Bilateral uveitis in dogs in Spain: leishmaniosis and ehrlichiosis
6-year-old Podenco living in the countryside in Andalusia, with bilateral anterior uveitis, weight loss, periocular scaling and one episode of epistaxis. No previous treatments.
What is the most appropriate next step?
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A. Start oral prednisolone at immunosuppressive doses to control the uveitis as soon as possible
Bilateral uveitis with systemic signs suggests an infectious cause. Immunosuppressing without a diagnosis can worsen leishmaniosis or ehrlichiosis.
B. Complete blood count, biochemistry with protein electrophoresis, urinalysis and serology for Leishmania and Ehrlichia, with topical treatment meanwhile
Correct. In Spain, leishmaniosis and ehrlichiosis are common causes of bilateral uveitis. A systemic work-up guides diagnosis and specific treatment, while topical anti-inflammatories and atropine control the eye.
C. Enucleation of the more affected eye and histopathology
It is an extreme and unnecessary measure at this stage: the cause is probably systemic and treatable, and the eye may retain vision.
D. Treat with antibiotic eye drops only, because bilateral uveitis is usually bacterial
Bilateral uveitis is rarely bacterial; it is usually immune-mediated or secondary to systemic disease, and antibiotic drops do not treat intraocular inflammation.
lightbulb Key takeaway
Bilateral uveitis is a systemic disease until proven otherwise. In leishmaniosis it may persist even when leishmanicidal treatment works, because it is immune-complex mediated, and it often needs prolonged ocular treatment.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.