A retrospective cohort study concerning the efficacy of Miltefosine in the treatment of canine Leishmaniasis, based on client owned dogs treated in 2017

Abstract

Background: CanL is a zoonotic disease caused by the protozoa Leishmania infantum. This disease can lead to several clinical signs and clinicopathological abnormalities. The alkyl phospholipid Miltefosine is one of the available treatment options. Because of the lack of nephrotoxic effect, it seems to be a good alternative for the use of meglumine antimonate. Aim: determine if the use of Miltefosine in the treatment of dogs with Leishmaniasis in a non-endemic country, the Netherlands, is effective. Side effects and survival probability will also be evaluated. Materials and methods: a retrospective cohort study was conducted based on patient files of dogs with confirmed CanL. Efficacy of Milteforan was based on comparison of clinical signs and clinicopathological parameters between pre-examination (T0) and checkup examination (T1) around the first course of Milteforan. Furthermore, abnormalities at time of diagnosis, side effects of Milteforan and survival probability were evaluated. Results: twenty-four dogs were included in the study, of which 15 dogs were used for the T0 – T1 comparison. There was no significant difference in clinical signs between those examinations. Concerning the clinicopathological parameters there was no significant difference between pre-examination and checkup time. However, the mean values of these parameters show a promising shift. Also, 30.8% of the dogs experienced a complete recovery of clinical signs. The signs lymphadenopathy, weight loss, anorexia, vomiting, diarrhea and polyuria and polydipsia had a recovery rate of 100 %. Side effects were seen in 28% of the Milteforan treatments. Kaplan-Meier survival probability is 87.3% 1.5 years after diagnosis and 73.5% 1.5 years after the start of the Milteforan treatment. Conclusion: the findings indicate improvement of clinical symptoms and clinicopathological abnormalities after the use of Milteforan in the treatment of CanL. However, for further research, a prospective, placebo-controlled clinical trial with an adequate sample size is recommended.