The disease is endemic in many parts of the world including Central and South America, Africa, India, and the Mediterranean basin. In many of the endemic areas, dogs are considered the major reservoir for human disease. Coinfections with other parasites such as Trypanosoma spp have been reported.
Concurrent transmissible venereal tumors is common in endemic areas.
Species which are pathogenic to dogs include:
- Leishmania infantum chigasi (Leishmanis donovani complex)
- Leishmania guyanensis
- Leishmania braziliensis
- Leishmania peruviana
- Leishmania panamensis
- Leishmania colombiensis
Leishmania spp cycle between vertebrate hosts and sand fly vectors in either the promastigote or amastigote form. Both stages are capable of replication via binary fission but not within the same host. Low parasite numbers are common in chronic cases, where infected macrophages or individual amastigotes enter the systemic circulation and slowly disseminate to visceral organs leading to internal disease.
Clinical signs are usually apparent in older dogs (> 3 years of age). IgG1 appears to correlate with clinical disease while asymptomatic dogs have higher IgG2 antibody levels.
Symptoms include skin lesions dermatitis, blepharitis, stomatitis, lethargy, anorexia, epistaxis, weight loss, fever, local or generalized lymphadenopathy, osteomyelitis, hepatosplenomegaly and prostatitis. Articular involvement is also fairly common and may present as lameness with swollen joints or simply as a stiff gait.
Laboratory analysis usually reveals hyperglobulinemia, often in conjunction with hypoalbuminemia. Serum protein electrophoresis commonly reveals a polyclonal gammopathy consisting primarily of IgG immunoglobulins and some acute phase proteins. This can be confused with plasmacytoma or ehrlichiosis. Proteinuria and hematuria are fairly common, associated with an underlying glomerulonephritis, which if present, is often fatal. Also commonly observed is elevated ALT and alanine aminotransferase.
Diagnosis is based on presenting clinical signs, demonstration of Leishmania spp amastigotes in biopsies of blood, bone marrow, lymph node, spleen, skin or other tissues. Definitive testing requires Immunofluorescent antibody (IFA), ELISA or PCR assays.
Treatment may be successful with:
- allopurinol alone, or in combination with a pentavalent antimonial such as meglumine antimonite or sodium stibogluconate
- miltefosine alone, or in combination with marbofloxacin or allopurinol
- amphotericin B
- pentamidine isethionate
- ketaconazole, miconazole, fluconazole and itraconazole have also been tested
The recent preventive vaccination of dogs in Brazil has led to a reduction in the incidence of canine and human disease.
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