8/6/2019 DVC PRESENTATN
1/43
8/6/2019 DVC PRESENTATN
2/43
yWhat is an autoimmune disease?
8/6/2019 DVC PRESENTATN
3/43
pathologypathology
CELL
Co ple e tpathway
Ag
Ab
Ag-Abcomplex
AB MEDIATED
CYTOTOXICITYCELL LYSIS
Ab ediatedreceptor bi di gofphagocytic cell
8/6/2019 DVC PRESENTATN
4/43
ETIOLOGYETIOLOGY
Infectious agents
Vaccines,drugs
Food & envmt
allergens etc
EXTFACTORS
Breed predispositionGENETICFACTORS
AU
T
O
I
M
MU
N
E
D
IS
E
A
S
E
S
8/6/2019 DVC PRESENTATN
5/43
8/6/2019 DVC PRESENTATN
6/43
AUTOIMMUNE HEMOLYTICAUTOIMMUNE HEMOLYTICANAEMIA (AIHA)ANAEMIA (AIHA)
&&
THROMBOCYTOPENIATHROMBOCYTOPENIA
8/6/2019 DVC PRESENTATN
7/43
8/6/2019 DVC PRESENTATN
8/43
8/6/2019 DVC PRESENTATN
9/43
PERACUTE ACUTE
y Middle aged, larger breeds
y Acute depression
y Variable icterus & Hburia
y Nonresp anaemia- become
resp in 3-5 daysy Thrombocytopenia &
thrombotic phenomena
y Prognosis poor even ith
prompt therapy
y
Cocker spanielsy Pallor , fatigue
y Icterus less common
y Hepatospleenomegaly
y WBC o due to BMhyperplasia
y Responds ell toglucocorticoids/cytotoxic
drugs
8/6/2019 DVC PRESENTATN
10/43
8/6/2019 DVC PRESENTATN
11/43
8/6/2019 DVC PRESENTATN
12/43
8/6/2019 DVC PRESENTATN
13/43
8/6/2019 DVC PRESENTATN
14/43
DIAGNOSISHematology
y
moderate to severeregenerative anemia
y anisocytosis
y
polychromasiay high reticulocyte count (> 120G/L)
y increased numbers of nucleated RBC
8/6/2019 DVC PRESENTATN
15/43
8/6/2019 DVC PRESENTATN
16/43
rouleaux spherocyte
o serum total bilirubin concentrationLeukocytosis ( ith neutrophilic left shift and toxic changes)
8/6/2019 DVC PRESENTATN
17/43
COOMBS TEST
(DAT)
8/6/2019 DVC PRESENTATN
18/43
TREATMENTSUPPORTIVE THERAPY
y Cage rest
y Blood transfusion- controversial!
y Aspirin- 0.5 mg/kg
8/6/2019 DVC PRESENTATN
19/43
INITIAL IMMUNOSUPPRESSIVE THERAPY
y Methylprednisolone:2-4 mg/kg od
follo ed by pred@ 1-2 mg/kg po bid fora minm of 7-10 days
y Weekly monitoring until anaemia resolves
y Tapered by 50% every 2 ks over a
3month pd
(hematocrit>30%,-ve DAT)
8/6/2019 DVC PRESENTATN
20/43
8/6/2019 DVC PRESENTATN
21/43
y OTHER TREATMENT
y doxycycline@10 mg/kg for 28 d in
endemic areas
8/6/2019 DVC PRESENTATN
22/43
MYASTHENIA GRAVISMYASTHENIA GRAVIS
8/6/2019 DVC PRESENTATN
23/43
y ACQUIRED MG
y 2-3 years of age or older than 9 years
y less common in intact male dogs
(possibly due to testosterone influence)
8/6/2019 DVC PRESENTATN
24/43
8/6/2019 DVC PRESENTATN
25/43
8/6/2019 DVC PRESENTATN
26/43
TREATMENT
y Oral long-acting ACh-Esterase Inhibitor:
Pyridostigmine bromide 1-3 mg/kg
Orally q 8-12 hrs.
available as MYESTIN 30mg,60mg tab
8/6/2019 DVC PRESENTATN
27/43
8/6/2019 DVC PRESENTATN
28/43
AUTOIMMUNE SKIN DISEASESAUTOIMMUNE SKIN DISEASES
8/6/2019 DVC PRESENTATN
29/43
8/6/2019 DVC PRESENTATN
30/43
PEMPHIGUS COMPLEXPEMPHIGUS COMPLEX
y Pemphigus foliaceous
y pemphigus vulgaris
y pemphigus vegetans
y Pemphigus erythematosis
8/6/2019 DVC PRESENTATN
31/43
8/6/2019 DVC PRESENTATN
32/43
8/6/2019 DVC PRESENTATN
33/43
8/6/2019 DVC PRESENTATN
34/43
DISCOID LUPUSDISCOID LUPUS
y benign form of SLE.
y Lesions are usually confined to the face
y depigmentation,
y erythema
y excess scale over the nasal region.
y ulceration
y UV light deteriorates the condition
y Breed predispositions-German shepherds
8/6/2019 DVC PRESENTATN
35/43
8/6/2019 DVC PRESENTATN
36/43
y Shifting lameness
y Polymyositis
y glomerulonephritis
8/6/2019 DVC PRESENTATN
37/43
8/6/2019 DVC PRESENTATN
38/43
TREATMENTTREATMENT
y Systemic glucocorticoids/topicalhydrocortisone sprays
(e.g. Cortavance)
y Azathiopriney Gold therapy (chrysotherapy)
y Cyclophosphamide
@2.2mg/kg/day poavailable as CYPHOS 200mg,500mg,1g vial
ENDOXAN-ASTA tab 50mg
8/6/2019 DVC PRESENTATN
39/43
8/6/2019 DVC PRESENTATN
40/43
8/6/2019 DVC PRESENTATN
41/43
CONCLUSIONCONCLUSION
y Goal
y
What e can do?
8/6/2019 DVC PRESENTATN
42/43
8/6/2019 DVC PRESENTATN
43/43
Top Related