What dog breeds are prone to autoimmune disease

Spontaneous, nasty lesions

These skin eruptions could be from an autoimmune illness

In an autoimmune disorder, the very cells designed to protect a dog from outside invaders turn rogue and attack the animals own body. When the disorder affects the outer epidermis and inner dermis of the skin, these layers can separate and cause painful, blistering lesions.

As the skin layers separate, blisters and pustules may form in the empty spaces. These fragile areas may break down due to erosions, develop crusts from the debris and fluid, and lead to hair loss in the affected areas. Secondary bacterial infections are common.

Severe, recurrent cases of atopic dermatitis are often a suspected cause, predisposing a dog to autoimmune skin problems. Symptoms usually include itching, sneezing, rashes, watery eyes and paw chewing. Unfortunately, by the time your dog is definitively diagnosed, the trigger may be long gone, which can make diagnosing and treating these illnesses tricky.

Viruses trigger autoimmune skin conditions in humans, but havent been well documented in dogs. A genetic predisposition, which is known to play a role in human autoimmune disorders, has not been proven in dogs, but it is suspected.

[For example], superficial pemphigus is recognized more frequently in some breeds like the Akita, says Dr. William H. Miller Jr., professor emeritus of medicine in the Department of Clinical Sciences.

Certain medications may be the trigger in individual dogs, such as antibiotics like sulfonamide, penicillin and cephalosporin. For some dogs, topical medications used for external parasite control may trigger the reaction. This includes topical ectoparasitic preparations containing fipronil, amitraz, S-methoprene, dinotefuran, pyriproxyfen or permethrin. In these cases, stopping the drug may lead to normal skin. Other dogs require treatment to restore and maintain normal skin.

Diagnosis

While autoimmune skin diseases in dogs are not common, they do occur. A thorough history is important to rule out any possible drug-induced conditions. Parasitic conditions should also be eliminated as causes of the skin lesions. If theres still no answer, a skin biopsy which is the only way to truly diagnose an autoimmune skin problem may be required.

This can be complicated. The ideal biopsy should capture a vesicle or pustule before it erodes. Unfortunately, these are very delicate lesions and are rarely found intact in time to do a biopsy. Also, any treatment prior to the biopsy can skew results.

Even with my 40 years of experience, says Miller, I cant absolutely tell you that your dog has an autoimmune skin disease without the biopsy."

"This can be expensive," he adds. "When money is an issue, as it is in many cases, a veterinarian might offer, Lets try steroids and see what happens. If they dont work well enough, or the lesions come right back after the steroid is stopped, then well biopsy. The biggest issue with that approach is that steroids cant be used for 14 to 21 days before the biopsy is taken. Otherwise, the histology will be altered and may lead to an incorrect diagnosis.

Treatment

In general, treatment with a combination of medications gives faster results. With lower doses of individual drugs, the chance of deleterious side effects is decreased. Most protocols start with glucocorticoids (steroids such as prednisone) alone or in combination with strong immunosuppressive medications such as azathioprine or cyclosporine (Atopica).

Steroids are inexpensive and easy for owners to give at home, but they do cause side effects when used long- term, starting with increased drinking and urinating, but potentially escalating into problems such as diabetes mellitus, liver disease and Cushings disease (iatrogenic hyperadrenocorticism).

Pulse therapy intermittent administration of large doses may be advocated with dogs receiving high doses of steroids initially, but then going to periodic dosing as opposed to lower dosages daily. For mild or localized problems, topical steroids or immunomodulators (drugs that help calm the immune system), such as tacrolimus, may be sufficient to hold the disease in remission, at least for a while.

Some dogs will need antibiotics to deal with secondary bacterial infections that thrive in the disrupted skin. Culture and sensitivity to determine the best antibiotic choice is recommended. Dogs with atopy or other allergic dermatitis conditions benefit from having that problem treated concurrently. The same is true for secondary yeast or fungal infections.

Newer areas being explored to treat canine autoimmune skin disease include acupuncture, especially if combined with the use of herbs such as such as radix Curcuma wenyujin, Tripterygium wilfordii, Artemisia annua and Berberis vulgaris.

Oclacitinib (Apoquel) appears helpful, but more study is required before widespread usage will be recommended. A benefit of oclacitinib is that, in general, side effects are less significant and safety is higher overall than long term corticosteroids.

Some dogs will go into remission for variable amounts of time and can be weaned to low levels of medication, or even go off medication for a while. In most instances, the disease will recur.

Finally, while it can be tempting to shampoo your dog, its best to hold off.

Shampoos have several problems. First, the commercially available ones contain 1% hydrocortisone, which isnt very potent, says Miller. The second issue with shampoos is that they can make things worse by the mechanical action needed to apply them and rinse them off. Autoimmune skin is more fragile than normal, and rubbing and rinsing can make it worse.

Types of canine skin autoimmune diseases

Pemphigus foliaceous

About one-third of all canine autoimmune disorders are pemphigus, making it the most common dermatological autoimmune disease. With pemphigus foliaceous, symmetrical lesions usually appear on the dogs ears and face. Hair loss, vesicles, pustules and erosions with ulcers might be observed. Their feet will become affected next and, if it progresses without any treatment, the groin area and trunk may be affected. The pustules tend to be large and fragile. After they break open, crusted lesions cover the open areas.

Dogs with severe cases may lose their appetite and appear depressed. Some dogs will have a fever. It generally first appears in middle-aged dogs but has been diagnosed in dogs of any age. While any dog can develop pemphigus foliaceous, Akitas and Chow Chows are common victims. Other breeds that seem to show a higher incidence include Labrador Retrievers, German Shepherd dogs, English Bulldogs and Cocker Spaniels.

Pemphigus erythematosus

This disease primarily affects parts of the head such as the nose, face and ears. It is the mildest form of pemphigus. Collies, German Shepherd dogs and Shetland Sheepdogs may be predisposed to this skin problem.

Pemphigus vulgaris

This form of pemphigus can be quite painful with ulcers and erosions in the mouth and other mucocutaneous junctions such as near the anus and the vulva.

Pemphigus vegetans

This is the least common member of the pemphigus complex. It produces proliferative lesions, not the erosions and ulcers seen in the other forms.

Cutaneous lupus erythematosus

This illness generally starts with lesions on the nose or footpads. Both areas lose their normal roughened appearance. This is due to the rogue immune cells shoving the normal cells aside. Pigment fades while the areas may become red and irritated. Erosive ulcers follow. While this tends to start on the nose, the lesions may extend up your dogs muzzle into the haired areas.

Certain breeds are prone to discoid lupus erythematosus, such as German Shepherd dogs, Siberian Huskies, Collies and Shetland Sheepdogs. Exposure to UV radiation is considered a trigger. Once a dog is affected, sunlight should be avoided, as it may exacerbate the skin sores. Generally, this is felt to be a fairly benign skin problem.

Systemic lupus erythematosus

In this serious autoimmune condition, the auto-antibodies attack many cell types and proteins, not just the ones holding skin cells together. The heart, joints and kidneys may be involved. Skin signs may be the first warning of a problem with 40-50% of the dogs with this autoimmune problem starting with skin lesions. Fever and lameness are common.

Breeds with a predisposition include Nova Scotia Duck Tolling Retriever, Old English Sheepdog, Afghan Hound, Beagle, Irish Setter, Poodle, Collies, Shetland Sheepdogs and German Shepherd dogs.

Bullous pemphigoid

This rare autoimmune skin disease is characterized by large sacks of clear fluid that rupture easily. Dogs with this condition are itchy and may have hives or welts. These blisters are generally found in the skin around the mouth, at mucocutaneous junctions (lips, nostrils and vagina), and in the armpits and groin areas. In some cases, the footpads will be involved. This disease may spontaneously regress unlike the other disorders.

This article has been reprinted with permission from the Cornell University College of Veterinary Medicines DogWatch newsletter, published by Belvoir Media Group. When you become a member of the Riney Canine Health Center, you will receive a free subscription to DogWatch.

Autoimmune Disease in Dogs: Detection & Treatment Strategies

A variety of threats confront our dogs on a daily basis. Bacteria, viruses, fungi, and parasites seemingly lurk around every corner, waiting to sicken our beloved pups.

Fortunately, most dogs have pretty robust immune systems, which thwack back these threats with ease. But in some cases, a dogs immune system can actually cause him to become sick.

We call these types of problems autoimmune diseases, and they can be some of the most frustrating and challenging ailments that dogs face.

Well talk more about autoimmune diseases below. Well explain some of the most common examples, detail some of the symptoms they often cause, and discuss what treatment options are available.

What Causes Autoimmune Diseases in Dogs?

There are many different autoimmune diseases that afflict dogs (as well as cats, people, and other animals dogs dont have a monopoly on these problems). And while each one manifests in slightly different ways, they all involve the same fundamental problem.

But before delving deeper into autoimmune diseases, lets take a step back and talk about how the immune system functions when everything works properly.

The Basics of a Healthy Immune System

Simply put, a healthy immune system works by recognizing foreign bodies and then taking them out ninja-style.

Often, the immune system is able to do so before the invader can cause illness, although viruses and other pathogens do sometimes get the upper hand. In such cases, your dog may feel rotten for a few days before the immune system is able to mount a sufficient counterattack and neutralize the invaders.

Obviously, immune systems arent perfect, or wed never have to worry about our dogs getting sick. But, for the most part, theyre pretty darn effective.

Out-of-Control Immune Systems

The immune systems of dogs suffering from autoimmune diseases try to work in the same way. They seek out invaders and break out their molecular nunchucks.

The problem is, autoimmune diseases often cause a dogs immune system to make mistakes.

They may still recognize and eliminate invading pathogens, but they also tend to mistake normal, healthy cells in the dogs body for threats. This means that your dogs body starts to effectively attack itself. This leads to a variety of different problems, depending on the specific type of autoimmune disease your dog is suffering from.

Why Do Some Dogs Suffer from Autoimmune Diseases?

Although genetics play a role in some autoimmune diseases,the causes of others remain poorly understood.

To complicate matters further, dogs are susceptible to a variety of different autoimmune diseases, which each progress in a different fashion and cause different symptoms not all autoimmune diseases are the same. Some seemingly target specific body tissues, such as the skin or liver, while others are systemic, meaning they affect multiple body systems.

Accordingly, different autoimmune diseases likely have different causes.

Researchers are working hard to find the answers to these questions, as well as treatments for some of the more common forms. In fact, because some autoimmune diseases in dogs also affect people, some of this research may even have implications for human medicine.

For example, researchers Nicola J. Mason, BVetMed, Ph.D., and Aimee S. Payne, MD, Ph.D. have recently received a National Institute of Health (NIH) grant to investigate a potential treatment for an autoimmune skin disease called pemphigus a disease that affects people and pups.

What Are Some of the Most Common Autoimmune Diseases in Dogs?

Vets have identified a variety of autoimmune disorders in dogs. Well discuss a few of the most common examples below.

Discoid Lupus Erythematosus

Discoid lupus erythematosus (DLE) is a disease that also goes by the name collie nose, although it is certainly not restricted to collies. In fact, we know that German shepherds, Shetland sheepdogs, and huskies can also suffer from the condition.

The primary symptom of the disease is a change in the color and texture of the skin around the nose, lips, eyes, ears, and genitals. According to VCA Animal Hospitals, the skin typically loses its pigment and becomes very smooth, rather than having a cobblestone-like texture.

No one is certain what causes DLE, although sun exposure appears to be a potential trigger. Some vets suspect that it is actually a relatively mild form of systemic lupus erythematosus. DLE can cause skin ulcers to form, but many dogs dont seem to be especially troubled by the condition.

Systemic Lupus Erythematosus

Systemic lupus erythematosus is sometimes considered a classic systemic autoimmune disease that affects multiple body systems.

Often called lupus for short, the disease is often very difficult to diagnose, as it mimics an array of other diseases. Often, vets must painstakingly rule out a variety of other potential health problems before they feel comfortable diagnosing it.

Lupus can cause a variety symptoms, ranging from fevers to joint stiffness to skin problems. It can also cause problems for a dogs blood. For example, a dogs platelet or white blood cell numbers may fall precipitously in response to the condition.

Note that most vets recommend that owners avoid vaccinating dogs who have SLE.

Autoimmune-Mediated Hemolytic Anemia

Autoimmune-mediated hemolytic anemia (AIHA) also called immune-mediated haemolytic anemia (IMHA) is a disease in which a dogs immune system attacks his red blood cells, causing anemia. If this sounds pretty serious, thats because it is.

Your dogs red blood cells are responsible for ferrying oxygen around inside your dogs body. Without enough red blood cells, your dogs body tissue will become starved of oxygen.

This can put your dogs life in immediate jeopardy, so prompt veterinary attention which will likely include blood transfusions is imperative.

AIHA occurs in two forms: primary and secondary. The primary form seemingly occurs on its own. Unfortunately, nobody knows what causes primary AIHA to occur. Secondary AIHA, on the other hand, results from any of a number of health problems, ranging from cancer to parasites.

Some breeds appear to be more susceptible to AIHA than others. This includes:

• Cocker spaniels
• Dachshunds
• Springer spaniels
• Bichon frises
• Irish setters

The symptoms of AIHA are pretty diverse, but a reduced energy level, increase in water consumption, and a decrease in your dogs appetite are all common signs.

Immune-Mediated Thrombocytopenia

Thrombocytopenia is a fifty-cent word that simply means that your dogs blood doesnt contain enough platelets. Platelets are specialized blood cells that help blood to clot following an injury, so its easy to see why this can be a very dangerous condition.

A few different things can cause thrombocytopenia, but dogs with immune-mediated thrombocytopenia (IMTP) suffer from the condition because their immune system attacks the platelets in their blood. This often leads to extensive bruising or abnormal bleeding. It can also cause anemia, which if left untreated can be fatal.

Like AIHA/IMHA, IMTP can occur in primary and secondary forms. The primary form is probably a hereditary disorder, but nobody understands exactly what causes it. It is most common in Labs, cocker spaniels, and miniature poodles, but dogs of any breed can probably suffer from it.

Secondary IMTP may arise in response to several health problems, including cancer, inflammatory diseases, and tick-borne illnesses.

Some of the most common symptoms of IMTP include lethargy, weakness, pale gums, and oral bleeding. With treatment, most dogs suffering from IMTP can live long, healthy lives.

Unfortunately, IMTP and IMHA/AIHA sometimes occur simultaneously. When this occurs, veterinarians referred to the condition as Evans Syndrome.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a disease (or collection of diseases) that results in the inflammation of the intestinal tract. The most common symptoms include chronic vomiting and blood-laden diarrhea, but fever, lethargy, and loss of appetite are also commonly associated with the condition.

IBD should not be confused with irritable bowel syndrome (IBS). While much still remains to be learned about each condition, IBD is characterized by chronic intestinal inflammation, while IBS doesnt usually cause the same type of physical changes to the intestinal tract.

There are a variety of causes for IBD in dogs, and it seems to have a hereditary component in some canines particularly German shepherds and boxers, among others.

Given the diverse array of things that are thought to cause the condition, it is often necessary to attempt several different treatment strategies before achieving success. However, dietary changes are almost always recommended.

Immune-Mediated Polyarthritis

Arthritis (or, osteoarthritis, as it is sometimes called) is a painful and mobility-limiting condition that affects many dogs. Essentially, it causes the tissues within a dogs joints to become painful and inflamed.

Arthritis is often caused by overuse. For example, dogs who are forced to repeatedly jump into and out of an elevated car may eventually suffer from the condition. It may also occur in dogs who are extremely active or participate in athletic activities.

However, arthritis can also be the result of an immune system disorder which results in the body attacking joint tissues. In such cases, it is often called immune-mediated polyarthritis or IMPA (the poly just means it can occur in multiple joints).

Immune-mediated polyarthritis typically causes symptoms like lameness, stiffness, joint pain, and abnormal gait, but it can also cause systemic problems, such as anorexia, fever, or weight loss. It often happens symmetrically, meaning that it will affect your dogs right and left sides relatively equally.

There are a variety of things that can cause IMPA. Some breeds including, most notably, Akitas and Shar-Peis appear to be genetically predisposed to the ailment. Other dogs may develop the problem in response to some medications.

However, many cases of IMPA are idiopathic meaning that no cause is ever conclusively established.

Bullous Pemphigoid

Bullous pemphigoid is a condition in which a dogs immune system attacks the skin or mucous linings of the body.

It isnt clear what causes a dogs body to start producing antibodies that attack these tissues, but sunlight exposure may be a contributing factor.

Bullous pemphigoid causes pus- or fluid-filled blisters, which may erupt, leaving raw, open sores. These can occur on a dogs head, neck, abdomen, groin, or feet, as well as the inside of the nose or mouth. The condition is likely very painful and uncomfortable for dogs, and it can be quite serious. Left untreated, bullous pemphigoid can prove fatal.

Some breeds, including collies, Shetland sheepdogs, and Dobermans, seem to be more susceptible to the disease than others.

The disease can usually be treated, but it often requires a multifaceted approach to dampen the immune system response and treat any secondary bacterial infections associated with the ulcers.

Pemphigus

Pemphigus or, as it is often called, pemphigus complex is a collection of five different, but related, autoimmune diseases that cause blisters to form. Despite the similarity of the names, pemphigus is a completely different condition than bullous pemphigoid.

In most cases, pemphigus causes blisters to form where mucosal tissues come into contact with skin, such as the eyelids, anus, lips, and nostrils.

The five forms of pemphigus include:

• Pemphigus Foliaceus (PF)
• Pemphigus vulgaris (PV)
• Pemphigus erythematosus (PE)
• Panepidermal pustular pemphigus (PPP)
• Paraneoplastic pemphigus (PNP)

Youll need your vets assistance to distinguish between the five forms and recommend an appropriate treatment strategy.

What Are the Symptoms of Autoimmune Disease in Dogs?

Because there are so many different autoimmune diseases that afflict dogs, its hard to summarize the symptoms considered to be normal.

Nevertheless, weve assembled a list of some of the most common signs and symptoms that may indicate that your dogs immune system is causing illness:

• Chronic vomiting or diarrhea
• Loss of appetite
• Changes in drinking behavior
• Unexplained skin ailments
• Lethargy
• Fever
• Blisters or rashes
• Weight loss
• Limping or stiffness
• Pale gums

Note that these symptoms can also indicate other illnesses, which highlights the importance of seeking veterinary assistance whenever you believe your pet may be sick.

How Do Vets Diagnose Autoimmune Diseases in Dogs?

If you suspect your dog has an autoimmune disease (or any other ailment, for that matter), youll want to take him into the vet for an evaluation.

Your vet will likely begin by taking a detailed history and then performing a physical examination. But from this point, your vets next steps will depend on the type of symptoms your dog is exhibiting.

There is no one-size-fits-all test to determine if a dog has an autoimmune disease. In fact, there arent very many tests that can determine if your dog has an autoimmune disease at all. Instead, vets usually diagnose autoimmune diseases via a two-pronged strategy.

To begin, your vet will likely try to rule out every common disease that may be causing your dogs symptoms. For example, if your dog presents with chronic vomiting and diarrhea, your vet wont try to establish that hes suffering from IBD. Instead, he or she will begin ruling out parasites, bacterial infections, intestinal tumors, and all of the other common causes of these symptoms.

Then, once non-autoimmune diseases have been ruled out, your vet may simply try to treat the symptoms as though theyre being caused by an autoimmune disease. In many cases, this will eliminate or reduce the severity of your dogs symptoms, which essentially confirms the diagnosis.

Can Autoimmune Diseases in Dogs Be Cured?

Most autoimmune diseases can be treated by modifying or dampening the immune system of your dogs body.

For example, some steroids are helpful in tamping down the immune response, and this often helps eliminate the symptoms associated with many autoimmune diseases.

But while most autoimmune diseases can be treated, true cures remain elusive. Prolonged even perpetual treatment is often required to prevent the symptoms from returning.

However, doctors have begun experimenting with a few novel treatment strategies in human patients. At least two of these strategies may eliminate autoimmune disease entirely.

Because the autoimmune diseases that afflict dogs are fundamentally similar in many ways to those that affect humans, these treatment strategies may eventually allow vets to cure autoimmune diseases in dogs too.

One such approach works somewhat similarly to vaccinations. The doctors identify the protein or antigen that is triggering the immune response. They then start exposing the patient to a miniscule amount of the offending trigger.

Over time, the body sometimes begins to recognize that the targeted protein or antigen is not dangerous. This stops the immune response from occurring and eliminates the troubling symptoms.

Another approach that has also generated positive results revolves around the patients gut flora.

According to recent findings, a bacterium called Enterococcus gallinarum is often found in the organs of people with autoimmune diseases. This bacterium normally lives inside the intestines, where it is largely benign. But when it migrates out of the digestive tract, it starts triggering the immune system, which leads to the symptoms associated with autoimmune disease.

This bacterium should prove relatively easy to kill, which may hopefully lead to a cure (or at least another effective treatment) for autoimmune diseases.

***

Autoimmune diseases can be very hard on your pet, but most can be treated to ensure your dog still enjoys a high quality of life. Just be sure to visit your vet quickly if you suspect that he is suffering from such a disease and work closely with him or her to devise an effective treatment strategy.

Has your pup ever battled an autoimmune disease? Tell us about your experiences. Let us know what specific autoimmune disease your dog suffered from and the type of treatment your vet recommended.