[Leish-l] Back to business

[Anthony Bryceson]

Dear vets
I would urge you to tread carefully with allopurinol in dogs, who seem  
to have a less efficient immune response to leishmania than do humans.  
Or is allopurinol metabolized differently in dogs, giving them an  
advantage over humans? Allopurinol was very disappointing on its own  
in all forms of human leishmaniasis and some patients with VL  became  
unresponsive, presumably because of drug resistance. I can expand on  
this if anyone is seriously interested. Do be sure that decent peer- 
reviewed trials have shown unequivocal results.
Anthony





On 7 Apr 2009, at 18:54, killickendrick wrote:

> Jacques,
>     You are right. If allopurinol is as good as Glucantime, it  
> should be used universally. Can you give us references to trials  
> that show this? if not, who will do a double blind trial and settle  
> the question once and for all. Are there any other than Jacques who  
> have an opinion for us?
> Bob
>
> Carlos,
>     It may be forbidden in Brazil. But Glucantime is widely used in  
> Europe in spite of the old Italian study showing the danger of  
> selecting resistance. (By 'old Italian', I mean a study done some  
> time ago - it is not a reference to the age of the workers who did  
> the study. I would not want to offend my friend Luigi Gradoni!)
> Bob
> ----- Original Message -----
> From: Carlos Brisola Marcondes
> To: Jaclamothe at aol.com
> Cc: leish-l at lineu.icb.usp.br
> Sent: Tuesday, April 07, 2009 3:16 PM
> Subject: Re: [Leish-l] Back to business
>
> Dear all
>    I would remind that the utilization for dogs of drugs utilized  
> for humans was forbidden in the last year by federal government.
>    Would it be viable to treat thousands of dogs in the huge (and  
> variable) endemic area of Brazil, which are replaced very quickly?  
> Would any of us like to have positive dogs being treated in our  
> neighbourhood?
>
> Best wishes
> Carlos Brisola Marcondes----- Original Message -----
> From: Jaclamothe at aol.com
> To: killickendrick at wanadoo.fr ; leish-l at lineu.icb.usp.br
> Sent: Monday, April 06, 2009 7:55 PM
> Subject: Re: [Leish-l] Back to business
>
> Dans un e-mail daté du 04/04/2009 19:55:11 Paris, Madrid (heure  
> d'été), killickendrick at wanadoo.fr a écrit :
> Surely Jacques is not recommending allopuriol alone as treatment? I  
> seem to remember a study that showed this was not a good idea.
> In France, Glucantime is geverally the answer to CanL with  
> allopurinol as well. Dogs are not destroyed by law. Medical doctors  
> question the use of Glucantime because of the risk of drug resustance.
>     By the way, 'vaccinated' dogs in Brazil are presumably  
> seropositive. if so, they should be killed!
>     Bob Killick-Kendrick
>             Allopurinol alone has a great advantage , the risk of  
> creating resistance transmitted to humans is neglectable (compared  
> with antimonials or ampho b )
> Pr Slappedel   in Netherland has begun and had good results (80%  
> long term  efficacy) . The paper you mention was published in 99  .  
> It was a comparative study , but in  the group allopurinol alone,   
> dogs were only treated 1 month...  (its difficult to make a clinical  
> studies with dogs belonging to owners) It is for me  impossible to  
> make any conclusion from these results even if it has been done...
>
> In  Greece , Pr Koutinas in a 4 months study has 100% improvement  
> and 50% of clinical cure . They have also excellent results in the  
> most severe forms of cl (renal disease) . Gad Baneth uses also this  
> treatment in Israel
> In the american focus , ive treated and closely followed around 20  
> dogs  (Glucantime  was not available , and i didnt want to use it)   
> and it was a succes. The only problem is that clinical cure is  
> reached after a longer time than with the classic association  
> Glucantime allopurinol. But dogs dont go to work on mondays.
>
> There is an emerging consensus in the vet community to avoid the use  
> of Glucantime and amphotericin B (recent papers of the vet leish  
> group in Trends in Parasitology)
>
>
> Regards from France
>
> Jacques Lamothe
>
>
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