He's completely asymptomatic but consistently tests positive for Leish in his blood panels, so is that considered active or inactive?
If it is evident in his blood, it is active.
"Milteforan doesn't work"
Total bollocks! If that were the case, there wouldn't be thousands of dogs on the Living with Leish page who have recovered from horrific Leish using Milteforan. This is what is used for the most severe cases, when the dog is at death's door and in complete renal failure
because it is so gentle on the kidneys. And just look up the clinical trials, they're all there to state that it absolutely does work.
but the side effects can cause more harm than good
Here's the thing, not wanting to scare you, but left untreated Leishmaniasis will kill your dog. Maybe not today, maybe not next year or the one after, but when those parasites get triggered, they can cause severe symptoms very quickly. Allopurinol is not something that can reduce the parasitic load.
The side-effects from using Milteforan (Miltefosine) are generally mild vomiting and diarrhea. Read the last paragraph under "Miltefosine" from this book:
Canine and Feline Infectious Diseases
My regular vet in Spain told me Milteforan works but it would blow out Carbon's kidneys
Again, nope. The last sentence of that paragraph in the above book states:
In contrast to meglumine antimoniate*, miltefosine** does not appear to contribute to renal pathology in dogs.
* Glucantime
** Milteforan
And there is loads of evidence in scholarly articles to support this.
Glucantime leads to significant lesions forming on the kidneys, which is why it is only given to dogs with healthy kidneys. But this is not true at all of Milteforan.
The nastiest side-effect is that it is very caustic if you let the liquid touch the dog's mouth or throat. But you can prevent that by feeding it in such a way that you protect the digestive tract from burning. That's why you use the food bombs, which are made from something smelly (often tuna) and Flora ProActiv, which helps it slide down (any other low-fat margarine would be fine). Here's a document about making food bombs:
Food bombs
Leish seems to be one of those infections that vets get their knickers in a twist over, and I don't know why that's the case. It's really quite simple. I'd encourage you to read the research for yourself, because it's very clear. Again, the
LeishVet website, put together by vets from a University in Madrid, is very good and supported by the science.
Not to mention all the horror stories I've heard from people who have given it to their dogs
There are horror stories about any drug you choose to pick out of the air. It's just the way it is. If that's all you're looking for, you'll convince yourself that's all there is. But why not pop onto the Living With Leish page and ask for real people's experiences. Share your concerns and see what they say?
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