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 youradopteddog@yahoo.com.

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

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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  

Curing a street dog of two deadly diseases might be easier than finding him a home 

Can love find a way? Deciding whether or not to euthanize sick, defensive 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.

ALL PHOTOS AND TEXT BY KATERINA LORENZATOS MAKRIS unless otherwise noted

COPYRIGHT 2012

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