Endemic diseases of continental Europe are being seen with increasing frequency in the UK as animals travel more widely. We have been dealing with an adopted Spanish dog, Abi who has been resident in the UK for some months now. She presented with ulcerating skin lesions, weight loss, lethargy and shifting lameness and joint swelling, A canine profile revealed a very marked hyperglobulinaemia, anaemia and thrombocytopenia and a joint tap confirmed an inflammatory arthropathy and suspected polyarthritis. Suspecting infectious disease acquired in Spain a panel of PCR tests was run including Leishmania, Ehrlichia, Borrelia, Bartonella and Babesia on EDTA blood. The results were all negative.

The clinical signs however strongly suggested leishmaniasis so a biopsy of the skin lesions was taken. This confirmed the presence of granulomatous inflammation that was consistent with, but not specific for Leishmania. The sensitivity of PCR for Leishmania on blood is not 100%, particularly if the infection has been present for some time so a serology panel for the same organisms was undertaken. The Leishmania titre was off the top of the immunofluorescent assay range!

Abi has been on treatment for a number of weeks now and is making good progress. One of the drugs used in her treatment, Meglumine (Glucantime), requires a Special Treatment Authorisation, as it is not licensed or available in the UK. To obtain this drug a confirmed diagnosis is required. The other drug, which acts synergistically with Meglumine, is Allopurinol (Zyloric). While Abi will never be cured there is a good chance of her disease achieving remission for a number of years with good quality of life.

http://www.leishmania.co.uk is an excellent website that the consulting vet for this case used. The site includes an order form for Glucantime, assistance in meeting the requirements for its use and discusses the alternative diagnostic tests. Diagnosing leishmaniasis is more difficult in dogs from endemic areas and sometimes more than one test will be needed to confirm the disease. The photograph abovet, from another recent case of leishmaniasis which presented to Andy, shows classical leishmaniasis present in the bone marrow.