Leishmaniasis-an overview

Canine Leishmaniasis (CanL) or Leish is a vector-borne disease caused by the Leishmania Infantum protozoan parasite and is transmitted by female Phlebotomine sand flies.

It is treatable, but not curable, but it is not life shortening.

Correctly monitored and treated Leish dogs have a good quality of life. Leish infection is endemic in Southern Europe, with about 60% of dogs estimated to be infected. Only about 5% - 10% of infected dogs, however, will ever develop symptoms or clinical/active Leish.

Dogs from endemic countries (whether they have tested positive to Leish or not) can develop active Leish up to seven years after coming to the UK. There is no specific trigger for this, but it is believed that physical or mental stress and a weakening of a dog’s immune system can be contributing factors.

Leish is an indirect zoonotic disease, it requires a vector (the sand fly) to spread from host to host. This means it cannot be transferred in nonendemic countries, like the UK, where the climate is too wet and windy for sand fly to survive. Even in endemic countries, direct dog to dog transmission is not possible, although it is advisable not to use infected dogs or bitches for breeding. CanL is one particular strand of Leishmaniasis, which infects canines and humans alike, however, due to the complexities of sandfly feeding and reproduction, even in endemic country humans are no more likely to be infected from their own dog, than from one 20 miles away. In the UK, where sandfly is not endemic, humans can not be infected from their dogs at all.

Reputable rescues/charities will provide Leish test results for all their rescues. It is worth noting that a SNAP test (akin to a fingerprick test) is not as reliable as a blood test analysed by a laboratory. Laboratory tests are analysed in various ways, ELISA and IFAT being the most common. Both of those should be acceptable to UK insurance companies and allow dogs with negative results to be fully insured. Ask your insurance to confirm this with their underwriters though, before entering into an agreement. 

Dogs with negative Leish tests do not require medication, however, owners are advised to look out for any possible Leish symptoms. Should they and their vet suspect Leish, dogs need to be blood tested as soon as possible. The earlier Leish is diagnosed and treated, the better the prognosis for the dog.

Dogs with positive Leish tests or those who have previously been treated for clinical/active Leish, will require Allopurinol (a human gout medication readily available in the UK) for around 18 months, or until the dog has had three clear sets of six monthly blood tests. Please note that in the UK Allopurinol is a prescription drug and can only be purchased with a Veterinary Prescription. Vets usually charge £ 12 for a three months prescription with one repeat, i.e. for six months. Boots or Tescos pharmacies dispense Allopurinol or it can be purchased online. The monthly cost of this for an average Setter weight dog is about £ 6. 

Dogs with clinical/active Leish should never travel and should receive treatment in their home country before rehoming. 

Unfortunately UK veterinarians do not receive education about Leish in vet school, neither does the British Veterinary Association encourage their learning. You may encounter prejudice and misinformation at your vet’s.

You will also find that the drugs used to treat clinical/active Leish (Milteforan liquid or Glucantime injections) are not licensed in the UK. Veterinarians have to apply for individual licences to treat dogs, which inflates the cost of treatment. However, as things stand, it appears possible for dog owners to purchase these drugs online without prescription (approx.. EUR 200 for a course of treatment for a setter weight dog) and adopters have been known to treat their dog at home. I am sure that legally this is a grey area, but equally I am not aware of any legal proceedings or prosecutions relating to this.

All adopters of Leish positive dogs will require veterinary support, for blood tests and ongoing monitoring/assessment of their dog’s health, so it is important to build a good working relationship with a UK vet, who is willing to learn about Leish and to support their client. There are many of them about. 

Symptoms

CanL symptoms can be varied and not all dogs will show all (if any) symptoms. Hence Leish positive dogs require regular blood tests as outlined below. 

Visceral — affects organs of the abdominal cavity 

• Severe weight loss

• Loss of appetite (anorexia) 

• Diarrhoea  Tarry faeces (less common)

• Vomiting  Nose bleed  

• Exercise intolerance 

Cutaneous — affects the skin 

• Hyperkeratosis-most prominent finding; excessive epidermal scaling with thickening, depigmentation (loss of skin colour), and chapping of the muzzle and footpads 

• Alopecia-dry, brittle hair coat with symmetrical hair loss

• Nodules usually develop on the skin surface 

• Intradermal nodules and ulcers may be seen  

• Abnormally long or brittle nails are a specific finding in some patients 

Other signs and symptoms associated with leishmaniasis include:

• Lymphadenopathy-disease of the lymph nodes with skin lesions in 90 percent of cases  Emaciation  

• Signs of renal failure-excessive urination, excessive thirst, vomiting possible

• Neuralgia-painful disorder of the nerves 

• Pain in the joints  

• Inflammation of the muscles 

• Uveitis or other eye symptoms 

• Osteolytic lesions — a "punched-out" area with severe bone loss

• Inflammation of the covering of bones; rare

• Fever with an enlarged spleen (in about one-third of patients) 

Leish positive dogs require six monthly blood tests, until three clear sets of tests are achieved. Blood tests recommended are serology/titre (an antibody test), standard haematology and biochemistry and SPE (serum protein electrophoresis, a test which in 93% of dogs with active Leish shows a very specific pattern). 

The Leish PCR test commonly offered by UK vets is only recommended in a very small number of cases with complications. It is highly unreliable when carried out on blood samples, but invasive (and mostly) unnecessary when carried out on tissue samples. It is advisable to ask the vet, to get a quote for the tests (usually from IDEXX or Axiom laboratories). They are usually around £120, plus the vet’s consultation fee, however, we have known vets to charge triple that. It is also advisable to avoid referral to specialist vet clinics or university clinics such as Langfords or Bristol. They do not work according to the latest Leish treatment protocols. 

Ask your veterinary instead, to go to www.leishvet.org and follow their diagnostic and treatment protocols. They are a group of highly experienced vets from endemic countries and their website is written by vets and for vets. Lastly there is a Leish support group on Facebook with nearly 6000 members, called Living with Leish, where admin provide free advice from diagnosis, to sourcing of drugs and treatment methods.

Written by Martina Hamburger-Willmer

The Living With Leish facebook group is a fantastic resource that provides “support and information on diagnosis and treatment of dogs with clinical Leishmania, according to Leishvet protocol”.

At Animals Help all dogs are SNAP tested for leishmaniasis, Spanish Happy Tails Rescue UK have also started requesting further blood tests for the dogs that have found adopters.

These further blood tests are more sensitive than SNAP tests and therefore more accurate.

Adopters receive copies of the blood test results, we are open and honest about any health issues that we are aware of. To date, all dogs we have helped find homes for have been clear of leish.

Adopt a dog from Spain

At Spanish Happy Tails Rescue UK we help rescue dogs from Spain find loving homes in the UK.

Adopting a dog from Spain is more straightforward than you might think, we deal with everything for you and with full Rescue Back Up, we are there for you from adoption and every day after that.