| dc.description.abstract | Background Canine Leishmaniasis (CanL) is a zoonotic, vector-borne disease caused by the intracellular protozoa Leishmania infantum. Despite the various therapeutic options and available guidelines, CanL persists to be a difficult and challenging disease to effectively treat and cure. Miltefosine, an alkyl-phospholipid (hexadecylphosphocholine), appeared to be safe and effective against CanL in several studies executed in endemic countries, and is nowadays widely used in the veterinary field as oral treatment against CanL.
Aim The aim of this retrospective study is to examine the efficacy of miltefosine (Milteforan, Virbac) in the therapy of CanL in first-line veterinary practice in the Netherlands, a non-endemic country. Materials and methods Patient files of dogs with confirmed CanL diagnosis treated with Milteforan in 2016 were retrospectively reviewed. Diagnosis of CanL was confirmed by the detection of a high level of antibodies using the quantitative serological techniques ELISA or DAT in combination with clinical signs and clinicopathological abnormalities related to CanL. Clinical outcome measured as difference between clinical signs and clinicopathological abnormalities compatible with CanL at the time of pre-examination (T0) and time of check-up after treatment (T1), recovery rates, Kaplan-Meier estimated survival time, and incidence of side effects was used to determine the efficacy of Milteforan.
Results A total of seventeen dogs was included. No significant reduction of clinical signs and no significant improvement of clinicopathological abnormalities were observed after Milteforan treatment. Nevertheless, a complete clinical recovery after treatment was found in 29.4% of the patients. The parameters diarrhea, weight loss, lymphadenomegaly, pale mucous membranes, muscle atrophy, splenomegaly, ulcerative dermatitis, long nails, overfilled joints, neurological signs and leucocytosis showed a 100% recovery rate. The Kaplan-Meier estimated survival time was three years, and side effects occurred in 17,7%.
Conclusion This study was performed as part of a larger study into the efficacy of milteforan treatment. These preliminary results give a tentative indication of efficacy of Milteforan in the therapy of CanL in first-line veterinary practice in the Netherlands. For more certainty it would be worth repeating this study with a larger patient group. | |
