Combination Allopurinol and Antimony Treatment versus Antimony Alone and Allopurinol Alone in the Treatment of Canine Leishmaniasis (96 Cases)

Abstract

The aim of the present study was to evaluate the long‐term clinical outcome for dogs with leishmaniasis that were treated with 3 different protocols: combined treatment with antimony and allopurinol, antimony alone, or allopurinol alone. Ninety‐six dogs included in this study were determined to have leishmaniasis on the basis of (1) clinical features, (2) identification of the parasite in smears of lymph node, bone marrow aspirates, or skin biopsies, and (3) specific immunofluorescent assay. Three groups of dogs were defined: 45 dogs (group 1) were treated with antimony (100 mg/kg SC q24h) given concurrently for 1 month with allopurinol (15 mg/kg PO q12h), and then allopurinol alone for 8 months at the same dosage; 40 dogs (group 2) were treated with antimony alone according to the manufacturer's instructions (200 mg/kg SC q24h at 2‐day intervals for 3–6 months); and 11 dogs (group 3) were treated with allopurinol alone (15 mg/kg PO q12h for 1–20 months). Information concerning signalment, history, physical examination findings, serologic testing and number of dogs becoming seronegative, outcome for each treated dog (clinical cure versus failure), and long‐term survival were recorded. The numbers of the clinical cures versus failures were significantly different among the 3 groups (χ2= 17.77, P < .001), between groups 1 and 2 (χ2= 8.02, P < .01), between groups 2 and 3 (χ2= 11.00, P < .01), and between groups 1 and 3 (χ2= 16.52, P < .001). No significant difference between groups 1 and 2 was noted in the type of failure (relapse or death), serologic test results, and number of survival years (χ2= 2.79, P > .05). The results of the present study indicate that antimony in combination with allopurinol produces better results than antimony alone or allopurinol alone for the treatment of the canine leishmaniasis. With combination treatment, duration of treatment with antimony is shorter and long‐term administration of allopurinol is well tolerated.

Evaluation of acute phase protein indexes in dogs with leishmaniasis at diagnosis, during and after short-term treatment

“…Regarding specificity, results of individual APPs and acute phase indexes should be interpreted with caution due to the variety of disease conditions that can lead an acute phase response and therefore produce a change in the indexes calculated that masks the response to therapy in a dog. In addition to the modifications reported in the acute phase proteins values, other abnormalities observed in the biochemical profile of dogs infected by Leishmania is a remarkable dysproteinemia related to hyperglobulinemia causing a pronounced albumin-globulin ratio inversion (Romdane et al, 1992;Denerolle, 1996;Ciaramella et al, 1997). The study of these modifications, has been reported to be useful for assessing the clinical course of the disease during and after suitable therapy (Romdane et al, 1992).…”

“…These circumstances make difficult to decide when to withdraw the treatment and thus a useful method to monitor the response to canine leishmaniasis therapy and to predict possible relapses of the disease is clearly needed. Most frequently used parameters to evaluate the response to therapy include the albumin-globulin ratio and the study of the electrophoretical pattern since normalisation in the electrophoretogram and therefore in this ratio indicates a good response to treatment (Romdane et al, 1992;Denerolle, 1996;Bourdoiseau et al, 1997;Amusategui et al, 1998). However, Leishmania parasites do not always cause modifications in the serum protein patterns (MartinezSubiela et al, 2002a), and in some cases abnormal electropherograms have been found after successful treatment of leishmaniasis (Romdane et al, 1992).…”

Avaliação hematológica de cães naturalmente infectados por Leishmania (Leishmania) chagasi submetidos a tratamento com antimoniato de meglumina

“…1,21 Pentavalent antimonials cause reduction of the symptoms and, in some cases, even clinical cure of the dogs. 22,23,24,25,26 The occurrence of blood alterations in dogs with visceral leishmaniasis is very important and frequent. The erythrogram shows anemia, generally normocytic normochromic nonregenerative in 57 to 94.2% of the animals.…”

Dynamics and Predictive Potential of Antibodies against Insect-Derived Recombinant Leishmania infantum Proteins during Chemotherapy of Naturally Infected Dogs

“…Several agents has been assayed to treat canine leishmaniasis, 11 although the most commonly used is a combination of meglumine antimoniate and allopurinol. 12 Successful chemotherapy has been correlated with a decrease in Leishmania -specific antibody levels, restoration of parasitespecific cell mediated immunity, and a reduction of parasite burden. 6,[13][14][15][16][17] However, drugs used to treat leishmaniasis have not been able to provide a sterile cure; although temporary clinical remission is normally achieved, relapses are frequent after use of the drug is stopped, 18 thus increasing the risk of parasitic resistance.…”