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The word “Leishmaniasis” strikes fear into the hearts of some people contemplating adopting a dog from the Mediterranean. Hopefully this interesting article will serve ao Reassure those people that in most cases dogs with Mediterranean Leishmaniasis go on to live full and happy lives, and that the disease is not transmissable from dog to any other creature. Please visit Facebook Page “Living with Leish” for full information Leishmania infantum is responsible for the Old World canine visceral leishmaniasis. Its geographical distribution (around the Mediterranean Sea) reflects the living area of the insect vector Phlebotomus spp. This is a small, silent, nocturnal, blood-sucking sandfly. WITHOUT SANDFLY, THE LEISHMANIA CAN’T BE TRANSMITTED TO OTHER DOGS. SO NO SANDFLY, NO LEISHMANIA. The incubation period is very long – between one month and seven years. In this period the microorganisms disseminate widely, with a predilection for the bone marrow, lymph nodes, spleen, and liver. Most of the positive dogs to this disease, won’t die of it, but they need general blood tests to check if the Leishmania is active or inactive every 6 months. They also need to avoid stress, steroids, and unnecessary vaccines that can flare up the dormant disease. SYMPTOMS Common clinical signs are skin lesions, weight loss, anorexia, ocular lesions, nasal bleeding, dandruff, long brittle nails, 'old socks smell' , crusty ears, dry white-ish nose, loss of energy, lethargy, limping and muscle atrophy. Chronic enteritis and renal failure are the most common cause of death. Affected animals may have other concomitant diseases such as demodicosis, dermatophytosis, and other parasitic diseases such as ehrlichiosis, anaplasmosis or rickettsiosis (common in Spain). Frequent clinical laboratory findings are polyclonal hyperglobulinemia, hypoalbuminemia, hyperprotinemia, a slight increase in liver enzymes, non-regenerative anemia and Thrombocytopenia, azotemia, proteinuria and creatininemia. Glomerulonephritis (kidney failure) is very common because of the immune reaction to the Leish. It can be reversible. DIAGNOSTIC TESTS Diagnosis is based on clinical symptoms and serological test to confirm presence of the antibodies. Tests used to diagnose Leishmaniasis are serology (also known as titre/antibody test) . There are two different tests called ELISA or IFAT. Those are done on blood sample. Another tests used for diagnosis is called PCR , but sensitivity when using blood is considered to be lower than when tissue samples are used (lymph node/liver/spleen aspirate or bone marrow sample) . TREATMENT Allopurinol: 10 mg/kg/twice a day should be started ASAP if Leishmania is suspected or newly diagnosed. They should take the allopurinol for at least 18 months while being monitored with various blood tests every 6 months. Some dogs need it for life, others don’t. Leishmaniastatic effect (slows down multiplication, but it doesn’t kill the parasite). In case of severe symptoms and blood tests suggesting kidney disease and/or anaemia additional treatments above should be started ASAP. Glucantime/Milteforan: Glucantime has to be injected every day for 4 weeks.It can be used if the kidneys are commpromised only under direct supervision of the vet IF treatment is intruduces slowly and at a lower than recommended dose . Milteforan is an oral solution and can be used safely even if the kidneys are not ok. Both treatments have leishmanicidal effect. Leishguard /Domperidone/Motillium : 0,5 mg/kg/once a day for a month, which helps fight the leishmania by supporting immune system at the cellular level. It can be repeated every 4 months. Originally Leishguard was developed as a supporting treatment against leishmania infection in addition to sand fly/tick collars. It's ability to help lower antibody levels in asymptomatic, infected dogs, determined its beneficial effect in use of Leishguard as a treatment as well. Marbofloxacine is an antibiotic that also has a leishmanicidal effect. Dose 2 mg/kg once per day for 28 days Non regenerative anaemia is a common symptom. There is an effective Chinese remedy called Gui Pi Tang and Marrow Plus for the anaemia. You can find it on the internet or in herbal stores. Common side effect of Allopurinol is formation of xanthine crystals that can also lead to formation of xanthine stones. To avoid this , dividing allopurinol dosage to 3 or 4 a day can lower the amount of crystals. Apple Cider Vinegar (ACV) and Chanca Piedra supplement can help with eliminating crystals and dissolve stones. POST TREATMENT TESTS General blood tests to monitor dog's general health status and activity of leish should be done every 6 months . Allopurinol should be also administered for at least 18 months. If 3 general blood tests done every 6 months show values withing normal, healthy , nonleish dog's ranges , leishmania can be considered stable and in remission Decision regarding further continuation or cessation of allopurinol treatment could be discussed with the vet at that time. Test used for monitoring Leish activity are Biochemistry and Hematology, Serum Protein Electrophoresis and basic urine tests. Serology test can be performed as well to monitor antibody levels but it is not stand-alone tests to monitor Leish status as there is very little correlation between severity of the disease and titre levels. DIET As one of the treatments is Allopurinol and can create ammonium crystals on the urinary system, it’s a very good idea to give a low purine diet as long as the dog is on allopurinol. There are some brands of commercial dog food. Alternatively, a raw food diet without organ meat and with none of the high purine vegetables (such as cauliflower, peas, spinach, mushrooms and legumes) is generally excellent as a diet for all breeds with a purine metabolism problem. Commercial kibble specifically prepared for Dalmatians is optimal low-purine diet If your dog has also kidney problems, it's also very important to give him food with not much Phosphorus, like commercial food for kidney problems. Please check this website: http://www.dogaware.com/health/kidneysamplediet.html#carbs WHERE CAN I GET MEDICATIONS? Veterinarians are able to prescribe Allopurinol and it can picked-up at the local pharmacy. Depending on the country the dog lives in, vets can obtain Milteforan or Glucantime for your dog. In many countries they are not easily available and vet requires import licence for them. That involves time consuming paperwork and might take several days . Cost of the medication obtained through the vet might exceed actual cost of that medication by several hundred percent. VERY IMPORTANT: Please, find a knowledgeable vet that knows the disease, or at least one that is interested in learning about it. List of recommended vets can be found on Living with Leish Page on Facebook Always talk to your rescue. They are used to this disease and they will guide you.

Health, Welfare

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Babesiosis Often if a dog from a Mediterranean country is sick, it is presumed to be caused by leishmania; but the animal should always be checked for for tick disease. It is not a life long disease such as leishmania but it can be more life threatening. There have been isolated cases in the UKwww.bbc.co.uk/news/science- environment-35815813 Babesia is a small parasite (protozoe) which affects the red blood cells of its host. Babesia is transmitted by ticks (Rhipicephalus, Dermacentor – brown female ticks). Ticks acquire Babesia whilst sucking blood from infected animals. Later, the tick sucks blood from a healthy animal and transmits Babesia.Babesia infections are reported in horses, dogs, foxes and other wild animals, also in man, but in the Mediterranean area it is mainly dogs who become infected because of the prevalence of Babesia Canis species. Direct infection between dogs and humans is not possible, it is always the tick which infects the mammals.After the bite of a tick infected with Babesia, the dog starts a period of incubation which lasts between 10 days and 3 weeks. During this time, Babesias start to penetrate the red blood cells and to multiplicate (“to breed”).After the incubation period, the dog will start with clinical symptoms, whose degree depends on the dogs own defence system:– dogs with a weak defence suffer an acute shock and die– dogs with a normal defence show high fever, loss of appetite, general weakness, pale mucous membranes and often a dark brown urine– in advanced cases, rheumatic like pain, muscle stiffness and serious problems with blood coagulation, spleen swelling and jaundice add to the symptoms mentioned above. Diagnosis Clinical symptoms and the demonstration of Babesia in the peripheral blood (ear vein) leads to a safe diagnosis. In chronic cases, a blood test (antibodies) for Babesia is recommended. TreatmentA special drug, administered twice by injection eliminates Babesia. In severe cases intensive treatment and blood transfusions are required. PreventionTick prevention! Protect your dog during the main tick season (March until November) with special tick collars or liquids (ask your vet). If you find a tick on your dog, remove it immediately (with turning clockwise movements). The tick needs 3 days of bloodsucking on the dog to transmit Babesia. The earlier you remove it, the less is the risk of this infection.