<HTML><FONT FACE=arial,helvetica><FONT SIZE=2 FAMILY="SANSSERIF" FACE="Arial" LANG="1">Dans un e-mail daté du 29/05/2003 15:52:25 Paris, Madrid, Phlebotome@aol.com a écrit :<BR>
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<BLOCKQUOTE TYPE=CITE style="BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px">I like your comment, and agree with it.<BR>
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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 (<U>not</U> 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. <BR>
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</FONT><FONT COLOR="#000000" style="BACKGROUND-COLOR: #ffffff" SIZE=2 FAMILY="SANSSERIF" FACE="Arial" LANG="1"> 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. </FONT><FONT COLOR="#000000" style="BACKGROUND-COLOR: #ffffff" SIZE=2 FAMILY="SANSSERIF" FACE="Arial" LANG="1"><BR>
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<BLOCKQUOTE TYPE=CITE style="BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px">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.<BR>
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</FONT><FONT COLOR="#000000" style="BACKGROUND-COLOR: #ffffff" SIZE=2 FAMILY="SANSSERIF" FACE="Arial" LANG="1">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. <BR>
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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"<BR>
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<BLOCKQUOTE TYPE=CITE style="BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px">To answer the questions: <I>How long does treatment last? Is it expensive?</I> <BR>
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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).<BR>
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</FONT><FONT COLOR="#000000" style="BACKGROUND-COLOR: #ffffff" SIZE=2 FAMILY="SANSSERIF" FACE="Arial" LANG="1">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®<BR>
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</FONT><FONT COLOR="#000000" style="BACKGROUND-COLOR: #ffffff" SIZE=2 FAMILY="SANSSERIF" FACE="Arial" LANG="1">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. <BR>
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<BLOCKQUOTE TYPE=CITE style="BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px">Just to mention: <BR>
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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).<BR>
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Sincerely yours,<BR>
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Torsten<BR>
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Congratulations to my friends Bob , Gad , Susan and others for this fantastic page. <BR>
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Jacques Lamothe<BR>
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Clinique veterinaire <BR>
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1 rond point de la roya <BR>
F 06510 CARROS <BR>
(0)4 93 29 06 95</FONT></HTML>