A two-month-old warmblood foal was presented with complaints of acute respiratory distress and lethargy. Both clinical examination and blood tests revealed icterus, dyspnea and kidney failure. The foal was euthanized and necropsy and histological examination showed extensive kidney damage, liver damage and alveolar hemorrhage. The diagnosis of leptospirosis was confirmed by immunofluorescense. Unlike in human cases of leptospirosis, respiratory symptoms caused by alveolar hemorrhage in horses are not often associated with leptospirosis. This case shows that the frequency of respiratory complications caused by alveolar hemorrhage after leptospira infection might be underestimated. It is important to consider leptospirosis in the differential diagnosis of dyspnea in the foal
