Successful treatment of feline leishmaniosis using a combination of allopurinol and N-methyl-glucamine antimoniate

Basso, Maria Alexandra; Marques, Cátia; Santos, Marcos; Duarte, Ana; Pissarra, Hugo; Carreira, L Miguel; Gomes, Lídia; Valério-Bolas, Ana; Tavares, Luís; Santos-Gomes, Gabriela; Pereira da Fonseca, Isabel

The occurrence of feline leishmaniosis (FeL) has increased worldwide, revealing a possible role of cats in leishmaniosis epidemiology. Better accuracy of laboratory techniques has improved the diagnosis of this disease, and changes in ecosystems over the last few years associated with the use of repellents on dogs might play a role in sandflies' altered feeding patterns in urban areas, leading to infections in other mammalian hosts. [1] [2] [3] Worldwide epidemiological surveys of Leishmania species causing feline asymptomatic infection and FeL have been reported. 4, 5 In Europe, Spain had the first described FeL case in 1932. 6 Some authors claim that low prevalence of FeL in endemic areas may be related to a natural resistance to the parasite in cats. 7 Moreover, the number of clinical cases may be underestimated, leading to few reports and lack of information by clinicians and owners. Although Portugal is an endemic country for canine leishmaniosis caused by Leishmania infantum, there are few published clinical reports of FeL, with the first description of it in 1994 in Sesimbra, followed by others in Porto and Lisbon. [8] [9] [10] Despite occasional reports of ocular and visceral disease, dermatological, mucocutaneous/mucosal presentations and lymph node enlargement are the most frequent clinical features. [11] [12] [13] [14] Clinical suspicion is based on history, clinical signs and clinicopathological abnormalities. Diagnosis is confirmed with parasitological and serological methods. 15 A long-term administration of allopurinol (10-20 mg/kg q12h or q24h) is the most recommended treatment protocol for FeL, 10, 11, 15 however, similarly to dogs, recurrence can occur if the infection is not cleared. Some authors have reported a good clinical response using N-methyl-glucamine antimoniate monotherapy (5-100 mg/kg or 375 mg/cat q24h SC or IM under different protocols). 8, 15 This study aims to describe the treatment of a recurring clinical case of FeL in a cat receiving combined therapy (allopurinol and N-methyl-glucamine antimoniate).