Rare diseases in the immune system
In spring of 2014, she again started to turn into the hairless donkey. Upon examination, I found that the donkey had hair loss with areas of ulceration and crusting over her entire body. The lesions extended onto her face, axillary, and groin regions. A skin biopsy was performed and the diagnosis of cutaneous lupus was made. This condition has only been rarely reported in the horse and never previously reported in a donkey. Thankfully, in comparison to systemic lupus erythematous which carries a grave prognosis, cutaneous lupus carries a generally good prognosis.
Cutaneous lupus is an autoimmune disease whereby the animals own immune system inappropriately attacks its’ own cells by producing autoantibodies and immune complexes that ultimately provoke an inflammatory response. This leads to damage and destruction of the normal tissue which in this case is the dermis or skin.
Once a diagnosis had been made, the next step was to institute therapy. Immune mediated diseases such as cutaneous lupus are treated with medications that minimize the body’s own “over reactive” immune response. Options for therapy in this case included both topical and oral corticosteroids or oral non-corticosteroid based immunosuppressive medications. There was significant concern for the possibility of inducing laminitis with oral corticosteroid therapy therefore it was not a viable treatment option. Instead, topical corticosteroid spray and oral Azathioprine therapy were instituted. Following approximately 4 months of therapy, the donkey has a beautiful coat.
In general, immune mediated diseases are relatively uncommon in the horse as compared to other species. However, there are some additional immune mediated diseases to be aware of.
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