A Questionnaire-Based Survey on the Long-Term Management of Canine Leishmaniosis by Veterinary Practitioners

Abstract

Canine Leishmaniosis (CanL) is a chronic and potentially fatal disease. In economically disadvantaged regions, costs associated with long-term patient monitoring may determine that some owners decline veterinary follow-up of their dogs. This online, questionnaire-based survey aimed to assess how Portuguese veterinary practitioners perform long-term patient monitoring and recognize relapses. More than 50% of respondents reported that 50-100% of dog owners declared financial restraints. Hence, in these circumstances, most veterinary practitioners only performed clinical examination and serology. However, when owners did not declare financial restriction, other tests were additionally performed, such as renal and hepatic profiles, hemogram, serum protein electrophoresis and urine protein creatinine ratio. The mean number of exams performed when owners presented financial restraints was significantly lower than the number of exams performed without economic limitations. Most veterinary practitioners prescribed allopurinol ad aeternum or until disease remission and domperidone. CanL relapses were recognized by more than half of respondents "Always", through the reappearance or worsening of clinical signs, whereas about a quarter detected an increase in anti-Leishmania antibody levels and identified abnormalities in the serum protein electrophoresis profile. The relapse rate was higher in the Lisbon Metropolitan Area and north, the most economically favored regions of Portugal. This study confirms that owner financial restraints negatively influence veterinary follow-up and relapse recognition, ultimately compromising clinical decision making and favoring the maintenance of Leishmania infantum infection endemicity.

Keywords: canine leishmaniosis; long-term treatment; questionnaire; relapse; veterinary follow-up.

Figure 1

Distribution of respondents and canine leishmaniosis (CanL) diagnoses by NUTS II regions. (a) Number of veterinary practitioners who responded to the questionnaire by NUTS II regions. (b) CanL diagnoses among different NUTS II regions, represented by means and standard deviations. Statistical analysis was performed using the non-parametric Kruskal–Wallis test with paired comparison (p < 0.05).

Figure 2

Number of dogs suspected of having CanL, diagnosed with CanL, and subjected to veterinary follow-up yearly, represented by means and standard deviations. Statistical analysis was performed using the non-parametric Kendall test with pairwise comparison (p < 0.05).

Figure 3

Exams performed by veterinary practitioners during the follow-up of dogs with CanL when owners did not refer to financial restraints.

Figure 4

Number of exams carried out by veterinary practitioners according to owner financial status, represented by means and standard deviation. The mean number of exams was calculated by adding the exams carried out “Always” and “Frequently” by veterinary practitioners. Statistical analysis was performed using the Mann–Whitney test (p < 0.05).

Figure 5

Different long-term treatments prescribed by veterinary practitioners to treat CanL.

Figure 6

Different clinicopathological exams employed by veterinary practitioners to identify relapses of CanL.

Figure 7

Relapse rate at different NUTS II regions of mainland Portugal. Statistical analysis was performed using the non-parametric Kruskal–Wallis test with pairwise comparison (p < 0.05).