Diagnose von der Leishmaniose!

Mirko ist ein ganz netter und lieber Kerl. Leider er hat Leishmaniose aber ihm geht's sehr gut. Die erste Tests sind negativ ergeben aber wir konnten nicht glauben dass er keine Leishmaniose hatte... etwas sehr interessantes ist passiert bis wir leider zum positiven Ergebnis von Leishmaniose gekommen sind... Aus diesem Grund ich habe diese Email auf Englisch zu einigen Tierschutzerinnen geschrieben. Ich habe mir den Text wiedergelesen und denke es kann interessant für Alle sein :

Here I wish to give to you my opinion about the diagnosis of leishmania. I hope you bear clearly in mind that some tests are direct and some are indirect when you are looking for leishmanias. This is a very important concept in order to understand the rest:

a) Among the indirect tests we have a series of trials where the sample is serum (IFI, ELISA...). These tests try to measure antibodies. If a dog has got antibodies against Leishmania it means that sometime he must have been bitten by the Phlebotomus (or maybe the mother has passed the antibodies to their offspring. But this idea hasn't been published yet I think). Not all the positive dogs are ill, so not all of them must be treated!
A diagnosing problem we might face is that a dog without antibodies can also have been bitten by the mosquito! and a dog with or without antibodies can have symptoms or not have them! EVERYTHING is possible, that is why this parasitosis is so challenging and hateful :-)
When a dog has got symptoms and a positive test, we usually believe the result and therefore we treat.
When a dog hasn't got any symptoms but a positive or doubtful test, we do not believe the result and do a pcr test. The pcr's problem is the cost and that there are dogs where it's rather difficult to take the bone marrow sample without sedation... normally it's no problem to do it easily with no sedation, but there are exceptions.

b) The two direct tests that I know are the bone marrow citology and the PCR (samples : blood+bone marrow + skin scraping (in case of skin or hair symptoms)+- lynfnode aspirate). ATTENTION: do not send blood alone: you are wasting your time and your money!!!
Through citology one might or not SEE the leishmanias. If you see them, here you are! BUT if you don't see them it doesn't mean the dog is free, and if you suspect Leishmania you must go on with further tests like the PCR, which sort of "catches" the DNA of the parasite if this is present in the sample.
It is VERY IMPORTANT that you send all possible samples (blood, b. marrow, skin scraping, lynfnode aspirate, etc) when you order a pcr!!! and here it is how Mirko has shown this to us:

When Mirko arrived we all suspected of leishmaniasis, he had symptoms of many kinds: but through his blood analyses we only diagnosed ehrlichiasis and treated him. The Leishmania antibody titer was negative but we didn't believe it! In the veterinary clinic we also diagnosed funghi and we're currently treating him. A pcr was then made with blood+bone marrow BUT I forgot to send an infected skin sample as well!!! so... the pcr was negative. Anyway Mirko's face kept on suggesting leishmaniasis... My vet colleague suggested me to send the hairs, crusts, etc, from infected areas that I had forgotten to send the first time and... THE PCR IS POSITIVE!


Es ist sehr Schade dass die Tiere Krankheiten haben, aber ich finde es noch trauriger wenn man an etwas unmögliches glauben möchte um sich das Leben einfacher zu machen... Manche Tierschützer sagten zu mir in der Vergangenheit warum ich die Leishmaniose verfolge "wenn ein Test negativ ist, es ist negativ und Schluss" (heutzutage Sie suchen auch, so wie ich ;-)  ). Das geht bei uns nicht, wenn wir an etwas wichtiges glauben, entweder Positives oder leider Negatives, wir versuchen es zu finden. Wir versuchen keinen undiagnostizierten Tier zu vermitteln, natürlich man kann Pech haben und einen Fehler in dieser Richtung machen, aber wir versuchen dass sowas nicht passiert um die Zukunft unseren Tieren sogut wie möglich zu garantieren :-)