Osteomyelitis and arthrosynovitis associated with Leishmania donovani infection in a dog

A 10-month-old male maremma shepherd dog was presented with chronic diarrhoea, moderate polyuria/polydipsia, lethargy, dysorexia and stiffness. Pain was elicited in the distal parts of all four limbs. Radiographs of the limbs showed increased endomedullary radiopacity and lysis, with thick periosteal proliferations at the metadiaphyseal areas of each radius-ulna and tibia and of the distal metacarpus on one side. Polyclonal hypergammaglobulinaemia was documented and a similar electrophoretic protein pattern was also found in the synovial fluid. Leishmania amastigotes were found in the macrophages in a bone marrow aspirate performed at the level of a distal radius and in a synovial fluid sample obtained from a carpal joint. An indirect immunofluorescence test confirmed the infection. Treatment with N-methyl-glucamine antimoniate was successful and the osteoarticular changes progressively disappeared.