|
We have come across a number of Shar-Pei with
Pemphigus Foliaceus, this condition is not commonly seen by vets and often
gets mis-diagnosed, there is no clear reason as to why some Shar-pei develop
Pemphigus, but it seems that periods of extreme stress have been involved in
relation to some Shar-pei we have seen and been directly involved with.
What is Pemphigus?
Pemphigus covers a group of uncommon disorders that occur in
dogs. With these conditions, there is an abnormal immune response to normal
components of the skin, resulting in separation of cells. This leads to
blisters, pustules, and crusting erosions in the skin. There are some
similarities to Pemphigus in humans, but many significant differences as well.
Breed predispositions are recognized for 2 forms - Pemphigus
Foliaceus and the milder Pemphigus Erythematosus. (There are no breed
predispositions recognised for the other 2 forms - Pemphigus vulgaris and
Pemphigus vegetans).
What does
Pemphigus mean to your Dog?
Pemphigus Foliaceus and Erythematosus develop around 4 years
of age. Pemphigus Erythematosus is thought to be a milder form of
Pemphigus Foliaceus. Both conditions begin with pustular, crusty lesions on
the face and ears. However with Pemphigus Foliaceus, the lesions spread to
the feet, the groin and other areas; there may be itching and pain; and
severely affected dogs may lose their appetite and become depressed.
Loss of pigment in the nose is common with both forms of
Pemphigus, and this results in photodermatitis - increased sensitivity to the
sun's rays so that the condition is worse in sunny weather.
How is
Pemphigus diagnosed?
Pemphigus Foliaceus is the most commonly seen form of
Pemphigus; however it is still uncommon. Your veterinarian will base the
diagnosis on your history of how the condition developed, physical
examination of your dog, and tests such as skin scrapings and smears, skin
biopsy, and immune testing to rule out other causes of similar skin lesions
such as a bacterial or fungal skin infection, mites, seborrhea,
dermatomyositis, and Lupus Erythematosus.
For the vet:
Multiple skin biopsies will increase the chances of finding
diagnostic histologic changes. Direct immunofluorescence or
immunohistochemical testing may or may not be helpful. These tests have
relatively low sensitivity and specificity.
How is
Pemphigus treated?
Treatment is based on suppressing the inappropriate immune
response. For Pemphigus Foliaceus, steroids (as a cream, or orally as a
tablet - prednisone) are used to accomplish this. Once the condition is
under control, your Vet will reduce the dosage to every second day to avoid
the side effects which can occur with these drugs. Long term treatment is
generally necessary. Where prednisone is not effective (as is sometimes the
case), your veterinarian will try other immunomodulating drugs or
chrysotherapy (gold salts).
For dogs that have lost pigment in the nose, protection
against the sun is important to prevent flare-ups of the condition. Keep your
dog out of the sun between 10:00 and 3:00 and/or use suncreens on the nose
with SPF of 15 or higher.
The milder form, Pemphigus Erythematosus, may be successfully
treated with sun avoidance and glucocorticoids applied to the skin. If this is
ineffective, oral glucocorticoids or other drugs may be required.
For the Vet: A combination of tetracycline and
niacinamide has been used with some success in dogs with Pemphigus
Erythematosus (Scott, 1995)
Breeding advice
It is advisable not to use affected dogs in breeding
programmes, even though inheritance for these conditions is not known.
|
|
|
