Title: Canine leishmaniasis

{{Short description|Disease affecting dogs}}
[[File:CanineVisceralLeishmaniasis.png|thumb|A dog displaying a typical clinical picture of visceral leishmaniasis]]
'''Canine leishmaniasis''' (LEESH-ma-NIGH-ah-sis) is a [[zoonotic]] disease (see human [[leishmaniasis]]) caused by ''[[Leishmania]]'' parasites transmitted by the bite of an infected [[Phlebotominae|phlebotomine]] [[sandfly]]. There have been no documented cases of leishmaniasis transmission from dogs to humans. Canine leishmaniasis was first identified in Europe in 1903, and in 1940, 40% of all dogs in Rome were determined to be positive for leishmaniasis.&lt;ref&gt;Dereure J., Pratlong F., Dedet, J.P (1999) ''Geographical distribution and the identification of parasites causing canine leishmaniasis in the Mediterranean Basin.  Canine leishmaniasis: an update.'' Proceedings of the International Canine Leishmaniasis Forum. Barcelona, Spain&lt;/ref&gt; Traditionally thought of as a disease only found near the [[Mediterranean basin]], 2008 research claims new findings are evidence that canine leishmaniasis is currently expanding in continental climate areas of northwestern Italy, far from the recognized disease-endemic areas along the Mediterranean coasts.&lt;ref&gt;{{cite journal |vauthors=Ferroglio E, Maroli M, Gastaldo S, Mignone W, Rossi L |title=Canine leishmaniasis, Italy |journal=Emerging Infect. Dis. |volume=11 |issue=10 |pages=1618–20 |date=October 2005 |pmid=16318709 |url=https://www.cdc.gov/ncidod/EID/vol11no10/04-0966.htm |doi=10.3201/eid1110.040966 |pmc=3366729}}&lt;/ref&gt; Cases of leishmaniasis began appearing in North America in 2000,&lt;ref name=&quot;Dean2000&quot;&gt;{{cite journal |author=Monti, Dean |title=Hunters hounded as leishmaniasis is diagnosed in Foxhounds |journal=J Am Vet Med Assoc |date=June 2000 |url=http://www.avma.org/onlnews/javma/jun00/s061500a.asp |pmid=10863579 |volume=216 |issue=12 |pages=1887, 1890}}&lt;/ref&gt; and, as of 2008, ''Leishmania''-positive [[foxhound]]s have been reported in 22 U.S. states and two Canadian provinces.&lt;ref name=autogenerated2&gt;Rosypal, Alexa. (2005)
[http://hdl.handle.net/10919/26873 Characterization of Canine Leishmaniasis in the United States: Pathogenesis, Immunological Responses, and Transmission of an American Isolate of ''Leishmania infantum'']. ''Veterinary Clinics of North America Small Animal Practice Journal''. Blacksburg, VA.&lt;/ref&gt;

==Forms and symptoms==
'''Cutaneous'''
* [[Alopecia]]
* Skin lesions
* Ulcerative or [[exfoliative dermatitis]]
* Interdigital furunculosis(ulcers between toes).&lt;ref&gt;{{Cite book |title=Leishmaniosis. Una revisión actualizada |date=2013 |isbn=978-84-941389-1-1 |language=es |chapter=Manifestaciones clínicas cutáneas |last1=Gallego |first1=Laia Solano |publisher=Servet }}&lt;/ref&gt;
Especially if there are other leishmania lesions, such as hair loss, on the same leg.

'''Visceral'''
* [[Epistaxis]] (nose bleeds)
* Kidney failure &gt; increased urination and drinking
* Ocular signs
* Progressive loss of weight with decreased appetite
* Swollen [[lymph nodes]]

==Cause==
Numerous strains and subgenus strains of ''[[Leishmania]]'' exist; with sandfly genome projects still underway, strains are still being discovered.&lt;ref&gt;{{cite web|url=http://www.genome.gov/Pages/Research/Sequencing/SeqProposals/SandFliesSeq.pdf|title=Proposal for Sequencing the Genome of the Sand Flies, Lutzomyia longipalpis and Phlebotomus papatasi |website=Genome.gov|access-date=17 March 2022}}&lt;/ref&gt;

In the [[Old World]], leishmaniasis transmitted by sandflies of the genus ''[[Phlebotomus]]'' documented in dogs are:
* ''[[Leishmania donovani|L. donovani]]'' in Sri Lanka&lt;ref&gt;{{cite journal | author = Nawaratna S.S.K. | year = 2009 | pages = 513–7 | title = Cutaneous leishmaniasis in Sri Lanka: a study of possible animal reservoirs | issue = 4 | pmid = 19095480 | volume = 13 | journal = International Journal of Infectious Diseases | doi = 10.1016/j.ijid.2008.08.023|display-authors=etal| doi-access = free }}&lt;/ref&gt;
* ''[[Leishmania infantum|L. infantum]]''  (began appearing dogs in the United States in 2000)

[[New World]] leishmaniasis strains are spread by ''[[Lutzomyia]]''; however, research speculates the North American sandfly could be capable of spreading, but this is to date unconfirmed.  Dogs are known reservoirs of ''L. infantum'', and the spread of disease from dog to dog has been confirmed in the United States.
* Suspected causes of canine visceral leishmaniasis are geographic variants of the ''Leishmania donovani'' complex, including&lt;ref name=&quot;Duprey2006&quot;&gt;{{Cite journal | author= Duprey Z.H. | year= 2006 | title= Canine visceral leishmaniasis, United States and Canada, 2000-2003 | journal= Emerging Infect. Dis. | volume= 12 | issue = 3 | pages = 440–6 | pmid=16704782 | doi=10.3201/eid1203.050811 | pmc=3291440|display-authors=etal}}&lt;/ref&gt; ''L. infantum, L. chagasi'' and ''L. donovani''.

The Mexicana (''L. mexicana, L. amazonensis, L. venezuelensis'', and ''L. pifanoi'') and Viannia (''L. braziliensis, L. guyanensis, L. panamensis'' and ''L. peruviana'') strains are not commonly found in dogs. Subgenus Viannia strains are found only in Central and South America, all of which cause leishmaniasis in humans.&lt;ref&gt;{{cite web
 | title = Pathogens
 | url = http://www.cvbd.org/4090.0.html
 | access-date = 30 April 2006
 | archive-url = https://web.archive.org/web/20090724024806/http://www.cvbd.org/4090.0.html
 | archive-date = 24 July 2009 }}&lt;/ref&gt;

===Transmission===
Traditionally, canine transmission is directly from sandfly to dog.  Cases in the United States have proven ''L. infantum'' transmission from dog to dog by direct contamination with blood and secretions, as well as transplacentally from an infected bitch to her pups.&lt;ref&gt;{{cite web |url=http://www.capcvet.org/?p=Guidelines_Leishmaniasis&amp;h=0&amp;s=0 |title=Companion Animal Parasite Council |publisher=Capcvet.org |date= |access-date=2012-10-04 |archive-url=https://web.archive.org/web/20120213142901/http://www.capcvet.org/?p=Guidelines_Leishmaniasis&amp;h=0&amp;s=0 |archive-date=2012-02-13 }}&lt;/ref&gt;  This mode of transmission seems to be unique to the ''L. infantum'' Mon1 strain found in the United States. Although ''in utero'' transmission is likely the predominant method of disease spread amount the ''L. infantum'' Mon1 strain, it is still a viable parasite (has not lost virulence factors associated with sandfly-uptake) which can be transmitted via sandfly bite.&lt;ref&gt;{{Cite journal|last1 = Schaut|first1 = Robert G.|last2 = Robles-Murguia|first2 = Maricela|last3 = Juelsgaard|first3 = Rachel|last4 = Esch|first4 = Kevin J.|last5 = Bartholomay|first5 = Lyric C.|last6 = Ramalho-Ortigao|first6 = Marcelo|last7 = Petersen|first7 = Christine A.|date = 2015-12-01|title = Vectorborne Transmission of Leishmania infantum from Hounds, United States|journal = Emerging Infectious Diseases|volume = 21|issue = 12|pages = 2209–2212|doi = 10.3201/eid2112.141167|issn = 1080-6059|pmc = 4672406|pmid = 26583260}}&lt;/ref&gt; A Brazilian study of 63 puppies from 18 ''L. donovani''-infected parents found no evidence of congenital or transplacental infection.&lt;ref name=autogenerated2 /&gt;

==Diagnosis==
In the United States, certain breed clubs are strongly recommending screening for ''Leishmania'', especially in imported breeding stock from endemic locations. For reasons yet unidentified the [[Foxhound]] and [[Neapolitan Mastiff]] seem to be predisposed or at higher risk for disease.&lt;ref name=&quot;Dean2000&quot;/&gt;&lt;ref&gt;Petersen CHF paper 2008&lt;/ref&gt; The Italian Spinone Club of America is also requesting all breeders and owners to submit samples for testing; the club reported 150 [[Spinone Italiano]] dogs have tested positive in the United States.&lt;ref&gt;
{{cite web
 | title = Spinone Club of America Health Information - Spinoni Italiani
 | url = http://www.spinone.com/frhealth.htm
 | access-date = 30 April 2006
 | archive-url = https://web.archive.org/web/20080116083822/http://www.spinone.com/frHealth.htm
 | archive-date = 16 January 2008 }}&lt;/ref&gt;

In the United States, the following veterinary colleges and government bodies assist with testing and treatment of ''Leishmania''-positive dogs:
* Centers for Disease Control and Prevention on Leishmaniasis in dogs &lt;ref&gt;{{Cite web|url=https://www.cdc.gov/parasites/leishmaniasis/dogs.html|title=CDC - Leishmaniasis - Leishmaniasis in Dogs FAQs|first=CDC-Centers for Disease Control and|last=Prevention|website=Cdc.gov|access-date=17 March 2022}}&lt;/ref&gt;
* Iowa State University Department of Pathology&lt;ref&gt;{{cite web |url=http://www.biotech.iastate.edu/Current_Research/faculty_by_department.html#vetpathology |title=Office of Biotechnology: Iowa State University |website=Biotech.iastate.edu |date= |access-date=2012-10-04 |archive-url=https://web.archive.org/web/20131016085027/http://www.biotech.iastate.edu/Current_Research/faculty_by_department.html#vetpathology |archive-date=2013-10-16 }}&lt;/ref&gt;
* North Carolina State University College of Veterinary Medicine

Diagnostic testing includes molecular biology and genetic techniques which provide high accuracy and high sensitivity/specificity. The most commonly employed methods in medical laboratories include [[Enzyme-Linked Immunosorbent Assays]], aka ELISA (among other serological assays) and [[Polymerase chain reaction|DNA amplification]] via Polymerase Chain Reaction ([[Polymerase chain reaction|PCR]]).
The [[Polymerase Chain Reaction]] (PCR) method for detecting ''Leishmania'' DNA is a highly sensitive and specific test, producing accurate results in a relatively short amount of time.
A study completed in which Foxhounds were tested using PCR showed that approximately 20% of the tested dogs were positive for leishmaniasis; the same population tested with serological/antibody assays showed only 5% positive.&lt;ref&gt;Petersen paper find notes&lt;/ref&gt;

Diagnosis can be complicated by false positives caused by the leptospirosis vaccine and false negatives caused by testing methods lacking sufficient sensitivity.

==Prevention==
In areas where the known vector is a sandfly, [[deltamethrin]] collars worn by the dogs has been proven to be 86% effective.&lt;ref&gt;{{cite journal |doi=10.3201/eid0705.010516 |vauthors=Reithinger R, Teodoro U, Davies CR |title=Topical insecticide treatments to protect dogs from sand fly vectors of leishmaniasis |journal=Emerging Infect. Dis. |volume=7 |issue=5 |pages=872–6 |year=2001 |pmid=11747701 |pmc=2631889 |url=https://www.cdc.gov/ncidod/eid/vol7no5/reithinger.htm}}&lt;/ref&gt;  The sandfly is most active at dusk and dawn; keeping dogs indoors during those peak times will help minimize exposure.

Unfortunately, there is no one answer for leishmaniasis prevention, nor will one vaccine cover multiple species.  &quot;Different virulence factors have been identified for distinct ''Leishmania'' species, and there are profound differences in the immune mechanisms that mediate susceptibility/resistance to infection and in the pathology associated with disease.&quot;&lt;ref&gt;{{cite journal |vauthors=McMahon-Pratt D, Alexander J |title=Does the Leishmania major paradigm of pathogenesis and protection hold for New World cutaneous leishmaniases or the visceral disease? |journal=Immunol. Rev. |volume=201 |pages=206–24 |date=October 2004 |pmid=15361243 |doi=10.1111/j.0105-2896.2004.00190.x |s2cid=23421726 |doi-access=free }}&lt;/ref&gt;

In 2003, Fort Dodge [[Wyeth]] released the Leshmune vaccine in Brazil for ''L. donovani'' (also referred to as ''kala-azar'' in Brazil).&lt;ref&gt;{{cite journal |vauthors=Nogueira FS, Moreira MA, Borja-Cabrera GP |title=Leishmune vaccine blocks the transmission of canine visceral leishmaniasis: absence of Leishmania parasites in blood, skin and lymph nodes of vaccinated exposed dogs |journal=Vaccine |volume=23 |issue=40 |pages=4805–10 |date=September 2005 |pmid=16011864 |doi=10.1016/j.vaccine.2005.05.011 |display-authors=etal}}&lt;/ref&gt;  Studies indicated up to 87% protection.&lt;ref name=autogenerated1&gt;{{cite journal |vauthors=Parra LE, Borja-Cabrera GP, Santos FN, Souza LO, Palatnik-de-Sousa CB, Menz I |title=Safety trial using the Leishmune vaccine against canine visceral leishmaniasis in Brazil |journal=Vaccine |volume=25 |issue=12 |pages=2180–6 |date=March 2007 |pmid=17239495 |doi=10.1016/j.vaccine.2006.11.057 }}&lt;/ref&gt; Most common side effects from the vaccine have been noted as anorexia and local swelling.&lt;ref name=autogenerated1 /&gt;
The president of the Brazil Regional Council of Veterinary Medicine, Marcia Villa, warned since vaccinated dogs develop antibodies, they can be difficult to distinguish from asymptomatic, infected dogs.&lt;ref&gt;{{cite web |url=http://www.brazzilmag.com/content/view/579/41/ |title=Authorized Use of Leishmaniasis Vaccine Made in Brazil - brazzil |website=www.brazzilmag.com |access-date=22 May 2022 |archive-url=https://web.archive.org/web/20050209110136/http://www.brazzilmag.com/content/view/579/41/ |archive-date=9 February 2005 }}&lt;/ref&gt;
Studies also indicate the Leshmune vaccine may be reliable in treating ''L. chagasi'', and a possible treatment for dogs already infected with ''L. donovani''.&lt;ref&gt;{{cite journal |vauthors=de Andrade RA, Reis AB, Gontijo CM |title=Clinical value of anti-Leishmania (Leishmania) chagasi IgG titers detected by flow cytometry to distinguish infected from vaccinated dogs |journal=Vet. Immunol. Immunopathol. |volume=116 |issue=1–2 |pages=85–97 |date=March 2007 |pmid=17287029 |doi=10.1016/j.vetimm.2007.01.002 |url=http://www.repositorio.ufop.br/handle/123456789/1032 |display-authors=etal}}&lt;/ref&gt;&lt;ref&gt;{{cite journal |vauthors=Santos FN, Borja-Cabrera GP, Miyashiro LM |title=Immunotherapy against experimental canine visceral leishmaniasis with the saponin enriched-Leishmune vaccine |journal=Vaccine |volume=25 |issue=33 |pages=6176–90 |date=August 2007 |pmid=17630055 |doi=10.1016/j.vaccine.2007.06.005 |display-authors=etal|pmc=7115527 }}&lt;/ref&gt; Vaccination and immunotherapy may also be a treatment for ongoing ''L. infantum'' infection in dogs.&lt;ref&gt;{{Cite journal |last1=Gonçalves |first1=Ana Alice Maia |last2=Leite |first2=Jaqueline Costa |last3=Resende |first3=Lucilene Aparecida |last4=Mariano |first4=Reysla Maria da Silveira |last5=Silveira |first5=Patricia |last6=Melo-Júnior |first6=Otoni Alves de Oliveira |last7=Ribeiro |first7=Helen Silva |last8=de Oliveira |first8=Diana Souza |last9=Soares |first9=Diogo Fonseca |last10=Santos |first10=Thaiza Aline Pereira |last11=Marques |first11=Alexandre Ferreira |last12=Galdino |first12=Alexsandro Sobreira |last13=Martins-Filho |first13=Olindo Assis |last14=Dutra |first14=Walderez Ornelas |last15=da Silveira-Lemos |first15=Denise |date=2019-12-18 |title=An Overview of Immunotherapeutic Approaches Against Canine Visceral Leishmaniasis: What Has Been Tested on Dogs and a New Perspective on Improving Treatment Efficacy |journal=Frontiers in Cellular and Infection Microbiology |volume=9 |page=427 |doi=10.3389/fcimb.2019.00427 |doi-access=free |issn=2235-2988 |pmc=6930146 |pmid=31921703}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal |last1=Baxarias |first1=Marta |last2=Martínez-Orellana |first2=Pamela |last3=Baneth |first3=Gad |last4=Solano-Gallego |first4=Laia |date=2019 |title=Immunotherapy in clinical canine leishmaniosis: a comparative update |url=https://linkinghub.elsevier.com/retrieve/pii/S0034528818331886 |journal=Research in Veterinary Science |language=en |volume=125 |pages=218–226 |doi=10.1016/j.rvsc.2019.06.009|pmid=31280121 |s2cid=195830094 |url-access=subscription }}&lt;/ref&gt;&lt;ref&gt;{{Cite journal |last1=Araujo |first1=Adjanna Karla Leite |last2=Gondim |first2=Adriana Leão de Carvalho Lima |date=2020-01-01 |title=Use of Immunotherapy in the Treatment of Canine Visceral Leishmaniasis |url=https://seer.ufrgs.br/index.php/ActaScientiaeVeterinariae/article/view/105438 |journal=Acta Scientiae Veterinariae |language=en |volume=48 |doi=10.22456/1679-9216.105438 |issn=1679-9216|doi-access=free }}&lt;/ref&gt;

==Treatment==
&lt;!-- Deleted image removed: [[Image:Leishpositivedog.jpg|thumb|100px|left|Leishmania Positive Dog]]  --&gt;
Currently, no cure exists for canine leishmaniasis, but various treatment options are available in different countries.  &lt;!--- not true - CDC does not regulate In the United States, all drugs used to treat it are controlled and regulated by the [[Center for Disease Control]] (CDC).--&gt; Treatment is best coordinated with veterinary research hospitals. Treatment does vary by geographic area, strain of infection and exhibited symptoms.  Dogs can be asymptomatic for years.  Most common treatments include:

''L. donovani''
* Amphotericin B is recommended, [[antimony]] resistant

''L. infantum''&lt;ref&gt;http://asmcourse.ivic.ve/articulos/urbina/urbina3.pdf {{Dead link|date=October 2019 |bot=InternetArchiveBot |fix-attempted=yes }}&lt;/ref&gt;
* [[Amphotericin B]]
* [[Meglumine antimoniate]]
* [[Miltefosine]]
* [[Allopurinol]]
* [[Domperidone]]&lt;ref&gt;{{Cite journal |last1=Travi |first1=Bruno L. |last2=Miró |first2=Guadalupe |date=2018-10-18 |title=Use of domperidone in canine visceral leishmaniasis: gaps in veterinary knowledge and epidemiological implications |journal=Memórias do Instituto Oswaldo Cruz |language=en |volume=113 |issue=11 |article-number=e180301 |doi=10.1590/0074-02760180301 |issn=0074-0276 |pmc=6193371 |pmid=30365645}}&lt;/ref&gt;
==Research directions==
In the United States, research examining the Foxhound and Neapolitan Mastiff is scheduled to continue into 2011 at the University of Iowa.  The goals of this project are to screen for the presence of the ''Leishmania'' parasite DNA and to be a stepping stone to future research of T-cell function with the hopes of understanding canine leishmaniasis as a model for better understanding human leishmaniasis.
* Foxhound submissions forms&lt;ref&gt;{{cite web |url=http://www.vetmed.iastate.edu/faculty_staff/profiles/kalicat.asp |title=Christine A. Petersen &amp;#124; Iowa State University |website=Vetmed.iastate.edu |date=2010-06-05 |access-date=2012-10-04 |archive-url=https://web.archive.org/web/20121114192905/http://vetmed.iastate.edu/faculty_staff/profiles/kalicat.asp |archive-date=2012-11-14 }}&lt;/ref&gt;
* Neapolitan Mastiff submission forms&lt;ref&gt;{{cite web |url=http://www.everythingneo.com/index.php?option=com_content&amp;view=article&amp;id=126&amp;Itemid=127 |title=Neapolitan Mastiff Study |website=Everythingneo.com |date=2009-02-26 |access-date=2012-10-04 |archive-url=https://web.archive.org/web/20120915203803/http://everythingneo.com/index.php?option=com_content&amp;view=article&amp;id=126&amp;Itemid=127 |archive-date=2012-09-15 }}&lt;/ref&gt;

Also in the United States, the CDC is monitoring Italian Spinones, with no end date indicated on sample submissions.

==See also==
* [[Portal:Dogs|Dogs portal]]

== References ==
{{reflist|30em}}

==External links==
{{Commons category}}
* [http://www.leishmaniasis.info/ The Canine Leishmaniasis Site by Vetstream] {{Webarchive|url=https://web.archive.org/web/20090302044223/http://www.leishmaniasis.info/ |date=2009-03-02 }}
* [https://web.archive.org/web/20080907221136/http://www.cvbd.org/4095.0.html Video of Leishmaniasis positive dog] (&lt;- link does not work)
* [http://www.atimana.it/news/lesmania.htm Treatment options (article in Italian)] {{Webarchive|url=https://web.archive.org/web/20080605083201/http://www.atimana.it/news/lesmania.htm |date=2008-06-05 }}
* [http://www.vet.uga.edu/VPP/clerk/joiner/ Overview of Canine Leishmaniasis] {{Webarchive|url=https://web.archive.org/web/20081008093218/http://www.vet.uga.edu/VPP/clerk/joiner/ |date=2008-10-08 }}
* [http://www.vet.uga.edu/VPP/NSEP/Brazil2002/index.htm US &amp; Brazil 2002 US Department of Defense funded Canine Leishmaniasis Project] {{Webarchive|url=https://web.archive.org/web/20081011063306/http://www.vet.uga.edu/vpp/nsep/Brazil2002/index.htm |date=2008-10-11 }}
* [http://www.leishvet.org/fact-sheet/ Guidelines for practising veterinarians]

{{DEFAULTSORT:Canine Leishmaniasis}}
[[Category:Dog diseases|Leishmaniasis]]
[[Category:Insect-borne diseases]]
[[Category:Leishmaniasis]]