HISTORY

A 14-month-old female mixed-breed dog with leishmaniasis and receiving allopurinol was examined because of anorexia, vomiting, and acute paraplegia. Neurological examination revealed paralysis of the hind limbs with loss of femoral and sciatic nerve-mediated reflexes, deep pain sensation and panniculus reflex in the lumbar area. The anus was dilated and unresponsive, and the tail was atonic. The neurological examination of the forelimbs and head was normal. Clinicopathologic results were consistent with glomerular disease and renal failure. The dog's haemostatic status was normal Because of leishmaniasis with advanced renal failure and pelvic limbs paralysis the dog was euthanatized. Histopathological examination demonstrated leukocytoclastic vasculitis in multiple organs. Rupture and thrombosis of inflamed vessels was the cause of hemorrhage in the spinal cord, severe degeneration of the nervous tissue and subsequent paralysis.

DISCUSSION

The neurological examination findings in this dog were indicative of diffuse or multifocal involvement of the lumbar and sacral spinal cord. No laboratory evidence of hypercoagulable state or disseminated intravascular coagulation were seen in this case and there was clear evidence of vasculitis affecting small blood vessels of the spinal cord; it can therefore be stated that vasculitis was the cause of hemorrhage within the spinal tissue. Leishmaniasis in this dog may have been the cause of vasculitis, as has been occasionally described, although drug-induced vasculitis due to allopurinol could be also be considered as a part of a generalized hypersensitivity reaction or toxicity in this case. This indicates that in dogs with leishmaniasis and receiving allopurinol necrotizing arteritis should not be overlooked as a possible cause of acute paralysis.