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Pemphigus Foliaceus in Dogs

Pemphigus Foliaceus in Dogs: Symptoms, Diagnosis, Treatment and Complication

Pemphigus foliaceus in dogs is an autoimmune skin condition that causes pustules. Pemphigus foliaceus (PF) is the number one dog autoimmune disease. Pustules are bulging skin patches filled with a yellow substance called pus. 

Pemphigus foliaceus occurs when the dog’s immune system attacks its skin's cell-to-cell connections. Sun exposure, certain medications, and chronic skin conditions increase the risk of PF. 

Collies, Dobermans, Newfoundlands, Akitas, Chow Chows, Dachshunds, Schipperkes, Shar Peis, and Cocker Spaniels are among dogs with a predisposition to pemphigus foliaceus.

Signs of pemphigus foliaceus include pustules, open sores, and scabs on dog's head. Other signs of PF in dogs include hair loss, depigmentation, itchiness, and secondary skin infections. The lesions start on the head and feet and spread all over the body. 

The treatment for a pemphigus foliaceus dog is immune system suppression paired with topical creams and antibiotics. CBD for dogs helps manage health and wellness and boosts dogs' immune systems. Dogs with pemphigus foliaceus must have limited sun exposure. 

Mild pemphigus foliaceus in dogs is manageable and allows medication tapering or discontinuation. Severe cases of PF require lifelong medication. 

What is Pemphigus Foliaceus in Dogs?

Pemphigus foliaceus in dogs is an autoimmune skin disease manifesting with vesiculobullous or blisters and pustular lesions. PF occurs when a dog’s immune system starts attacking the connections between skin cells. 

The epidermis (outer layer of the skin) comprises multiple layers of keratinocytes, a type of skin cell. The keratinocytes are connected via cell-to-cell adhesion molecules known as desmosomes, which consist of various proteins, such as desmocolin and desmoglein. 

PF develops when the immune system attacks the desmosomes, and the desmosome destruction results in superficial skin lesions.  

Pemphigus foliaceus in dogs is treatable, but some dogs require life-long medical support to control the signs and symptoms. Pemphigus foliaceus in dogs is the most common canine autoimmune skin disease. 

How common is Pemphigus Foliaceus in Dogs?

Pemphigus foliaceus is very common in dogs. Dogs are rarely diagnosed with autoimmune conditions, and pemphigus foliaceus is the most prevalent. The disease occurs mainly in medium-aged and senior dogs. 

Pemphigus foliaceus is a common disease in cats. Adverse drug reactions are cats' most frequent skin condition, followed by PF.

Pemphigus foliaceus was diagnosed in 17 cats (0.9%) in a study “Feline dermatology at Cornell University: 1407 cases (1988–2003)” published in the Journal of Feline Medicine and Surgery in 2012. 

Is Pemphigus Foliaceus a common autoimmune disease in dogs?

Yes, pemphigus foliaceus is a common autoimmune disease in dogs. Autoimmune conditions in dogs are rare, and pemphigus foliaceus is the dominant diagnosis. 

Pemphigus foliaceous is the most common dog autoimmune disease according to a study, “Pemphigus Foliaceous,” published in the Canadian Veterinary Journal in 2019. 

Pemphigus foliaceus is a more common autoimmune skin disease in dogs than pemphigus vulgaris, pemphigus erythematosus, and bullous pemphigoid, which are rare autoimmune diseases affecting the dog’s skin. 

What are the Causes of Pemphigus Foliaceus in Dogs?

The causes of pemphigus foliaceus in dogs are listed below. 

  • Genetics: Certain dog breeds are predisposed to pemphigus foliaceus. These include Akitas, Dachshunds, Dobermans, Chow Chows, Newfoundlands, Schipperkes, Shar Peis, Collies, and Cocker Spaniels. 
  • Chronic Skin Diseases: Chronic skin diseases provoke the immune system, resulting in autoimmune conditions in predisposed dogs. 
  • Environmental Factors: Allergens contribute to pemphigus foliaceus because they trigger chronic skin diseases when poorly managed. Exposure to UV light is another environmental risk factor. 
  • Certain Medications: Antibiotics such as sulfonamides, penicillins, cephalosporins, and topical ectoparasitic medications, such as metaflumizone, fipronil, amitraz, S-methoprene, dinotefuran, pyriproxyfen, or permethrin are associated with pemphigus foliaceus. 
  • Autoimmune Diseases: Dogs with co-existing autoimmune diseases, like generalized discoid lupus erythematosus (DLE), are more prone to developing pemphigus foliaceus. DLE causes discolorations, ulcers, and crusts to the hairless portion of the nose and, in severe cases, nosebleeds in dogs. 

Is Pemphigus Foliaceus in Dogs Hereditary?

Yes, pemphigus foliaceus in dogs is hereditary. Pemphigus foliaceus is transmitted through generations in dogs predisposed to it. 

Dogs with a hereditary disposition to pemphigus foliaceus include Collies, Akitas, Schipperkes, Chow Chows, Cocker Spaniels, Newfoundlands, Dachshunds, Schipperkes, and Doberman Pinschers. Another breed believed to be at a higher risk is the English Springer Spaniel.  

Labrador Retrievers and Doberman Pinschers are prone to the drug-induced form of pemphigus foliaceus which occurs when the dogs react to medication. 

What are the Symptoms of Pemphigus Foliaceus in Dogs?

The symptoms of pemphigus foliaceus in dogs are listed below. 

  • Pustules: Pustules are pus-filled blisters on the dog’s skin and a hallmark PF symptom. The pustules appear alone or in multiple clusters, starting on the dog’s head and feet. The pustules progress and spread to the neck, trunk, abdomen, and groins. 
  • Open Sores: The pustules open, creating open sores resembling erosions and ulcers. Erosions are superficial, and ulcers are deep defects in the skin. 
  • Scabs and Crusts: The ulcers and erosions are short-lived and transform into scabs or crusts. The scabs or crusts irritate the dog and give it an unkempt appearance. 
  • Itching and Scratching: Dogs with pemphigus foliaceus are itchy and constantly scratch, rub, or lick themselves to provide temporary relief. The itchiness aggravates the condition and causes self-inflicted injuries. 
  • Hair Loss: The skin lesions and itchiness associated with pemphigus foliaceus cause skin damage, resulting in hair loss. The medical term for hair loss in dogs is alopecia. 
  • Reduced Appetite: Reduced appetite is a universal symptom in troubled dogs. Dogs with pemphigus folioceus do not eat enough, which weakens the immune system. 
  • Lethargy: Skin lesions cause lethargy in dogs with pemphigus foliaceus. Lethargy manifests in reduced activity and an increased tendency to sleep. 
  • Fever: Fever or increased body temperature occurs with advanced pemphigus symptoms and complications, such as secondary skin infections in dogs. 

What are the potential complications of Pemphigus Foliaceus in dogs?

The potential complications of pemphigus foliaceus in dogs are listed below. 

  • Secondary Skin Infections: Open skin sores combined with constant scratching increase the risk of secondary skin infections, which are caused by bacteria and fungi. 
  • Generalized Skin Lesions: The skin lesions start on the dog’s head and feet, but as the pemphigus foliaceus progresses, they advance and are present all over the body. The distribution is then called generalized. 
  • Skin Depigmentation: Skin depigmentation is a common complication of pemphigus foliaceus and a sign of severe and prolonged damage. 
  • Systemic Complications: Skin issues affect the dog’s well-being and cause pain, reduced appetite, lethargy, and fever. Behavioral changes and mood swings are common in dogs with complicated PF. 

What does Pemphigus Foliaceus in Dogs look like?

Pemphigus foliaceus in dogs looks like symmetrically distributed pustules. The pustules are sac-like structures or blisters filled with pus. Pustules are raised lesions that look like large pimples. Pustules occur alone or in clusters and are yellow, reddish, or brown.  Pemphigus dog photos are shown below.

Are dogs more prone to get Pemphigus Foliaceus in certain body parts?

Yes, dogs are more prone to get pemphigus foliaceus in certain body parts. Canine PF starts on the dog’s head and feet. The condition progresses and spreads to other parts of the body. The skin lesions on the head are widely distributed on the muzzle, nose, ears, and around the eyes. Pemphigus foliaceus dog nose is the standard facial manifestation. Pemphigus foliaceus dog paws occur on the pads and between the toes. 

How do Veterinarians Diagnose Pemphigus Foliaceus in Dogs?

Veterinarians diagnose pemphigus foliaceus in dogs with a skin biopsy. Vets perform a complete body examination and consider the dog’s clinical signs and detailed medical history. 

The clinical manifestation is enough to suspect a diagnosis of pemphigus foliaceus. The diagnosis is confirmed via a skin biopsy, which entails taking a small skin plug from a skin lesion. 

The biopsy is done with the help of local or general anesthesia. A veterinary pathologist analyzes the collected sample under a microscope. 

What are the Tests done to diagnose Pemphigus Foliaceus in Dogs?

The tests done to diagnose pemphigus foliaceus in dogs are skin biopsies and histological examinations. 

The tests are challenging in some dogs because the disease stage and the skin sample quality complicate the biopsy's diagnostic value. 

Skin samples must be collected from sites associated with early skin lesions and immediately prepared for analysis. The more biopsies the vet sends to the lab for microscopic analysis, the greater the chance of finding PF-specific markers. 

Secondary skin infections complicate PF diagnosis tests. Veterinarians manage the secondary infection before collecting skin samples.  

How serious are Pemphigus Foliaceus Dogs?

Pemphigus foliaceus in dogs is serious. The prognosis for dogs with PF is good. Individual responses vary based on general health and treatment response. 

Dogs with PF are able to recover and are weaned off medications, while other dogs need lifelong medication use. 

Dogs with PF go into remission in 50% of cases, and the remission lasts for four to seven weeks, according to a study, “Pemphigus Foliaceus in 91 Dogs,” published in the Journal of the American Animal Hospital Association in 2006. 

How long can a dog survive with pemphigus foliaceus?

A dog can survive for long with pemphigus foliaceus. The survival rate and prognosis depend on the dog’s response to therapy. Dogs with PF go into remission, but the risk of relapses is high. 

Relapses occur after the medications are tapered or the therapy is discontinued, suggest a study, “A Review of Autoimmune Skin Diseases in Domestic Animals: I - Superficial Pemphigus,” issued in Veterinary Dermatology in 2006. 

Dogs that do not go into remission survive and live a normal lifespan when the condition is managed appropriately. The prognosis is poor and includes euthanasia for dogs that fail to respond to treatment. 

Can Dogs Die from Pemphigus Foliaceus?

Yes, dogs can die from pemphigus foliaceus. The condition is not fatal, but complications are possible. The long use of immunosuppressive mess triggers life-threatening adverse effects in some dogs. 

Adverse treatment effects occur in about half of dogs with PF, suggests a study, “Clinical and Histopathological Features of Pemphigus Foliaceus with and without Eosinophilic Infiltrates: A Retrospective Evaluation of 40 Dogs,” published in Veterinary Dermatology in 2010. 

Commonly seen adverse effects are skin fragility syndrome, secondary infections, iatrogenic hyperadrenocorticism, hepatotoxicity, diabetes mellitus, and stomach upset. 

What are the Treatments for Pemphigus Foliaceus in Dogs?

The treatments for pemphigus foliaceus in dogs are immune system suppression and symptom control. 

Immune system suppression is achieved through high doses of steroids, alone or combined with specific immunosuppressants. Immunosuppressants include cyclosporine, azathioprine, chlorambucil, and mycophenolate.

Symptom control is achieved with oral antibiotics, which treat secondary skin infections. The antibiotic used is based on the infection-causing agent. 

Topical therapies, such as antimicrobial shampoos, steroid creams, and tacrolimus, are treatments for certain dogs with PF. Sun avoidance is an essential part of the pemphigus foliaceus dog treatment.

How long does it take for Pemphigus Foliaceus in Dogs to heal?

It takes several weeks to months for pemphigus foliaceus in dogs to heal. The healing time depends on the severity of the lesions. Skin lesions are slow-healing, and remissions are possible after the medication is discontinued. 

Dogs that respond well to the PF treatment start tapering medication to check for remission. The treatments are stopped if there is no remission. Some dogs do not heal completely and need lifelong PF management. 

Can Pemphigus Foliaceus be cured at home?

No, pemphigus foliaceus cannot be cured at home. PF is not a curable condition, and symptom control requires a strict treatment strategy. 

At-home remedies, such as dietary changes, natural supplements, and topical balms, are helpful for some dogs. Home treatments must not be used as traditional pemphigus foliaceus therapy substitutes. 

Consult the veterinarian and ask if they recommend specific at-home remedies. Stick to the veterinarian’s guidelines, and do not try to treat PF alone. 

How can CBD Oil help treat Pemphigus Foliaceus in Dogs?

CBD oil can help treat pemphigus foliaceus in dogs by modulating the immune system, reducing inflammation, and relieving itchiness. 

CBD, or cannabidiol, is a natural hemp extract with health-boosting properties. CBD modulates the immune system by addressing the underlying trigger for pemphigus foliaceus. 

Cannabidiol has anti-inflammatory features that reduce inflammation and an anti-pruritic effect that decreases itchiness. 

Cannabidiol for dogs is not a PF treatment but helps with the symptoms. CBD for dogs is natural and safe to use in conjunction with mainstream pemphigus foliaceus medications. 

How can Boosting a Dog's immune System help prevent Pemphigus Foliaceus in Dogs?

Boosting a dog’s immune system can help prevent pemphigus foliaceus in dogs in the ways listed below. 

  • Allergy Relief: The risk of allergic reactions is minimized when a dog’s immune system is supported. Allergic reactions contribute to pemphigus foliaceus. Allergies damage the skin and trigger high immune system activity in the skin. 
  • Skin Infection Control: A strong immune system fights off bacterial and fungal pathogens that cause chronic skin infections, which increase the PF risk in predisposed dogs. 
  • Overarching Wellness: A complete dog immune system boost helps keep the dog healthy, which is vital because PF is prevalent in dogs with underlying health conditions.  

Is there a way to prevent Pemphigus Foliaceus in dogs?

No, there is no way to prevent pemphigus foliaceus in dogs. Owners are able to reduce the risk of PF in predisposed dogs. 

Support the dog’s immune system and manage underlying skin conditions promptly to avoid chronic infections. Avoid exposure to UV light as it triggers PF episodes. Do not medicate the dog without consulting the veterinarian. 

Are certain breeds of dogs more prone to Pemphigus Foliaceus?

Yes, certain breeds of dogs are more prone to pemphigus foliaceus. High-risk breeds for PF are Collies, Dobermans, Akitas, and Chow Chows. Other risky breeds include Schipperkes, Cocker Spaniels, Newfoundlands, and Dachshunds.  

Pemphigus foliaceus was prevalent among Bearded Collies, Akitas, Newfoundlands, and Schipperke dogs in a study “Pemphigus Foliaceus in Dogs: A Review of 37 Cases” published in the Journal of The American Veterinary Medical Association in 1985. 

The cutaneous adverse medication reaction form of PF is common in Labrador Retrievers and Doberman Pinschers. Cutaneous adverse reactions include undesirable skin function, structure, or mucus membrane changes. 

What is the difference between Pemphigus Foliaceus and Pemphigus Vulgaris?

The difference between pemphigus foliaceus and pemphigus vulgaris (PV) is in mucosal membrane involvement and disease severity.  

Pemphigus foliaceus causes skin lesions on the superficial skin layers. Pemphigus vulgaris damages mucosal membranes. Dogs with PV have lesions on the mouth and eyelids. 

Pemphigus vulgairs is a more severe condition than pemphigus foliaceus. PV has a poor prognosis and is fatal in many cases.