Review and statistical analysis of clinical management of feline leishmaniosis caused by Leishmania infantum

Abstract

Background There is limited information about feline leishmaniosis (FeL) management in clinical practice. Leishmania infantum is the species of Leishmania most frequently reported in both dogs and cats in countries of the Mediterranean region (henceforth ‘Mediterranean countries’), Central and South America, and Iran. This study was conducted to provide veterinary clinicians with an updated overview of evidence-based information on leishmaniosis in cats. Methods A review was performed using PubMed, Science Direct, Google Scholar and Web of Science. Case reports of FeL caused by L. infantum were sought for the period 1912 to 1 June 2021. Results Sixty-three case reports are included in this review. Fifty-nine out of the 63 cats were from Europe, mostly from Mediterranean countries (88.9%). Most of them were domestic short-haired cats (90%) with a mean age of 7.9 years, and had access to the outdoors (77.3%). Sixty-six percent of the cats had comorbidities, of which feline immunodeficiency virus infection was the most frequent (37.7%). Dermatological lesions (69.8%) was the most frequent clinical sign, and hyperproteinemia (46.3%) the most frequent clinicopathological abnormality. Serology was the most performed diagnostic method (76.2%) and was positive for 93.7% of cats. Medical treatment was applied in 71.4% of cats, and allopurinol was the most used drug (74.4%). Survival time was greater for treated cats (520 days; 71.4% of cats) than non-treated cats (210 days; 25.4%). Conclusions The majority of the cats had comorbidities, of which feline immunodeficiency virus was the most frequent. Dermatological lesions were frequently reported, and systemic clinical signs and clinicopathological abnormalities were also common. Serology may be useful for the diagnosis of FeL in clinical practice, and a positive titer of ≥ 1/40 may be a useful cut-off for sick cats. The reported treatments and dosages varied, but there was a good clinical response and longer survival in most of the cats treated with allopurinol monotherapy. Graphical abstract

Proliferative papulo‐nodular glossitis due to Leishmania infantum in a dog

“…21 In general, skin lesions are the most common findings on physical examination in cats with leishmaniosis. 22 In humans, leishmaniosis is caused by L. infantum and other Leishmania species with mucocutaneous and visceral tropism. The parasite is able to cause oral lesions, which can be often detected in immunosuppressed patients.…”

“…In the case of cats, the first report of oral lesions in feline leishmaniosis has been recently described in 2022 21 . In general, skin lesions are the most common findings on physical examination in cats with leishmaniosis 22 …”

A case report of leishmaniosis with primary oral manifestation in a cat

“…Other diseases can predispose cats to develop leishmaniosis (2,(13)(14)(15). Some authors have identified a strong association between FIV positivity in cats and Leishmania infection (14)(15)(16)(17).…”

“…Other diseases can predispose cats to develop leishmaniosis (2,(13)(14)(15). Some authors have identified a strong association between FIV positivity in cats and Leishmania infection (14)(15)(16)(17). Indeed, in the presence of co-infection (FIV-Leishmania), oral lesions are the most frequent finding (15).…”

“…Regardless, even after periodontal treatment and tooth extractions, the suspected lesion did not resolve despite the overall posttreatment improvement on the contralateral side of the oral cavity. Therefore, not all signs can be related to leishmaniosis, since many cats have comorbidities (13)(14)(15)(16)(17). Primary localized lesions can become more severe and extensive in the presence of a comorbidity, which, in turn, contributes to generalized immunosuppression and decreases the primary resistance of cats to this parasite.…”