Mediterranean diseases

Leishmaniasis is a serious disease. Owners of LH-positive dogs should be well informed and have their dog looked after by a vet who is familiar with the treatment. There are also internet forums and groups to exchange information with other sufferers. We have gathered the most important information on leishmaniasis here:

Leishmaniasis in dogs is caused in Europe by Leishmania infantum. This is the name of the unicellular pathogen that is transmitted by the so-called butterfly or sand fly (Phlebotomus). The sand fly is at home in southern European countries; in southern Germany it has so far only been detected very sporadically and selectively. Leishmaniasis can also be passed on from a bitch to her puppies before birth, during mating or during a blood transfusion.
Leishmaniasis is a zoonosis. This means that the bite of a sand fly carrying pathogens could transmit leishmaniasis from dogs to humans. Where there are no sand flies, this cannot happen. Direct transmission from dog to dog or from dogs to humans has not been documented in Germany.

Not every infected dog has to fall ill. Whether the disease breaks out or how it progresses depends on how well the immune system reacts. German Shepherds and Boxers are considered particularly susceptible, while breeds from the Mediterranean region such as the Podenco are relatively robust. A wide range of symptoms can occur a few months to 8 years after infection. The disease often begins unspecifically. The dog gets tired more quickly or develops a fever. In the chronic course, symptoms such as weight loss and scaly, non-itchy skin changes occur, especially on the edges of the ears, nose and around the eyes. Changes to claws and pads, but also gastrointestinal disorders, eye changes, lameness and/or an increased tendency to bleed can occur. Increased thirst and increased urine production can be signs of kidney damage.

A blood test is carried out to diagnose leishmaniasis. For those interested in the medical details, here are the typical changes: Increased total protein with a shift in the protein fractions (low albumin, high gamma globulin), protein losses via the kidneys (which can be detected via the so-called UPC in the urine), mild anaemia and thrombocytopenia as well as increased liver enzymes.

After entry from southern Europe (at the earliest at the age of 10 months) and always if leishmaniasis is suspected, a special blood test must be carried out, a so-called antibody test (ELISA, IFAT). The antibodies can often only appear and be detected months after an infection. Therefore, dogs should be tested at the earliest 8 weeks after arrival from a leishmaniasis area. Dogs with a negative initial test should also be retested 6 months later. In addition, direct pathogen detection by means of a so-called PCR (polymerase chain reaction) from skin, lymph nodes, spleen, bone marrow or conjunctival swabs can be useful.

Only the vet can give a treatment recommendation. It depends on the clinical stage of leishmaniasis. It is not possible to eliminate the pathogen completely. The disease is therefore not curable. However, just because antibodies are detected does not necessarily mean that treatment is necessary or that the dog is ill. If a pathogen is detected by PCR but the animal shows no symptoms, many vets also do not recommend immediate treatment. It is then important to monitor the course of the disease by means of blood tests every 6 to 12 months so as not to miss the time to start treatment.

Of course, a vet can also give advice on necessary medication. Here is just an overview of the current treatment options: Sick dogs are usually treated with allopurinol. A possible side effect is the formation of xanthine urinary stones. This is why we are switching to a low-purine diet. A combination of allopurinol with megluminantimonate (side effects for the kidneys) or allopurinol with miltefosine (side effect for the gastrointestinal tract) is also possible. The immune system can be supported with domperidone (Leisguard).

Those who have regular blood and, if necessary, urine tests can better assess the course of the disease. Unfortunately, the level of the antibody titre does not always correspond to the state of health. Sometimes the dog gets better without the titre dropping. Nevertheless, regular examinations are important. A significant increase in titre indicates that the disease has returned.

Anyone travelling to southern Europe with their dog should seek advice from their vet about good mosquito prophylaxis (e.g. with Scalibor tape, Advantix or Vectra 3D). The dog is also protected if it is not allowed outside during the mosquito activity period - at dawn and dusk.

There are vaccines such as Canileish® or Letifend®. However, they only reduce the risk of dogs contracting leishmaniasis, but do not offer any reliable protection against infection with Leishmania infantum.
Further information on leishmaniasis can be found at http://www.leishvet.org

Filariae are threadworms that infest the connective tissue or the skin. One of these nematodes is Dirofilaria immitis, or heartworm. Heartworm disease is transmitted by various species of mosquitoes found in southern and eastern Europe. Worm larvae enter the dog's body through the bite of the mosquito. It can take between one and six months from infection to the outbreak of heartworm disease. The larvae migrate to the pulmonary artery and the right side of the heart and grow into worms. They can grow up to 30 cm long. The worms release larvae, known as microfilariae, into the bloodstream. Further worms can develop from these.

An infestation is detected by the antibody test as part of the Mediterranean check. As with other travel illnesses, early detection is important and the test must be repeated after treatment has been completed. A weak infestation can remain without symptoms if the immune system is good. However, a severe infestation can lead to thrombosis, heart, liver and kidney failure if left untreated. In extreme cases, surgical intervention may be necessary.

There are several ways to treat heartworm infestation. On the one hand, there is the "fast kill method". The drug melarsomine is injected, which kills the worms immediately. This fast-acting method is unfortunately very risky, as it can lead to cardiac arrest.

That is why we use the gentler "slow kill method". Treatment begins with a four-week course of antibiotics. Invermtectin is then administered regularly once a month for a year. The antibiotic ensures that the filariae cannot produce any more larvae. Subsequent treatment weakens the heartworms, which gradually die.

It is important to avoid exerting the dog during the treatment. The blood test is repeated at the end of the treatment. If worms are still present, the treatment is extended accordingly. Spot ons and/or collars containing permethrin and flumethrin can be useful for prevention. However, whether and when this makes sense should always be discussed with the vet.

Babesiosis is also a parasitic disease. Babesia is transmitted by ticks and enters the bloodstream. If the disease is not treated, they destroy the red blood cells, which can be life-threatening. There are various babesias that are transmitted by three different tick species: the alluvial forest tick, the brown dog tick and probably the hedgehog tick. These ticks have different distribution areas, but one species or another is native to every part of Europe. This means that dogs from all our placement areas and also in Germany, Austria and Switzerland may be affected. It can take between five days and three weeks from transmission to illness.

The symptoms can vary greatly. They range from loss of appetite, fever, movement disorders and weight loss to life-threatening anaemia and renal insufficiency. There are very rapid and severe courses and also completely asymptomatic cases where only a positive babesiosis test is available but the dog shows no symptoms of the disease.

In any case, the disease must be treated and monitored. It makes sense to do a complete blood count and a full Mediterranean check. This is because babesiosis often occurs together with other travel illnesses. For treatment, the dog is given one injection of imidocarb dipropionate every fortnight to kill the babesia. The success of the treatment is checked by a blood test after a period of two to three months.

The medication can also be administered prophylactically for preventive protection. Spot ons and/or collars containing permethrin and flumethrin also protect against tick bites. Whether one of these measures is advisable must be discussed with the vet on a case-by-case basis.

Ehrlichiosis is also a parasitic disease. It cannot be transferred to humans. The pathogen is called Ehrlichia canis. They belong to the bacterial species Rickettsia.
Ehrlichia is transmitted by the brown dog tick, which is widespread throughout southern Europe. Although it does not yet occur in the wild in our country, it can spread in a heated environment if it has travelled with a dog. In the course of global warming, it can be assumed that the borders of the distribution area will continue to shift towards northern Europe.

Ehrlichiosis is also diagnosed by an antibody test. As with leishmaniasis, this is the IFA or ELISA test and is part of the test for the so-called Mediterranean or traveller's diseases.
Ehrlichiosis also sometimes has no symptoms or they are very unspecific: for example fever, apathy, nosebleeds or gastrointestinal problems. Chronic ehrlichiosis can lead to retinal detachment or kidney damage. But if recognised in time, it doesn't get that far. This is because the disease can be treated well with antibiotics. Here too, if the result is positive, a complete blood count is recommended; a so-called PCR analysis also helps to recognise how active the disease is so that an appropriate response can be made.

When travelling to tick areas, permethrin and flumethrin spot ons and/or collars are a good preventative measure. This should always be discussed with the vet. Not every active ingredient is suitable for every animal and the timing of use is also important to ensure that the protection is effective.

Giardia are gastrointestinal parasites that are quite common. The protozoa can be ingested when drinking stale water, for example. The parasite always enters the body via the mouth. Giardia not only affects dogs, but also other mammals and can also be transmitted to humans. But don't worry, with normal hygiene the risk of infection for humans is very low. Unless the immune system is weakened. Small children are also more likely to be infected, as thorough hand washing after contact with the dog is not always guaranteed and they often put their fingers in their mouths.

The protozoa settle on the intestinal wall and multiply there if the dog's immune system is not strong enough. They cause slimy, yellowish diarrhoea and sometimes vomiting. Typical for a Giardia infestation is that the animals usually have a good general condition and a healthy appetite. The diarrhoea disappears and then suddenly reappears. The animals often continue to lose weight if the disease is not treated.
Diagnosis is based on a faecal examination. As Giardia is not excreted with every faecal discharge, the faeces from three consecutive days are collected and examined.

Giardia in dogs is usually treated quickly. A "tightened" worming treatment is carried out for this. Most vets recommend the dewormer Panacur (fendabendazole), which, unlike a worming treatment, is administered several days in succession in several doses with breaks. In the case of heavy infestation, it is important that the lying areas are also hot-washed at short intervals. The easiest way to do this is to cover everything with washable linen or towels.

Cleaning the entire flat with hot steam is absolutely not necessary. Such measures should only be taken if the giardia keeps reappearing. However, such persistent cases are extremely rare and, in our experience, are more common in cats than in dogs. It is much more helpful to strengthen the dog's immune system. This includes, above all, taking care of the intestines. Ask your vet what you can do to build up the intestinal flora. If the dog has been suffering from an unrecognised Giardia infestation for a long time, the intestinal wall is often damaged.

Only a broad-spectrum antibiotic will help.

b.) Coccidiosis

Another protozoan (a class of protozoa) is coccidia, which should be treated with sulphonamides.

The best thing to do in the case of intestinal diseases is always to have a faecal examination carried out by the vet to find out in detail whether the pathogen causing the diarrhoea is bacteria, giardia or worms.

It is always important to change the food, e.g. chicken with rice or the good old gruel soup, which also provides relief for our four-legged friends.

It is also very important now to provide sufficient water and minerals (especially for puppies and young animals), otherwise dangerous "dehydration" can easily occur.