Is pancreatitis associated with meglumine antimoniate treatment for canine leishmaniosis? A multicentric prospective study

Abstract

Background: Meglumine antimoniate is used to treat canine leishmaniosis. In humans, it has been associated with pancreatitis. Although a few case reports have described acute pancreatitis secondary to antimonial treatment in dogs, some studies have concluded that pancreatitis is not an adverse effect of this medication. The objective was to evaluate whether treatment with meglumine antimoniate could induce pancreatitis in dogs with leishmaniosis, on the basis of clinical signs, canine serum specific quantitative pancreatic lipase immunoreactivity (cPLI) concentration, and ultrasonographic abnormalities.

Methods: A prospective, observational, longitudinal, and multicentric study was conducted from April 2021 through February 2023.

Results: A total of 33 dogs with leishmaniosis were included and classified into LeishVet clinical stages; 13 (39.4%) were included in stage II, 11 (33.3%) in stage III, and 9 in stage IV (27.3%). and 14 (42.4%) developed pancreatitis, 10 during treatment with meglumine antimoniate, and 4 at the end of the treatment. Advanced LeishVet clinical stage was statistically associated with development of pancreatitis. In addition, nine dogs received prednisone at the beginning of treatment, but it was not statistically associated with the prevention of pancreatitis.

Conclusions: Meglumine antimoniate remains the first line leishmanicidal treatment option for canine leishmaniosis, but it appears to induce pancreatitis in a significant percentage of dogs. Monitoring serum cPLI levels and performing an abdominal ultrasound should be considered when pancreatitis-associated clinical signs are observed, or when there is a high suspicion of circulating immune complexes in dogs with advanced LeishVet clinical stage.

Keywords: Antimonials; Dog; Leishmania; Pancreas.