Canine leishmaniosis

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Sections available in full article Introduction, Presenting signs, Geographic incidence, Age predisposition, Breed predisposition, Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Epidemiology (population dynamics), Diagnosis, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Monitoring, Subsequent management, Prevention, Control, Prophylaxis, Sequelae, Prognosis, Sources, Publications, Vetstream contributor(s),
Contributors Dr Gad Baneth DVM PhD
Dr Alex Morrow MVB BA PhD MRCVS
Dr Lisa Moore DVM DipACVIM
Dr Bryn Tennant BVSc PhD CertVR MRCVS
Ms Susan E Shaw BVSc (Hons) (Syd) MSc DipACVIM DipECVIM FACVSc MRCVS
Synonyms CanL; Kala-azar (in its visceral form in humans)

Introduction

  • Serious zoonotic protozoal infection of man and animals.
  • Cause : intracellular protozoan parasites of the genus Leishmania Leishmania infantum.
  • Transmission is predominantly by sand-fly bites Phlebotomine sandfly.
  • Signs : include alopecia, exfoliative dermatitis, nodular skin lesions, generalized lymphadenopathy, progressive weight loss, muscle atrophy, exercise intolerance, lethargy, decreased appetite, polyuria, polydipsia, ocular lesions.
  • Diagnosis : demonstration of the parasite in macrophages in lymph node or bone marrow aspirates Cytology: lymph node aspirateBone marrow aspiration and serology or PCR Leishmania infantum: blood smear.
  • Prognosis : relapses usually occur.
    Print off the owner factsheet on Leishmaniosis Leishmaniosis to give to your client.

Diagnosis

Clinical signs

  • Leishmaniosis is a chronic disease. Clinical signs seen are variable and dogs may present with signs referable to one or multiple organs Leishmaniosis 15: generalized alopecia and poor body condition :
    • Skin lesions, eg exfoliative dermatitis, periocular alopecia, ulcerative and/or nodular dermatitis involving the nose, lips, eyelids, tips of ears, tail and feet; occasionally Onychogryposis.
    • Generalized lymphadenopathy Lymphadenopathy.
    • Progressive weight loss.
    • Muscle atrophy.
    • Exercise intolerance, lethargy.
    • Decrease appetite.
    • Splenomegaly.
    • Polyuria, polydipsia.
    • Ocular lesions, eg keratitis Keratitis , uveitis Uveitis , chorioretinitis Chorioretinitis , corneal edema, glaucoma Glaucoma.
    • Epistaxis Epistaxis.
    • Anemia.
    • Polyarthritis - intermittent lameness Arthritis: polyarthritis - idiopathic.
    • Gastrointestinal disease - vomiting, diarrhea.
  • Co-infections with Leishmania Leishmania infantum , Ehrlichia canis Ehrlichia canis , Anaplasma platys, Hepatozoon canis Hepatozoon canis and/or Babesia species Babesia spp may occur and complicate the clinical picture. If regenerative anemia and/or thrombocytopenia are major signs in a suspect case of leishmaniosis, then investigation of these infections is warranted.

Diagnosis

Differential diagnosis

  • Leishmaniosis is a chronic multisystemic disease. If a dog is resident in or has been to an endemic area and has any of the clinicopathological signs mentioned above, then leishmaniosis should be ruled out in the first instance. If leishmaniosis cannot be confirmed, then investigation of other differentials referable to the body system involved is appropriate.
  • Other causes of non-pruritic exfoliative dermatitis and alopecia Skin: alopecia - overview :
    • Nutritional, endocrine, demodicosis Skin: demodectic mange , dermatophytosis Skin: dermatophytosis , sebaceous adentitis Skin: idiopathic/granulomatous sebaceous adenitis.
  • Other causes of generalized lymphadenopathy:
    • Neoplasia, other generalized systemic infections, demodicosis.
  • Other causes of protein losing nephropathy.
  • Systemic lupus erythematosus Systemic lupus erythematosus.
  • Other causes of polyarthritis, anemia.

Sequelae

Prognosis

  • Although clinical response is good in the majority of dogs. It is guarded to poor in dogs with evidence of disseminated immune-mediated disease, and those with severe renal disease or failure.
  • Parasitological cure is considered rare - although many dogs with low infection loads may remain asymptomatic for long periods.

Sources

Publications

Refereed papers

  • Recent references from PubMed.
  • Solano-Gallego L et al(2009) Directions for the diagnosis, clinical staging, treatment and prevention of canine leishmaniosis. Vet Parasitol 165 , 1-18 PubMed.
  • Roze M (2005) Canine leishmaniosis. A spreading disease. Diagnosis and treatment. EJCAP 15 (1), 39-52.
  • Pennisi M G, De Majo M, Masucci M, Britti D, Vitale F & Del Maso R (2005) Efficacy of the treatment of dogs with leishmaniosis with a combination of metronidazole and spiramycin. Vet Rec 156 , 346-349.
  • Franch J et al(2004) Management of leishmanial osteolytic lesions in a hypothyroid dog by partial tarsal arthrodesis. Vet Rec 155 , 559-562.
  • Lamonthe J (2001) Activity of amphotericin B in lipid emulsion in the inital treatment of canine leishmaniasis. JSAP 42 , 170-175.
  • Owens S D, Oakley D A, Marryott K et al(2001) Transmission of visceral leishmaniasis through blood transfusions from infected English Foxhounds to anemic dogs. JAVMA 219 , 1076-1083.
  • Orndorff G R (2000) Canine visceral leishmaniasis in Sicily. Mil Med 165 (1), 29-32.
  • Denerolle P & Bourdoiseau G (1999) Combination allopurinol and antimony treatment vs antimony alone and allopurinol alone in the treatment of canine leishmaniasis (96 cases). JVIM 13 (5), 413-415.
  • Cavaliero T, Arnold P et al(1999) Clinical, serologic and parasitologic follow-up after long-term allopurinol therapy of dogs naturally infected with Leishmania infantum. JVIM 13 , 330-334.
  • Bravo L, Franks L A & Brenneman K A (1993) Canine Leishmaniasis in the United Sates. Comp Cont Educ Pract Vet 15 , 699-708. (Comprehensive review.)
  • Kontos V J (1993) Old World Canine Leishmaniasis. Comp Cont Educ Pract Vet 15 , 949-960. (Comprehensive review.)

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