Leishmania infantum is the most common and important cause of canine leishmaniasis worldwide. Skin lesions are the most common sign associated with clinical leishmaniasis in endemic areas and may include regional (often facial) alopecia and non-pruritic, ulcerative, nodular, or papular dermatitis. When symptoms do occur they usually appear between 4 and 12 days after exposure to the bacteria, and can include fever, muscle pain, vomiting and diarrhea, loss of appetite, lethargy, depression, and blood in the urine.