Leptospirosis can be transmitted from animal to human
Dear Dr. Roach: Our family dog got sick and needed to be admitted to the veterinary hospital, where she was diagnosed with leptospirosis. The vet says she will pull through, but do I need to be concerned about my family? — E.V.
Answer: A handful of diseases — called zoonoses — can be transmitted from dogs to humans. Of these, leptospirosis is the only one that can be transmitted by urine. It’s most likely your dog was in contact with an infected rodent in the house or yard, or it could have come from stagnant water where animal urine could be found.
Unfortunately, yes, the disease can be passed from your dog to your family, so you need to be vigilant in watching all family members for sudden onset of symptoms.
Leptospirosis is a bacterial infection that can cause serious illness. The most common initial signs are fever, muscle aches, shaking, chills and headache. These symptoms typically start suddenly. Redness of the conjunctiva, seen as redness in the white part of the eyes, is a typical finding, but there are other less-specific signs, including abdominal pain, cough, joint pain and rash.
I do not recommend medication to prevent infection in humans. Any symptoms should be evaluated by your regular doctor, whom you should tell about the dog’s diagnosis.
Carefully cleaning all hard surfaces (mix 1 part bleach to 10 parts water for an effective solution or use a professional antibacterial cleaning solution) and washing bedding where the dog has been would be wise. Once the dog has gotten the OK from your vet to come home, wash your hands after handling the dog, and use gloves if you are handling its waste.
There is a dog vaccine, which unfortunately is not 100% effective. There is no vaccine for humans. I would also consider professional pest control to make sure you don’t have any mice or rats living in the home.
Leptospirosis can affect many animals. Dogs are common, but in the rare case, cats get it too.
Dear Dr. Roach: I am 72 years old and have developed severe tendonitis in my right shoulder. After having seen a doctor, receiving two shots, undergoing six weeks of therapy and trying my best to curtail use of my right arm, I find there is still significant pain. The doctor says the last remaining option is surgery, which I am not in favor of. I have been in pretty good health. Other than some prostate and heart issues, I believe I am in reasonably good shape, having done outdoor work and gardening. Any suggestions on moving forward? — E.C.
Answer: Tendon problems of the shoulder can cause very significant loss of function, and the best treatment is usually what you have done: physical therapy and sometimes joint injections.
I agree with you that surgery is not a great option. Try asking your therapist if you are continuing to improve, or are not getting any better. If you are still improving, even if slowly, continue the exercise for at least another few weeks. Ask your therapist about home activity. Most often, they want you to do more, not less, so curtailing use at home might be the wrong move.
An MRI scan is considered standard before surgery and can help be sure there are no other issues. If the surgeon says you aren’t going to get better without surgery, and you aren’t getting better with more therapy (and possibly injections), I recommend getting the surgery done if your regular doctor says your heart issues make surgery safe for you. Having both arms working well improves quality of life a lot.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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