Glucantime

RE: Glucantime

Martin Atkinson — Thu, 02 Jun 2016 09:24:32 GMT

[quote user="Simon Baker"]The dog was originally under the care of a vet in Portugal. She was symptomatic but tested -ve for Leishmania at the time. I've asked VMD about the legality of him prescribing if we can regard the animal as being sufficiently recently under his care.[/quote]I've not visited this thread previously but read it as its been bumped.

Out of interest we have the opposite situation: a former client who now lives in Bahrain has an epileptic cat and his vet can't obtain phenobarbital. So she writes a prescription which he brings over, I dispense the tablets and he flies back with them. I passed this by the inspector from the VMD when he did his last practice inspection and said he could see nothing wrong with what I was doing, it was up to the client to determine if it was legal to import the drug into Bahrain. I guess that's where HMRC come in but the bottom line is it is the client's risk not our's.

RE: Glucantime

Silvia Maldonado — Wed, 01 Jun 2016 19:30:06 GMT

Has anyone tried of Letifend, a new vaccine against leishmania? Has anyone heard of it?

RE: Glucantime

Simon Baker — Sat, 09 Jan 2016 10:28:45 GMT

As to previous experience, I've never treated one, but I saw one that my wife treated about 20yrs ago. However, it arrived via quarantine with diagnosis and drugs already in place.

It does sound like cases are not turning up very often in the UK. There was a website promising easy access to the drugs, but it's now a dead link. I assume there have not been enough cases for anyone to have maintained the service.

RE: Glucantime

Simon Baker — Sat, 09 Jan 2016 10:24:15 GMT

Thanks Andy and Steve

The dog was originally under the care of a vet in Portugal. She was symptomatic but tested -ve for Leishmania at the time. I've asked VMD about the legality of him prescribing if we can regard the animal as being sufficiently recently under his care. Frustratingly they've said HMRC need to advise, which is odd because it's VMD that would take action if something was done wrongly. An owner can legally bring a drug in for their own animal that's been under treatment abroad, but I want to be sure if the situation before setting the owner off down that route. If I can't get an adequate answer then it'll need to be an SIC import

RE: Glucantime

Andrew Kent — Sat, 09 Jan 2016 09:38:11 GMT

miltefosine is 2mg/kg daily for 28 days along with the allopurinol. Doses are in Bsava formulary.

If it's a disease that you haven't seen much of before it is worth looking at the leish vet guidelines - they are all on their website and give guidance for different stages of disease.

Andy

RE: Glucantime

Stephen Courtney — Sat, 09 Jan 2016 09:27:06 GMT

[quote user="Simon Baker"]

Thanks, Andy

My Spanish colleague was more familiar with Glucantime. She knew about miltefosine but Glucantime was her default option in Spain. Given that miltefosine has all those advantages I think I'll change direction. What is the dosing regimen?

[/quote]

Contact the technical vet at Virbac - I forget his name, which is rude considering he gave a wonderful in-house CPD evening on this very subject but it was some years ago, and fortunately i have not had a case since then.

Glucantime is ridiculously expensive if you import it legally, in addition it is potentially nephrotoxic. I've used it 4 times over 20 years, and the last dog ( which was elderly and had a relapse of previously successfully treated Leish, died of acute severe renal failure, which wasn't suspected based on pre treatment bloods. the other three did well, no problems but one had a relapse.

If the client has friends or relatives in Spain they may be able to acquire it at a reasonable price BUT obviously that is illegal....

We have just diagnosed one new case in the practice which is getting Miltefosine, but i am not involved with it so can't answer dose queries personally, sorry!

RE: Glucantime

Simon Baker — Sat, 09 Jan 2016 08:44:25 GMT

Thanks, Andy

RE: Glucantime

Andrew Kent — Fri, 08 Jan 2016 23:17:14 GMT

Hi Simon,

i usually use miltefosine (milteforan from virbac) for leishmania now as its oral, much more pleasant for the dog and has less side effects with equal efficacy.

Virbac keep some stocks of it in the uk so if you call them they will talk you through the certificate import process.

Neither option is cheap, usually £200-500 depending on size.

Andy