Pemphigus in dogs

Pemphigus is a group of autoimmune skin diseases that can be found in humans, cats, dogs, and even horses. There are three main types, all of which affect the skin:

• Pemphigus Vulgaris (PV).  The first to ever be described in veterinary medicine in 1989, and the most severe. The affected tissue is often deep within the skin, making it the most difficult to treat, too
• Pemphigus Erythematosus (PE). Symptoms are similar to pemphigus foliaceous, but milder in form
• Pemphigus Foliaceus. The most common form, often seen in older and mature pups.

Pemphigus is classified as an autoimmune disease, meaning the body’s immune system identifies the body as a foreign object, implementing defense mechanisms to protect yourself against… yourself. Other common types of autoimmune disease are IBS and polyarthritis. Dogs with a robust immune system are less likely to suffer from skin conditions and other autoimmune diseases.

Pemphigus is not contagious, however, you should not breed from a dog that suffers from it, as the genetic underpinnings are yet to be understood.

Risk factors

Despite it being a painful (sometimes fatal) ailment in dogs, there’s less research on this disease than other autoimmune diseases. However, researchers believe pemphigus is caused by a mix of both genetic disposition and environmental triggers.

These breeds are prone to Pemphigus Foliaceus:

• Akitas
• Chow Chows
• American bulldogs
• Collies
• Dobermans

👉 Animals are most often middle-aged when the onset of Pemphigus occurs.

Like many other skin conditions, diagnosis can prove difficult. The skin has a limited number of reactions, so the symptoms are similar to allergies, intolerances, eczema, and dermatitis. However, the more symptoms your dog has, the more options there are for diagnosis.

Skin scrapes can help your vet decide what is causing your dog’s itchy symptoms. In crusts, your vet can perform a skin biopsy by lifting the crusting skin and scraping it. Intact pustules are best left for a biopsy, however, your vet may think it best to rupture one with a sterile needle and gather the contents for analysis. It is good practice to gain samples from more than three pustules and crusts.

Once a sample has been taken, your vet will look for cells present, which indicate an autoimmune response. These cells are called acantholytic keratinocytes, and they are often surrounded by neutrophils. Blood tests can also show antibodies in the bloodstream.

You should think about any incidents which may have triggered the onset of pemphigus. For example, have you used any new products on your dog? Has his diet changed? Have you been walking somewhere with lots of different plants, that could have caused a reaction?

Your vet may also check for secondary infections if your dog has been behaving lethargic.

Cost of diagnosis

Diagnosis can cost from $300 to $1,000. Multiple diagnostic methods may be used, which will inflate the price. However, only your vet can diagnose pemphigus.

The onset of clinical signs can be either rapid or very slow. The onset of symptoms is not linear: they may decrease, only to rapidly spike again. Common areas for the symptoms to show are the nose, face, and footpads.

• Itching. This symptom can cause secondary infections, as your dog’s paws itch the affected area and break the skin, exposing him to bacteria.
• Pustules. In pemphigus foliaceus, pustular lesions form on the face. Pustular lesions are pus-filled spots that can burst. This symptom can be hard to spot. As the pustules form and rupture, you will be left with hairless patches with crusts and redness.
• Lesions. Most commonly found in the skin, but can form in the eyes, nose, mouth, throat, and genitals.
• Blisters. When the blisters break, they often form painful sores.
• Swelling. The skin under the crusts, lesions, and blisters will often swell and be painful.
• Hot if infected. Secondary infection can occur, as pemphigus makes the dog’s skin vulnerable to exposure.
• Organ damage. Only a risk if secondary infection occurs.

As pemphigus is a skin disorder, your dog should be functioning well. Of course, pain, irritation, and even secondary infections can cause lethargy in your pup. The treatment and diagnosis can be tricky and expensive, and you may have to change your own and your dog’s lifestyle to halt remission. Often, long term therapy will be used to manage the condition. The three types of pemphigus differ in severity- but with early diagnosis and ongoing treatment your dog can live a happy life. In severe cases, euthanasia may be advised but this is rare and will be assessed on a case-by-case basis.