The Use of Two Clinical Staging Systems of Canine Leishmaniasis in A Clinical Setting : a Critical Evaluation

Objective: To evaluate the use in practice and agreement between, two classification systems: Solano-Gallego (LEISHVET SYSTEM) and Canine Leishmaniasis Working Group (CLWG) clinical staging systems in a population of dogs with leishmaniasis. Methods: Clinicopathological data extracted from medical records of dogs previously diagnosed with leishmaniasis was evaluated using the two staging systems. Dogs that did not meet the criteria for classification were defined as unclassified. The agreement between the two staging methods was evaluated using unweighted K statistic (k) and Spearman’s coefficient of rank correlation (rho). Statistical significance was P < 0.05. Results: Eighty dogs met the inclusion criteria. There were 3 dogs in LEISHVET SYSTEM stage I, 52 dogs in LEISHVET SYSTEM stage II, 12 dogs in LEISHVET SYSTEM stage III, 6 dogs in LEISHVET SYSTEM stage IV and 7 dogs unclassified. No dog was in CLWG stage A or B, 56 dogs were in CLWG stage C, 23 dogs in CLWG stage D and 1 dog unclassified. k value: 0.669, rho: 0.558, with P<0.0001. Clinic significance: Despite the different number of clinical stages between the two systems, the classification of dogs with or without proteinuria and renal involvement was possible with both methods. LEISHVET SYSTEM distinguishes among the different levels of proteinuria and serum creatinine concentration in the staging. CLWG system identifies a cut off value for these parameters only to formulate a prognosis. Despite the presence of discordances, there was good agreement between the two systems in the staging of CanL.