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The vaccine Canileish® is distributed in Europe to reduce the risk of developing an active infection and clinical leishmaniosis. An English Setter dog vaccinated with Canileish® and treated with anti-feeding and repellent medications showed typical clinical signs of leishmaniosis. The dog was presented with dysorexia, weight loss, fever and forelimb lameness. The physical exam revealed moderate generalized external lymph node enlargement, sero-purulent ocular discharge, photophobia, and swollen and painful right carpal joint. Clinico-pathological findings revealed moderate microcytic-hypochromic non-regenerative anemia, mild neutropenia and thrombocytopenia, hyperglobulinemia, hematuria and mild elevation of urine protein-to-creatinine ratio, polyclonal peak in the gamma globulins, Leishmania spp. amastigotes in lymph nodes and bone marrow, and immunofluorescence antibody titer (IFAT) of 1:5120. The successful treatment included meglumine antimonate and allopurinol for 40 days, and metronidazole-spyramicin for 24 days. The dog was monitored up to 9 months and normalization of most hemato-biochemical abnormalities was achieved. The bone marrow qPCR for Leishmania infantum was negative, while IFAT was 1:160. Despite the systematic leishmaniosis prevention, the typical clinical disease can occur.