The Saga of Sage
Three-month old puppy Sage developed clinical signs quickly. “She was vomiting excessively, extremely lethargic, had a diminished appetite, and hid under the couch,” says Katharine Altman, owner of the predominantly chihuahua and rat terrier mix.
Altman took Sage to her local veterinarian, who did blood work, noticed she was not urinating, and thought she might have leptospirosis—a zoonotic disease caused by infection with Leptospira bacteria, found in soil and water, which can cause kidney and/or liver failure. They performed a DNA-PCR test. Due to her severe illness, further evaluation was recommended, so the Altmans took Sage to Veterinary Emergency Group, where she received an ultrasound and intravenous fluids. The veterinary team was convinced that Sage had contracted leptospirosis.
Altman was referred to Cummings School of Veterinary Medicine at Tufts University. “They told us that there was a strong possibility that she would need hemodialysis to have a chance to survive and Tufts is the only tertiary hospital in the area that performs the procedure,” Altman explains. Hemodialysis filters and removes waste products in the blood of an animal whose kidneys are not functioning normally.
At Cummings School’s Foster Hospital for Small Animals, the Altmans were introduced to Dr. Devyn Schultz, a resident in small animal internal medicine. “He was already caught up on Sage’s condition, and was compassionate and patient with us,” Altman shares.
Sage was reevaluated. “She was weak but able to stand and didn’t appear to be volume overloaded so she was put on intravenous fluids and a continuous fusion of Lasix to see if we could establish urine output,” says Mary Labato, V83, the Anne Engen and Belle Professor in Clinical Nephrology and associate chair of the Department of Clinical Sciences.
“Sage’s potassium, sodium, and bilirubin levels were concerning, but not life-threatening,” says Labato. “It seemed like a case of lepto.”
Since hemodialysis treatment can cost $10,000 or more and comes with risks, the Altmans were counseled by Dr. Schultz while making a difficult decision. “Dr. Schultz explained our treatment options in a way that we could understand. We tried a less costly treatment for one day to see how she responded and, thankfully, Sage showed improvement rather quickly,” Altman admits.
“She spent five nights in the hospital and received incredible care,” says Altman.
Not all dogs who develop similar symptoms are as lucky as Sage, according to Labato. “Dog owners should know that vaccines are not complete until their pets receive the whole series of shots,” she says.
“Sage had not received the full series, and most likely contracted lepto in our yard,” Altman contends. Rodent infestations are a common source of spreading the bacteria that causes this disease, according to the Centers for Disease Control and Prevention.
“Medical management of lepto signs works in some cases, but those that are very sick need to go on dialysis and only somewhere between 68 and 78 percent of lepto cases make it out of the hospital and survive,” Labato shares.
The Altmans are grateful for the excellent care Sage received at Foster Hospital. “Everyone we encountered at Tufts, from the front desk, to technicians, and staff were kind, caring, and helpful. They worked hard to save Sage’s life. My husband and I agreed that if we have another emergency, we will bring Sage to Tufts Foster Hospital.”
Altman reports that Sage has put on a few pounds since the early August incident and is doing very well. “At five months old she is a happy and healthy puppy trying to chew on anything and everything. She has a big personality and loves meeting people and other dogs.”
Department:Dept. of Clinical Sciences ,  Foster Hospital for Small Animals