10 mo old pup with SLE

[Trisha]

Hello my name is Trisha and I'm new here. My 10 mo old Australian cattle dog Diesel was diagnosed with SLE. I have had a hard time finding anyone with first hand experience with SLE. So wondering how many or if any here have had pets with SLE?

[Jo CIMDA]

Hi Trisha and welcome

I'm really sorry that your young cattle dog has SLE. I have had a dog with SLE and it first started with immume mediated masticatory myositis and other body systems became involved thereafter.  The correct and prompt treatment is key to achieving remission.  Please check out the Michael J Day drug protocol in the files.  Also bear in mind that some young dogs need higher dose of steroidsto bring the disease process under control.

  Do you know how the vet has arrived at this diagnosis because there is no one definitive test for SLE.  The following gives a brief outline of the disease/diagnosis.

SLE - Systemic Lupus Erythematosus

SLE is a multisystemic disease that can affect many parts and systems of the body.  It is categorised into major and minor signs.
Major signs can be:
Shifting lameness (polyarthritis ), anaemia and thrombocytopenia(blood abnormalities), skin lesions, kidney nephritis (inflammation)
Minor signs can be:
Inflammation of the heart, lungs & muscles, mouth ulcers, enlarged lymph nodes, gastrointestinal signs (vomiting and diarrhoea), central nervous system may be affected causing: Behavioural changes, seizures, and staggering (ataxia).
Clinical signs can be extremely varied and not all dogs with SLE will show the same symptoms. An antinuclear antibody blood test (ANA) can be useful in diagnosis but a negative result still does not rule out SLE.
The dog will normally demonstrate signs of pain and stiffness in the joints and this may be accompanied with anaemia, skin lesions and one or more of the minor signs.  One would expect the dog to show other clinical signs such as high temperature, enlarged lymph nodes, thrombocytopenia, lethargy, depression, lack of appetite, muscle weakness (myosytis) sometimes causing weakness of the throat muscles (megaoesophagus).   Megaoesophagus is a serious complication and if this is present then the quicker correct treatment is started the more chance you have of limiting the effects.  A dog will have difficulty in drinking and eating and this can cause recurring aspirate pneumonia.  The primary autoimmune disease may have been brought under control but the effects of megaoesophagus may not resolve completely.
SLE can affect any body system/s. A definitive diagnosis may not be achieved, but it may be presumed, based on clinical evidence and response to treatment.  Again knowledge of breed predisposition and family history will be beneficial in obtaining a diagnosis.   Dogs can have periods of remission and relapse.  The prognosis for SLE is guarded.


I do hope your dog improves soon.

Jo

[Trisha]

Diesel started with shifting lameness pale gums and lethargy. Soon after he had extrem swelling in his hocks.  We first tested for tick born illnesses and checked for RA. Results for those came back neg. his general blood work also came back good but a slightly lower red cell count. He also had a fever at the vet. We then had X-rays and joint taps after all test and I'm sure I have forgotten some we came to a diagnoses of systemic lupus Erythematosus. Diesel has been on meds for about 3 weeks and was doing very well at first with a lot of swelling going down and he was acting more like a normal puppy. Unfortunately this past week we have had a flare up. He now is back to limping on his front end and swelling has come back in his hocks as well as developing lupus ulcsers in his mouth. He also is dealing with a lot of muscle wastage as he has been dealing with this from about 5mo old.  We have talked to the vet and we most likely be upping his pred or adding something else in. Being a growing puppy it is going to take more ajusting to keep his levels balanced so we can at least have some remission time. I am so happy to have found a group where people know what Deisel and I are going through.  Jo may I ask how old was your dog at time of onset and how long did your dog live with SLE?

[Jo CIMDA]

Hi Trisha

Diesel's symptoms are very similar to my Ziggy's.  Like Diesel, Ziggy also had extreme body swelling, and oedema especially on his limbs.  This was probably due to systemic vasculitis.  He had so many systems wrong (in fact the consultant at the RVC said he had everything wrong) but the steroids did have good effect and he stabilised, but when the steroids were reduced the symptoms returned so they put him back on to the original steroid dose and added Azathioprine. 

The dose of prednisolone must be at least 1mg/kg/12hrs but puppies often need a higher dose.  This may be because their metabolism is perhaps a bit quicker. Puppies and smaller dogs cope much better that big dogs when they are on high doses of steroids. It is unfortunate Diesel is so young and you have no choice but to use steroids,  but they are a life saver and the only  drug that has immediate effect and will bring the disease into remission.   Introducing another drug at this stage will enable you to reduce the steroids and still maintain a good level of immunosuppression. 

Ziggy was 5 years old when he first became unwell and he lived for 4 years after diagnosis.  Unfortunately he developed pancreatitis and he didn't survive the acute onset. Ziggy was maintained on an every other day dose of steroids.  We were unable to wean him off steroids completely but he did have a good quality of life for those four years - and he didn't know he was ill!  He would relapse about every 9 months and I would increase the steroids for a couple of weeks and it would bring him back into remission. It was very manageable. 

It sounds as if this has been coming on for a couple of months and this is not unusual.  Very often a dog with SLE develops progressive clinical signs over a period of many weeks, and is pretty unwell before the blood results reflect the clinical signs, and this can make obtaining a diagnosis very difficult.  Well done to your vet for even thinking of SLE.  Please make sure Diesel is on the correct dose of prednisolone.  As his clinical signs are returning you don't really have any option but to increase the steroids.  Any additional drug will not kick in for at least 4-6 weeks so although it is a good move to introduce another drug you cannot take the effect of a new drug into consideration at this stage.

It is crucial to treat with the correct dose of steroids but it is also very important to monitor the side effects of the drugs.  Is Diesel on something to protect his stomach?  If he isn't then I think you should ask your vet to put him on a gastroprotectant as the steroids can cause stomach ulcers and he doesn't need complications.  Also try to keep him on a low fat diet to help the pancreas cope.

Fingers crossed you can stabilise him again very soon.

Jo