Leishmaniosis is a serious zoonotic disease caused by the intracellular protozoan parasite Leishmania infantum. It is predominantly transmitted by biting sandflies. Infection is endemic in areas between 40°N and 40°S in Africa, South America, Europe and Asia. Dogs living or travelling to areas around the Mediterranean (for example, southern France, Italy, Greece, Spain, Portugal and Turkey) and the Middle East are therefore at risk.
Clinical signs
Dogs with leishmaniosis typically have swollen glands, poor appetite, listlessness, unwillingness to exercise, weight loss and skin problems. Loss of hair especially around the head and ears, scaly skin, and swellings and ulcers on legs, foot pads and other areas including the mouth and tongue may be seen (Figure 1). Ulcers and inflamed areas can appear around the lips, nose, eyes and, especially, the tips of the ears. The nails may become very long and brittle. Affected dogs may be lame, and have eye problems, bleeding from the nose, drinking and urinating too much, and vomiting and/or diarrhoea.
Diagnosis and treatment
The most commonly used treatment protocols involve a combination of meglumine antimoniate and allopurinol or a combination of miltefosine and allopurinol. For dogs in endemic areas, a vaccine is available
Vets will diagnose leishmaniosis based on a dog’s history and the results of various tests including PCR, serology and detection of the parasite in lymph node or bone marrow aspirates.
Treatment is not straightforward and is expensive. The drugs licensed in Europe may have to be imported into the UK with a Special Import Certificate (SIC). The most commonly used treatment protocols involve a combination of meglumine antimoniate and allopurinol or a combination of miltefosine and allopurinol. For dogs in endemic areas, a vaccine is available.
Prevention
At present, dogs that have never travelled outside the UK are at low risk of developing leishmaniosis. However, dogs travelling to countries where leishmaniosis is common will require protection against biting sandflies, ie a topical spot-on or insecticidal collar. Both pet owners and vets must recognise that dogs that have been in endemic regions may be infected. Leishmaniosis is a chronic multisystemic disease and by not considering the disease initially, diagnosis may be delayed.
