Introudction

[rainddobes]

Hi Everyone,

I have a girl with Lupus. She was diagnosed about 1.5 years ago after many different blood tests.
It is pretty much under control at this point, but it seems like can flair up at any give time.
I do think that Heartguard has set it off in the past and or the past year she does not get that med.
Her name is Neytiri and she is 4.5 years.
Her first system appeared about 1.5 years ago. She was running a low grade fever and one of her angles was very swollen... off to the vet thinking she broke her ankle...All kinds of meds and X-Rays (my regular Vet was off that day)
I knew she was in terrible pain. The swelling went down and she was back to herself.
About 1 year ago as I was getting the dobes up and out to potty and eat, Neytiri would not get up.
She was running a temp of 105 and her ankle was swollen again.   Off to the vet.  Lots of blood tests including a super chem, full panel Lyme. All were negative. My Vet said the only thing left was auto-immue test. It came back with elevated aga's Not sure if that is the correct name.
We started a Pred treatment and she was back to normal in about a week. She sometimes gets minor flair-ups just like that. The pred keeps it at bay.  I have no idea what the future holds for her and would love some information what to expect.

[Jo CIMDA]

Hi and welcome

I'm sorry Naytiri has an autoimmune disease.  If it is lupus (I presume systemic lupus) then you have done really well to have brought it under control.  You say the preds keep it at bay - do you reduce the dose down to a low maintenance dose, perhaps every other day dosing, after a flare up or is she on high doses every day?

It is impossible to predict what her future holds as individual dogs respond differently.  If you can keep her in remission without being on steroids or only on a low every other day dose then she may go on for many years and make old bones too, but if she is on a daily, significant dose of steroids then the steroids will start to have lasting side effects.  You have the option of introducing another immunosuppressive drug, such as Azathioprine, and this may allow you, after 3-4 weeks or so, to lower the pred dose.  This combination treatment regime would be better for her in the long term if she has to stay on daily preds.

Heartworm preventatives and any chemical, vaccine etc., all have the potential to trigger autoimmune disease in a genetically predisposed dog.  It is always best to keep a dog with an AI disease as natural as possible, limiting any chemicals or stress and feeding food that doesn't have preservatives etc.  There should be no need to annually vaccinate your dog.  It is likely if dogs are vaccinated as an adult they will be immune for life to many of these infectious diseases. The best advice is given on the WSAVA website, Vaccination Guidelines.   

It is very easy to pick on one thing, such as vaccination,  and blame it for something like autoimmune disease, but AI disease is more likely to be the result of inappropriate inbreeding of pedigree dogs for many previous decades. Vaccinations are more likely to play the role of 'trigger' factor.   The more dogs are bred to close family members (perhaps to achieve a particular type or characteristic or to establish a pedigree line of dog) the more chance the breeder has of the resulting pups not achieving a full quota of genes from both parents. If the mother and father have the same copy of a gene/s (which is likely if they are closely bred)  then the pup will only inherit one gene copy instead of the normal two (one from each parent). If those genes are involved in the control of health, or immune system of the dog, then the dog will be predisposed to developing an 'inherited' disease.  Once genes are lost, they are lost forever in that dog. It may be possible to replenish the gene pool by out crossing or using, for example, a working strain into the breeding programme.
 
When a dog is diagnosed with an AI disease you know that it has a genetic predisposition. Autoimmune disease cannot occur in an animal (or a human) who is not genetically predisposed.  Both parents will contribute to the inheritance, which means they are either carriers or 'genetically affecteds' that may, or may not yet, have developed an AI disease.

Siblings may or may not be affected.  Unfortunately, at this time, there are no DNA tests for AI disease and until a dog shows clinical signs there is no way of differentiating between those who have a 'predisposition' and those who are 'carriers' or 'clears'.  When a dog develops AI disease you know the status of both parents are 'carriers' at least.  Work has been done in this area and some scientists are continuing to collect data but identifying the numerous genes involved has proved to be more difficult than first thought.  A polygenic inheritance may amount to many, perhaps tens or hundreds of genes involved. 

I hope Neytiri continues to be well.

Jo

[polly]

Do you use monthy Heartguard  tablets or get an annual injection of anti-heartworm medication from the vet?
I have not immunised Jasper since his diagnosis with IMHA but I continue  to give him  anti-heartworm tablets every month because  I live in an area where mosquitos carry  heartworm.   I give the lowest dose possible. It hasn't triggered a relapse. 

It used to be possible to buy tablets which can be given daily. These would be a much lower dose and less of a shock to the system if you are worried  about another relapse.

I guess it depends too on whether you live in a mosquito prone area and whether  Naytri is outside a lot during times/seasons when  mozzies  are active. Actually I haven't encountered many mozzies this summer because my neighbour has one of those anti-insect lights switched on 24 hours a day.