Leishmaniasis, caused by the Leishmania infantum parasite, carried by sandflies, is a severe, incurable disease, which is frequently lethal in dogs. Humans can also contract Leishmaniasis.
The disease is common in Southern Europe, particularly the Mediterranean, and is spreading north as a result of climate change. It is also prevalent in the Middle East, South and Central America, and southern Mexico, and has been reported in some states within the USA.
What is Leishmaniasis?
In dogs, the disease is caused by a protozoan parasite, Leishmania infantum, which is a single-celled microscopic organism found in dogs, cats, and some rodents.
Symptoms of Leishmaniasis can show up several years after a bite from an infected sandfly.
How Is Leishmaniasis Transmitted
The parasite is transmitted between mammalian hosts by female biting sandflies. Like female mosquitoes, they need blood in order to reproduce.
Leishmania infantum can also be transmitted in the following ways:
- from mother to child, female dog to puppy
- through blood transfusion
- through shared syringes
- direct dog to dog transmission through bites or wounds is suspected
Which Parts of Europe Are Prone to Leishmaniasis
Blood-sucking phlebotomine sandflies need temperatures above 15.6oC for at least three months of the year and can’t easily survive winters below 10oC. With global warming, sandflies are able to survive further north.
- Greece (has one of the highest levels of incidence)
- Southern France, including Corsica
- Italy, excluding the far north
- The Balkans (Albania, Bulgaria, Bosnia, Croatia (coastal), Macedonia (northern), Montenegro, Serbia (southern), Slovenia (coastal).
Leishmaniasis in Humans
Humans can also contract leishmaniasis, but there is not yet a human vaccine. The strains that affect humans are mostly found in the developing world, since the vectors are absent in Europe.
Those with malnutrition or a weakened immune systems are at increased risk of this disease. Humans can carry some species of the Leishmania parasite for long periods without becoming ill. Symptoms depend on the form of the disease – there are more than twenty strains which can infect humans.
As in dogs, the infection can be cutaneous (skin) or visceral (organs). The most common human form is cutaneous. Symptoms can include skin sores that occur weeks or months after the bite. They often clear up without treatment, but can be serious in some cases.
Although the disease can be cured and managed in humans, particularly with early intervention, it can be fatal if not treated.
Symptoms of Leishmaniasis in Dogs
Leishmaniasis can cause one or two types of infection, cutaneous and visceral. Virtually all dogs develop the visceral form, with ninety percent of those showing cutaneous signs. The cutaneous form of leishmaniasis more commonly affects cats.
- A cutaneous (skin) infection
- Thickening and hardening of the tissues on the muzzle and footpads, called hyperkeratosis.
- Many dogs will lose the pigment or dark coloring of these tissues as the disease progresses.
- Nodules or hard lumps may form in the skin and the coat often appears dull and brittle with areas of hair loss. The nails may grow long and curve abnormally.
- A visceral (organ) infection
- Anorexia (lack of appetite)
- Weakness and decreased stamina
- Severe weight loss
- Diarrhoea and vomiting
- Increased drinking and urination
- Bleeding from the nose
- About one-third of dogs will develop swollen lymph nodes, an enlarged spleen and will progress to kidney failure.
- Muscle pain, joint inflammation, and swelling of the testicles may also be present.
This poor dog we found in Albania is showing symptoms of Leishmaniasis. Sadly, there was nothing we could do for him, other than give him food and water. Bless him, he still managed to wag his tail at us, which broke my heart. If you want to help dogs in Albania, there is a link at the bottom of my blog.
Treatment of Leishmaniasis
There is no cure for Leishmaniasis, all the vet can do is manage the symptoms and the disease. Unfortunately, the medication itself can also cause side-effects. The prognosis for an infected dog is ‘guarded to grave’ due to the potential for organ damage and failure, although some dogs with Leishmaniasis can live a long and happy life. As with most diseases, early diagnosis and treatment is key.
How To Prevent Leishmaniasis in Dogs
In Europe, the highest risk of sandflies being active occurs between dawn and dusk, from May to October.
1. Physical Precautions:
- Keep your dog indoors when sandflies are active, between dawn and dusk, during May to October. Do not let your dog sleep outside.
- Keep windows and doors closed while sandflies are active, or use nets over open windows and doors.
- Sandflies are attracted to the yellowy-orange light generated by conventional lightbulbs, so it’s doubly important to cover windows if you have the lights on.
- Even if you use other preventatives, such as vaccination or insect repellants, you should observe these physical precautions.
2. Flea and Tick Collars:
These are impregnated with potent insecticides and repellents which release over time to protect your dog against insect bites. The collars should not be used with other parasite treatments in case the medicines contain the same the active ingredients and overdose your pooch, or react with each other.
It is important to note that collars protect against bites, not insect-borne diseases, so it is worthwhile still following the physical precautions above. Also, most collars are NOT effective against the sandflies which carry Leishmania – so speak to your vet or buy from a reputable supplier like Viovet.
- Scalibor Collar – manufactured by Merck Animal Health is impregnated with a potent insecticide and repellent deltamethrin, which is effective in preventing fleas, ticks, sandflies and mosquitoes from biting dogs. As the collar exerts its full effect after one week, the collar should be worn seven days before your pet travels to an affected area. Note – Scalibor is toxic to cats. Click here to view DEFRA’s product information page on Scalibor Collars.
- Seresto Collar – manufactured by Bayer. Although the Seresto collar is licenced for canine leishmaniasis, an Art. 13 review in 2018 by the European Medicines Agency determined its protection against sandflies was ‘variable’.
- Broad Spectrum – collars protect against several insects that carry parasites and disease
- Long Lasting – They slowly release the protective chemicals and last for six to eight months, so they covers your dog for the season. Although they are expensive to buy, they probably work out cheaper than a spot on treatment.
We don’t use the collars for a number of reasons:
- Sleeping with your dog when wearing a collar – there are mixed reports about whether it is safe to sleep with a dog wearing an insectiside-impregnated collar, but in general we have been advised that it’s fine!
- They must be fitted tightly and worn permanently – or they are not effective.
- They can cause allergy in some dogs, so monitor your pup closely when you use a collar. At least if they do react, you can simply remove the collar.
- Scalibor is toxic to cats – like a number of canine flea and tick treatments, the active ingredient is toxic for felines, so not recommended if you also have cats as pets.
- Getting the Collars Wet – the collars are waterproof in the rain and are still effective if your dog is wet, however;
- Certain Shampoos remove the lipid layer in the dogs skin which harbours the active ingredient, and reduce the effectiveness of a Scalibor collar.
- Deltamethrin is Harmful to Aquatic Life – the active substance in Scalibor is very harmful to fish and other aquatic organisms, so it is not ideal for dogs who love to swim.
- Seresto’s effectiveness reduces over time with frequent immersion.
- Not for use on puppies fewer than 7 weeks old.
- Do not use on dogs with skin lesions – remove the collar until the lesions have healed.
3. Spot On Treatments
It is really difficult to find comprehensive information about many treatments, so this is the best we’ve been able to compile in association with vets and our own research.
Note Advantix and Vectra 3D contain permethrin, which is toxic to cats. Other than Simparica Trio, none of the treatments cover worms.
- Simparica Trio protects against almost everything for one month; mosquitoes, ticks, fleas and most worms, apart from whipworm and tapeworm. It does not protect against sandflies. For further information, click here.
- Vectra 3D – is effective for 1 month against sandflies and mosquitoes.
- Advantix – is a monthly treatment, although its stated effectiveness against sandflies is 3 weeks and mosquitoes 2 weeks.
- Bravecto – is a 3 monthly treatment, best given with food. It is effective against sandflies, but gives 2 months’ protection against ticks.
It is important to understand that vaccination does not prevent infection: it simply strengthens the dog’s immune response and reduces the likelihood of symptoms and suffering.
As such, it is essential still to take physical precautions to prevent bites by staying indoors when sandflies are active, plus using a collar or spot on in conjunction with the vaccine.
Previously, CaniLeish was the only vaccine available. Available since 2011, it requires three injections given at three-weekly intervals, plus a single annual booster. CaniLeish prevents fatal consequences in approximately 90% of cases, and 93% of vaccinated dogs get through a leishmaniasis infection without showing any symptoms.
The Fab Four had LetiFend, a single-dose vaccine. One month after vaccination, it is 72% effective in prevention of canine leishmaniasis. It requires annual boosters.
Both vaccines can be administered in dogs older than six months, but cannot always be given at the same time as other vaccines.
If you frequently spend time in at-risk areas, it is advisable to get your dog tested regularly for leishmania pathogens and their antibodies, even if your dog is vaccinated. LetiFend does not affect the test, although antibodies generated by CaniLeish can cross-react with some serological tests for the disease.
Leishmaniasis can be carried asymptomatically, so testing can diagnose the infection before it actively erupts, when the organs are still unaffected.
With early diagnosis, medication is extremely effective in alleviating symptoms, and can prevent the pathogens from spreading further.
Some countries where Leishmaniasis and other animal diseases are not present, such as Australia, require blood tests to determine that your dog is disease free. Even if your pet does not show symptoms, they may be denied entry to the country if they test positive for the parasite.
For more information and advice on travelling with dogs, including a printable packing list, check out my Wuff Guide to Travelling with Dogs.
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The Living with Leish Facebook group offers support and information on diagnosis and treatment of dogs with clinical Leishmania, according to Leishvet protocol. The group has up-to-date information not only from owners of dogs living with Leishmaniasis, but also helpful professionals in the field.
Please note, I am a biochemist but not a vet, and have written this blog as a summary of my own research. As such, you use this information at your own risk. Although I make every effort to ensure that the information I provide is correct at the time of writing, things change all the time and it is essential that you always seek the most up to date advice from a qualified professional. Please see my Disclaimer page for more information.
How To Help Dogs In Albania
There are a lot of dogs in need in Albania. We spoke to a French EU representative in Albania who said that sadly, there is still much corruption in Albania, and the funds for neutering and care of strays does not always reach the intended destination.
The Animal Veterinar Hospital in Fier runs a sanctuary for dogs and cats. Their love of animals is absolutely clear. To thank them for saving our little Kai’s life after he was attacked and badly bitten by a stray, we made a donation to assist the hospital’s work in providing care and sanctuary for stray animals, particularly disabled ones, such as Boni, who Dr. Luiza found in a canal. He was born with the deformity to his legs.
By giving direct, we knew that the money would be used solely for the benefit of the 4 Paws. The vets provide their work and expertise to strays free of charge, but rely on donations to buy food and medicine. You can make a donation via Paypal on firstname.lastname@example.org. Any amount would be much appreciated!
Here are a few of the pups who will benefit at the animal hospital in Fier.
- https://www.healthline.com/health/leishmaniasis (in humans)
- https://www.cdc.gov/parasites/leishmaniasis/disease.html (in humans)