What is Systemic Autoimmune Disease?
Commonly, the signs of systemic autoimmune disease are vague, such as lack of energy, weakness, skin ulcers, joint pain, and weight loss. A definitive cause is often not identified but a genetic tendency (such as with Persians and their crosses) or viral triggers are suspected in many cases. The long-term outlook is poor.
Systemic autoimmune disease (SAD), also known as Systemic Lupus Erythematosus (SLE), affects the cat’s immune system such that it attacks its own cells. The damage done and resulting symptoms depend on which tissue is targeted. For example, if red blood cells are attacked, the cat becomes weak due to anemia from lack of blood cells.
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Symptoms of Systemic Autoimmune Disease in Cats
Systemic autoimmune disease can potentially destroy any body tissue, depending on which cells are mislabeled for attack. Thus, the signs of disease vary depending on what part which tissue is damaged. This leads to vague symptoms that should alert the cat owner their pet is unwell and to seek professional veterinary advice. Common clues include one or more of the following:
- Weakness and Lethargy: This can arise because of anemia or because the cat feels unwell.
- Skin lesions: A common site of problems is where the skin meets mucous membranes, such as the lips, eyes, and anus. The skin becomes inflamed, ulcerated, and scabby.
- Bleeding: One form of SLE attacks thrombocytes, whose job it is to clot blood.
- Lameness: Another form of SLE targets the joints, causing pain and a shifting lameness.
- Excessive thirst: This is most typical when the kidneys are targeted
- Waxing and waning illness: The cat may not be ill all the time but have ‘good’ and ‘bad’ days.
- Poor appetite and weight loss
Causes of Systemic Autoimmune Disease in Cats
This disease is caused by the immune system when it turns on itself and damages normal, healthy tissue. The body’s immune system produces antibodies (which fight infection and destroy diseased cells) in response to antigens (substances that trigger an immune reaction.) Normally the body ignores its own antigens, but when for some reason it misreads self-antigens as foreign, this results in destruction of its own tissue. Possible reasons why this happens include:
- A genetic tendency: Breeds such as the Siamese, Persian, and Persian crosses are over-represented amongst cats suffering from SAD
- Viral infections
- Hormonal factors
This said, the underlying trigger is rarely identified and usually remains a mystery.
Diagnosis of Systemic Autoimmune Disease in Cats
Unfortunately, diagnosis is not always straightforward, since the tests are associated with a high percentage of false negatives. This means, although the test result comes back negative, if the cat has highly suggestive symptoms then SAD cannot be ruled out and the vet may need to probe deeper still.
After taking a history, the vet examines the cat and takes note of symptoms such as pale gums, joint pain, an enlarged spleen, or evidence of recent bleeding. This helps the vet to rule some conditions out, as well as decide which tests are most helpful.
An appropriate first step is a general blood profile which looks at hematology (the cat’s red and white cells) plus biochemistry. This gives an overview of whether the cat is anemic or deficient in a particular cell line, and if there is organ damage. The vet uses this information to pinpoint further tests. Unfortunately, no one single test is 100% accurate or 100% reliable, so false negatives and false positives can confuse the picture.
Further blood tests used include:
- Anti-Nuclear Antibody (ANA) test: False positives can occur with liver disease or in feline leukemia positive cats.
- Coombs test: False negatives can occur in mild SAD
- Examining a fresh blood smear under the microscope: Looking for specific types of red blood cell damage that indicate attack by the immune system
In addition, the vet may harvest samples from specific areas that are affected, such as a skin biopsy or joint fluid.
Treatment of Systemic Autoimmune Disease in Cats
Treatment is based on using drugs to switch off the inappropriate immune response and stop the body attacking itself. Surgical intervention is not appropriate or helpful.
Corticosteroids
High doses of corticosteroids such as prednisolone are often used as the first option as they are highly effective and inexpensive. These drugs are usually given daily by mouth so that fine dose adjustments can be made. They should be given with or after food to reduce the risk of gastric ulceration
High doses are initially given for two to four weeks until a sustained improvement occurs. After that, the dose is decreased incrementally every two to four weeks. The aim is to stop treatment once the SAD has switched off. Unfortunately, relapses are common at some point in the future.
Steroids are associated with side effects such as increased thirst and appetite in the short term, and the possible complication of inducing diabetes or Cushing’s disease in the long term. Regular monitoring of the blood is necessary to check the response to treatment; this may be weekly or bi-weekly at first.
Other Immunosuppressive Drugs
Should the cat fail to respond to corticosteroid treatment, other immunosuppressive drugs such as azathioprine can be added into the protocol. Many cats respond to initial treatment for a period of time but relapses are common.
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Recovery of Systemic Autoimmune Disease in Cats
For those cats on treatment, regular follow-up appointments and blood tests are essential. This allows dose adjustments (up or down) to be made, depending on how the pet is responding. A sick or weak cat may need hospitalization for the first few days of treatment, in order to receive a blood transfusion or supportive intravenous fluids. Once stable, or if the SAD is mild, treatment is undertaken at home with daily or alternate day doses of medication.
The short-term outlook is favorable when the problem is diagnosed before it reaches a crisis point, but deterioration or relapse are common and associated with a high mortality rate.
For those cats that respond to treatment, the owner must be vigilant for relapse and seek urgent veterinary attention should their cat become unwell.
Systemic Autoimmune Disease Average Cost
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Top
Systemic Autoimmune Disease Questions and Advice from Veterinary Professionals
domestic short hair
Munchkin
1 Year
7 found this helpful
7 found this helpful
My pet has the following symptoms:
Pale Pink Gums
I have recently adopted my cat from a shelter, after 15 days I went for a normal check up and the doctor told me that the cat has red cells of 10% which is a severe concern. When she ran all the tests she told me that the cats body is attacking itself and there is nothing she can help with it. She also prescribed a steroid but she told me that it will have many side effects on the cat. Initially when she ran tests for FeLV the reports were positive but the lab results says it’s negative and she took few samples today where it says positive again but I haven’t heard from the lab yet. The vet told me that this is something very unusual which she can’t help as there is only 10% of red cells and some reticulocyte which is 25 instead of 50. And she asked me to wait for a week and if health detiorates then euthanize him. I really want some help, please help me with this situation. I can’t live without him. Please help me!
June 26, 2018
7 Recommendations
There are different causes for haemolytic anaemia including immune mediated haemolytic anaemia, infections and poisoning; reticulocyte count isn’t a reliable indicator of new red blood cells being produced as this may be close to zero in healthy cats in some cases, however it does show that the bone marrow is producing more red blood cells. Try the immunosuppressive therapy to see if there are any signs of improvement, however without examining Munchkin myself I cannot say for certain what the specific cause is. Regards Dr Callum Turner DVM
June 27, 2018
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Unsure
Baxter
11 Years
1 found this helpful
1 found this helpful
I've taken my cat to the vet and the blood work they did to test for hyperthyroidism and diabetes came back negative. I think they did a few more tests as well, but I'm not sure what. Anyway, Baxter is almost 11 and he recently has lost quite a bit of weight - around 7lbs. He was around 25lbs. In addition to the weight loss, he has licked his hair off around his butt, legs, and he's shedding terribly and his collar wore off the hair around his neck. Also, the pads of his paws have peeled and they bother him when he walks. I also have noticed that his nails are turning dark and a couple of his nail pads have split and are swollen. He is on prednisone now one tablet every 12 hrs. to see if it's allergies. But now that I've noticed his nails, I'm thinking he has an autoimmune disease. Should the prednisone help to manage the symptoms if that's what's wrong? Is it worth another trip or call to the vet?
June 10, 2018
Answered by Dr. Michele K. DVM
1 Recommendations
I'm not sure how long it has been since your veterinary visit, but if has only been 1 or 2 days, it may be a good idea to see if the medication is going to help. Without seeing Baxter, I'm not sure if an immune disease is a possibility, but it would be worth calling your veterinarian to see if that is a possibility, and if that is what they were thinking when they put him on the prednisone.
June 10, 2018
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American Shorthair
Buddy
3 Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Breathing Difficulty
I’m not sure if this is what my cat has. It started with his ears dripping dark fluid then progressed to drooling and had breath after about two days he seemed better began eating drinking acting normal now he’s having trouble breathing like he’s stopped up and I can hear it in his chest . Any idea what this may be?
May 8, 2018
0 Recommendations
I don’t think this is an autoimmune disease; however without examining Buddy it is difficult to say what the specific cause of the symptoms may be. The symptoms may indicate an infection but due to the vague nature of the symptoms it is difficult to pin down a diagnosis. Regards Dr Callum Turner DVM
May 8, 2018
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Maine C
Charlotte
2 Years
2 found this helpful
2 found this helpful
Our 2year old Maine coon cat is getting ulcerated lesions on her body. Prednisone cleared them initially then they came back. She is behaving normally except for this. Appetite and feces are normal. Has been about 4 months that we are treating this
Nov. 9, 2017
2 Recommendations
There are various different autoimmune diseases which may affect cats which result in them breaking out in ulcers on their body; corticosteroids generally clear these up by suppressing the immune system. Treatment can be long term and unrewarding; you should discuss possible long term treatment options with your Veterinarian. Regards Dr Callum Turner DVM
Nov. 9, 2017
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domestic short hair
Lola
1 Year
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Fever
Loss Of Appetite
Hiding
Third Eyelid Showing
Eye Leaking
Palpitation
*Unknown likely autoimmune disease.* Started when Lola was a little over 1 year old. She Got a fever and stopped eating. Her fever of unknown origin panel came back negative. Urine and fecal looked fine so the dr prescribed steroids and antibiotics to treat the fever. She was feeling better almost immediately. A few months later the non eating and fever was back as well as hiding. 106 degrees. Took her to emergency vet where she was on Iv and mason gastric tube because she would not eat. The er did not want to treat her until they could figure out what was wrong so she could be treated correctly. they worked to keep her fever down with fans and ice and fluids. More bloodwork was ran in addition to xrays, ultrasounds, urine and bone marrow. After all the tests were completed she was put on antibiotics and steroids. It had been 5 days no eating and dr suggested that if she did not eat within the next few days I should consider end of life. ALL tests came back negative for any disease. Her white blood cell count was bottomed out amongst other things. The emergency clinic was at a loss and said it’s more than likely and unknown autoimmune disease or filv or filp that just will not show up on the tests. The steroids started working and by the next day she ate a little and basically made a miracle recovery. I’m convinced if she had gotten steroids from the first day I took her in she would not have been there so long. Another 3 months later, today (a little over 1.5 years old) she got another fever and would not eat. I was still in the process of stepping down her steroids from last time. The dr had wanted to keep her on them longer. It was now 1/2 tab every 3rd day. I kept her cool with ice packs and alcohol on her paws a few times last night until I could get her into the vet this morning. 105.2 degree fever. The dr said there is no point to do tests since the emergency clinic had already done everything last time. she has a plan to go heavier on the steroids. Doing one prednisone am and Pm as well as one ml Azithromycin. Mid day she decided to lick some gravy treat and at end of day she ate a full meal. I’m hopeful this gets her back to her normal self soon.
I am concerned with where her future lies though. How long can she survive like this? The last two times she bounced back right after threatened starter but Got sick a few months later.
Dr says cats handle steroids better than any other species and that she can continue to be on them.
If this has anything to do with it, it’s worth saying when I got her she has no hair on the top of her tail and was treated with antibiotics and it came back eventually. Related?
Any idea for what could be wrong or prognosis.
Gray Tabby
Pepper
11 Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Lethargy
We had one cat, Tashi, who fell ill in May of 2018. Her gums were white and after taking her to the vet they found her hematocrit at 14%. We rushed her to a vet who could do a transfusion. She was placed on Prednisone and another drug which I don't recall. She then had an ultrasound, that showed nothing. She limped along until August, when she went down hill rapidly. She passed away shortly thereafter. We now are dealing with her biological sister and heading down the same exact road. In our case, this seems definitely hereditary. Her prognosis does not look any better. I hope this information helps anyone dealing with this devasting disease.
Systemic Autoimmune Disease Average Cost
From 538 quotes ranging from $500 - $5,000
Average Cost
$2,000
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