Introduction
Two forms of lupus can occur in dogs: systemic lupus erythematosus (SLE) and discoid lupus erythematosus (DLE). If your dog is diagnosed with lupus, the treatment plan will depend upon which of these your dog has. The effects of and treatment protocols for each type of lupus are very different. However, they both are caused by an autoimmune disorder which essentially causes the dog’s body to attack itself.
Treating SLE
SLE cannot be cured. The goals of treating SLE are to resolve the clinical signs of the disease and prevent progressive renal or other organ failure. Because effects of the disease naturally wax and wane, not all cases need to be treated aggressively at all times.
Dogs suffering from severe, acute effects of SLE may need to be hospitalized for initial management, until the condition can be stabilized. A variety of drugs are available for use in acute cases, including corticosteroids to reduce inflammation and suppress the abnormal immune reaction, and non-steroidal anti-inflammatory medications, commonly called “NSAIDs.” NSAIDs and steroids normally are not given in combination because of the increased risk of gastrointestinal ulceration. Your veterinarian will decide upon the appropriate medical protocol for your pet.
In order to alleviate the dramatic and often painful effects of SLE, chronic treatment is designed to suppress the dog’s immune system (which is attacking itself). Often a combination of steroids and other immunosuppressant drugs is used to combat the effects of lupus. Supportive care, enforced rest and dietary restrictions may also be considered. In most cases, treatment (or more accurately, management) of SLE must be continued for life, although doses can be tapered if remission occurs.
Long-term immunosuppressive therapy has adverse side effects that must be taken into account when designing a treatment protocol for dogs with SLE. These include bone marrow suppression and increased risk of severe infection such as bronchopneumonia and urinary tract infections, among other things. Weight gain is also seen with steroid use. Unfortunately, use of immunosuppressive drugs is the only viable method for managing SLE. There is no surgical option. Regular physical examinations, urinalyses and blood tests should be conducted periodically on an outpatient basis to monitor the side effects of medication. Affected animals should not be bred. Given its unpredictable and progressive course, the prognosis for dogs with SLE is guarded to poor.
Treating DLE
Discoid lupus erythematosus also cannot be cured, but it is more manageable than the systemic form of the disease. The goal of treatment is to control and resolve the skin lesions. DLE is a variant of lupus that primarily affects a dog’s face, particularly the hairless areas of the nose. Treatment protocols can include oral antibiotics, topical ointments, oral vitamin E, oral essential fatty acid supplements and oral or topical steroids.
Clinical signs of SLE and DLE usually worsen with exposure to ultraviolet light. Accordingly, affected dogs should be kept out of the sun as much as possible. Owners can apply waterproof, high SPF sunscreen to affected areas as well.
As with SLE, dogs with DLE should be checked by a veterinarian regularly to assess progression of the disease and to monitor the success of treatment. Affected dogs should not be used for breeding. Unlike DLE, the prognosis for dogs with DLE is fairly good, since this disease is progressive but not life-threatening. Dogs with DLE often go into remission, making chronic immunosuppressive therapy less commonly used. Moreover, dogs with DLE usually feel fine, even though the condition can be disfiguring.