Friday, November 2, 2012

Treating Leishmaniasis (Part One): Vet’s instructions for curing rescued dog’s wicked disease

His eyes bleed. (Photo: Katerina Lorenzatos Makris)
by Katerina Lorenzatos Makris

It’s no fun looking at Agapi. If you’re an even slightly empathetic person, it hurts. He’s a hideous sight: bloody eyes and legs, sparse fur, and an overall scrungy look.

But he’s getting better—fast. Of course it’s been helpful to get the plentiful chow (much of it freshly homemade by his handy slave, guess who) plus the clean water, soft bed, and low-stress life he’s enjoyed since we trapped him in a small village here on the Greek island of Kefalonia. He had reportedly languished on the streets there for two years before we brought him to our place a few miles away.  

But I believe two medications are largely responsible for the improvement: Zylapour (allopurinol) and Milteforan.

The cheap drug and the spendy one

Zylapour is often used for gout in humans. (Isn't that ironic, given that gout is something that typically afflicts folks indulging in fatty diets, while dogs who get Leishmaniasis and need this med are often starving strays who can indulge in fatty diets only in their longing dreams?)

The other drug, Milteforan, is a type of chemotherapy.

Zylapour is relatively cheap.  At three euros (about $3.80 U.S.) for a packet of 30, he’ll need to receive 2.5 tablets per day for the rest of his life. 

Agapi will need these pills every day for life (Photo: Katerina Lorenzatos Makris)
Milteforan is outrageously expensive. For Agapi’s weight, 28 kilos (about 61 pounds), he needs to receive 2.8 milliliters of the liquid form of this med for 28 days, at a cost of about 300 euros ($388 U.S.).

Both of these drugs are supposed to zap a vicious disease called canine Leishmaniasis, caused by a protozoan parasite that is transmitted via the bite of a certain type of sand fly. It’s tragically common and attacks millions of dogs in Mediterranean countries, giving them nightmarish symptoms like hair loss, skin lesions, rapid and twisted nail growth, organ damage, heart attacks, and more.

For Agapi, it seems this dynamic drug duo is already starting to take effect. Dr. Amanda noticed it first when she came to give him his second checkup last Friday. She pointed out the reduced swelling in his legs and paws. The sores and ulcers there are also looking less inflamed, with signs of healing, and some bits of fur starting to grow back in. The Zylapour, she said, often goes to work very quickly.

And now, after only three days’ dosage of Milteforan, I think I’m seeing even more improvement on the legs and paws. Not so much on the eyes yet, but Dr. Amanda predicts that will come.

Leg lesions looking better (Photo: Katerina Lorenzatos Makris)
More beasties

Agapi also suffers from a tick-borne parasitic disease, Ehrlichia, which we’ll cure with a month-long course of doxycycline, an antibiotic, after he finishes the Leish treatment.

Oh and let’s not forget, at the beginning he had additional beasties plaguing him: a tape worm on the inside and literally hundreds of fleas on the outside. But in the first week we nuked those with a Droncit tablet and a Advantix ampule, respectively.

Dosing dos and don’ts

Zylapour is relatively easy to administer. I break the tablets into small pieces and hide each piece in chunks of canned dog food. We started him on this drug a couple of weeks ago.

Now you see the pieces of the Zylapour tablet...  (Photo: Katerina Lorenzatos Makris)
...and now you don't.  (Photo: Katerina Lorenzatos Makris)
*Please see note below regarding feeding pets and being vegan.

Milteforan, which we started two days ago, is more complicated.

The Milteforan comes in a cute little boxed kit complete with a vial of the liquid medication, a syringe, and six pairs of oh-so-chic disposable plastic gloves. They really, really don’t want you to touch this stuff.

Boxed kit of Milteforan (Photo: Katerina Lorenzatos Makris)
Here’s what our vet Dr. Amanda said to do.

  • Prepare a large amount of appealingly aromatic and tremendously tasty food, so as to mask the smell and taste of the medication, which I gather must be pretty nasty.
  • Wear gloves
  • Follow the package instructions to fill the syringe with exactly the right amount of med.
  • Squirt into food.
  • Thoroughly mix.
  • Make sure he eats it all.
  • Follow up with a chaser of a little more food.
  • Don’t worry if he gets diarrhea—that’s normal—but if he develops vomiting, call her so she can prescribe an anti-emetic.
  • Do not miss even one day of medication. If that happened, we'd have to start all over again from the beginning. (!)
Which reminds me… time for today’s dose.

In the next post we’ll review the fascinating Milteforan package instructions. I’m not kidding--I find the little kit riveting. Or maybe I’m just desperate to squeeze some entertainment out of that dang 300 euros.

UP FOR ADOPTION: In about a month when Agapi completes his Leish treatment, he will be available for adoption. We will handle transport to nearly anywhere. Please contact

Please visit The Dozen Dogs Diaries again soon for upcoming articles about Agapi.

Better yet, sign in with the 'Join this site' button above to receive an email notice whenever there's a new article.

For previous articles please see archive to the right, including the following, and more...

Love comes home: the challenging rescue of a sick and bloody street dog  

Read Melissa Beamish's excellent blog about her round-the-world trip volunteering in animal shelters, including a month at Kefalonia's ARK.

To donate or to volunteer on behalf of animals in Kefalonia, contact Animal Rescue Kefalonia (ARK) and Kefalonia Animal Trust (KATs)

*Please note:  Regarding the photos and references to feeding Agapi and other dogs and cats, there's the issue of using animals to feed animals. Before I came to Greece I had worked my own horde of dogs in California up to a homemade 80% plant diet. It was a process to develop recipes that would work for all of them. When I'm in Greece rescuing dogs off the street, often in emergency situations, I resort to commercial dog foods and cooking chicken stews for them in the beginning, then try to segue to plant foods, but in my experience sometimes it can be tricky digestion-wise and takes time. An ongoing dilemma.

The Dozen Dog Diaries (DDD) would be delighted if you'd spread the links to these articles. Please just keep in mind that reprint or re-post of more than a paragraph or two of the text or of any of the photos is allowable only by explicit permission from DDD, who may be contacted at youradopteddogATyahooDOTcom. Thanks for visiting!


  1. Dear Katerina,
    I am in desperate need of the medicine for this disease for a dog we have rescued. Can you email me at

    Thank You
    Michelle Smith

  2. This comment has been removed by the author.

  3. Hi katerina
    I am in desperate need of the medicine for this disease for my dog here in london and i don't know where i can buy
    can you hepl me?
    my email is :
    thank you

  4. Hi Katerina
    My dog has leishmaniasis, I was use Glucantime. I want to buy Milteforan, can you tell me how is your dog? My dog weighs 20 kg, in the 60 mg cost 79.37 euro

  5. Hi Katerina
    My dog has leishmaniasis, I was use Glucantime. I want to buy Milteforan, can you tell me how is your dog? My dog weighs 20 kg, in the 60 mg cost 79.37 euro

  6. In 2013 my dog was diagnosed with leishmaniasis. He was prescribed allopurinol for 3 months, and since the liver/kidneys were perfect, nothing else was done. I gave him several supplements to nourish his body and inmune system, and found one herbal tincture used in humans to cure leismaniasis, Quassia Amara, so started giving it to him. Last week, in september 2016, another test was done and he came negative to leishmania. The liver and kidneys are perfect. I don't know if Quassia did cure him, but it only costs 20€ a year (eBay) and I think it's worth giving it a try...

    1. so haapy for this readding, i want to now allopurinol and Quassia Amara do you give at same time or not and please dose for Quassia Amara my dog have 13 kg.

    2. and what kind of sumpplements give you re dog

    3. Hi,
      Sorry, I didn't see your comment earlier.
      My dog is 24Kg and I give him about 1 teaspoon daily. I guess you can give half teaspoon to your dog. Since Quassia is a natural extract, it doesn't have any overdose risk.
      I don't give Quassia with Allopurinol. I just gave my dog Allopurinol during 3 months and never again.
      The supplements during the first months were specially the ones to boost his immune system, salmon oil, and provide him a good food (I give him Orijen, Acana or Taste of the Wild). If you can provide him exercise that would be great. I was afraid about him running but he has gainned a lot of muscle mass and looks very healthy now.
      I also give him supplements like Hokamix (mix of hebs), Seaweeds in powder for dogs (they contain minerals and other nutrients), and others.
      I just buy the ones that have good reviews that are good to keep your dog healthy.
      And I try to avoid artificial medicines (allopurinol, antibiotics, glucantime, etc).
      Good luck to you and your doggie! ;)

    4. I live in Spain. I can tell you the names of the supplements I gave him. I bought them online from Zooplus. But surely you can find many more stores that sell them. About the Quassia, I buy it from an eBay seller from UK.

  7. I have my neo mastiff on allapurinol. I'm from Pennsylvania. My dog came from Italy. Coat me almost 4,000 to find out what is wrong with her. I would love to try milteforan for her. I love her so. Can any one help me get this medicine cheaper. Thank you

  8. Here is a new study about Quassia Amara antileishmanial properties. Please note that Leihmania Infantum is the one that causes Leishmania in dogs...

    Over decades people have been using nature's remedies to treat diseases, but nature doesn't provide money to pharmaceutical companies.... you know the story.
    Our pets can be healed with natural remedies too!

  9. Hi, I´m from Brazil and I will start the same treatment with my dog tomorrow. I hope everything gets better.