Therapy
Information regarding the therapy for FeL is currently derived solely from descriptive, non-controlled studies.
Empirical treatment involving two of the most recommended drugs for dogs is generally considered clinically effective and appears to be safe in most cases. The most frequently used protocol is currently the combination of meglumine antimoniate and allopurinol. However, allopurinol or meglumine antimoniate monotherapies have also been found clinically effective and widely used, particularly in case of adverse effects with one of the two drugs. In certain instances, allopurinol is the preferred choice when owners prefer to avoid performing subcutaneous injections.
Table 2. Drugs most frequently used for treating FeL (currently used in combination)
| Drugs | Dose | Adverse effects |
| Meglumine antimoniate | 50 mg/kg SC, q24h for 30 days | Acute kidney injury |
| Allopurinol | 10 mg/kg PO q12h or 20 mg/kg PO q24h for at least 6-12 months | Acute kidney injury Head and neck dermatitis/Pruritus Increased liver enzymes Xanthinuria |
PO: Per os – SC: Subcutaneous
Cats under therapy with allopurinol and/or meglumine antimoniate should always be carefully monitored for any adverse effects. Suspected acute kidney injury (meglumine antimoniate and/or allopurinol) and reversible skin reactions (allopurinol) were reported in some cases.
Propylene glycol is among the excipients of the miltefosine oral formulation licensed for the treatment of CanL.
Propylene glycol can cause Heinz body formation in feline red blood cells as demonstrated in a pilot study on healthy cats treated with Milteforan© for 15 days. A consequence of Heinz body formation is anemia, due to a decreased life span of feline red blood cells. Therefore, miltefosine is not recommended for the treatment of FeL.
Disclaimer: Information given here on drugs and dosages are based on a consensus of clinical and scientific experience by the LeishVet members. Most recommendations have been published in scientific peer-reviewed journals. Veterinary practitioners are requested to check with product leaflets and product registrations in their related country prior to any product selection and initiation of treatment.