[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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