Société Protectrice
des Animaux du Maroc

The Humane Society
of Morocco

Leishmaniasis

Leishmaniasis in Dogs

Overview

  • Leishmaniasis (or ‘leishmaniosis’) is a disease that is present in Morocco.
  • Leishmaniasis is caused by infection from a protozoan.
  • The parasite is transmitted by small biting sand flies.
  • It is an important disease to be aware of because humans can also contract leishmaniasis.

What is leishmaniasis?

Leishmaniasis is a disease caused by a protozoan (single-celled) parasite found in dogs, cats, and certain rodents in many parts of the world, most commonly in rural areas. The parasite is transmitted by small biting phlebotomine sand flies. It is an important disease to be aware of because humans can also contract leishmaniasis.

Leishmaniasis can cause one or two types of infections – a cutaneous (skin) infection and a visceral (organ) infection. Leishmaniasis is common in the Mediterranean, including Morocco.

The major species present in the kingdom are: Leishmania major, L. tropica, L. infantum, and L. Killicki.

What are the symptoms of leishmaniasis?

Clinical signs of the visceral form include fever, anorexia (lack of appetite), weakness, decreased stamina, severe weight loss, diarrhea, vomiting, increased drinking and urination, and bleeding from the nose. About one-third of dogs will develop swollen lymph nodes and an enlarged spleen and will progress to kidney failure. Muscle pain, joint inflammation, and swelling of the testicles may also be present.

“About one-third of dogs will develop swollen lymph nodes and an enlarged spleen and will progress to kidney failure.”
Clinical signs of the cutaneous form most commonly include 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.

Virtually all dogs that acquire leishmaniasis will develop the visceral form of the disease. Ninety percent of those dogs will also have cutaneous involvement. The cutaneous form of leishmaniasis more commonly affects cats.

 

There are four classified stages of leishmaniasis based on clinical signs and diagnostic tests:

  • Stage 1: mild disease with little or no changes seen in blood work.
  • Stage 2: moderate disease with antibodies seen in the blood along with elevations in protein and mild anemia. Signs include skin changes, weight loss, and bleeding from the nose.
  • Stage 3: severe disease with Stage 2 changes as well as more severe signs including kidney disease, eye inflammation, enlarged lymph nodes, and an enlarged spleen.
  • Stage 4: extremely severe disease with more severe clinical signs including difficulty breathing and blood work consistent with kidney failure.

How is leishmaniasis in dogs diagnosed?

Leishmaniasis is diagnosed based on a dog’s medical and travel history (especially travel to an area with endemic leishmaniasis) and clinical signs. Blood and urine tests are usually performed along with tissue biopsies. Occasionally, the organism can be found on aspirates of lymph nodes or smears made from skin lesions, but these are not very sensitive. A PCR blood test can be sent to a laboratory. This test has the best chance of detecting leishmaniasis but is not 100% definitive. Antibodies may be seen in the blood, depending on how long the dog has been infected. General blood tests may reflect changes if specific organs are affected.

Is there any treatment for leishmaniasis in dogs?

The goal of treatment is to resolve the clinical signs of leishmaniasis. There are many treatments available that are often used in combination. Sodium stibogluconate has been used but is difficult to obtain. Alternative treatments include meglumine antimonite (not available in Morocco), allopurinol with or without domperidone, and marbofloxacin. Supportive treatments include intravenous fluids, special therapeutic diets, and antibiotics (if the skin lesions are infected). Solitary skin lesions can be removed surgically. Unfortunately, there is no cure and dogs may relapse.

What is the prognosis?

The prognosis for a dog diagnosed with leishmaniasis is guarded to grave. Many dogs die from the resulting kidney failure. Severely ill dogs may not be able to undergo treatment. Your veterinarian will provide you with specific treatment recommendations based on your dog’s condition.

Leishmaniasis Fact Sheet

Information for pet owners on the infectious disease Leishmaniasis.

What is Leishmania?

Leishmania is a parasite that causes a disease called Leishmaniasis, Leishmaniasis is a severe disease that can affect dogs and other mammals including humans. The parasite is transmitted to dogs via an insect (sandfly) that is present in Morocco. Dogs that travel or have lived in Morocco are at risk of becoming infected.

What are the symptoms of the disease?

Some dogs have no symptoms for months or years after becoming infected. When they become ill with the disease, they often develop skin lesions and become unwell (they may be depressed, lose weight, drink excessively, etc). Some dogs develop kidney failure. It is possible for infected dogs to become unwell without having any skin lesions.

Can cats develop Leishmaniasis?

Yes, but it is very rare.

If I am traveling with my dog to Morocco, could he become infected?

Leishmaniasis has been diagnosed in traveled dogs in Morocco, it is not extremely rare. Dogs can also get infected through other less effective routes (e.g. sexual transmission, blood transfusions, or bites from infected dogs – the latter is not proven). Fleas and ticks do not appear to be able to transmit the disease.

How will my vet diagnose Leishmaniasis?

It depends on the presenting signs but it is likely to be through a combination of blood tests and sampling (e.g. samples from the skin, lymph nodes or internal organs).

What is the treatment?

Treatment can vary depending on the clinical presentation. For example, some dogs are infected but asymptomatic and do not always require treatment. However, most dogs will require medication and this is likely to be a combination of two drugs (allopurinol and miltefosine or allopurinol and meglumine antimoniate). Allopurinol in most cases will be continued for a few months until the signs have resolved and blood tests have all returned to normal. Unfortunately, treatment is not curative and the dog will remain persistently infected so relapses are common after stopping medication.

 

So if they are not cured, should they stay on treatment for life?

No, you need to follow your vet’s advice on this but we do not treat for life as this could induce treatment resistance. They are carefully monitored during and after treatment and the medication re-started when there are early signs of relapse. This may not happen for months or years.

Will my dog die of the disease?

Leishmaniasis is a very serious disease and is best avoided at all costs. However, it can be effectively controlled if it is well monitored. Many dogs with the disease live normal, happy lives.

How can I prevent my dog from becoming infected?

Do not take your dog to areas where Leishmania is present! This is the best advice to protect your dog against infection.
However, if this is not possible there are good products to repel sandflies and prevent transmission of the parasite (spot-on treatments and collars). Speak to your vet for advice on what would be the best product for your pet. They must be applied correctly and you must follow the instructions on the frequency of application. Avoiding exposure to sandflies (the insects that transmit Leishmania) is the most effective way to prevent infection. Sandflies are more active at dusk – so avoid taking your dog out at this time and keep your dog indoors at night.

Can I vaccinate my dog against Leishmania?

Yes, there are vaccines against this parasite which are licensed to be used in Morocco. They reduce the likelihood of your dog developing symptoms if he becomes infected but do not prevent infection itself. The only way to prevent infection is to avoid contact with the sandfly.
We recommend vaccination in dogs that travel to affected areas for long periods but they must always be used in combination with a sandfly repellent.

I have heard that people can develop Leishmaniasis and it is a very serious disease in people too. Could I become infected from my dog?

Yes, you can get the disease directly from your dog in Morocco as a sandfly is required for transmission of the disease. But, once dogs are receiving adequate treatment, they are unlikely to spread the disease even in the presence of the sandfly so the risk is very low.

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