Informações Gerais Sobre Leishmaniose Visceral Canina   Prof.M.Sc. André Luis Soares da Fonseca –CRMV/MS 1404 – OAB/MS 9131- e-mail: afonseca@nin.ufms.br
Autor: ASPAN SABARA | Publicado: 2011-09-29T12:43:00-03:00

                                  
Informações&nbsp;Gerais&nbsp;Sobre&nbsp;Leishmaniose&nbsp;Visceral&nbsp;Canina&nbsp;Prof.M.Sc.&nbsp;André&nbsp;Luis&nbsp;Soares&nbsp;da&nbsp;Fonseca&nbsp;–CRMV/MS&nbsp;1404&nbsp;–&nbsp;OAB/MS&nbsp;9131-&nbsp;e-mail:&nbsp;afonseca@nin.ufms.br&nbsp;<!--[if gte mso 9]>     Normal   0                           21         false   false   false      PT-BR   X-NONE   X-NONE                                                     MicrosoftInternetExplorer4                                                   <!--[endif]--><!--[if gte mso 9]>  <w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true"
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 Em&nbsp; atenção&nbsp; às&nbsp; constantes&nbsp; perguntas&nbsp; formuladas&nbsp; em&nbsp; relação&nbsp; à&nbsp; LVC,&nbsp; é&nbsp; importante&nbsp; que&nbsp; o&nbsp;proprietário/veterinário&nbsp;tenha&nbsp;consciência&nbsp;dos&nbsp;seguintes&nbsp;aspectos:&nbsp;&nbsp;1.&nbsp; A&nbsp;LVC&nbsp;é&nbsp;doença&nbsp;tratável,&nbsp;apresentando&nbsp;cura&nbsp;clínica&nbsp;(desaparecimento&nbsp;de&nbsp;sinais&nbsp;clínicos),&nbsp;mas&nbsp; dificilmente&nbsp; apresenta&nbsp; cura&nbsp; parasitológica&nbsp; (o&nbsp; parasita&nbsp; não&nbsp; desaparece&nbsp; completamente&nbsp; do&nbsp;organismo&nbsp;do&nbsp;animal/ser&nbsp;humano).&nbsp;Este&nbsp;fato&nbsp;não&nbsp;é&nbsp;preocupante&nbsp;nem&nbsp;incomum,&nbsp;haja&nbsp;vista&nbsp;que&nbsp;em&nbsp;doenças&nbsp;causadas&nbsp;por&nbsp;protozoários,&nbsp;como&nbsp;são&nbsp;as&nbsp;Leishmanioses,&nbsp;a&nbsp;Doença&nbsp;de&nbsp;Chagas&nbsp;e&nbsp;a&nbsp;Toxoplasmose&nbsp;(todas&nbsp;doenças&nbsp;que&nbsp;atingem&nbsp;tanto&nbsp;os&nbsp;homens&nbsp;como&nbsp;os&nbsp;cães)&nbsp;NÃO&nbsp;EXISTE&nbsp;A&nbsp;ELIMINAÇÃO&nbsp;COMPLETA&nbsp;DO&nbsp;PARASITA,&nbsp;seja&nbsp;no&nbsp;cão,&nbsp;seja&nbsp;no&nbsp;ser&nbsp;humano.&nbsp;O&nbsp;homem&nbsp;e&nbsp;o&nbsp;cão&nbsp; podem&nbsp; viver&nbsp; normalmente,&nbsp; mas&nbsp; devem&nbsp; fazer&nbsp; acompanhamento&nbsp; periódico&nbsp; para&nbsp; que&nbsp; a&nbsp;doença&nbsp;não&nbsp;volte&nbsp;a&nbsp;se&nbsp;manifestar.&nbsp;2.&nbsp; Existem&nbsp; diversas&nbsp; drogas&nbsp; para&nbsp; tratamento&nbsp;da&nbsp; LVC.&nbsp;As&nbsp; drogas&nbsp; mais&nbsp; eficazes&nbsp; são&nbsp; também&nbsp;as&nbsp;mais&nbsp; tóxicas,&nbsp; podendo&nbsp; até&nbsp; matar&nbsp; o&nbsp; animal/ser&nbsp; humano&nbsp; (anfotericina&nbsp; B&nbsp; (Fungisone),&nbsp;antimoniais&nbsp; (Glucantime&nbsp; etc)).&nbsp; Nós&nbsp; particularmente&nbsp; utilizamos&nbsp; drogas&nbsp; menos&nbsp;eficazes,&nbsp; mas&nbsp;que&nbsp;também&nbsp;trazem&nbsp;efeitos&nbsp;colaterais&nbsp;menos&nbsp;prejudiciais.&nbsp;3.&nbsp; As&nbsp; drogas&nbsp; utilizadas&nbsp; para&nbsp; animais&nbsp; são&nbsp; as&nbsp; mesmas&nbsp; utilizadas&nbsp; em&nbsp; humanos,&nbsp; pois&nbsp; tais&nbsp; drogas&nbsp;agem&nbsp; matando&nbsp; o&nbsp; parasita.&nbsp; NÃO&nbsp; EXISTE&nbsp; E&nbsp; NUNCA&nbsp;IRÁ&nbsp;EXISTIR&nbsp;DROGAS&nbsp;QUE&nbsp;TRATAM&nbsp;SOMENTE&nbsp;A&nbsp;DOENÇA&nbsp;NO&nbsp;CÃO&nbsp;OU&nbsp;SOMENTE&nbsp;NO&nbsp;HOMEM.&nbsp;Recentemente&nbsp;uma&nbsp;portaria&nbsp;dos&nbsp;ministérios&nbsp;da&nbsp;Saúde&nbsp;(MS)&nbsp;e&nbsp;Agricultura&nbsp;(MAPA)vem&nbsp;Tentando&nbsp;proibir&nbsp;o&nbsp;tratamento,&nbsp;mas&nbsp;a&nbsp;proibição&nbsp;se&nbsp;restringe&nbsp;a&nbsp;drogas&nbsp;específicas&nbsp;para&nbsp;leishmaniose&nbsp;de&nbsp;uso&nbsp;e&nbsp;fabricação&nbsp; para&nbsp; seres&nbsp; humanos.&nbsp; Entendemos&nbsp; que&nbsp; o&nbsp; tratamento&nbsp; não&nbsp; está&nbsp; proibido,&nbsp; pois&nbsp;portaria&nbsp;não&nbsp;é&nbsp;ato&nbsp;capaz&nbsp;de&nbsp;proibir&nbsp;o&nbsp;tratamento,&nbsp;que&nbsp;só&nbsp;poderia&nbsp;ser&nbsp;proibido&nbsp;mediante&nbsp;LEI.&nbsp;4.&nbsp; O&nbsp; tratamento&nbsp; da&nbsp; LVC&nbsp; exige&nbsp; acompanhamento&nbsp; por&nbsp; médico&nbsp; veterinário,&nbsp; pois&nbsp; os&nbsp; remédios&nbsp;usados&nbsp;podem&nbsp;causar&nbsp;problemas&nbsp;sérios&nbsp;e&nbsp;até&nbsp;matar&nbsp;o&nbsp;animal&nbsp;(iatrogenia&nbsp;=&nbsp;doença&nbsp;causada&nbsp;pelo&nbsp;uso&nbsp;de&nbsp;medicamento).&nbsp;5.&nbsp; Como&nbsp;esta&nbsp;leishmaniose&nbsp;é&nbsp;VISCERAL,&nbsp;não&nbsp;é&nbsp;preciso&nbsp;que&nbsp;o&nbsp;cão&nbsp;apresente&nbsp;lesões&nbsp;externas.&nbsp;6.&nbsp; A&nbsp;causa&nbsp; da&nbsp;morte&nbsp;na&nbsp;leishmaniose,&nbsp;seja&nbsp; canina,&nbsp;seja&nbsp;humana,&nbsp;é&nbsp;a&nbsp;lesão&nbsp;renal&nbsp;e/ou&nbsp;do&nbsp; fígado&nbsp;que&nbsp; podem&nbsp; se&nbsp; tornar&nbsp; irreversíveis;&nbsp; por&nbsp; isso,&nbsp; entendemos&nbsp; que&nbsp; deva&nbsp; ser&nbsp; PERIÓDICA&nbsp; E&nbsp;OBRIGATÓRIA&nbsp; a&nbsp;exigência&nbsp;dos&nbsp;seguintes&nbsp;exames&nbsp;de&nbsp;sangue:&nbsp;Creatinina,&nbsp;Uréia,&nbsp;ALT&nbsp;(ou&nbsp;Fosfatase&nbsp; Alcalina),&nbsp;Hemograma&nbsp;e&nbsp;Proteinograma&nbsp;(Eletroforese&nbsp;de&nbsp;proteínas).Sendo,&nbsp;possível,&nbsp;sugerimos,&nbsp;ainda,&nbsp;a&nbsp;realização&nbsp;de&nbsp;sorologia&nbsp;“IgM&nbsp;para&nbsp;Erlichiose”,&nbsp;pois&nbsp;cerca&nbsp;de&nbsp;40&nbsp;a&nbsp;80%&nbsp;dos&nbsp;cães&nbsp;com&nbsp;leishmania&nbsp;também&nbsp;desenvolvem&nbsp;a&nbsp;doença&nbsp;do&nbsp;carrapato.&nbsp;7.&nbsp; Estes&nbsp;exames&nbsp; devem&nbsp;ser&nbsp;realizados&nbsp;a&nbsp;cada&nbsp;3&nbsp; ou&nbsp;4&nbsp;meses,&nbsp; OBRIGATORIAMENTE,&nbsp;senão&nbsp;o&nbsp;animal&nbsp;deixa&nbsp; de&nbsp; morrer&nbsp; por&nbsp; causa&nbsp; da&nbsp; leishmania,&nbsp; mas&nbsp;podemorrer&nbsp;por&nbsp;causa&nbsp;dos&nbsp;medicamentos.&nbsp;As&nbsp;lesões&nbsp;renais&nbsp;e&nbsp;hepáticas,&nbsp;quando&nbsp;instaladas,&nbsp;são&nbsp;praticamente&nbsp;irreversíveis&nbsp;e&nbsp;o&nbsp;animal&nbsp;tende&nbsp;a&nbsp;morrer&nbsp;com&nbsp;visível&nbsp;evolução&nbsp;na&nbsp;perda&nbsp;de&nbsp;peso.&nbsp;8.&nbsp;Os&nbsp;medicamentos&nbsp;que&nbsp;utilizamos&nbsp;podem&nbsp;trazer&nbsp;efeitoscolaterais:&nbsp;falta&nbsp;de&nbsp;apetite,diarréia,&nbsp;prostração,&nbsp;perda&nbsp;de&nbsp;peso,&nbsp;vômitos.&nbsp;Nestes&nbsp;casos,&nbsp;a&nbsp;medicação&nbsp;deve&nbsp;ser&nbsp;suspensa&nbsp;e&nbsp;o&nbsp;médicoveterinário&nbsp;responsável&nbsp;deve&nbsp;ser&nbsp;imediatamente&nbsp;informado.&nbsp;9.&nbsp; A&nbsp;medicação&nbsp;realizada&nbsp;pelo&nbsp;proprietário&nbsp;pode&nbsp;trazer&nbsp;efeitos&nbsp;benéficos&nbsp;nos&nbsp;primeiros&nbsp;6&nbsp;meses,&nbsp;mas&nbsp; o&nbsp;quadro&nbsp; geralmente&nbsp;regride&nbsp; após&nbsp;este&nbsp;período,&nbsp;principalmente&nbsp; pela&nbsp; falta&nbsp; dos&nbsp; exames&nbsp;e&nbsp;pelo&nbsp; uso&nbsp; errado&nbsp; dos&nbsp; medicamentos,&nbsp; seja&nbsp; por&nbsp; causa&nbsp; da&nbsp; dose,&nbsp; seja&nbsp; por&nbsp; causa&nbsp; de&nbsp; indicação&nbsp;inadequada.&nbsp;10.&nbsp;O&nbsp; animal&nbsp; portador&nbsp; de&nbsp; LVC&nbsp; deve&nbsp; ser&nbsp; monitorado&nbsp; e&nbsp; tomar&nbsp; medicamentos&nbsp; praticamente&nbsp; pelo&nbsp;resto&nbsp;da&nbsp;vida.&nbsp;Caso&nbsp;venha&nbsp;a&nbsp;se&nbsp;tornar&nbsp;sorologicamente&nbsp;negativo,&nbsp;a&nbsp;medicação&nbsp;contínua&nbsp;poderá&nbsp;ser&nbsp;suspensa,&nbsp;mas&nbsp;o&nbsp;animal&nbsp;deverá&nbsp;continuar&nbsp;a&nbsp;realizar&nbsp;os&nbsp;exames,&nbsp;porém&nbsp;em&nbsp;um&nbsp;intervalo&nbsp;de&nbsp;tempo&nbsp;maior&nbsp;(a&nbsp;cada&nbsp;6&nbsp;meses&nbsp;a&nbsp;1&nbsp;ano).&nbsp;11.&nbsp;Raramente&nbsp;ocorrem&nbsp;curas&nbsp;naturais&nbsp;e&nbsp;o&nbsp;tratamento&nbsp;que&nbsp;utilizamos&nbsp;leva&nbsp;à&nbsp;sorologia&nbsp;negativa&nbsp;em&nbsp;apenas&nbsp; 20%&nbsp; dos&nbsp;casos.&nbsp; Os&nbsp; demais&nbsp; animais&nbsp; geralmente&nbsp; ficam&nbsp; portadores&nbsp; do&nbsp; parasita,&nbsp; mas&nbsp; a&nbsp;capacidade&nbsp;de&nbsp;transmissão&nbsp;cai&nbsp;quanto&nbsp;menos&nbsp;sintomas&nbsp;forem&nbsp;apresentados.&nbsp;12.&nbsp;Os&nbsp; trabalhos&nbsp; científicos&nbsp; claramente&nbsp; demonstram&nbsp; que&nbsp; não&nbsp; há&nbsp; correlação&nbsp; entre&nbsp; ter&nbsp; animais&nbsp;portadores&nbsp; em&nbsp; casa&nbsp; e&nbsp; os&nbsp; moradores&nbsp; terem&nbsp; doença.&nbsp; Ou&nbsp; seja,&nbsp; cientificamente&nbsp; não&nbsp; há&nbsp; risco&nbsp;significativo&nbsp;de&nbsp;se&nbsp;ter&nbsp;um&nbsp;cão&nbsp;portador&nbsp;em&nbsp;casa&nbsp;e&nbsp;deste&nbsp;animal&nbsp;transmitir&nbsp;a&nbsp;doença&nbsp;para&nbsp;um&nbsp;morador.&nbsp;Portanto,&nbsp;se&nbsp;você&nbsp;tiver&nbsp;um&nbsp;cão&nbsp;portador&nbsp;em&nbsp;casa,&nbsp;use&nbsp;repelentes&nbsp;nele&nbsp;e&nbsp;em&nbsp;sua&nbsp;casa.&nbsp;O&nbsp;fato&nbsp;de&nbsp;você&nbsp;ter&nbsp;um&nbsp;cão&nbsp;doente&nbsp;em&nbsp;sua&nbsp;casa&nbsp;demonstra&nbsp;claramente&nbsp;que&nbsp;o&nbsp;“mosquito”&nbsp;transmissor&nbsp;está&nbsp;na&nbsp;sua&nbsp;região&nbsp;e&nbsp;da&nbsp;mesma&nbsp;forma&nbsp;que&nbsp;transmitiu&nbsp;a&nbsp;doença&nbsp;para&nbsp;o&nbsp;seu&nbsp;cão,&nbsp;pode&nbsp;transmitir&nbsp;a&nbsp;doença&nbsp;para&nbsp;você&nbsp;e&nbsp;para&nbsp;sua&nbsp;família.&nbsp;Assim,&nbsp;cuidado&nbsp;com&nbsp;os&nbsp;“mosquitos”.&nbsp;13.&nbsp;AS&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; LEISHMANIOSES&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; SÃO&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; DOENÇAS&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; TRANSMITIDAS&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; POR&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; VETORES&nbsp;(“MOSQUITOS”)&nbsp; E&nbsp; NÃO&nbsp; SÃO&nbsp; DOENÇAS&nbsp; CONTAGIOSAS&nbsp; (TRANSMITIDAS&nbsp; POR&nbsp;CONTATO&nbsp;NATURAL:&nbsp;BEIJO,&nbsp;TOQUE,&nbsp;SECREÇÕES)&nbsp;14.&nbsp;COMBATEM-SE&nbsp; AS&nbsp; LEISHMANIOSES&nbsp; COM&nbsp; O&nbsp; USO&nbsp; CONSTANTE&nbsp; DE&nbsp;REPELENTES,&nbsp;NO&nbsp;AMBIENTE&nbsp;DOMESTICO&nbsp;E&nbsp;NOS&nbsp;CÃES,&nbsp;DOENTES&nbsp;OU&nbsp;NÃO.&nbsp;15.&nbsp;Recomendamos&nbsp;fortemente&nbsp;o&nbsp;uso&nbsp;constante&nbsp;de&nbsp;repelentes&nbsp;que&nbsp;tem&nbsp;por&nbsp;base&nbsp;de&nbsp;Cipermetrina&nbsp;na&nbsp;formulação&nbsp;“Pour&nbsp;On”.&nbsp;Nesta&nbsp;formulação&nbsp;(oleosa),&nbsp;devem-se&nbsp;pincelar&nbsp;os&nbsp;locais&nbsp;infestados&nbsp;ou&nbsp;preferidos&nbsp;pelos&nbsp;mosquitos,&nbsp;mesmo&nbsp;dentro&nbsp;de&nbsp;casa:&nbsp;debaixo&nbsp;das&nbsp;camas,&nbsp;atrás&nbsp;dos&nbsp;armários,&nbsp;no&nbsp;arco&nbsp; das&nbsp;portas&nbsp;e&nbsp;janelas,&nbsp; e&nbsp;em&nbsp;peças&nbsp; de&nbsp;madeira&nbsp;(armários,&nbsp;móveis&nbsp;etc).&nbsp;Este&nbsp;procedimento&nbsp;deve&nbsp; ser&nbsp;repetido&nbsp; mensalmente.&nbsp;Estes&nbsp;produtos&nbsp;são&nbsp; baratos&nbsp; (cerca&nbsp;de&nbsp;8&nbsp;a&nbsp;15&nbsp;reais,&nbsp;o&nbsp; litro)&nbsp;e&nbsp;podem&nbsp; ser&nbsp; utilizados&nbsp; diretamente&nbsp; nos&nbsp; cães,&nbsp; MAS&nbsp; NÃO&nbsp; NOS&nbsp; SERES&nbsp; HUMANOS.&nbsp; São&nbsp;produtos&nbsp;de&nbsp;baixa&nbsp;toxicidade&nbsp;nas&nbsp;doses&nbsp;recomendadas.&nbsp;Somente&nbsp;são&nbsp;encontrados&nbsp;em&nbsp;casas&nbsp;de&nbsp;produtos&nbsp;veterinários&nbsp;(não&nbsp;se&nbsp;encontram&nbsp;em&nbsp;pet&nbsp;shops).&nbsp;Aplicados&nbsp;em&nbsp;alvenarias&nbsp;e&nbsp;madeiras,&nbsp;estes&nbsp; produtos&nbsp; têm&nbsp; efeito&nbsp; residual&nbsp; por&nbsp; até&nbsp; 4&nbsp; meses,&nbsp; mas&nbsp; recomendamos&nbsp; que&nbsp; as&nbsp; aplicações&nbsp;sejam&nbsp;realizadas&nbsp;num&nbsp;intervalo&nbsp;menor&nbsp;do&nbsp;que&nbsp;1&nbsp;mês.&nbsp;16.&nbsp;Recomendamos&nbsp; aplicar&nbsp; inseticidas&nbsp; nos&nbsp; locais&nbsp; habituais&nbsp; para&nbsp; o&nbsp; cão:&nbsp; casinhas,&nbsp; varandas,&nbsp;debaixo&nbsp;de&nbsp;mesas&nbsp;etc.&nbsp;A&nbsp;pulverização&nbsp;pode&nbsp;ser&nbsp;feita&nbsp;com&nbsp;produtos&nbsp;que&nbsp;se&nbsp;diluem&nbsp;e&nbsp;água&nbsp;como,&nbsp;K-Otrine,&nbsp;Flytick,&nbsp;dentre&nbsp;outros,&nbsp;todos&nbsp;adquiridos&nbsp;em&nbsp;casas&nbsp;de&nbsp;produtos&nbsp;veterinários&nbsp;(e&nbsp;não&nbsp;em&nbsp;pet&nbsp;shops).&nbsp;Devem&nbsp; ser&nbsp; pulverizados&nbsp; locais&nbsp; escuros&nbsp;freqüentados&nbsp; por&nbsp; mosquitos:&nbsp; casinha&nbsp;do&nbsp;cão,&nbsp;debaixo&nbsp;das&nbsp;camas,&nbsp;atrás&nbsp;dos&nbsp;armários,&nbsp;no&nbsp;arco&nbsp;das&nbsp;portas&nbsp;e&nbsp;das&nbsp;janelas.&nbsp;(Caso&nbsp;você&nbsp;tenha&nbsp;dificuldades&nbsp; em&nbsp; encontrar,&nbsp; adquira&nbsp; estes&nbsp; produtos&nbsp; através&nbsp; da&nbsp; internet&nbsp; no&nbsp; site&nbsp;www.agroline.com.br&nbsp;ou&nbsp;em&nbsp;agrotouro@hotmail.com.&nbsp;17.&nbsp;NÃO&nbsp; RECOMENDAMOS&nbsp; usar&nbsp; animais&nbsp; portadores&nbsp; de&nbsp; Leishmania&nbsp; sp.&nbsp; para&nbsp; reprodução.&nbsp;Trabalhos&nbsp;científicos&nbsp; recentes&nbsp;tem&nbsp; demonstrado&nbsp;a&nbsp;presença&nbsp;de&nbsp;leishmanias&nbsp;na&nbsp;placenta&nbsp;e&nbsp;no&nbsp;sêmen&nbsp;de&nbsp;cães.&nbsp;Sugere-se&nbsp;que&nbsp;a&nbsp;fêmea&nbsp;possa&nbsp;se&nbsp;contaminar&nbsp;com&nbsp;o&nbsp;sêmen&nbsp;canino&nbsp;e&nbsp;que&nbsp;o&nbsp;feto possa&nbsp;nascer&nbsp;portador&nbsp;de&nbsp;Leishmania&nbsp;sp.&nbsp;18.&nbsp;Nos&nbsp; animais&nbsp; tratados&nbsp; ocorre&nbsp; uma&nbsp; redução&nbsp; (mas&nbsp; não&nbsp; eliminação&nbsp; completa,&nbsp; que&nbsp; é&nbsp; menos&nbsp;comum)&nbsp; dos&nbsp; parasitas&nbsp; e&nbsp; daí&nbsp; o&nbsp; tratamento,&nbsp; juntamente&nbsp; com&nbsp; o&nbsp; uso&nbsp; de&nbsp; repelentes&nbsp; nos&nbsp; cães,&nbsp;reduzir&nbsp;em&nbsp;muito&nbsp; o&nbsp;risco&nbsp; de&nbsp; transmissão&nbsp; ou&nbsp;nova&nbsp; contaminação&nbsp; da&nbsp;doença&nbsp; pelo&nbsp; cão&nbsp; e&nbsp; pelas&nbsp;pessoas&nbsp;que&nbsp;vivem&nbsp;ao&nbsp;redor&nbsp;do&nbsp;animal.&nbsp;19.&nbsp;O&nbsp; “mosquito”&nbsp; da&nbsp; leishmania,&nbsp; ao&nbsp; contrário&nbsp; do&nbsp; mosquito&nbsp; da&nbsp; Dengue,&nbsp; não&nbsp; vive&nbsp; e&nbsp; nem&nbsp; se&nbsp;reproduz&nbsp;em&nbsp;água.&nbsp;A&nbsp;fêmea&nbsp;põe&nbsp;seus&nbsp;ovos&nbsp;em&nbsp;terrenos&nbsp;férteis&nbsp;e&nbsp;relativamente&nbsp;úmidos&nbsp;(jardins,&nbsp;vasos,&nbsp;praças&nbsp;etc)&nbsp;daí&nbsp;a&nbsp;importância&nbsp;de&nbsp;manter&nbsp;estes&nbsp;locais&nbsp;limpos.&nbsp;20.&nbsp;Os&nbsp;trabalhos&nbsp;científicos&nbsp;também&nbsp;informam&nbsp;que&nbsp;a&nbsp;eutanásia&nbsp;de&nbsp;cães&nbsp;não&nbsp;resolve&nbsp;o&nbsp;problema&nbsp;da&nbsp;leishmaniose.&nbsp;Em&nbsp;locais&nbsp;em&nbsp;que&nbsp;a&nbsp;eutanásia&nbsp;foi&nbsp;ou&nbsp;está&nbsp;sendo&nbsp;aplicada,&nbsp;os&nbsp;filhotes&nbsp;de&nbsp;cães&nbsp;que&nbsp;substituem&nbsp; os&nbsp; animais&nbsp; eutanasiados&nbsp; têm&nbsp; apresentado&nbsp; uma&nbsp; maior&nbsp; propensão&nbsp; a&nbsp; desenvolver&nbsp;doença,&nbsp;pois&nbsp;quando&nbsp;se&nbsp;mata&nbsp;um&nbsp;cão&nbsp;e&nbsp;não&nbsp;se&nbsp;retira&nbsp;o&nbsp;“mosquito”&nbsp;transmissor,&nbsp;este&nbsp;irá&nbsp;picar&nbsp;outro&nbsp; cão&nbsp; ou&nbsp; outro&nbsp; ser&nbsp; humano,&nbsp; propagando,&nbsp; assim,&nbsp; a&nbsp; doença&nbsp; (o&nbsp; que&nbsp; tem&nbsp; sido&nbsp; verificado&nbsp;atualmente).&nbsp;E,&nbsp;para&nbsp;agravar&nbsp;a&nbsp;situação,&nbsp;quando&nbsp;um&nbsp;cão&nbsp;é&nbsp;eliminado,&nbsp;o&nbsp;proprietário&nbsp;coloca&nbsp;em&nbsp;seu&nbsp; lugar&nbsp; um&nbsp; filhote,&nbsp; que&nbsp; é&nbsp; muito&nbsp; mais&nbsp; sensível&nbsp; do&nbsp; que&nbsp; um&nbsp; animal&nbsp; adulto&nbsp; e&nbsp; que&nbsp;invariavelmente&nbsp; vem&nbsp; a&nbsp; apresentar&nbsp; a&nbsp; doença&nbsp; muito&nbsp; mais&nbsp; cedo.&nbsp; Além&nbsp; do&nbsp; mais,&nbsp; trabalhos&nbsp;recentes&nbsp; publicados&nbsp; na&nbsp; Europa&nbsp; demonstraram&nbsp; que&nbsp; em&nbsp; gatos&nbsp; de&nbsp; Portugal&nbsp; e&nbsp; Itália,&nbsp; foram&nbsp;encontradas&nbsp;reações&nbsp;sorológicas&nbsp;entre&nbsp;6&nbsp;a&nbsp;30%&nbsp;da&nbsp;população&nbsp;de&nbsp;gatos&nbsp;e&nbsp;de&nbsp;até&nbsp;33%&nbsp;em&nbsp;ratos&nbsp;de&nbsp;rua.&nbsp;Em&nbsp;São&nbsp;Paulo,&nbsp;capital,&nbsp;foram&nbsp;encontrados&nbsp;morcegos&nbsp;portadores&nbsp;de&nbsp;Leishmania&nbsp;sp.&nbsp;21.&nbsp;O&nbsp;“mosquito”&nbsp;da&nbsp;leishmania&nbsp;tem&nbsp; pequena&nbsp; capacidade&nbsp;de&nbsp;vôo&nbsp;e&nbsp;dificilmente&nbsp;voa&nbsp; acima&nbsp; de&nbsp;1&nbsp;metro&nbsp; de&nbsp;altura.&nbsp;Mas&nbsp; como&nbsp; ele&nbsp; é&nbsp; muito&nbsp;pequeno,&nbsp;pode&nbsp;ser&nbsp; levado&nbsp; por&nbsp;correntes&nbsp; de&nbsp; vento&nbsp; a&nbsp;alturas&nbsp;muito&nbsp;maiores.&nbsp;Este&nbsp;“mosquito”&nbsp;voa&nbsp;até&nbsp;a&nbsp;uma&nbsp;distância&nbsp;de&nbsp;200&nbsp;metros&nbsp;de&nbsp;onde&nbsp;nasceu.&nbsp;Portanto,&nbsp; cuide&nbsp; também&nbsp; dos&nbsp; vizinhos&nbsp; e&nbsp; instrua-os&nbsp; a&nbsp; usar&nbsp; inseticidas&nbsp; em&nbsp; suas&nbsp; residências&nbsp; e&nbsp;coleiras&nbsp;e&nbsp;outros&nbsp;repelentes&nbsp;em&nbsp;seus&nbsp;cães.&nbsp;22.&nbsp;A&nbsp;recomendação&nbsp;é&nbsp; que&nbsp;as&nbsp;pessoas&nbsp;que&nbsp; morem&nbsp;em&nbsp; locais&nbsp;de&nbsp;risco&nbsp; utilizem&nbsp;permanentemente&nbsp;telas&nbsp;mosquiteiras&nbsp;bem&nbsp;finas,&nbsp;principalmente&nbsp; nos&nbsp; quartos&nbsp;das&nbsp;crianças&nbsp; e&nbsp; das&nbsp;pessoas&nbsp;idosas,&nbsp;mantendo&nbsp;sempre&nbsp;a&nbsp;porta&nbsp;da&nbsp;casa&nbsp;e/ou&nbsp;dos&nbsp;quartos&nbsp;fechadas.&nbsp;23.&nbsp;É&nbsp; FUNDAMENTAL&nbsp; só&nbsp; tratar&nbsp; o&nbsp; animal&nbsp; depois&nbsp; de&nbsp; terem&nbsp;sido&nbsp; feitos&nbsp; os&nbsp; exames&nbsp; sorológicos&nbsp;tradicionais:&nbsp; E.L.I.S.A.&nbsp; e&nbsp; R.I.F.I.&nbsp; (Reação&nbsp; de&nbsp; Imunofluorescência&nbsp; Indireta);&nbsp; várias&nbsp; doenças&nbsp;apresentam&nbsp; sinais&nbsp; clínicos&nbsp; semelhantes:&nbsp; Erlichiose,&nbsp; Pênfigo,&nbsp; Lupus&nbsp; Eritematoso,&nbsp; Babesiose&nbsp;etc.&nbsp;Os&nbsp;melhores&nbsp;exames,&nbsp;no&nbsp;momento,&nbsp;para&nbsp;o&nbsp;diagnóstico&nbsp;da&nbsp;LVC&nbsp;são&nbsp;a&nbsp;Punção&nbsp;de&nbsp;Medula&nbsp;Óssea&nbsp;e/ou&nbsp;Linfonodos&nbsp;(chamada&nbsp;de&nbsp;“PAAF”)&nbsp;e&nbsp;o&nbsp;PCR&nbsp;de&nbsp;Medula&nbsp;Óssea,&nbsp;além&nbsp;do&nbsp;qPCR&nbsp;e&nbsp;a&nbsp;Imunohistoquímica&nbsp; de&nbsp; pele&nbsp; (todos&nbsp; mais&nbsp; caros).&nbsp; Reforçamos&nbsp; que&nbsp; os&nbsp; demais&nbsp; exames&nbsp;complementares,&nbsp;após&nbsp;confirmada&nbsp;a&nbsp;Leishmaniose,&nbsp;são&nbsp;igualmente&nbsp;fundamentais:&nbsp;Creatinina,&nbsp;Uréia,&nbsp;ALT,&nbsp;Proteinograma&nbsp;e&nbsp;Hemograma.&nbsp;24.&nbsp;Animais&nbsp;que&nbsp;apresentam&nbsp;sorologia&nbsp;positiva&nbsp;para&nbsp;Leishmaniose&nbsp;mas&nbsp;não&nbsp;apresentam&nbsp;sintomas&nbsp;podem&nbsp;ser&nbsp;vacinados&nbsp;normalmente&nbsp;contra&nbsp;outras&nbsp; doenças,&nbsp;desde&nbsp;que&nbsp; se&nbsp;apresentem&nbsp;sadios&nbsp;e&nbsp;sem&nbsp;sintomas.&nbsp;Caso&nbsp;o&nbsp;animal&nbsp;apresente&nbsp;sintomas&nbsp;da&nbsp;doença,&nbsp;deve&nbsp;ser&nbsp;primeiramente&nbsp;tratado&nbsp;e&nbsp;depois&nbsp;deve&nbsp;tomar&nbsp;as&nbsp;vacinas&nbsp;para&nbsp;as&nbsp;outras&nbsp;doenças.&nbsp;25.&nbsp;O&nbsp;animal tratado&nbsp;e&nbsp;que&nbsp;venha&nbsp;a&nbsp;apresentar&nbsp;sorologia&nbsp;negativa&nbsp;(curado&nbsp;?)&nbsp; pode&nbsp; apresentar&nbsp;recrudescência&nbsp; da&nbsp; doença&nbsp; ou&nbsp; ser&nbsp; reinfectado&nbsp; novamente,&nbsp; principalmente&nbsp; se&nbsp; vive&nbsp; em&nbsp; região&nbsp; endêmica.&nbsp; Por&nbsp; isso,&nbsp; é&nbsp; fundamental&nbsp; continuar&nbsp; com&nbsp; o&nbsp; acompanhamento&nbsp; através&nbsp; de&nbsp; exames&nbsp; e&nbsp;usar,&nbsp;para&nbsp;o&nbsp;resto&nbsp;da&nbsp;vida,&nbsp;repelentes,&nbsp;seja&nbsp;na&nbsp;forma&nbsp;de&nbsp;coleiras&nbsp;inseticidas,&nbsp;seja&nbsp;na&nbsp;forma&nbsp;de&nbsp;inseticidas&nbsp;oleosos&nbsp;para&nbsp;pele.&nbsp;26.&nbsp;E&nbsp; lembre-se:&nbsp;não&nbsp; há&nbsp; respaldo&nbsp; científico&nbsp;para&nbsp; recomendar&nbsp;a&nbsp; eutanásia&nbsp; como&nbsp; método&nbsp;de&nbsp;controle&nbsp;da&nbsp;leishmaniose.&nbsp;27.&nbsp;E&nbsp;MAIS:&nbsp;Você&nbsp;não&nbsp;é&nbsp;obrigado&nbsp;de&nbsp;forma&nbsp;alguma&nbsp;a&nbsp;entregar&nbsp;o&nbsp;seu&nbsp;animal&nbsp;aos&nbsp;fiscais&nbsp;da&nbsp;saúde&nbsp;pública.&nbsp;SEU&nbsp;CÃO&nbsp;É&nbsp;SUA&nbsp;PROPRIEDADE.&nbsp;Nem&nbsp;mesmo&nbsp;um&nbsp;Delegado&nbsp;de&nbsp;Polícia&nbsp;pode&nbsp;ir&nbsp;na&nbsp;sua&nbsp;casa&nbsp;e&nbsp;exigir&nbsp;que&nbsp;voce&nbsp;entregue&nbsp;seu&nbsp;animal.&nbsp;Para&nbsp;sua&nbsp;informação,&nbsp;um&nbsp;Delegado&nbsp;de&nbsp;Polícia&nbsp;ou&nbsp;um&nbsp;policial&nbsp;só&nbsp;podem&nbsp;entrar&nbsp;na&nbsp;sua&nbsp;casa&nbsp;com&nbsp;um&nbsp;mandado&nbsp;judicial&nbsp;ou&nbsp;com&nbsp;sua&nbsp;autorização.&nbsp;Se&nbsp; alguém&nbsp; (Delegado&nbsp; ou&nbsp; Fiscal&nbsp; da&nbsp; Saúde)&nbsp; te&nbsp; constranger,&nbsp; não&nbsp; deixe&nbsp; de&nbsp; anotar&nbsp; o&nbsp; nome&nbsp; da&nbsp;pessoa&nbsp;para&nbsp;formular&nbsp;uma&nbsp;ocorrência&nbsp; policial&nbsp;por&nbsp;abuso&nbsp;de&nbsp;autoridade&nbsp;e/ou&nbsp;constrangimento&nbsp;ilegal.&nbsp;Seja&nbsp;cidadão,&nbsp;exija&nbsp;seus&nbsp;direitos&nbsp;!!!!&nbsp;28.&nbsp;Se&nbsp;na&nbsp;sua&nbsp;cidade&nbsp;o&nbsp; Centro&nbsp; de&nbsp;Controle&nbsp; de&nbsp;Zoonoses&nbsp; eliminam&nbsp; cães&nbsp; NÃO&nbsp;DEIXE&nbsp;que&nbsp;estes&nbsp;agentes&nbsp;tenham&nbsp;acesso&nbsp;ao&nbsp;seu&nbsp;cão.&nbsp;Isso&nbsp;não&nbsp;é&nbsp;proibido.&nbsp;É&nbsp;exercício&nbsp;regular&nbsp;de&nbsp;direito!!!!&nbsp;29.&nbsp;Se&nbsp;alguém&nbsp;te&nbsp;constranger&nbsp;a&nbsp;entregar&nbsp;o&nbsp;seu&nbsp;animal,&nbsp;procure&nbsp;uma&nbsp;Delegacia&nbsp;de&nbsp;Polícia&nbsp;e&nbsp;registre&nbsp;um&nbsp;boletim&nbsp;de&nbsp;ocorrência&nbsp;(B.O.)&nbsp;alegando&nbsp;abuso&nbsp;de&nbsp;autoridade&nbsp;e/ou&nbsp;constrangimento&nbsp;ilegal&nbsp;e&nbsp;procure&nbsp; a&nbsp; Ordem&nbsp; dos&nbsp; Advogados&nbsp;do&nbsp; Brasil&nbsp;–&nbsp; OAB&nbsp;-&nbsp; (Comissão&nbsp; de&nbsp; Direitos&nbsp;Humanos&nbsp; e/ou&nbsp;Comissão&nbsp;de&nbsp;Meio&nbsp;Ambiente)&nbsp;e&nbsp;formule&nbsp;sua&nbsp;reclamação.&nbsp;