(05) - Canine Discoid Lupus Erythematosus Flashcards
1
Q
- Discoid lupus erythematosus is the second most common autoimmune skin disease after pemphigus foliaceus
- only what is involved?
A
- skin
2
Q
- Depigmentation, erosions, ulcers, alopecia, erythema, scaling, and crusts usually develop on what?
- Ulcerative lesions heal?
- LEsions are exacerbated by what?
A
- the planum nasal and dorsal muzzle
- with a scar
- sunlight
3
Q
- History (dog developed lesions on his nose which tend to get worse under the sunlight but animal is feeling good) and clinical signs (erosions, ulcers, crusts and depigmentation on planum nasal and dorsal muzzle) are important information for a definitive diagnosis
- What is essential for a definitive diagnosis?
- Direct immunofluorescence will show deposition of what at the dermoepidermal junction? Remember!
- ANA is negative or yield very low titers.
A
- histopathology (will show hydropic degeneration of the basal cell layer and/or lichenoid band-like inflammatory infiltrate at the dermoepidermal junction.)
- immunoglobulin and/or complement (False negative results are common.)
4
Q
THERAPY FOR AUTOIMMUNE DISEASES AFTER THIS
A
d
5
Q
- DLE, SLE and pemphigus erythematous lesions can be aggravated by the sunlight so use a waterproof
sunscreen with a SPF of at least 15 on sun-exposed skin
A
d
6
Q
What can be adjunctive therapy with other immunosuppressive agents in cases of DLE and
SLE?
A
- Vitamin E
7
Q
- What combination can be used as the first treatment choice for milder cases of DLE?
- For more severe cases use what first ?and after the disease is in remission maintain the case on what?
- Side effects of tetracycline and niacinamide are uncommon and include anorexia, vomiting, and
diarrhea.
A
- Tetracycline and niacinamide
2. glucocorticoids or cyclosporine; tetracycline and niacinamide
8
Q
- What are the first treatment choice for autoimmune diseases?
- The induction dosage for dogs ranges from 2.2 mg/kg/day to 6.6 mg/kg/day and for cats dosage is what compared to dogs?
- Cases that fail to respond by full remission at these induction dosages within 7 to 14 days are
candidates for another immunosuppressive therapy. (Approximately 50% of the cases respond to glucocorticoids alone.)
A
- Glucocorticoids
2. TWICE DOGS DOSAGE
9
Q
- Once remission has been achieved, gradually decrease to low dose alternate day medication. Changing the dose from daily to every-other-day dosing may precipitate a relapse; in this case consider adding azathioprine (dogs) or chlorambucil (cats).
- If glucocorticoids are used as the sole therapy, semi-yearly to yearly CBCs, chemistry profiles, urinalysis and, urine cultures should be performed to monitor for common side effects.
A
d
10
Q
- What are usually given with corticosteroids so that a lower dose of corticosteroids can be used
to control the disease ?
A
- cytotoxic drugs
11
Q
- What is the drug of choice to be used with corticosteroids to manage autoimmune diseases in dogs?
- can you use it in cats?
A
- Azathioprine
2. ABSOLUTELY NOT (can cause profound leukopenia and thrombocytopenia)
12
Q
- What is the slowest acting and the least toxic of the alkylating agents and it can be added to a glucocorticoid regimen?
- It is a good option to manage pemphigus foliaceus in what animal?
- Side effects relate to myelosuppression and mild GI signs.
A
- Chlorambucil
2. cats.
13
Q
- what can be used to manage pemphigus diseases in dogs and cats?
- What is the parenteral form preferred by many veterinarians?
- Clinical response is not observed before 6 to 12 weeks of therapy, therefore the drug is often used in conjunction with oral glucocorticoids initially during the lag phase.
- Side effects in dogs include thrombocytopenia, proteinuria, hepatic necrosis, muscle soreness, drug eruption and toxic epidermal necrolysis
- Platelet counts, CBC, and urinalysis should be performed every 2 weeks during the first 16 weeks of therapy.
A
- Gold salts
2. Aurothioglucose (Solganol)
