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This Disease Kills Countless Dogs, but It Doesn’t Have To

Analysis by Dr. Karen Shaw Becker

Story at-a-glance -

  • Dr. Artur Vasconcelos is a Brazilian veterinarian with a great deal of experience treating a very difficult-to-manage disease called leishmaniasis
  • Leishmaniasis is a significant problem for dogs in Brazil, and until recently, the drugs used to treat the disease weren’t available to veterinarians
  • Because the drugs carry serious side effects, don’t work for all dogs and in some cases are quite toxic, Dr. Vasconcelos has developed his own treatment protocol using natural compounds
  • When the disease is caught early, proactive pet parents and veterinarians can use a total health approach, including a natural protocol, to keep infected dogs healthy, with a normal lifespan

Today I'm talking with a very special guest, Dr. Artur Vasconcelos. Dr. Vasconcelos is a Brazilian veterinarian, and we met while I was visiting his country a few months ago.

I was very inspired by a lecture he gave, and I asked him if I could interview him sometime because as a small animal veterinarian in Brazil, he sees many diseases I know nothing about. Dr. Vasconcelos addresses some of these complex disorders using adjunctive therapies and protocols he has created, partly out of desperation and partly because he wanted options when nothing else was working.

"I want to thank you for this opportunity to bring what we do here in Brazil to the whole world," Dr. Vasconcelos says. "We have some challenges that you don't have. But I think it can be helpful for other diseases too, this approach that I use here."

Leishmaniasis Is a Serious Problem for Brazil's Canine Population

Our topic today is leishmaniasis. Never in the history of my veterinary career, which spans two decades now, have I seen a single case of this disease. However, the number of dogs affected by it in Brazil is high.

"Leishmaniasis is actually a global disease," Dr. Vasconcelos explains. "It's not just in Brazil. It's in India, Pakistan, some parts of Europe, and other locations in Latin America as well. There are different kinds of protozoa that cause the disease, but here in Brazil, the hot topic is the visceral form of the disease in which the dog is a reservoir.

Leishmaniasis is a zoonotic disease. It can affect humans, dogs and other animals like cats, rats, and wildlife. It's a hot topic because it's all around the country. It's not endemic due to the climate, but in some big cities more than 50 percent of dogs test positive for the disease.

Where I practice, we believe it's between 20 and 30 percent of the dogs — I'm in in a big city of 3 million. We have lots of dogs, most of which aren't tested. They can transmit the disease to other dogs and to people, too. Leishmaniasis is a disease that isn't curable, but it's manageable."

In the US, 22 States Have Reported Cases of Leishmaniasis

When I got home from Brazil after hearing Dr. Vasconcelos' lecture on the disease and the treatment protocol he developed, I was fascinated and did some research. I discovered that in North America, 22 states have reported cases of leishmaniasis, along with two provinces in Canada.

"It can travel," says Dr. Vasconcelos, "and so do dogs. Also, because the climate is changing, places without leishmaniasis today may see it in 10 or 20 years. Right now, it's not an epidemic, but I think it's endemic. The levels are stable, but high. It has a high morbidity."

According to the research I did, in the U.S. the disease is seen primarily in foxhounds. I know that some rescue organizations are bringing dogs into this country from Cuba and South America. It's also possible that affected animals in the U.S. travelled outside the country with their owners and brought the disease-causing protozoa back home with them.

The disease is spread by a certain species of sand fly, and is potentially zoonotic, although no cases of transmission from dogs to humans have been documented.

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Drugs to Treat the Disease Have Only Recently Become Available in Brazil

Dr. Vasconcelos taught at a veterinary school in Brazil and I asked him if that was where he was first introduced to leishmaniasis.

"My introduction was before I went to the veterinary school because I had a dog that acquired the disease," he answered. "I had the challenge of treating him with the help of other vets. But at the veterinary school hospital we had lots of leishmaniasis patients, including dogs brought in by their owners for a second opinion. So every day I was seeing two, three or four cases of leishmaniasis."

I asked Dr. Vasconcelos about the success rate of the current standard of care for these patients. I've heard there are problems getting the drugs needed for treatment.

"For the last 20 or 30 years in Brazil, the treatment was prohibited," he explained. "Euthanasia was recommended for dogs with leishmaniasis. Some pet owners brought contraband drugs in from Europe. Some veterinarians were willing to use the drugs and the dogs were successfully treated.

In the last two to three years, the second round drug in Europe, miltefosine, was allowed by the government here in Brazil to treat dogs with the disease. It was a big win for pet parents because they now can legally treat their dogs. Veterinarians can help them more openly and seek other options beyond the drugs imported from Europe.

But we aren't identifying every dog with leishmaniasis. There isn't enough money and people with infected dogs aren't allowing their pets to be euthanized."

The Ineffectiveness and Side Effects of Drugs to Treat Leishmaniasis Drove Dr. Vasconcelos to Search for Alternatives

Since Dr. Vasconcelos' dog acquired leishmaniasis early in his career, I asked him how he approached the problem. Did he have access to the drugs from Europe?

"Actually, the vet who was helping me already had the drugs in his clinic, brought in by another client whose dog ultimately died," he answered. "So the vet tested the drugs on my dog. The problem with the drugs is they're very toxic. Not every dog responds well.

My dog responded very well. But around two years later, he developed a complication from the disease. It's very common. Not every dog who is treated continues to improve. Sometimes the disease recurs and the dog is given another round of drugs. This is why I started looking for other options, and thinking outside the box.

Brazil is one of the more biodiverse countries in the world. There is a big interest, especially inside the universities, to study compounds that can be commercialized as drugs in the future. For example, I used quercetin for allergic dogs. I used the agaricus blazei, an edible mushroom from Brazil, for cancer patients.

When I realized these compounds can be as effective as standard drugs, I asked myself, 'Why not try it for leishmaniasis patients?' The compounds are safe. They have doses for other diseases. Dogs didn't respond well to the drugs used to treat the disease, perhaps because their liver or kidneys were already very damaged. Why not use natural compounds and see how it goes?"

I think it's wonderful that Dr. Vasconcelos was willing to think outside the box. Many of our conventional colleagues, even when their heart aches for their dying patients, just will not step outside the standard of care.

His Current Protocol Combines Natural Compounds With Low-Toxicity Drugs, a High-Quality Diet and a Low-Stress Environment

I asked Dr. Vasconcelos to give some details on his current protocol to treat leishmaniasis.

"We really need more studies to design a protocol," he explained. "But as I said, I was using natural compounds for other conditions, so I started to apply some of them to dogs with the disease to see if they had an effect. I learned quercetin has a very nice leishmaniasis effect.

And I especially like the agaricus blazei mushroom, I think it's interesting because I can use it continuously. It has a potent immune-stimulant effect. It elevates the cellular TH1 response that is most effective against the disease. I can keep dogs on this mushroom indefinitely. I use it with cancer patients, and it works by a similar mechanism in dogs with leishmaniasis.

We also use domperidone as a prokinetic. It has very low toxicity. In some studies in dogs, it has proved very effective, together with other drugs and also as a preventive buffer for the disease. I usually use quercetin and domperidone in the first two months, and combine it with agaricus. After that period, I just give the agaricus and the leishmania static drug allopurinol, which also has very low toxicity.

Dogs in generally good health, thriving at home, eating a raw diet, and have proactive owners and a low-stress environment usually respond very well to a more basic treatment approach. They usually don't need the more toxic drugs. In my experience, leishmaniasis is a disease that requires a functional approach to a dog's overall health. Dogs who are in bad health when they acquire the disease tend to suffer more."

Why Dr. Vasconcelos Recommends a Homemade, Species-Appropriate Diet for Dogs With the Disease

I'm very interested in Dr. Vasconcelos' mention of a raw diet, so I asked him if in his experience, dogs who eat better diets have a better immune system response. He replied that they definitely do.

It's important for pet parents to know that if they rescue or encounter a dog who is positive for leishmaniasis, it's not an automatic death sentence. And if you work to improve the immune system by improving the diet, it actually helps the dog's overall response to this chronic, long-term condition.

"For sure," Dr. Vasconcelos agrees. "Leishmaniasis is primarily an inflammatory disease. If you feed homemade, species-appropriate food, you can bring the inflammation down. You can also add supplements and closely watch the fatty acid balance to help decrease inflammation.

We have problems with the dogs kept on allopurinol, the leishmania static drug, because we don't have a commercial diet here in Brazil that's low in purines. With a homemade diet, you can wash the purine content off the food and prevent problems with shunting kidney and bladder stones. I think it's essential for dogs with leishmaniasis to eat a homemade diet, a well-designed one."

Dr. Vasconcelos Is a Veterinary Role Model for Outside-the-Box Thinking

Dr. Vasconcelos stresses the importance of catching leishmaniasis as early as possible, before it does organ damage, to give affected dogs the best chance to enjoy a normal lifespan. Currently, he has two dogs at home who are both positive for the disease, and they're doing very well on his protocol.

What really inspired me about Dr. Vasconcelos' work is that his elegantly simple and inexpensive protocol is maintaining quality of life in dogs with a very difficult to manage disease. The cost aspect is very important in Brazil.

"We have pet parents who have money, but we have a very poor population," he explains. "The drugs to treat the disease are very expensive. If we can offer less toxic and less expensive treatments, it's a great benefit, but pet parents have to invest time and patience to find a veterinarian who is open minded."

In my view, Dr. Vasconcelos is a role model for veterinarians worldwide in terms of having the courage to pursue nontoxic options even in "hopeless" situations. In the case of leishmaniasis, his protocol has proven to be incredibly beneficial for long-term support, again, at a very reasonable price.

"Thank you for this opportunity," says Dr. Vasconcelos. "I'm very inspired by how you speak to pet parents. You are so proactive. You empower them. I think it's very important to change the way we currently practice veterinary medicine. We have to listen to pet parents and offer them better options. We have to use our imaginations."

What's really neat is that pet parents around the world are beginning to expect and even demand better answers from us. They want to be an important part of their pet's healing. They want to be involved. They want to know what's happening. They don't want a doctor to dictate to them. They want to be an integral part of helping their pets heal.

Brazil Has a Thriving Integrative Veterinary Community

Another thing that really impressed me in Brazil was that Dr. Vasconcelos' integrative veterinary community is incredibly supportive of one another. They share information.

"I'm working with someone to build a website," says Dr. Vasconcelos. "I'm putting together a group of open-minded vets to make information more accessible to pet parents. Most people in Brazil don't understand English. The resources I have access to, they don't have at home, so I'm trying to get more involved in the education process.

The site is directed toward pet parents. I'm hoping to post information about leishmaniasis and other topics, as well as an explanation of functional medicine, and how homemade diets and a pet's environment can bring back health. We are hoping it will be a great tool for pet parents."

It would be wonderful if pet owners in Brazil could have access to the resources and tools they need to make better decisions. I think Brazil could be a leader when it comes to proactive integrative veterinary medicine.

"Thank you," says Dr. Vasconcelos. "I hope we get there!"