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Pemphigus Vulgaris in Dogs

Pemphigus Vulgaris in Dogs: Cause, Symptoms, and Treatments

Pemphigus vulgaris in dogs is a rare autoimmune condition belonging to the pemphigus disease group that causes severe skin problems. The skin disease is the most severe form of pemphigus in dogs and results in vesiculation, acantholysis, ulceration, fever, depression, and anorexia. Pemphigus vulgaris occurs due to the production of antibodies that destroy the dog’s epidermal cellular attachments. 

Myasthenia gravis in dogs is a similar autoimmune or congenital disease that leads to weakness and paralysis. Pet owners asking, “What causes myasthenia gravis in dogs?'' must know that the answer is through acquired or congenital means linked to certain breeds. The process occurs through antibodies that attack and occurrence destroy receptors of neurotransmitters. Studies have linked myasthenia gravis with pemphigus vulgaris in humans. Myasthenia gravis in dogs symptoms include muscle weakness, respiratory weakness, and exercise intolerance. 

Autoimmune diseases such as pemphigus vulgaris are rare, severe conditions requiring immediate care. The diagnosis of pemphigus vulgaris is based on physical examination, hematology, and elimination of secondary infections. Treatments for pemphigus vulgaris involve immunosuppressants, antibiotics, prescription diets, and regular follow-ups. The prognosis is generally poor due to the severity of the disease. 

What is Pemphigus Vulgaris in Dogs?

Pemphigus vulgaris is a rare autoimmune condition in dogs whose immune system targets the skin cells. The disease causes a production of autoantibodies in or near the epidermal-dermal junction. The antibodies are deposited in the intercellular junction, causing cellular detachment (acantholysis). Pemphigus vulgaris is the rarest and most deadly form of pemphigus in dogs. The prognosis for the disease is poor due to the widespread nature of the effects. 

Pemphigus vulgaris affects dogs’ skin structure by destroying healthy cellular attachments in the skin cells. The condition results in skin erosions, ulcers, vesicles, and bullae, especially around the groin. Similar lesions affect the nail beds, lips, nares, eyelids, oral cavity, and vulva.

How can Dogs get Pemphigus Vulgaris?

Dogs can get pemphigus vulgaris through factors such as breed, genetics, and environment, with the exact contraction mechanism unknown. The pemphigus skin conditions are a series of autoimmune diseases due to the body’s immune cells attacking the dog. Viral infections and ultraviolet light exposure “can trigger inflammation in the skin, which can make the dog more likely to develop an autoimmune reaction such as pemphigus,” according to Hunter and Barnette of VCA Animal Hospitals. 

Pemphigus vulgaris research on humans proposes that the condition is triggered “when a person who has a genetic tendency to this condition comes into contact with an environmental trigger such as a chemical or drug,” according to Johns Hopkins Medicine. The exact cause of pemphigus remains idiopathic or unknown, like most autoimmune diseases.

Is Pemphigus Vulgaris a Type of Autoimmune Disease in Dogs?

Yes, pemphigus vulgaris is a type of autoimmune disease in dogs. Pemphigus is a group of autoimmune diseases caused by the immune system attacking the dog’s skin cells. The diseases are characterized by extensive dermatological lesions leading to poor skin and coat health. 

Other forms of pemphigus include pemphigus erythematosus and pemphigus foliaceus. Pemphigus vulgaris seldom appears in dogs but is considered the most severe form. The lesions of pemphigus look similar, but they have different pathogenic mechanisms. The treatment for autoimmune diseases in dogs such as pemphigus is identical, with dogs with pemphigus vulgaris having a poorer prognosis than other conditions. 

What are the symptoms of Pemphigus Vulgaris in dogs?

The symptoms of pemphigus vulgaris in dogs are listed below.

  • Skin Erosions and Ulcers: The most common sign of pemphigus is extensive skin erosions due to acantholysis. The skin becomes red, inflamed, and infected, leading to erosive dermatitis. The skin erosions coalesce into painful boils and ulcers, spreading infection. The skin erosions extend extensively throughout the body, face, legs, and footpads, putting the dog in extreme pain and discomfort. 
  • Alopecia: Dogs with pemphigus vulgaris suffer from alopecia or hair loss. The disease affects the skin at a cellular level and affects hair follicles. The hair follicles are unable to grow due to the inflammatory processes of autoimmune reactions. Secondary bacterial and fungal infections are prominent in pemphigus vulgaris. The infections make hair loss more extensive. 
  • Boils Around the Lips and Mouth: Erosive lesions around the nares and oral cavity are common in pemphigus vulgaris. The red coalescing lesions extend through the palate, tongue, lips, and gingiva. There is marked salivation and bad breath due to the pain. The dermatitis develops into infected boils that are extremely painful after ulcerating. 
  • Depression: The lesions of the pemphigus extend throughout the body. Daily activities such as eating, playing, and sleeping become unbearable for the dog. The disease leads to poor concentration and lack of playfulness as the dog battles chronic pain and inflammation. Dogs with pemphigus vulgaris lack energy due to autoimmune diseases. 
  • Fever: Concurrent fever is common in pemphigus vulgaris. The antibodies attached to the skin cell attachments trigger an immune response of chemotactic cells, increasing body temperature. Cytokines and inflammatory cells are constantly triggered, making the inflammatory disease chronic and painful. Severe pyoderma contributes to infection and fever. 

How is Pemphigus Vulgaris Different from Glomerulonephritis in Dogs?

Pemphigus vulgaris is different from glomerulonephritis in that pemphigus vulgaris is a dermatological autoimmune disease, while glomerulonephritis is a renal disease affecting the kidneys. 

Immune-mediated glomerulonephritis is associated with neoplasia, rickettsial diseases, systemic lupus erythematosus (SLE), heartworm disease, pyometra, chronic septicemia, and adenovirus infection. Pemphigus vulgaris has an idiopathic etiology with differences linked to genetics, breed, and environmental factors. 

Glomerulonephritis in dogs has minimal dermatological involvement and mainly causes Chronic Kidney Disease (CKD). Pemphigus vulgaris is rare in dogs, while glomerulonephritis (membranoproliferative) is one of the dog’s most common glomerular diseases.

The appearance of pemphigus vulgaris includes a wide range of severe skin lesions, while glomerulonephritis seldom causes a rash. The two diseases are immune-mediated, but the pathologies involve separate organ systems. 

How is Pemphigus Vulgaris diagnosed in dogs?

Pemphigus vulgaris is diagnosed in dogs by ruling out differentials, dermatohistopathology, immunofluorescence or immunohistochemistry, and bacterial culture. 

The first step to diagnosing pemphigus is to rule out other diseases. The top differentials for pemphigus vulgaris include bullous pemphigoid, systemic lupus erythematosus, erythema multiforme, and drug reactions. 

A veterinarian performs laboratory tests to eliminate the differentials. Dermatohistopathology is accomplished by taking a sample of the skin tissue, staining it, and examining it for acantholysis and acantholytic cells. 

Immunofluorescence or immunochemistry of skin biopsy specimens detects intercellular antibody depositions. The vet examines bacterial cultures to isolate and identify the bacteria present in the dog. 

What is the treatment for Pemphigus Vulgaris in dogs?

The treatment for pemphigus vulgaris in dogs is listed below.

  • Immunosuppressive Medication: Nonsteroidal immunosuppressants such as cyclosporine, chlorambucil, and cyclophosphamide are used with regular corticosteroids. The medications actively suppress the immune system with fewer chances of adverse reactions. Prolonged steroid use causes adverse drug reactions and immunosuppression-induced secondary diseases. 
  • Steroids: Commonly used corticosteroids like prednisone, prednisolone, and methyl-prednisolone treat pemphigus vulgaris in dogs. Steroids reduce inflammation and suppress the immune system. Immunosuppressive doses are needed to lessen the dog’s immune response and stop attacking the skin. Prolonged steroid use leads to adverse drug reactions and immunosuppression-induced secondary diseases.
  • Medicated Baths: Secondary infections are prevalent in pemphigus vulgaris. Medicated baths containing antibacterial and antifungal medications treat skin infections topically. The dog is soaked for a few minutes in the bath regularly to aid skin healing. Medicated baths help to soothe and alleviate the deep pyoderma in the skin. 
  • Antibiotics: Pyoderma is a common problem associated with pemphigus vulgaris. Bacterial infections penetrate deep into the skin layers and require antibiotic treatments. Medications such as cephalexin, co-amoxiclav, and clindamycin are most widely used for treating pyoderma. Non-healing pyoderma needs a bacterial culture to identify the most suitable antibiotic for the dog. 
  • Prescription Diets and Supplements: Veterinary prescription diets are formulated to aid in returning skin to normal. Supplements contain EPAs and DHAs (omega fatty acids) that help boost skin and coat health. Skincare diets are prescribed as long-term, maintenance diets to hasten skin healing. Consult a veterinarian to know which diet is best for dogs with pemphigus vulgaris. 

How does Pemphigus Vulgaris affect a dog's skin?

Pemphigus vulgaris affects dogs’ skin due to the destruction of healthy cellular attachments of the skin cells. The result of pemphigus vulgaris is skin erosions, ulcers, vesicles, and bullae on the skin, including the groin. The nail beds, lips, nares, eyelids, oral cavity, and vulva are affected by erosions and boils that become painful open ulcers that make it hard for the dog to eat or drink. The dog’s entire body is affected, causing extreme pain and discomfort with slow healing. 

Deep, bilaterally symmetrical erosions on the face coalesce to form severely inflamed patches of skin. There is stomatitis of the gums and palate, ulceration, and erosion around the anus, and the footpad has clear desquamation with the appearance of the skin essentially sloughing off. 

Can Pemphigus Vulgaris in dogs be fatal?

Yes, pemphigus vulgaris can be fatal. Pemphigus vulgaris is the rarest but most severe form of pemphigus in dogs. The rare strain of pemphigus affects the deep epidermal layers, making healing difficult. 

The treatment for pemphigus is aggressive, and long-term adverse reactions are present due to the length of the medication. The medication for pemphigus vulgaris requires long-term steroids and immunosuppressants to counteract the dog’s immune system. The immunosuppression creates a vicious disease cycle as it increases susceptibility to other diseases, leading affected dogs to have poor prognoses. 

Are there natural remedies available for managing Pemphigus Vulgaris in dogs?

No, there are no natural remedies available for managing pemphigus vulgaris in dogs. Pemphigus vulgaris is a serious and life-threatening condition requiring veterinary attention. Management effectiveness is based on correct immunosuppression. The veterinarian determines the best treatment plan to tone down the dog’s immune system response enough for the pemphigus vulgaris to be managed with the least harm. Secondary infections are controlled with prescription medication and proper home care. 

What are the stages of Pemphigus Vulgaris in dogs?

The stages of pemphigus vulgaris in dogs are vesiculation, erosion, and ulceration. Pemphigus vulgaris initially presents as broad areas of deep, elevated patches of skin or boils. 

Vesiculation causes the affected regions to lose fur and appear sore and red. The resulting acantholysis, or breakdown in skin cells, causes classical erosive dermatitis lesions, which resemble crusty, scaly, and inflamed patches of skin that are painful to the touch. 

Erosion makes the skin lose its normal appearance, with bumpy, crusty, dry, and cracking skin. Ulceration occurs when the boils rupture, causing a concavity on the skin that is often wet in appearance. The ulcers are excruciating and are grounds for complicated pyodermal infections. 

Is Pemphigus Vulgaris in dogs contagious?

No, pemphigus vulgaris is not contagious. Pemphigus vulgaris is an autoimmune disease that is mainly idiopathic. The disease is not transmittable through physical contact since the cause is linked to the affected dog’s immune system. Pemphigus vulgaris affects dogs, cats, and humans. The lesions in cats and humans look similar to dogs. The erosive and ulcerative lesions are slow-healing and painful, causing deep epidermal damage. 

Can Pemphigus Vulgaris Affect Dogs' Nasal Systems?

Yes, pemphigus vulgaris can affect dogs’ nasal systems. The disease affects the nares (external) part of the nose. Depigmentation and erosive dermatitis are common in dogs with pemphigus vulgaris. The nose becomes discolored, and the skin looks like it is falling off. Dogs' nasal problems include a crusty, cracked, and dry appearance. The internal respiratory system is unaffected by pemphigus vulgaris, but respiration is affected due to pain and discomfort. 

What is the life expectancy of a dog with Pemphigus Vulgaris?

The life expectancy of a dog with pemphigus vulgaris depends on the severity of the disease. The prognosis for dogs affected with pemphigus vulgaris is fair to poor. Lifelong therapy is needed to prevent remission. Dogs that respond poorly to therapeutic treatment are often humanely euthanized. Regular monitoring is needed to assess any complications from drug adverse reactions. Immunosuppression-induced bacterial infection is common in pemphigus vulgaris treatment. 

Are there any specific breeds more prone to developing Pemphigus Vulgaris?

No, there are no specific breeds more prone to developing pemphigus vulgaris. Pemphigus vulgaris is the rarest pemphigoid autoimmune disease. The disease does not have a well-established breed predilection. Pemphigoid foliaceus is commonly observed in Cocker Spaniels, Chow Chows, English Bulldogs, and Dachshunds. 

Does Pemphigus Vulgaris Only Affect Dog's Skin?

No, pemphigus vulgaris does not only affect a dog’s skin. Pemphigus vulgaris affects the oral cavity. Erosive lesions are found inside the mouth, such as the palate, around the tongue, and gums. The disease affects the nares or nose exterior, giving the appearance of the nose sloughing off due to acantholysis. The condition severely impacts the mucocutaneous junctions of the dog’s body, making eating and drinking uncomfortable. 

Is Pemphigus Vulgaris a Type of Skin Infection?

No, pemphigus vulgaris is not a type of skin infection. Pemphigus vulgaris is an autoimmune disease rather than a skin infection. Secondary skin infections are common in dogs because the deeply affected tissue is broken and exposed to the environment. The increased inflammation and heat make a suitable environment for bacteria to proliferate and cause further damage. The autoimmune nature of pemphigus vulgaris and similar skin infections in dogs make the dog vulnerable to diseases since the immune system is compromised.