Leishmaniasis in dogs: symptoms, tests, treatment, and prevention
Canine leishmaniasis (also known as leishmaniosis, or historically as “kala-azar”) is one of the most important parasitic diseases affecting dogs in Greece and throughout the Mediterranean. It is chronic, can remain “hidden” for months or years, and when it becomes symptomatic, it can damage the skin, eyes, joints and, above all, the kidneys.
The good news: proper prevention greatly reduces the risk, and with early diagnosis, most dogs live for many years with a good quality of life. In this guide, we explain what you need to know, drawing on the international guidelines of the LeishVet group and our clinical experience.
Contents
WHAT IS LEISHMANIASIS AND HOW IS IT TRANSMITTED?
It is caused by a microscopic parasite, Leishmania infantum, which lives inside cells of the immune system. It is transmitted mainly through the bite of infected sand flies, small insects that resemble mosquitoes but are much smaller and silent.
- When they bite: mainly from dusk until dawn, and mostly during the warmer months, roughly from spring through fall.
- Other routes of transmission: more rarely, through blood transfusions from infected donors, from mother to puppies, and through mating.
- It is not transmitted through ordinary play or living with another dog.
Important: in areas where the disease is present, many more dogs are infected than become ill. A dog can be infected and appear perfectly healthy. That is why regular testing is so important.
SYMPTOMS OF LEISHMANIASIS IN DOGS
Leishmaniasis does not have one “signature” symptom. It can resemble many other conditions and often starts mildly. The most common signs are:
- Swollen lymph nodes (e.g., under the jaw, behind the knees)
- Weight and muscle loss, fatigue
- Skin problems: dry, flaky skin; hair loss around the eyes (like “glasses”) and on the ears; sores on the nose, paw pads or tips of the ears
- Overgrown or deformed nails
- Nosebleeds
- Eye problems (redness, cloudiness)
- Lameness or joint pain
- Increased thirst and urination, vomiting or loss of appetite when the kidneys are affected
Blood and urine tests often reveal anemia, increased globulins (blood proteins) and protein loss in the urine. Kidney damage is the most serious complication and the main factor determining the prognosis.
See your veterinarian if your dog is losing weight for no reason, has swollen lymph nodes, has a nosebleed, has skin lesions that will not heal, or is drinking much more water than before. You can also read our guide to why dogs drink excessive amounts of water.
LEISHMANIASIS TESTING: WHICH TEST IS NEEDED AND WHAT THE RESULT MEANS
Testing is mainly needed in two situations: when a dog has suspicious symptoms, and as an annual preventive screening for apparently healthy dogs living in an area where the disease is present, such as Attica. Testing is also needed before vaccination against leishmaniasis, before breeding, and for blood-donor dogs.
THE MAIN TYPES OF TESTS
| Test | What it shows |
|---|---|
| Rapid test | Results in a few minutes, “positive” or “negative.” Useful for initial screening, but a positive result needs confirmation. |
| Quantitative serology (IFAT or ELISA) | Performed in a laboratory and measures how many antibodies the dog has. High titers, together with compatible symptoms, confirm the disease. This is the main test for diagnosis and monitoring. |
| PCR | Detects the parasite’s DNA. Useful when results are inconclusive. |
| Cytology | A small sample of cells from a lymph node or other tissue is examined under a microscope for the parasite. |
If a test is positive, your veterinarian will also request a complete blood count, blood chemistry, protein electrophoresis and urinalysis with a urine protein-to-creatinine ratio (UPC). These show whether the dog is simply infected or is ill, and what stage the disease is at.
A POSITIVE TEST DOES NOT ALWAYS MEAN THE DOG IS SICK
A dog with low antibody levels and no symptoms may be infected but healthy. Such a dog does not necessarily need treatment, but does need close monitoring. By contrast, a dog with symptoms and high antibody levels has the disease and needs treatment. That is why a veterinarian must always interpret the result alongside the clinical examination.
When to have the annual test: after infection, it usually takes several months for antibodies to appear. For this reason, annual screening is usually done in winter or early spring, after sand fly season and before the next season begins.
At Vet Heroes, we can collect blood samples at home, avoiding travel and stress for your dog, and discuss the results with you. See our at-home veterinary services.
STAGES OF LEISHMANIASIS
The international LeishVet guidelines divide the disease into four stages, according to antibody levels, symptoms and, above all, kidney function. The stage determines the treatment and prognosis:
| Stage | What it means | Prognosis |
|---|---|---|
| I – Mild disease | Mild signs (e.g., swollen lymph nodes only), normal kidneys | Good |
| II – Moderate disease | Skin lesions, weight loss, nosebleeds, changes in blood test results; normal kidneys or mild protein loss | Good to guarded |
| III – Severe disease | Early-stage chronic kidney disease or significant protein loss in the urine | Guarded to poor |
| IV – Very severe disease | Advanced kidney failure or nephrotic syndrome | Poor |
That is why early diagnosis matters so much: a dog diagnosed at stage I or II has much better prospects than one diagnosed after the kidneys have already been affected.
TREATMENT AND MONITORING
Treatment is tailored to each dog’s stage. It usually combines:
- a medication that kills or inactivates the parasite (meglumine antimoniate by injection or oral miltefosine) for several weeks, and
- allopurinol, which slows the parasite’s multiplication and is given for an extended period.
When kidney disease is present, appropriate treatment for the kidneys is also given. The medications, dosages and duration are always determined by the veterinarian. Never start treatment without a diagnosis, as some of these medications can have side effects that require monitoring.
It is important to know that treatment usually does not completely eliminate the parasite. Most dogs improve significantly, but the disease may relapse. That is why regular monitoring with blood and urine tests is needed: more frequently at first, then at regular intervals for the rest of the dog’s life.
PREVENTION: HOW TO PROTECT YOUR DOG
The best protection is a combination of measures:
- Sand fly repellent throughout the risk period. Medicated collars or spot-on treatments approved specifically to protect against sand fly bites. Not every antiparasitic product protects against sand flies, so ask your veterinarian which one is suitable.
- Reduce exposure in the evening. As much as possible, have your dog sleep indoors during the warmer months, and avoid walks at dusk near vegetation or stables.
- Vaccination. One vaccine for canine leishmaniasis is currently available in Europe. It is given only to dogs that test negative and does not replace repellent; it complements it.
- Annual testing, so that an infection can be detected early.
Important if you also have a cat: some products for dogs contain permethrin, which is highly toxic to cats. Always ask your veterinarian before using them in a home with a cat. “Natural” repellents (e.g., citronella) have no proven protective effect and do not replace approved products.
Repellent and vaccination can often be given at the same visit as your dog’s other vaccines. See also the dog vaccination schedule.
IS IT A RISK TO HUMANS?
Leishmaniasis is a zoonotic disease: it can also affect humans. However, it is not transmitted directly from dogs through petting or living together. A sand fly is always required for transmission. The dog is the main “reservoir” of the parasite, which is why protecting it from sand flies also indirectly protects the family. A dog with leishmaniasis that is monitored and protected with repellent can live at home as usual.
FREQUENTLY ASKED QUESTIONS
Click a question to see the answer.
Leishmaniasis or leishmaniosis? Are they the same?
Yes, they refer to the same disease. Veterinarians more commonly use the term “leishmaniosis,” while “leishmaniasis” or “kala-azar” are also heard in everyday language.
Can leishmaniasis be treated?
It can be controlled, but is usually not completely eliminated. Most dogs diagnosed early live for many years with a good quality of life, with treatment and regular monitoring.
How often should my dog be tested?
In areas where the disease is present, such as Attica, testing is recommended once a year, usually in winter or early spring. If suspicious symptoms appear, testing should be done immediately.
The test was positive, but my dog seems fine. What should I do?
Quantitative antibody testing and blood and urine tests are needed to determine whether the dog is simply infected or is ill. Many dogs with low antibody levels and no symptoms need only monitoring.
Can I catch leishmaniasis from my dog?
Not directly. Transmission requires a sand fly bite. Protecting your dog with repellent also reduces the risk to your family.
Is vaccination enough for protection?
No. The vaccine reduces the risk of your dog developing the disease, but does not prevent bites. Sand fly repellent remains the primary protection.
IN SUMMARY
Leishmaniasis is serious, but it is not a death sentence. Three things make a big difference: sand fly repellent throughout the risk period, an annual test and a prompt visit to the veterinarian as soon as you notice anything suspicious.
Would you like your dog to have its annual test without leaving home? See the areas we serve and book a visit with Vet Heroes.
SOURCES
- Solano-Gallego L, Miró G, Koutinas A, et al. LeishVet guidelines for the practical management of canine leishmaniosis. Parasites & Vectors 2011;4:86. doi.org/10.1186/1756-3305-4-86
- LeishVet Group. Fact sheet: Practical management of canine leishmaniosis (2024). leishvet.org
- Solano-Gallego L, Koutinas A, Miró G, et al. Directions for the diagnosis, clinical staging, treatment and prevention of canine leishmaniosis. Veterinary Parasitology 2009;165(1-2):1-18.
- Baxarias M, et al. Use of preventive measures and serological screening tools for Leishmania infantum infection in dogs from Europe. Parasites & Vectors 2022;15:134. doi.org/10.1186/s13071-022-05251-5
- European Medicines Agency (EMA). CaniLeish – withdrawn marketing authorisation. ema.europa.eu
