Leishmaniosis in cats: ABCD guidelines on prevention and management

OVERVIEW: Leishmania infection is less known in cats than in dogs and humans; felids were traditionally considered a resistant species, and canids as the main reservoir. Only sporadic cases of feline disease have been reported worldwide, mainly caused by L infantum. Epidemiological investigations have confirmed, however, that feline infections are not rare and that disease occurrence might be underestimated in endemic areas. INFECTION: Cats are infected by the same Leishmania species that infect dogs and humans in tropical and subtropical areas worldwide. Sand fly vectors take blood meals from cats and are competent vectors for L infantum, as shown experimentally. DISEASE SIGNS: Skin lesions (ulcerative, crusty, nodular or scaly dermatitis) are the most frequent clinical manifestations and sometimes the only findings on physical examination. Lymph node enlargement, weight loss, ocular involvement (nodular blepharitis, uveitis, panophthalmitis), decreased appetite, chronic gingivostomatitis and lethargy are the most frequent non-cutaneous findings, alone or in combination. DIAGNOSIS: Direct confirmation can be obtained by cytology, histology, isolation or polymerase chain reaction (PCR) on samples of skin, lymph nodes, blood or any affected tissue. Serology using a validated immunofluorescence test, ELISA, direct agglutination or Western blot has been used to assess infection frequencies. DISEASE MANAGEMENT: Little information is available about treatment with follow-up reports. Long-term administration of allopurinol (10-20 mg/kg q12h or q24h) is usually clinical effective. Vaccines are licensed for dogs only.