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Anecdotal Evidence and Hindsight
Do either have any value or should we wait for the
evidence to be proven by science before reacting to unproven 'coincidences?'
Cases of AI disease are still relatively uncommon
within the general dog population. However, during the past year, owners of
dogs in over 80 different breeds (including a few cross breeds and mongrels)
have contacted me at CIMDA, and information has been received from many
owners whose dogs have suffered from an auto-immune disease of one kind or
another.
When information is received in this way, it is
inevitable that 'common factors' will be highlighted. Sadly, there are many
'coincidences' that are not instantly recognised as possible indicators to
AI diseases.
This article has been composed from the accounts of
owners who have been unfortunate enough to have a dog diagnosed with an AI
disease.
Many of these anecdotal references cannot be regarded
as having been confirmed by any scientific evidence, but they do illustrate
some of the common recurring signs that seem to be associated with a dog
suffering from an AI disease. (Dogs have shown one or more of the following
‘symptoms').
General Observations Regularly Reported Prior to a
Diagnosis
1. Diarrhoea - with or without traces of blood e.g.
colitis.
2. Depression and lethargy, and the look of premature
ageing.
3. Skin irritation, skin sores, nail bed problems,
mouth ulcers, nose or anal lesions.
4. High temperature.
5. Weakness in the legs.
6. A tendency to lameness - limping.
7. Anaemia.
8. Collapse.
9. Intermittent symptoms that can disappear and
reappear.
10. Young to middle aged dogs were the most commonly
affected.
11. Ongoing symptoms that even after treatment remain
constant and unresolved.
Haemolytic Anaemia (AIHA or IMRA)
12. Signs of AIHA that have been reported are: orange
coloured faeces, orange coloured urine, craving to eat earth or gnaw
concrete, weight loss, pale gums, high temperature, lethargy, fainting and
little or nor appetite (but some dogs do not go off their food until they
are desperately ill).
To confirm AIHA, a Coombs blood test is usually carried
out, to look for red cell-bound antibodies. A negative result does not
necessarily mean that the anaemic dog does not have AIHA, as the red cell
destruction could be occurring in the bone marrow.
To examine the bone marrow, a biopsy would have to be
taken.
Thrombocytopenia (IMTP)
Many owners, whose dogs were eventually diagnosed with
RITP, have said that some of the common symptoms were:
13. Bleeding from the nose or gums, blood shot eyes,
bruising on the body, blackened or dark coloured faeces (traces of dark
coloured blood), high temperature.
14. That the dogs suffered from anaemia, haemorrhaging,
lethargy and little or no appetite (some dogs will not go off their food
until they are desperately ill).
Another indicator was
1. That the vet initially suspected poisoning and not
an AI disease, as the symptoms were similar to 'Warfarin' poisoning. Vitamin
K was frequently prescribed.
Signs for AIHA and IMTP can come on quickly, or show
gradually over a period of a few weeks, and then the dog can deteriorate
rapidly.
Several owners have said that their vet didn't appear
to attach too much importance to their dog's nosebleed, in fact one vet
operated on a dog, and removed a small bone from her nose. IMTP is a
bleeding disorder, whereby the dog's blood loses ability to clot. Performing
an operation on this dog was probably the worst thing the vet could have
done. The dog haemorrhaged and was quickly referred to a specialist.
Fortunately, after a blood transfusion, intensive treatment and care, she is
now well and fully recovered.
With so many AI diseases, the owners have said that for
sometime before their dog became acutely ill they had noticed the dog had an
intermittent limp. Very often the dog was thoroughly investigated, without a
diagnosis being achieved.
The Pemphigus Group and Lupus Group
These AI diseases can show in varying forms of skin
problems.
Owners have reported:
15. These diseases have been particularly difficult to
diagnose and the poor dogs have suffered from very painful and uncomfortable
skin lesions/ulcers, sometimes to the face only, and sometimes to the face
or body or nails, or a combination of all three.
The vet has usually taken biopsies and treated the dog
with various antibiotics, antibacterial shampoos and new diets.
The process of trying to reach a conclusive diagnosis
of some AI diseases, especially skin conditions, can prove to be costly and
often without any significant progress being obvious. It can be extremely
difficult to confirm a diagnosis as blood tests and biopsy results can be
returned as 'inconclusive'.
Anecdotal reports appear to have shown than an AI
disease, in an acute stage, has often caused the dog to have a high
temperature. Understandably, the vets have suspected an infection and
usually prescribed antibiotics or put the dog on an intravenous drip, which
has shown some improvement in the dog's condition.
If the improvement is only temporary, and the vet
cannot establish what is wrong with the dog, you may choose to ask for a
referral to a vet college, or even seek a second opinion from another vet.
This might seem obvious, but when you are trying to cope with a desperate
situation, the obvious is not always the first consideration, especially
when your hopes and trust are placed with a vet who may appear to have the
situation under control but is really struggling for a solution.
Some owners have said that their vets continued to
treat their dog in the same way, without successfully finding out the
underlying cause of the illness. The treatment, in many cases, continued for
some considerable time, without any real improvement.
There have been some reports that certain vets have
failed to make an accurate diagnosis, even when the symptoms presented were
'classic' to a particular AI disease. On the other hand, most owners praised
their vets very highly and attributed the 'saving' of their dog to the
prompt diagnosis, skill and attention they received.
When the illness is prolonged, it is not uncommon for a
dog to go into a 'crisis'.
This is often the case with Addisons disease,
vasculitis or one of the AI blood disorders. The situation turns into 'a
fight against time' and so often a diagnosis is reached at 'the eleventh
hour'. This can be too late, and the poor dog may not have any time left to
respond to treatment. A correct, early diagnosis can make the difference
between life and death for your dog.
This article attempts to share 'anecdotal evidence' and
observations that many unfortunate owners of dogs with AI disease have
noted. There are reports where the owner (because they were aware of the
health status of their breed) had made a suggestion to the vet, which
subsequently led to a correct diagnosis and saved the dog's life.
These anecdotal accounts indicate that more dogs seem
to survive AI disease than die. Many dogs that have survived their initial
'crisis' have continued to lead a normal life and have been 'weaned off'
their medication.
With Addison's disease and hypothyroidism, once a
diagnosis has been reached, the appropriate hormone therapy started, and the
dog stabilised, the prognosis is excellent.
Care must he taken not to assume that your dog has an
AI disease simply because one or more of the 'signs' are apparent. If you
are at all concerned, always contact your vet.
It is hoped that reporting these facts may help to
provoke a (quicker) diagnosis, thereby minimising suffering and possibly
save the life of a dog in the future.
Jo Tucker
An AI disease survey is being conducted by The Queen's
Veterinary School Hospital, Cambridge University, and will hopefully shed
more light on the issue of AI disease in the dog. The results of the survey
will give the vets valuable information to further investigate the cause of
these diseases. Anyone wanting to assist with this study or has a dog
suffering from an immune mediated disease and would like further information
please contact.' CIMDA, 73 Osidge Lane, Southgate, London N14 5JL. Tel. 020
8368 9148 email: jo@cimda.fsnet.co.uk
Your contribution is vitally important to this study.
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