What are Pemphigus Foliaceus?
Pemphigus foliaceus is an autoimmune skin disease that typically begins in middle age dogs. Pemphigus foliaceus usually starts off as small, red patches, which quickly become pustules (pus filled blisters) and burst open. Thick crusts (scabs) form after the pustules bursts. The skin beneath the crusted area can be swollen and may be painful. The blisters typically begin along the nasal bridge, around the eyes, and the ears. The dog’s foot pads may become thickened and crack, which will make walking very painful.
In pemphigus the autoimmune antibodies form against the desmoglein I. Desmoglein I is what helps the epidermal cells to adhere to each other. When the desmoglein I is disrupted, the cells become separated from each other and the epidermis loses its intercellular connections. The breakdown of this component causes the outer layer of skin to split apart and blister.
The disease is most common in the Akitas, Chow Chows, Bearded Collies, Dachshunds, Doberman Pinschers and in the Newfoundland breed.
Pemphigus foliaceus (PF) is the most common autoimmune disease in dogs. It is characterized by pustules, ulcers and crusts (scabs) developing on the canine’s skin surface.
Symptoms of Pemphigus Foliaceus in Dogs
- Redness
- Blisters
- Pus
- Yellow-brown crust (scabs)
- Depression
- Lethargy
- Fever
- Sometimes itchy
- Hair loss
- Ulcers
- Lack of appetite
- Swollen lymph nodes
There are 4 different types of pemphigus in dogs.
- Pemphigus foliaceus affects the top layer of skin; it is the most common type of pemphigus in dogs
- Pemphigus erythematosus commonly shows itself through pale dog gums and attacks the skin on the face and on the ears
- Pemphigus vulgaris is the most serious type of pemphigus, and can include painful ulcer formation in the mouth; it can also affect the nose, prepuce, anus and vaginal area
- Pemphigus vegetans is very rare, it causes wart-like growth that may ulcerate
Causes of Pemphigus Foliaceus in Dogs
- Pemphigus foliaceus can develop spontaneously, without a discernible cause
- Breed disposition
- The disease may be triggered by a reaction to a prescribed medication; penicillin, cephalosporins, and sulfonamides have been linked to the development of pemphigus
- Pemphigus foliaceus can develop in dogs with a history of chronic conditions such as allergies
- Ultra-violet lights may be a trigger factor
Diagnosis of Pemphigus Foliaceus in Dogs
The veterinarian will go over your pet’s medical history. Let the veterinarian know if your dog is currently on any medications. He will ask you when the condition first started. The veterinarian will perform a physical examination of your pet.
Bloodwork such as a complete blood count (CBC) and a urinalysis will help determine if there are any other health issues involved. If your veterinarian suspects your pet has pemphigus foliaceus he may recommend a skin biopsy. In most cases a local anesthetic is used, but if the patient is anxious, general anesthesia may be required. A small block of skin is removed from your pet and the tissue sample is sent to a veterinary pathologist. Cytology of an intact pustule can be a helpful diagnostic test that can be done by your veterinarian, pending the biopsy results.
Treatment of Pemphigus Foliaceus in Dogs
There is no known cure for pemphigus foliaceus. The objective is to keep the disease in remission. In cases where pemphigus foliaceus is confined to a certain area on the dog’s body, it can be treated with topical steroids. For more generalized cases a combination of oral glucocorticoids and non-steroid immunosuppressive medications will be prescribed. The non-steroidal immunosuppressive drugs are used to minimize the side effects of glucocorticoids (liver enlargement, weight gain, increased drinking and urinating). Your veterinarian will start your pet with a higher dosage of medication until the disease is in remission. This may take 4 to 12 weeks; then the medication will be tapered down to a lower dosage that maintains remission.
Ingestion of gold salts (chrysotherapy) has been successful as a treatment aid. Reducing the exposure to ultraviolet light can help the healing process. A sunscreen that does not contain zinc oxide can be used to protect the affected areas. If there is a secondary bacterial infection, antibiotics will be prescribed. It will be very important that you follow your veterinarian’s treatment plan.
Recovery of Pemphigus Foliaceus in Dogs
The prognosis from Pemphigus foliaceus is usually good. Lifelong treatment is required to maintain the remission of the disease. Follow up visits will be necessary monitor your pet’s progress and to check on any side effects from the medications.
Pemphigus Foliaceus Questions and Advice from Veterinary Professionals
Has Symptoms
We were given the biopsy results today diagnosing our 11 yr old Shitzu Poodle mix with Pemphigus Foliaceus. We started seeing these lesions about a week after she got a lymne vaccination. Thinking it could be ringworm as it appeared as a round ring like raised scab which was angry red around the perimeter and kept growing our vet started a ringworm culture which would take a month to diagnose. She was put on an antibiotic and In that month we had her back to the vet numerous times for various tests and skin scrapings etc.... the lesions started other parts of her body. We were referred to a Dermapathologist Vet. She was given a urinalysis test and put on 2) 40mg Methylprednisolone pills 1x daily immediately following her biopsy. We waited 2) weeks for results and now knowing the diagnosis we must decide on a treatment plan which I dread due to the possible side effects. A)OPTION We add 50mg Atopica to her current Medrol regiment in hopes she will be one of the 50% this drug will help and in future be able to reduce the Medrol strength lower or possibly completely...B) OPTION is to add Azathioprine which works for 90% of dogs but must be closely monitored by requiring blood work every 2 weeks to watch for liver toxicity and bone marrow suppression. I've read so many horrible things about both of these medications as well as having Medrol included in the regiment. I even read you have to wear gloves while administering the Atopica!! And this poison goes into my little fur baby. I noticed about 4 new lesions within the first 2 days of starting the Medrol which was 12 days ago and have not seen any new lesions in past 10 days.
I am having a very hard time with this decision of adding another drug to the Medrol.
Any opinions?
Also I have such a hard time getting larger pills into this little girl. I can force them down her throat and she can still get them up and spit out!!! Recommendations?
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My 9 year old cocker spaniel has suffered with pemphigus for 2 years mainly affecting his eyes, nose and pads. The last two days he has been struggling to walk on one of his back paws, holding it up and limping. I have bathed his paws in the bath with antibacterial and anti fungal shampoo, given him prednisone and pardale v. He is clearly suffering and I’m worried this could be the end as I don’t want him to struggle. What would you suggest?
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My 3 year old German shepherd has been diagnosed with pemphigus. Have any studies been done on the effects of feeding raw on the condition? My vet prescribed Aller G3. Would naturally occurring omega 3 fatty acids be better? I have done some research on raw feeding, and for every bad comment, I can find a good comment. I want what is best for my dog.
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My dog is 7 years old and has Pemphigus. His body is infrecting himself. He gets scabby sores and is now on a small does of Predesone . This has been going on for a year. Is there anything else either natural or not Predesone for this issue?
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I understand your concern with the mainstream treatment of pemphigus, but this treatment of prednisone is effective at suppressing the immune system lessening the severity of the condition. I am not familiar with effective alternative treatments, I tend to only recommend treatments where there is a peer reviewed scientific paper published in a reputable journal before giving a recommendation. You may try contacting a Veterinary Herbalist from the link below, all graduates of the institution in the link are licensed Veterinarians which have completed course in chinese medicine. Regards Dr Callum Turner DVM
www.tcvm.com/Resources/FindaTCVMPractitioner.aspx
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If my dog has this will he get better with the treatment i mean completely better are will he have it for the rest of his life he has scabs n crust itching on the head ,face and legs and ears he has been like this for almost 1 year i have taken him to 3 different vets n olso a dermatologist n they have not done nothing to help him to get better please help me what can i do to help him ?
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Pemphigus foliaceus is an autoimmune disease with treatment consisting of immunosuppressive drugs (corticosteroids) along with other drugs which would need to be tried on a trial basis to check their efficacy. I cannot say whether the symptoms will improve or if he will get better as these are on a case by case basis. Regards Dr Callum Turner DVM
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