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Lupus in Dogs

What Is Lupus in Dogs?

Lupus in dogs, formally known as systemic lupus erythematosus (SLE), is a complex immune-mediated disorder affecting multiple organs in canines. This condition arises when the immune system, responsible for defending the body against foreign substances, malfunctions and begins producing antibodies against its own proteins, leading to the formation of immune complexes.

These immune complexes can infiltrate various tissues in the dog’s body, triggering inflammation and exacerbating the disease. The symptoms exhibited by affected dogs depend on where these immune complexes accumulate:

  • When they lodge in the kidney glomerulus, the filtering units of the kidney, dogs may develop glomerulonephritis and ultimately kidney failure.
  • If the joints are targeted, dogs may experience pain, stiffness, lameness, and muscle wasting.
  • Targeting red blood cells or platelets can result in anemia or clotting disorders, characterized by pale gums, lethargy, bruising, and bleeding from bodily orifices.

Although lupus in dogs is not an immediate medical emergency, it can lead to potentially fatal complications if left untreated, causing considerable discomfort and pain for the affected animal.

Discoid lupus erythematosus (DLE) represents a milder form of lupus that primarily affects the skin of the nose and face. Unlike SLE, DLE is considered a benign variant that does not progress to systemic lupus erythematosus.

Symptoms

Symptoms of lupus in dogs can manifest in various ways. Besides facial lesions affecting the lips, nose, eyes, and ears, dogs may exhibit the following signs of skin disease:

  • Nasal depigmentation and loss of normal nose texture
  • Redness (erythema) of the skin
  • Hair loss
  • Scaling and crusting of the skin
  • Skin ulcers
  • Itching

Dogs with systemic lupus erythematosus (SLE) might also display nonspecific symptoms, which can emerge suddenly or intermittently over time. These signs vary based on which part of the body is affected.

Unfortunately, dogs often present multiple symptoms, including:

  • Skin lesions (observed in approximately 50% of SLE cases), commonly found across the body, with a higher frequency on the face, ears, and extremities
  • Enlarged lymph nodes (located under the jaw, armpits, behind the knees)
  • Fever
  • Decreased appetite or difficulty eating
  • Lethargy
  • Vomiting
  • Muscle pain
  • Protein in the urine
  • Seizures
  • Mouth ulcers and halitosis
  • Muscle wasting
  • Pale gums
  • Anemia (low red blood cell count)
  • Increased heart rate
  • Fainting
  • Sneezing, often accompanied by blood (epistaxis)
  • Blood in the urine or stool
  • Difficulty breathing or heightened respiratory rate
  • Bruising and pinpoint hemorrhages visible on the gums or skin (petechiae)
  • Kidney failure
  • Limb or abdominal swelling.

Causes

The occurrence of lupus in dogs exhibits some patterns regarding gender and breed:

  • Female dogs tend to experience lupus more frequently than males.
  • Lupus can develop in dogs of any breed and age. However, it tends to manifest more commonly in middle-aged dogs of specific breeds, indicating a potential genetic component. These breeds include:
    • German Shepherds
    • Chow Chows
    • Siberian Huskies
    • Shetland Sheepdogs
    • Collies
    • Beagles
    • Cocker Spaniels
    • Boxers

Lupus is primarily understood as an autoimmune disease, often occurring without a discernible cause. Nonetheless, factors such as UV light and prolonged sun exposure may contribute to its onset. Sunlight can exacerbate the condition, and some veterinarians speculate that certain medications, viruses, and other environmental elements might also play a role in worsening the disease.

Diagnosis

When analyzing all test results together, veterinarians gain sufficient information to diagnose lupus in dogs. During a physical examination, veterinarians observe any symptoms the dog may exhibit and may recommend bloodwork and urine testing.

These tests aim to detect signs of anemia, decreased platelet count, and protein in the urine. Additionally, they screen for infectious parasites and tick-borne diseases using tick PCR or tick titer tests to identify the DNA of specific ticks in the dog’s blood or the dog’s antibody response to tick antigens, respectively.

Veterinarians may also conduct other tests to identify antibody and immune complex formation, including the Coombs test, ANA (antinuclear antibody test), lupus erythematosus (LE) cell test, and immunofluorescence testing.

Diagnosing discoid lupus erythematosus (DLE) typically requires a biopsy, where samples of the dog’s skin are surgically removed and analyzed by a veterinary pathologist. For systemic lupus erythematosus (SLE), biopsies of other organs and fluid analysis from joints, abdominal, or chest cavities may be necessary.

Stitches from biopsy procedures are typically removed after a few weeks. In cases of secondary skin infection, veterinarians may recommend treating the infection before conducting a biopsy, as pyoderma can complicate diagnosis.

Treatment

Treatment for lupus in dogs involves utilizing prescription medications known as immunosuppressants to regulate the immune system. Steroids, often prescribed at high doses, are the most commonly used and effective drugs for treatment. However, they come with several adverse side effects, including increased thirst and urination, gastrointestinal upset, lethargy, heightened risk of infection, susceptibility to certain endocrine disorders, liver toxicity, and bone marrow suppression.

To mitigate or prevent these side effects, veterinarians may combine steroids with other immunosuppressive medications such as azathioprine, chlorambucil, mycophenolate, cyclosporine, and leflunomide. Topical therapies, especially common in dogs with discoid lupus erythematosus (DLE), involve the use of ointments, shampoos, or conditioners with antibacterial, antifungal, and/or steroidal properties.

Topical ointments like tetracycline-niacinamide or tacrolimus are particularly effective for localized lesions and are often used alongside oral medications to reduce the required dosage of oral steroids. Bathing the dog to remove crusts and scales can provide relief from itching and soothe the skin. Limiting sun exposure is crucial as sunlight and UV light can exacerbate lesions.

Walking the dog during early morning or late evening hours and applying pet-approved sunscreen on the bridge of the nose and non-haired skin can help protect against sun exposure. Additionally, considering a doggie hat or visor for the pup is advisable.

Due to the propensity for secondary skin infections in dogs with lupus, veterinarians may prescribe antibiotics such as cephalexin, clavamox, clindamycin, and antifungal medications like fluconazole or miconazole.

While dietary changes or supplements may not always be necessary for dogs with lupus, consulting with the veterinarian about the most suitable topicals, supplements, and diet based on the dog’s specific medical and nutritional requirements is recommended. Fatty acid supplements can assist in maintaining the skin barrier and reducing inflammation, while prescription diets can help bolster the immune system.

Living and Management

Lupus remains incurable in dogs, with management being the primary approach. Dogs afflicted with discoid lupus erythematosus (DLE) typically exhibit a favorable prognosis, often showing improvement within eight to 12 weeks. Conversely, the outlook for dogs affected by systemic lupus erythematosus (SLE), especially if multiple organs are involved, can be more ominous. When severe complications like seizures and kidney failure arise, the prognosis for the dog becomes significantly grim, potentially leading to the recommendation of humane euthanasia.

Managing lupus, whether DLE or SLE, demands vigilant attention from pet owners. Dogs often require lifelong medication, and noticeable healing may take several months. Permanent scarring of the skin, pigment loss, and other symptoms like chronic kidney failure might persist.

Once a dog’s condition improves, and symptoms diminish, veterinarians may advise tapering off immunosuppressive drugs to find the lowest effective dose while minimizing discomfort from side effects. Although relapses may occur during this adjustment period, it’s essential to remain hopeful as the long-term benefits of reducing drug therapy outweigh the risks.

Consistent and thorough follow-up care with the veterinarian is paramount to diminish the risk of relapse. It’s crucial for pet owners to monitor the disease progression and any potential side effects of medications diligently. Adhering to all veterinarian recommendations is imperative, and altering medication dosage or frequency should never be done abruptly without consulting the veterinarian first.

Prevention

Regrettably, lupus cannot be preempted in dogs. Should your dog develop the condition, adhering to your veterinarian’s guidance is crucial as it can aid in reducing the frequency of flare-ups.

Given that specific medications, including vaccines, hold the potential to stimulate an affected dog’s immune system, they should be administered cautiously, following your veterinarian’s recommendations, or avoided altogether.

Lupus in Dogs FAQs

How long will a dog with lupus live?

The life expectancy of dogs with lupus varies. Dogs diagnosed with discoid lupus erythematosus (DLE) generally have a longer life expectancy compared to those with systemic lupus erythematosus (SLE). Approximately 50% of dogs may achieve long-term remission. However, some dogs, particularly those experiencing organ involvement such as kidney failure or neurological issues, or those encountering adverse effects from medication, may require euthanasia, accounting for around 40% of cases within the first year.

What happens if lupus goes untreated in dogs?

If lupus remains untreated in dogs, both systemic lupus erythematosus (SLE) and discoid lupus erythematosus (DLE) pose significant and life-threatening risks. Untreated symptoms significantly impact a dog’s quality of life, leading to weakness and fatigue.

Navigating treatment can be complex and risky, contingent upon your dog’s overall health. Collaborate closely with your veterinarian to establish the optimal treatment and care strategy tailored to your pet’s well-being and comfort.

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