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His wife had insisted they buy the dog when she had been diagnosed with cancer. The dog had been with them through her journey until the cancer finally took her three years ago.
He had never been separated from the dog since, even taking him to her funeral. Not separated until two days ago when the dog had been admitted into this hospital collapsed and in pain.
Only five years old but so far, no treatment had helped despite all the tests so far coming up ‘normal’. The vet said they would commence a therapy trial while waiting for more complicated blood tests to be run. The memory of the agonising death his wife had endured had never dulled so he wasn’t prepared to allow the dog to go through further suffering.
“Mr. Wrightson,” the voice made the old man look up, but things were a blur, tears now freely running down his face. “It’s great news. Your dog has improved immensely. It’s most certainly autoimmune disease and so far the treatment response has been very positive.”
Autoimmune disease can kill your dog. Knowing the signs could save your dog’s life as early intervention means a better chance of successful management.
The immune system is there to protect the body against pathogens - like bacteria, viruses, protozoa and other foreign organisms - as well as fighting and killing cancer cells (a busy job as our body is hit by some twenty million cancer cells EVERY day).
While autoimmune diseases can occur in many animals, they are in fact more common in dogs than they are in humans. Because so many different tissues can be affected by autoimmune disease there is no one symptom that is present to give a definite diagnosis. In fact, the array of symptoms that can be present in any one type of autoimmune disease would most certainly be a symptom that is present in a totally different disease process.
Hence, diagnosis of an autoimmune disease can be extremely challenging.
Autoimmune diseases are life-threatening, so owners must be aware of the signs because the earlier treatment is instigated the more likely it is that the dog’s body might control the disease.
What are the most common types of autoimmune diseases in dogs?
#1. Lupus. Two types of Lupus occur in dogs.
“Mr. Wrightson,” the voice made the old man look up, but things were a blur, tears now freely running down his face. “It’s great news. Your dog has improved immensely. It’s most certainly autoimmune disease and so far the treatment response has been very positive.”
Autoimmune disease can kill your dog. Knowing the signs could save your dog’s life as early intervention means a better chance of successful management.
Autoimmune disease occurs when the body’s own immune system starts attacking normal, healthy tissues in the body.The immune system doesn’t just go wild, attacking every tissue at one time; rather, the immune system goes renegade attacking one specific tissue of the body.
The immune system is there to protect the body against pathogens - like bacteria, viruses, protozoa and other foreign organisms - as well as fighting and killing cancer cells (a busy job as our body is hit by some twenty million cancer cells EVERY day).
While autoimmune diseases can occur in many animals, they are in fact more common in dogs than they are in humans. Because so many different tissues can be affected by autoimmune disease there is no one symptom that is present to give a definite diagnosis. In fact, the array of symptoms that can be present in any one type of autoimmune disease would most certainly be a symptom that is present in a totally different disease process.
Hence, diagnosis of an autoimmune disease can be extremely challenging.
Autoimmune diseases are life-threatening, so owners must be aware of the signs because the earlier treatment is instigated the more likely it is that the dog’s body might control the disease.
What are the most common types of autoimmune diseases in dogs?
#1. Lupus. Two types of Lupus occur in dogs.
Discoid (or Cutaneous) Lupus Erythematosus (DLE) is the more common and rarely fatal type, affecting only some areas of the skin.
Symptoms include loss of pigment on the nose, itching and scratching, often sores, crusting and redness on the nose and around the lips. Diagnosis of DLE is made by taking a few samples of affected skin for histopathology.
Cutaneous forms of lupus, especially Discoid Lupus Erythematosus, can be aggravated by sun exposure.
Systemic Lupus Erythematosus (SLE) is often fatal but fortunately not as common. SLE can affect many organs and tissues including kidneys, liver, spleen, joints, blood as well as skin and even heart. Consequently, symptoms include shifting lameness (from one limb to another), swollen organs, anaemia, fever, loss of pigmentation, increased drinking and urination. Diagnosis is far more complex requiring a thorough history, physical examination, imaging via ultrasound and radiology as well as blood analysis.
#2. Autoimmune Haemolytic Anaemia (AHA) occurs when the dog’s red blood cells come under attack.
#2. Autoimmune Haemolytic Anaemia (AHA) occurs when the dog’s red blood cells come under attack.
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| Hemolysis comes from the Greek words hemo meaning blood and lysis meaning to break open |
In severe cases, jaundice occurs as destruction of red blood cells becomes extremely rapid.
Diagnosis is made simpler by use of a blood marker called the direct Coombs test; this is a specific test for AHA.
#3. Autoimmune Polyarthritis is associated with swollen, hot joints. Obviously, this leads to a lameness that can shift from one leg to another. A high fever is common as well as enlarged lymph nodes. The disease mimics septic arthritis (infection in joints), so diagnosis requires joint fluid examination by a pathologist.
#3. Autoimmune Polyarthritis is associated with swollen, hot joints. Obviously, this leads to a lameness that can shift from one leg to another. A high fever is common as well as enlarged lymph nodes. The disease mimics septic arthritis (infection in joints), so diagnosis requires joint fluid examination by a pathologist.
#4. Immune-mediated Thrombocytopenia (ITP):
Thrombocytes (also called platelets) are actually pieces of large cells that reside in bone marrow. Thrombocytes are found in the blood, essential in forming blood clots to arrest haemorrhage. They plug and repair damaged blood vessels thereby preventing blood loss. Thrombocytopenia occurs when the blood is low in thrombocytes.
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Thrombocytopenia can manifest in many ways, e.g. small petechiae on gums. |
There are many causes of thrombocytopenia, autoimmune being just one so the veterinarian must assess history, physical examination and various laboratory tests to find the cause.
#5. Hypothyroidism:
#5. Hypothyroidism:
This disease occurs as a result of autoimmune thyroiditis. In other words, the immune system attacks the thyroid gland. The disease occurs slowly because 75% of the thyroid needs to be destroyed before symptoms appear.
A dog affected by hypothyroidism becomes lethargic, overweight despite dieting, fails to grow a proper coat and often has bilateral, non-pruritic alopecia (hair loss that is symmetrical on both side of the body yet not itchy). Blood testing for thyroid hormones will reveal low levels in hypothyroidism.
#6. Inflammatory Bowel Disease (IBD):
#6. Inflammatory Bowel Disease (IBD):
When a dog’s immune system overtly attacks the bacteria in the gastrointestinal system, the bowel (intestine) becomes reactive and inflamed. This disease is similar to IBD in humans with symptoms being frequent (or even constant) soft or watery faeces, intermittent vomiting, weight loss, blood in droppings, gas and a gurgling abdomen. Obviously, these symptoms occur in many other diseases so diagnosis is not immediately apparent; rather, the patient will need to undergo a bowel biopsy under a general anaesthetic.
7. Juvenile Cellulitis:
7. Juvenile Cellulitis:
Pustules (pimples) soon develop and the lymph nodes under the chin and neck region become greatly enlarged. Despite the pus that is seen bacterial are rarely isolated.
The cause is not fully understood, especially because, unlike all other autoimmune diseases, once the symptoms are resolved, they very rarely return. Yet, the disease does respond to therapy used to treat autoimmune diseases.
#8. Aseptic Meningitis:
#8. Aseptic Meningitis:
Sometimes called steroid responsive meningitis-arteritis (SRMA). The meninges are three layers of thin tissue that covers the brain and the spinal cord. Nutrition to the meninges occurs via small blood vessels running throughout the layers.
Antibody is produced that attacks the walls of these blood vessels (arteritis). Symptoms include ataxia (uncoordinated walk) or even collapse as well as severe pain along the neck and along the spinal column.
Affected dogs usually have an elevated body temperature. All tests such as blood tests and radiographs of the spine are normal; study of the fluid in the neural system (cerebro-spinal fluid) may show inflammatory cells but even this fluid can appear normal.
Of course, there are more autoimmune diseases, beyond the scope of this article to discuss every type. Rare types like:
Of course, there are more autoimmune diseases, beyond the scope of this article to discuss every type. Rare types like:
✔️ Autoimmune neutropenia (AIN) is extremely odd because the immune system attacks and destroys its own white cells which are the very cells that fight infection
✔️ Myasthenia gravis which causes muscle weakness and collapse; connective tissue disease resulting in elastic and very fragile skin.
The list goes on however it is imperative that should you observe anything unusual in your dog, report it immediately to your veterinarian for a clinical appraisal as early therapy gives greater chance of managing autoimmune diseases.
Watch German Shepherd Bohdi's story:
Causes of autoimmune diseases in dogs have been extensively studied as they greatly resemble similar diseases in humans.
What are the main causes of autoimmune diseases?
✔️ Genetics – although autoimmune diseases are seen in all breeds of dogs as well as cross breeds, some diseases certainly have a breed predisposition so discuss this with your vet; such knowledge will give you an even greater idea of symptoms that might alert you to disease in your dog.
✔️ Genetics – although autoimmune diseases are seen in all breeds of dogs as well as cross breeds, some diseases certainly have a breed predisposition so discuss this with your vet; such knowledge will give you an even greater idea of symptoms that might alert you to disease in your dog.
✔️ Poor diet – especially unbalanced diets that may promote or demote any one particular nutrient thus causing upset in the intestinal tract.
✔️ Toxins that lead to inflammation of the gut allowing foreign substances to enter the blood stream.
✔️ Overuse of pharmaceuticals.
✔️ Toxic environment, especially if there is exposure to heavy metals or fluorocarbons.
✔️ Over-vaccination. In some breeds vaccinating against the kennel cough syndrome (parainfluenza and Bordetella bronchiseptica) can lead to autoimmune meningitis – this has been recorded frequently in the Weimaraner.
Treatment will vary according to the severity of the case as well as the specific condition. Some dogs, such as the dog in our opening paragraph, will require hospitalisation in an attempt to stabilise the patient.
Cortisone will play an important role in treatment. Clients always ask, “Won’t cortisone decrease the dog’s life span and has many side-effects?” The answer is simple, cortisone, used properly will not decrease the life span of the dog as much as autoimmune disease might.
Commonly, a combination of drugs is utilised to suppress the immune system. The choice of which compounds to use will depend on the specific condition as well as the response to therapy within the first few days that treatment is instigated.
Commonly, a combination of drugs is utilised to suppress the immune system. The choice of which compounds to use will depend on the specific condition as well as the response to therapy within the first few days that treatment is instigated.
The biggest mistake owners make is deciding to help the immune system with herbal products.
Understanding that there is a problem with the immune system, owners elect to give such products as Echinacea, Olive Leaf extract, Astragalus Root or Manuka Honey might well boost the immune system but this is exactly what you do not want to happen to your dog. Giving these products may well boost that arm of the immune system that is attacking your dog’s healthy tissue.
Herbal products may be useful to support the treatment of autoimmune disease but only the anti-inflammatory products. New Zealand green-lipped mussel tablets, Glucosamine with Chondroitin and Turmeric could all support a dog with autoimmune disease by decreasing inflammation.
A balanced diet as well as the addition of a good quality probiotic will help reduce the risk of toxins in the gut.
Be careful what additives are in the food you are using as some diets may well be designed to assist the immune system.
Most autoimmune disease are managed for life. Treatment may go for some nine to twelve months then, pending the severity of the initial attack, may attempt weaning off the drugs.
However, if the disease returns, stabilisation may not eventuate so intimate discussion about each specific case is essential between the owners and the veterinarian. Unfortunately, not all autoimmune cases can be stabilised, and this is as much true in humans as it is in dogs.
written by Bondi Vet's Dr Robert Zammit, October 2022 for Australian Dog Lover (all rights reserved).
For more information, visit bondivet.com or follow them on Instagram @bondi_vet
About Dr Robert Zammit
Known
for his media work in such programs as A Country Practice, Burke's
Backyard and 2GB, Dr Rob’s first love is veterinary science with a special
interest in small animal reproduction work. He lives on the premises with his
family, including the numerous pets roaming around.
Dr Rob’s interest in zoo work has seen his family rear some
unusual pets including lion cubs, tigers and a puma! He is an ambassador for
the Animal Welfare League of NSW, as well as the director of Zambi
Wildlife Retreat.
Dr Rob also hosts a weekly podcast called TheDoggy Pod which is a must listen for anybody with a four legged furry friend or anyone who just loves dogs.
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