Systemic or systemic lupus erythematosus (SLE) or systemic lupus erythematosus (SLE) is an autoimmune disease described in dogs with both skin manifestations and general symptoms. Systemic or systemic lupus erythematosus (SLE) or systemic lupus erythematosus (SLE) is an autoimmune disease described in dogs with both skin manifestations and general symptoms. And, systemic lupus erythematosus in dogs is a common disease.
An autoimmune disease is a disease linked to an imbalance in the animal’s immune system: for reasons sometimes unknown, the players in the immune system (white blood cells called leukocytes and antibodies) no longer recognize certain elements of the body and destroy them. It is this destruction which generates a local and / or generalized inflammatory phenomenon and which is at the origin of the symptoms.
In systemic lupus erythematosus, the parts of the body that may not be recognized are many and varied:
- The joints (90% of cases)
- Skin and mucous membranes (60% of cases)
- Kidneys (50-60 cases)
- Blood (red blood cells, blood platelets)
- Muscles, nerves, heart, nervous system,… (rarer)
Given the dissemination of dysfunctions, there is an alteration in the general condition of the animal.
It is important to note that this article deals with systemic lupus erythematosus and not cutaneous lupus, which is also an autoimmune disease whose symptoms are only cutaneous without deterioration of the general condition: the dog classically presents an attack of the face with depigmentation of the nose, ulcers, redness that may spread with exposure to the sun. The lips and ears can sometimes affect. Cutaneous lupus never progresses to systemic lupus erythematosus.
Causes of Systemic Lupus Erythematosus in Dogs
The causes of immune dysfunction appear to multifactorial (genetics, environment, etc.). But nothing will clearly elucidate.
Symptoms of systemic lupus erythematosus in dogs
There seems to be a predisposition of males and medium to large breeds (German Shepherd, Collie,…).
It is sometimes difficult to highlight this disease given that the symptoms can progress from a subacute to chronic manner, with progressive outbreaks interspersed with a period of remission.
As mentioned earlier, the symptoms depend on the components of the body that are affected.
The dog suffering from systemic lupus erythematosus systematically presents a deterioration of the general condition: fatigue, weight loss, sawtooth fever.
It can also present:
- Lameness during joint damage (often the first sign to appear). The dog does not correctly pose his or her affected limbs (sometimes with a removal of the support). Jumping or lifting can be difficult for your pet. Some joints may swell. There may associate muscle wasting.
- Skin lesions with frequent involvement of the head (nose, lips, ear) or areas with thin skin (ars, groins, stomach) or sometimes pads: loss of hair (called alopecia), redness, ulcers, depigmentation (loss color). They can associate with pain or itching.
- Specific skin lesions with hematomas or small scattered red dots on the skin (called petechiae). They appear following the destruction of blood platelets which involves in coagulation.
- Clear, pale or even yellow mucous membranes (gums, cheeks): in the latter case, we speak of jaundice. This is associated with the destruction of red blood cells which releases a pigment, bilirubin, in the body, which causes this coloration.
- Much rarer symptoms: convulsions, breathing difficulties, edema, dilation of the abdomen (secondary to the presence of fluid in the belly).
It is important to note that many abnormalities (renal, blood for example) require to perform additional examinations in order to objectify them; there are not always obvious clinical manifestations.
Diagnosis of systemic lupus erythematosus in dogs
The diagnosis of systemic lupus erythematosus is not always obvious at first intention. In fact, given the ups and downs of the symptoms and their very gradual appearance, the context can be insidious. It is obviously easier to diagnose an advanced disease with a combination of several symptoms than when the animal shows just a simple lameness (which would in fact be the very first symptom of systemic lupus erythematosus).
To establish a diagnosis, it is essential to give your veterinarian as much information as possible: is this the first time that you have noticed the symptoms? Have you noticed any changes depending on the exposure to the sun? Have there been any treatments before? …
Your veterinarian will examine your animal to explore the symptom for which you brought it but will try to highlight other more insidious abnormalities (organs of abnormal size on palpation, abnormal cardiac and respiratory auscultation, pain when handling certain joints,…).
To establish a diagnosis of systemic lupus erythematosus, your veterinarian will have to combine different complementary examinations. Indeed, it is necessary to highlight an association of several anomalies to conclude a diagnosis. The following examinations will propose to you, and will carry out according to the symptoms present:
- blood tests to assess how well organs are working (biochemical tests) and to assess the number of blood cells (full blood count or blood count)
- urinalysis
- joint puncture and synovial fluid analysis
- joint radiography – assay of anti-nuclear antibodies in the blood (ESSENTIAL examination)
- skin biopsies – abdominal ultrasound, cardiac ultrasound, lymph node puncture, cerebrospinal fluid puncture (more rarely)
A single analysis does not allow a diagnosis!
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Treatment of systemic lupus erythematosus in dogs
It is essential to have a definite diagnosis before setting up a treatment because the latter is often intense and aggressive.
The basic treatment is the use of corticosteroids: large doses (at least initially) and a long duration will be necessary. Your veterinarian will gradually adjust the doses, possibly combine other molecules and control the therapeutic response. For this, control visits and the repetition of additional examinations will be essential.
It is important to keep in mind that the treatment can last from several weeks to several months. In some cases, the care can be lifelong, so don’t self-medicate – that’s the best way to make big mistakes.
Prognosis
It depends on the earliness of the treatment and the intensity of the symptoms.