Pemphigus foliaceus in association with systemic lupus erythematosus, and subsequent lymphoma in a cocker spaniel

Canine and Feline Pemphigus Foliaceus-an Update on Pathogenesis and Treatment

Pemphigus foliaceus (PF) is one of the most common autoimmune skin diseases of dogs and cats and is characterized by the development of pustules, crusts, erosions, scales, and alopecia. Albeit poorly understood, the pathophysiology of canine and feline PF appears to involve immune dysregulation and immunoglobulin G autoantibodies that are directed against the keratinocyte cell surface. At present, the management of canine and feline PF relies on the long-term to lifelong prescription of immunosuppressive medications. Current knowledge on the pathogenesis of canine and feline PF, as well as traditional and emerging therapies used to treat both diseases, will be reviewed herein.

Probiotic potential of Enterococcus hirae in goat milk and its survival in canine gastrointestinal conditions simulated in vitro

In canine nutrition, the use of goat nutraceutical dairy products is an innovative proposal. Therefore, the objective of this study was to prepare fermented goat milk with probiotic potential in dogs in an in vitro model. A total of 40 lactic acid bacteria (LAB) species were grown, of which 30 were CAP isolates originally from goat milk and 10 were CAN isolates originally from fecal material of newborn dogs. The isolates were selected based on resistance to the simulated canine gastrointestinal condition and acidifying ability. After this preliminary screening, the analyses were performed regarding β-galactosidase and exopolysaccharide formation, diacetyl production, adhesion proteins Mub and mapa, hydrophobicity, DPPH assay, virulence and antibiotic resistance. With these evaluations, four LAB isolates were identified using sequencing of the 16S rRNA gene. These were identified as Enterococcus hirae and were used to produce fermented goat milk. For statistical analysis, the data were analyzed using the Scott-Knott test and also submitted to analysis of variance and the Tukey test (P < 0.05). In the evaluation of goat milk fermented with E. hirae and control, over the 36-day storage period there was a reduction in pH and an increase in acidity, and higher levels of LAB were observed in goat milk fermented with E. hirae. Therefore, both these E. hirae isolates and the fermented goat milk produced showed satisfactory results in vitro, demonstrating probiotic efficiency and food safety for dogs.

Clonality testing in the lymph nodes from dogs with lymphadenomegaly due to Leishmania infantum infection

INTRODUCTION

In southern European countries, multicentric lymphoma and leishmaniosis are the main differential diagnoses in dogs presented with generalized lymphadenomegaly. The cytological examination is in some cases inconclusive and polymerase chain reaction (PCR) for antigen receptor rearrangement (PARR) has become a common method to confirm or rule out a lymphoproliferative neoplasia. According to the literature, leishmaniosis may lead to clonal arrangements and therefore to a false diagnosis of lymphoma, but this assumption is made from a single leishmania infected dog. Therefore, the objective of this study was to prospectively evaluate results from PARR in dogs with lymphadenomegaly due to clinical leishmaniosis at the moment of diagnosis.

MATERIALS AND METHODS

31 dogs with a diagnosis of leishmaniosis based on the LeishVet guidelines were included in the study. Samples from enlarged lymph nodes were taken for cytological examination, clonality testing and Leishmania infantum PCR.

RESULTS

All 31 dogs had medium to high positive antibody titers against Leishmania spp. and 30/31 had a positive Leishmania PCR from the lymph node. A polyclonal arrangement for B cells (immunoglobulin heavy chain gene) and T cells (T-cell receptor gamma chain gene) antigen receptors was found in 28/31 dogs. Two out of 31 dogs showed a monoclonal arrangement for Ig with high (1:2) and low (1:7) polyclonal background respectively; and one of the 31 dogs showed a monoclonal arrangement for T cell receptor with low (1:3) polyclonal background.

CONCLUSION

Infections with Leishmania infantum resulted in clonal rearrangement, and therefore in a possible false diagnosis of lymphoma, in 3 out of 31 dogs (9.7%). Although, PARR is a useful method to differentiate lymphoma from reactive lymphoid hyperplasia in dogs with leishmaniosis, mono-/biclonal results should be interpreted carefully, especially in the presence of any degree of polyclonal background, and together with other clinicopathological findings.

ACVIM consensus statement on the diagnosis of immune-mediated hemolytic anemia in dogs and cats

Immune-mediated hemolytic anemia (IMHA) is an important cause of morbidity and mortality in dogs. IMHA also occurs in cats, although less commonly. IMHA is considered secondary when it can be attributed to an underlying disease, and as primary (idiopathic) if no cause is found. Eliminating diseases that cause IMHA may attenuate or stop immune-mediated erythrocyte destruction, and adverse consequences of long-term immunosuppressive treatment can be avoided. Infections, cancer, drugs, vaccines, and inflammatory processes may be underlying causes of IMHA. Evidence for these comorbidities has not been systematically evaluated, rendering evidence-based decisions difficult. We identified and extracted data from studies published in the veterinary literature and developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria for IMHA, comorbidities, and causality. Succinct evidence summary statements were written, along with screening recommendations. Statements were refined by conducting 3 iterations of Delphi review with panel and task force members. Commentary was solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted. The resulting document is intended to provide clinical guidelines for diagnosis of, and underlying disease screening for, IMHA in dogs and cats. These should be implemented with consideration of animal, owner, and geographical factors.

Canine pemphigus foliaceus with concurrent immune-mediated thrombocytopenia

A 3 yr old wirehaired fox terrier was presented to his primary care veterinarian with fever, thrombocytopenia, and generalized crusting dermatitis. The skin lesion had progressed for at least 18 days, and thrombocytopenia had developed 3 days before presentation. Histopathology and direct immunofluorescence studies of the skin were consistent with pemphigus foliaceus (PF). Immunofluorescence revealed immunoglobulin G deposition around the keratinocytes in the stratum spinosum. A diagnosis of immune-mediated thrombocytopenia (IMT) was confirmed by the presence of platelet surface-associated immunoglobulin using flow cytometry. Systemic immunosuppressive therapy with cyclosporine and azathioprine was effective, and the dog survived for >2 years from the initial presentation. IMT is rarely associated with PF. This appears to be the first detailed report of a definitive diagnosis of concurrent PF and IMT in a dog. The authors' findings indicate that canine PF could be complicated by hematologic immune-mediated diseases such as IMT.

A review of autoimmune skin diseases in domestic animals: I - superficial pemphigus

In humans, the pemphigus denomination encompasses a group of autoimmune blistering skin diseases with intraepidermal separation resulting from cell-cell detachment by acantholysis. Entities are classified based on the level of blistering in the epidermis, and both superficial (pemphigus foliaceus, IgA pemphigus) and deep (pemphigus vulgaris, pemphigus vegetans and paraneoplastic pemphigus) variants are recognized. In domestic animals, subsets of pemphigus have been recognized since the mid-1970s, and the disease classification resembles that used for human patients. This article reviews up-to-date knowledge on the epidemiology, clinical signs, histopathology, immunopathology and treatment outcome of superficial pemphigus in domestic animals. Detailed information on canine, feline, equine and caprine pemphigus foliaceus, canine and feline pemphigus erythematosus and canine panepidermal pustular pemphigus is provided.