- Location
- Andorra and Spain
As you know from @Emily_Babbelhund's threads, leishmaniasis is endemic in Spain, and several other Mediterranean countries (as well as the Americas, Asia, and Middle East). It is a disease that is transmitted by a little git called a phlebotomus, or sand fly - so-called, because of their sandy colour, rather than being anything to do with beaches. The infection itself is a parasite, which can live in the host, totally dormant and undetected, for months or years before becoming active and causing damage.
There are two types of leishmania: cutaneous (affecting the skin) and visceral (affecting the abdominal organs). Around 90% of dogs with clinical symptoms will present with cutaneous issues, whether or not they have visceral involvement, too.
When the parasite becomes active, there are two options for treatment. One is a daily injection of a drug called glucantime, the other is a liquid to be taken orally, called milteforan. Glucantime is the far more aggressive treatment, and slightly more effective, but can only be administered to dogs with no sign of renal compromise. If the kidneys are damaged, then milteforan must be used; this is slower to take effect, and so kinder on the internal organs as the parasites die off. The problem with milteforan is that it is highly caustic (you must wear gloves to prevent it coming into contact with your skin), and if not administered very carefully, can cause burning of the throat and GI tract.
Alongside these drugs, and for a much longer term, a tablet called allopurinol is given twice daily. Once the parasite is under control, this helps it to remain in remission. Some dogs are on allopurinol for life, although the protocols are changing more recently around this. The issue with allopurinol is that it creates a high risk of crystals forming in the kidneys, which can lead to damage and, ultimately kidney failure. This is mitigated by providing a diet which is low in purines. That means, no offal, very little or no red meat, restriction of certain fish and vegetables etc. It is possible to buy specific kibble for this: these crystals are very common in Dalmatians, so Dalmatian-specific food tends to be very low in purine.
If the leishmania is not treated, the dog will normally die from organ failure.
So, why am I telling you this?
Over a year ago, I was struggling to find the cause of a rash that Squidge was having on her tummy and armpits. We tried dietary restriction, but it didn't seem to help. I asked the vet to take a scraping to see if it was demodectic mites. Unbeknownst to me, at the same time, she took a blood test and it came back positive for leish. I hadn't even considered this possibility at the time, so to say it was a gut-punch would be an understatement. In a bit of a daze, we started her on allopurinol and a 30-day course of glucantime injections.
My beautiful little monster was a total and utter superstar during this treatment. It was really hard for me to go through emotionally, but she just soldiered on through, jumping up on the sofa in wait for her plate of cream cheese when I got the needles out. The injection was absolutely huge - 10ml every day - and by the end of the course, it was becoming really difficult to find a suitable injection site, as her entire neck and back was rock solid from the inflammation of all the previous injections. I had to do this almost entirely alone, too, as J was working in Andorra at this time, so I was so grateful to her that she was so calm about it all.
Since then, she has had several sets of blood tests to keep an eye on progress. Each one has shown the parasite to be totally inactive. Yesterday, we got the latest set. I was really worried about this, as her rash has reappeared the last few days. So when the vet phoned to ask me to come in and have her weighed because she needed medication, I was certain it meant the leish had become active again, and she would be back on the glucantime. Thankfully, not. Her leish is still totally inactive, but she just has a bit of inflammation in her liver, so she's on a 30-day course of drugs for that.
I do constantly wonder whether the initial diagnosis was a false positive; it is possible in some cases to get these. The thing is, we'll probably never know. Her rash is obviously unrelated to leish, so we still have to find out what is causing that, and we'll continue to do six-monthly blood tests to check for leish for all the dogs (at €150 a pop
) so that, if the little bastards do become active at any point, we can get onto treatment straight away.
The good thing is that, with fit, healthy, and unstressed dogs, it's far less likely to become active.
It is something that will be in the back of our minds forever, but for now, no-one would have any idea of her diagnosis by looking at her, and if it remains under control, then it will have no impact on her longevity or quality of life.
Worse news, from her point of view, is that the scales were not kind to her and now she on a die-uht and is having to come running with me so we can both shed some pounds.
There are two types of leishmania: cutaneous (affecting the skin) and visceral (affecting the abdominal organs). Around 90% of dogs with clinical symptoms will present with cutaneous issues, whether or not they have visceral involvement, too.
When the parasite becomes active, there are two options for treatment. One is a daily injection of a drug called glucantime, the other is a liquid to be taken orally, called milteforan. Glucantime is the far more aggressive treatment, and slightly more effective, but can only be administered to dogs with no sign of renal compromise. If the kidneys are damaged, then milteforan must be used; this is slower to take effect, and so kinder on the internal organs as the parasites die off. The problem with milteforan is that it is highly caustic (you must wear gloves to prevent it coming into contact with your skin), and if not administered very carefully, can cause burning of the throat and GI tract.
Alongside these drugs, and for a much longer term, a tablet called allopurinol is given twice daily. Once the parasite is under control, this helps it to remain in remission. Some dogs are on allopurinol for life, although the protocols are changing more recently around this. The issue with allopurinol is that it creates a high risk of crystals forming in the kidneys, which can lead to damage and, ultimately kidney failure. This is mitigated by providing a diet which is low in purines. That means, no offal, very little or no red meat, restriction of certain fish and vegetables etc. It is possible to buy specific kibble for this: these crystals are very common in Dalmatians, so Dalmatian-specific food tends to be very low in purine.
If the leishmania is not treated, the dog will normally die from organ failure.
So, why am I telling you this?
Over a year ago, I was struggling to find the cause of a rash that Squidge was having on her tummy and armpits. We tried dietary restriction, but it didn't seem to help. I asked the vet to take a scraping to see if it was demodectic mites. Unbeknownst to me, at the same time, she took a blood test and it came back positive for leish. I hadn't even considered this possibility at the time, so to say it was a gut-punch would be an understatement. In a bit of a daze, we started her on allopurinol and a 30-day course of glucantime injections.
My beautiful little monster was a total and utter superstar during this treatment. It was really hard for me to go through emotionally, but she just soldiered on through, jumping up on the sofa in wait for her plate of cream cheese when I got the needles out. The injection was absolutely huge - 10ml every day - and by the end of the course, it was becoming really difficult to find a suitable injection site, as her entire neck and back was rock solid from the inflammation of all the previous injections. I had to do this almost entirely alone, too, as J was working in Andorra at this time, so I was so grateful to her that she was so calm about it all.
Since then, she has had several sets of blood tests to keep an eye on progress. Each one has shown the parasite to be totally inactive. Yesterday, we got the latest set. I was really worried about this, as her rash has reappeared the last few days. So when the vet phoned to ask me to come in and have her weighed because she needed medication, I was certain it meant the leish had become active again, and she would be back on the glucantime. Thankfully, not. Her leish is still totally inactive, but she just has a bit of inflammation in her liver, so she's on a 30-day course of drugs for that.
I do constantly wonder whether the initial diagnosis was a false positive; it is possible in some cases to get these. The thing is, we'll probably never know. Her rash is obviously unrelated to leish, so we still have to find out what is causing that, and we'll continue to do six-monthly blood tests to check for leish for all the dogs (at €150 a pop
) so that, if the little bastards do become active at any point, we can get onto treatment straight away.The good thing is that, with fit, healthy, and unstressed dogs, it's far less likely to become active.
It is something that will be in the back of our minds forever, but for now, no-one would have any idea of her diagnosis by looking at her, and if it remains under control, then it will have no impact on her longevity or quality of life.
Worse news, from her point of view, is that the scales were not kind to her and now she on a die-uht and is having to come running with me so we can both shed some pounds.
