[leish-l] Comments content of new Canine VL site
Jaclamothe at aol.com
Jaclamothe at aol.com
Thu May 29 16:36:19 BRT 2003
Dans un e-mail daté du 29/05/2003 15:52:25 Paris, Madrid, Phlebotome at aol.com
a écrit :
> I like your comment, and agree with it.
>
> Via my local canine-leishmaniasis-page (www.leishmaniose.de or
> www.phlebotomus.com - in german language only), I had the last year (2002) 84 imported
> dogs under therapy. Therapy was done with allopurinol and/or glucantime or
> allopurinol and Oleyl-PC (not miltefosine - but a derivate of it). A follow-up
> study is difficult, in most of the cases a symptomatic cure seems to have taken
> place more or less rapidly, but parasites or antibody-titers are mainly still
> present. And Germany is not (seems to be not jet) an endemic leishmaniasis
> country.
>
I agree with you, i (and others ) have done a follow up with PCR on bone
marrow but i have never seen any relation with prognosis and relapses.
> With the beginning of this year (2003) I changed the therapy-method and use
> now cristalline or liposomale Amphotericine B (AmB) (in combination with
> allopurinol and ketoconazole/itraconazole). Clinical therapy success appears
> much quicker in dogs than before (Allopuronol or Glucantime), parasite status
> -after treatment- remains unclear - time will tell. There should not be a
> resistance problem using AmB.
>
Its obvious, the in vitro activity of ampho b is much more higher than
antimonials (400 times?) or allopurinol. Is a shorter treatment really important
for dogs? W hen dogs are clinically cured, allopurinol must be given as a
maintenance treatment , even with amphotericion B ; I have presented a new protocol
at the congress of European Society Of veterinary dermatology in Nice last
september with amphotericin B desoxycholate treated by heat. Using this protocol
dogs are cured after 5 or 6 injections. (I will try to publish this, its
difficult i m just a practicionner) (i can send the communication to those who
are interested) But allopurinol must be given daily because in many cases they
relapse if it is not given.
I think there is no interest associating ampho b and allopurinol or azole
derivates ; amphotericin B is a massive weapon, destroying the cells of poor
leishmania parasites. Allopurinol and azoles derivates acts on parasite
metabolism . Its like the story of the little mouse and the elephant running in the
savanah, with a lot of dust behind them, and the mouse, says to the elephant
"you see all this dust, we make together"
> To answer the questions: How long does treatment last? Is it expensive?
>
> An AmB treatment lasts 3 to 4 weeks and is more expensive than a Glucantime
> - therapy - trial ... for Germany and for a dog of 20 kilogram of weight
> about 500 - 1000 Euro using cristalline AmB, 1000 - 2000 Euro using liposomale
> AmB (both including all Vet's costs and the supervising of kidney-function
> during therapy).
>
is there any publication showing the better efficacy of Ambisome® or Abelcet®
versus Fungizone® in humans? I know that the cost of the hospital is the
reason why theses presentations are preferred, but i dont understand the use of
these presentations in dogs treatment . You would earn more money, and the
cost could be less important for owners, with a similar efficacy, using
Fungizone®
I think that the first line treatment of dogs (in endemic areas ) should be
allopurinol alone. We should abandon the use of Glucantime ® because of the
problems of resistances in humans, but it is perhaps too late.
> Just to mention:
>
> Another page under construction ... reflecting to nearly all imported (into
> Germany) diseases, should/will be availiable bilingual (german/english) until
> the end of this year is (www.parasitus.com).
>
> Sincerely yours,
>
> Torsten
>
Congratulations to my friends Bob , Gad , Susan and others for this fantastic
page.
Jacques Lamothe
Clinique veterinaire
1 rond point de la roya
F 06510 CARROS
(0)4 93 29 06 95
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