Autoimmune diseases – what’s happening inside my dog’s body?

When the body produces antibodies against its own structures, this is referred to as an autoimmune disease. The immune system mistakenly attacks parts of the body, thereby damaging certain functions and organs—in some cases leading to their complete destruction. Autoimmune diseases in dogs include various forms of the pemphigus and lupus complexes. The individual diseases are distinguished based on the different target structures in the body.

INHALT
Pemphigus Complex Lupus Complex General Outlook
Pemphigus Complex

Pemphigus foliaceus

In the group of pemphigus diseases, the body produces immune cells that attack specific proteins that bind skin cells together. Pemphigus foliaceus is the most common form of pemphigus in dogs.

Causes and Symptoms

The destruction of these cellular connections leads to the formation of large pustules in the skin, which become inflamed. As the condition progresses, this causes the outermost layers of the skin to detach and die off. Extensive open skin wounds form, which heal poorly and are prone to infection. Symptoms are most commonly seen on the nose, bridge of the nose, around the eyes, ears, and paws, usually appearing as scabs, scales, or redness. In severe cases, fever and loss of appetite may also occur.

Diagnosis

The characteristic clinical presentation allows your veterinarian to make an initial presumptive diagnosis. A biopsy (examination of a tissue sample) or the examination of cellular material from an opened pustule, combined with a blood sample, provides confirmation and thus confirms the diagnosis.

Pemphigus vulgaris

In pemphigus vulgaris, the body’s immune response targets cell junctions located much deeper within the skin. This manifests in the disease’s presentation as significantly more severe skin changes.

Symptoms

At the onset of the disease, blister-like lesions also appear, but these quickly progress to deeper tissue damage with an ulcerative character. Unlike pemphigus foliaceus, these lesions are found not only on the skin but also in the oral cavity and at the junctions between skin and mucous membranes. Affected dogs often exhibit general symptoms such as fever and loss of appetite.

Bullous pemphigoid

Collies, Shelties, and Dobermans are predisposed (=particularly susceptible) to this very rare form of pemphigus.

Symptoms

The disease begins with the formation of small blisters caused by the destruction of the underlying connective structures of the skin. However, this stage is short-lived. The disease is usually first recognized by highly inflamed, ulcerated skin lesions, which most commonly occur in the axillary and inguinal regions and in the oral cavity. The symptoms are difficult to distinguish from those of pemphigus vulgaris.

Pemphigus erythematosus

Development and Causes

Triggers for this form of pemphigus—which is thought to be a benign or early form of pemphigus foliaceus or systemic lupus—can include medications, viruses, or UV light in individuals with a corresponding genetic predisposition.

Symptoms

The immune system’s overreaction primarily targets cell junctions at the skin-mucous membrane interfaces, such as the nose, eyes, lips, anus, vagina, and foreskin. The skin lesions resemble those of pemphigus foliaceus, but the general well-being of affected dogs is not impaired.

Treatment of pemphigus diseases

All forms of pemphigus are treated with medications that suppress the immune system’s overreaction and allow the inflammation to heal. The destruction of the uppermost layers of the skin leads to increased sensitivity to sunlight, which is why protection from strong sunlight must be an essential part of the therapy to prevent long-term damage.

Microscopic image of pemphigus
Microscopic image of a skin lesion caused by pemphigus
Lupus Complex

Systemic lupus erythematosus

Unlike pemphigus diseases, lupus diseases attack the cell nuclei rather than the cell junctions.

Causes and Development 

Systemic lupus erythematosus can be triggered or exacerbated by many different diseases, physical factors, and medications. In this case, the body’s immune response targets a wide variety of cells in all organ systems and tissues of the body.

Symptoms

Depending on the location of the immune response, the disease manifests itself through a wide range of skin and organ symptoms, some of which can be severe. In addition to the redness and ulcerative skin lesions on the head and limbs that occur in most cases, systemic lupus often also causes fatigue, fever, joint and muscle pain, or exhaustion. If left untreated, the disease can quickly lead to death.

Diagnosis

The wide range of possible organ and skin symptoms makes diagnosis difficult. Examination of tissue samples and detection of autoantibodies in the blood are essential to rule out all possible differential diagnoses (=diseases with similar symptoms).

Discoid Lupus Erythematosus

Discoid lupus erythematosus describes the benign form of lupus, which is limited to specific areas of the skin. It occurs relatively frequently in dogs, with German Shepherds, Huskies, Collies, and Shelties being particularly affected.

Symptoms

The first noticeable symptoms are usually loss of pigmentation, redness, and ulceration (formation of sores) around the nose, and less commonly on the lips, eyelids, and ears. The lesions sometimes heal spontaneously, but remain very sensitive and can quickly reopen and bleed. UV light and secondary infections can lead to a significant worsening of symptoms.

Diagnosis

Here, too, a biopsy is necessary to make a definitive diagnosis and rule out other skin and autoimmune diseases.

Treatment of Lupus Diseases

Here, too, medications are used to suppress the immune system’s overreaction and allow the inflammation to heal. Affected dogs must be consistently protected from strong sunlight due to the extensive depigmentation. This can be achieved by administering special vitamins and applying UV-protective ointments to the affected areas.


General Outlook

The prognosis for all autoimmune skin diseases should always be viewed with caution. Among all forms of lupus and pemphigus, pemphigus foliaceus has the most favorable prognosis. The more severe the skin damage, the more serious the course of the disease. However, for a dog whose condition is well-managed with appropriate medication, the chances of living with the disease are generally good. Treatment, however, usually needs to be continued for life.