Efficacy of intralesional meglumine antimoniate in the treatment of canine tegumentary leishmaniasis: A Randomized controlled trial

Abstract

Dogs living in areas of Leishmania (Viannia) braziliensis transmission may present canine tegumentary leishmaniasis (CTL) characterized by cutaneous or muzzle ulcers as well as asymptomatic L. braziliensis infection. It is not clear if dogs participate in the transmission chain of L. braziliensis to humans. However, dogs may remain with chronic ulcers for a long time, and as there are no public policies about CTL, these animals die or are sacrificed. Here we compare the efficacy of intralesional meglumine antimoniate with intralesional 0.9% NaCl solution in CTL treatment. This randomized control study included 32 dogs with cutaneous or muzzle lesions who had L. braziliensis DNA detected by PCR in tissue biopsied. Group one received 5ml of intralesional Glucantime, and group two received 5ml 0.9% NaCl solution, both applied in the four cardinal points on days 0, 15, and 30. Cure was defined as complete healing of the ulcers in the absence of raised borders on day 90. There was no difference in animals’ demographic and clinical features in the two groups (p >.05). While at the endpoint, the cure rate was 87.5% in the group test, and in those who received 0.9 NaCl the cure rate was only 12.5%. As important as the high cure rate, the healing time was faster in dogs treated with antimony than in those treated with saline (p < .001). Intralesional meglumine antimoniate is effective in the treatment of dogs with L. braziliensis infection and accelerates the healing time of CTL. Author summary Dogs play an important role in the transmission of Leishmania infantum, the causal agent of visceral leishmaniasis. But very little is known about L. braziliensis infection in dogs. Canine tegumentary leishmaniasis (CTL) caused by L. braziliensis is documented in endemic areas of human cutaneous leishmaniasis. CTL occurs predominantly in males, and the scrotal sac and muzzle are the primary site of infection. As there are no policies regarding therapy for CTL, dogs die from the disease or are sacrificed. A few uncontrolled studies showed a cure of CTL after treatment with intralesional Glucantime (Sanofi-Aventis). Here, we compare the efficacy of intralesional Glucantime (N = 16) versus intralesional saline (N = 16) in the treatment of CTL. All dogs presented ulcerated lesions. The DNA of L. braziliensis was documented by PCR in biopsied tissue of all animals in the study. There were no differences among the two groups regarding age, gender, illness duration, lesion size, and lesion site. However, a higher cure rate (87.5%) was observed in the dogs treated with Glucantime compared to 12.5% in those treated with saline (p < .001). This study showed that intralesional Glucantime cures dogs infected with L. braziliensis and should be used to treat canine tegumentary leishmaniasis.