Domperidone and Allopurinol combination effectiveness in the treatment of canine visceral leishmaniasis

Some concerns involving; deficiency of drugs for clinical and especially parasitological cure that are used in treatment of visceral leishmaniasis, resistance developed within Leishmania strains against drugs, relaps of clinical disease, excessive toxicological effects, expensive prices and rarely finding of drugs cause difficulties at therapy.Domperidone, a D2 receptor antogonist used as gastric prokinetic and anti-emetic, has recently been used in the treatment of canine visceral leishmaniasis, provide significant increase in serum prolactine level besides cause decrease in anti-Leismania antibody titers by clinical remission, whereas allopurinol has also been used for the treatment of canine visceral leishmaniasis because of clinical recovery, deemed as reasonably price, easily availability, minimal side effects and oral usability. In the present study the aim was to determine the efficacy of combined use of both domperidone and allopurinol in treatment of dogs with visceral leishmaniasis. A total of 17 dogs diagnosed as visceral leishmaniasis with clinical findings besides identification of amastigotes in lympoid nodules aspirates and serological tests (IFAT) were enrolled in this study. Dogs with visceral leishmaniasis were randomly divided into two groups: in first group dogs were treated with domperidone at a dosage of 2 mg/kg per orally for one month period and plus oral allopurinol at a dosage of 30 mg/kg once a day for 3 months period. In the second group infected dogs were given allopurinol solely aat a dosage of 30 mg/kg once a day for 3 months period. Dogs infected with visceral leishmaniasis in both gorups were examined clinically, haemato-biochemically, parasitologically and serologically in pre-treatment (day 0) and during treatment period.In the present study in animals belonging to groups treated with domperidone and allopurinol combination had tendency for recovery in the first 15 days, however in group treated solely with allopurinol dogs did not recover in the first month. Besides in domperidone and allopurinol combination group following clinical recovery variances in WBC, RBC, PCV and albumin values were statistically significant (p <0.05) in contrast to group involving solely allopurinol treated. In domperidone and allopurinol combination group, in that amastigotes were diagnosed within lymph node aspirates, 6 out of 8 after 15 days and in other 2 after 60 days amastigotes were nor detected furthermore. In group with solely allopurinol application in dogs with amastigote diagnosis, 1 out of 4 after 30 days and in 2 after 60 days and in 1 after 90 days no more amastigotes were detected. In domperidone and allopurinol combination group at the end of therapy period in paralel to clinical recovery anti-Leishmania antibody titers were decreased in 7 (77%) and were remained stabilised in 2 of dogs, respectively. Besides in group with solely allopurinol application anti-Leishmania antibody titers were increased in 2 dogs and remained stabilised and decrased in 2 and 4 dogs, respectively.In conclusion it may be suggested that domperidone and allopurinol combination therapy against canine visceral leishmaniasis may be more efficacious for relieving clinical signs, remission of hematobiochemical signs, controlling of the disease and decreasing anti-Leishmania antibody titers in contrast to alone allopurinol therapy.