more information or to book an appointment with Dr. Elise Robertson, please contact us at 2679 1000 or via WhatsApp message at 5919 3038.