Follow-up monitoring in a cat with leishmaniosis and coinfections with Hepatozoon felis and ‘Candidatus Mycoplasma haemominutum’

Attipa, Charalampos; Neofytou, Kyriaki; Yiapanis, Christos; Martínez-Orellana, Pamela; Baneth, Gad; Nachum-Biala, Yaarit; Brooks-Brownlie, Harriet; Solano-Gallego, Laia; Tasker, Séverine

The LeishVet Group 1 and the Advisory Board on Cat Diseases Guidelines 9 both recommend allopurinol treatment (10-20 mg/kg q24h or q12h) for FeL, based on the extensive clinical use of this medication in previous cases. In contrast, meglumine antimoniate has only been described in a few cases of FeL. 10, 11 Additionally, a combination of allopurinol and N-methyl-glucamine antimoniate in a cat with FeL due to L infantum was reported to have led to successful clinical resolution and significant reduction of the parasitic load, suggesting that this therapeutic protocol could also be considered for FeL. 12 The cat in this case had complete clinical resolution of the cutaneous lesions during the treatment period with no relapse by month 24 after completion of the 6 months of allopurinol treatment. However, the PCR results post-treatment showed that elimination of L infantum had not occurred, indicating progressive subclinical infection. Given the potential role of the cat as a secondary reservoir and the zoonotic nature of L infantum, an alternative treatment could have been implemented for this patient, such as a combination of allopurinol with meglumine antimoniate or N-methylglucamine antimoniate.