DS
Uploaded byDr Abhijith S.P.
PPTX, PDF170 views

Canine Immune Mediated Diseases short lecture

The document discusses immune-mediated diseases in dogs and cats, highlighting how a malfunctioning immune system can inappropriately attack the body's own cells, leading to various disorders such as immune-mediated hemolytic anemia and immune-mediated thrombocytopenia. Treatment primarily involves immunosuppressive therapy to control the inappropriate immune response, though these treatments carry risks of infection. Clinical signs and diagnostic procedures are detailed along with prevalence among different animal species and specific breeds.

Embed presentation

Download to read offline
1 / 123
2 / 123
3 / 123
4 / 123
5 / 123
6 / 123
7 / 123
8 / 123
9 / 123
10 / 123
11 / 123
12 / 123
13 / 123
14 / 123
15 / 123
16 / 123
17 / 123
18 / 123
19 / 123
20 / 123
21 / 123
22 / 123
23 / 123
24 / 123
25 / 123
26 / 123
27 / 123
28 / 123
29 / 123
30 / 123
31 / 123
32 / 123
33 / 123
34 / 123
35 / 123
36 / 123
37 / 123
38 / 123
39 / 123
Most read
40 / 123
41 / 123
42 / 123
43 / 123
44 / 123
45 / 123
46 / 123
47 / 123
48 / 123
49 / 123
50 / 123
51 / 123
52 / 123
53 / 123
54 / 123
55 / 123
56 / 123
57 / 123
58 / 123
59 / 123
60 / 123
61 / 123
62 / 123
63 / 123
64 / 123
65 / 123
66 / 123
67 / 123
68 / 123
69 / 123
70 / 123
71 / 123
72 / 123
73 / 123
74 / 123
75 / 123
76 / 123
77 / 123
78 / 123
79 / 123
80 / 123
81 / 123
82 / 123
83 / 123
84 / 123
85 / 123
86 / 123
87 / 123
88 / 123
Most read
89 / 123
90 / 123
91 / 123
92 / 123
93 / 123
94 / 123
95 / 123
96 / 123
97 / 123
98 / 123
99 / 123
100 / 123
101 / 123
102 / 123
103 / 123
104 / 123
105 / 123
106 / 123
Most read
107 / 123
108 / 123
109 / 123
110 / 123
111 / 123
112 / 123
113 / 123
114 / 123
115 / 123
116 / 123
117 / 123
118 / 123
119 / 123
120 / 123
121 / 123
122 / 123
123 / 123
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) Immune Mediated Diseases (Canine & Feline) Abhijith S.P MVSc Scholar Department of Veterinary Medicine
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) INTRODUCTION • A strong and healthy immune system is necessary for combating many types of diseases and infections. • In healthy dogs and cats, the immune system is tasked with recognizing foreign cells like bacteria or fungi, and then destroying and/or removing them from the body. • There are diseases, however, in which the immune system responds inappropriately, and may begin attacking the animal’s own cells. • These conditions, as a group, are called immune-mediated disease.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) PATHOGENESIS Destruction of these vital cells can lead to dangerous anemia, cardiac arrhythmias, and clotting disorders. The body creates inflammation, but instead of directing the inflammation at a pathogen, it directs this inflammation towards the tissues of the body. The most common immune-mediated diseases in animals are those in which the immune system destroys circulating cells like red blood cells or platelets.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) MAIN IMMUNE MEDIATED DISEASE • Immune-mediated hemolytic anemia • Immune-mediated thrombocytopenia • Immune-mediated polyarthritis • Myasthenia gravis • Immune-mediated skin diseases • Keratoconjunctivitis Sicca • Glomerulonephritis • Immune mediated intestinal disease
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) IMMUNOSUPPRESSIVE THERAPY • To reduce and/or eliminate the inappropriate immune response. • Mostly, dogs and cats will remain on some kind of immune-suppressive therapy for 4-6 months. • Sometimes : therapy continues lifelong. • While these immune-suppressive medications are helpful for treating disease, they also pose their own risks. • Risk of other infection: HIGH. • Basically, immunosuppressants is the basic treatment protocol.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) BLOOD TRANSFUSION? • Immune-mediated diseases are not limited to the bloodstream. • There are diseases of many body systems that can develop an inappropriate immune response. • For the immune-mediated diseases that attack red blood cells, many dogs and cats will require a blood transfusion to help stabilize them.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) IMMUNE-MEDIATED HEMOLYTIC ANEMIA
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) 1.IMMUNE-MEDIATED HEMOLYTIC ANEMIA • Serious and life-threatening condition. • Formation of antibody against RBC Surface Antigen/ Direct Macrophage Clearance. • With careful treatment, up to 75% of dogs with IMHA can make a full recovery and go on to lead a normal life. • Most common immune-mediated hematologic disorders in dogs and cats • In dogs, IMHA is commonly primary or idiopathic in origin, but also occurs secondary to triggers, such as infectious, inflammatory, neoplastic diseases, drugs, vaccines, toxins. • In cats, the condition is usually secondary to an underlying cause. • New protocols have a much better chance of survival than previously.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) CLINICAL SIGNS Collapse Weakness Increased breathing rate Yellow or pale gums Red or black urine Hyporexia/vomiting
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) PAPERY WHITE ORAL MUCOSAL MEMBRANE
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) DIAGNOSIS There is no single test that is definitively diagnostic for IMHA.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) 1.HEMATOLOGY & SERUM BIOCHEMISTRY • “PCV” (Packed Cell Volume) which gives you a quick count red blood cells, reported as a percentage. • Normal level of PVC is between 35-55%, with anything less than 35% indicating that your dog is anemic. • Total Bilirubin • % Reticulocytes / RDW Value
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) 2.SALINE AGGLUTINATION TEST • It is used to determine whether red cell agglutinates are present in a blood sample. • When red cell agglutinates are present this indicates that Anaemia is due immune-mediated hemolysis. • A blood sample from a dog with IMHA. • Note that the blood is "agglutinating” or clumping together – this is a classic sign of IMHA. • Note that the plasma (liquid) in the blood is a yellow color, also commonly seen with IMHA.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) SALINE AGGLUTINATION TEST Examine the slide on 10x objective of your microscope or higher if needed. Place a coverslip on top of the saline. Mix the sample by rocking the slide backwards and forwards lengthways. Add 2 drops of EDTA Vial Blood Place a few drops of saline onto a glass slide.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) SALINE AGGLUTINATION TEST A positive agglutination test - sample on gross exam (left) and under the microscope (right)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) THERAPEUTIC APPROACH The cornerstone of treatment for IMHA is immunosuppressive therapy. Immunosuppression is usually accomplished with glucocorticoids, with the addition of a second immunosuppressive agent, if needed. Therapy consists of 2 phases: 1. Acute phase, with induction of remission 2. Chronic maintenance phase
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) GLUCOCORTICOID THERAPY • Glucocorticoids have multiple effects on the immune system, but the most important effect for IMHA patients is inhibition of macrophages within the mononuclear phagocytic system. • Response to glucocorticoids often takes between 3 and 7 days. Dexamethasone A dosage of 0.3 to 0.5 mg/kg IV Q 24 H is often administered in both cats and dogs. Prednisolone Dogs-1 to 2 mg/kg PO Q 12 H, Cats-4 mg/kg PO Q 24 H
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) Prednisone is a prodrug that is metabolized into prednisolone. When cats receive oral prednisolone, higher plasma concentrations of prednisolone are achieved compared with cats administered oral prednisone; therefore, prednisolone is preferred for use in cats.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) SECOND-LINE IMMUNOSUPPRESSIVE THERAPY • Criteria that should prompt consideration of additional immunosuppressive agents include: • Severe disease (intravascular hemolysis or transfusion dependency) • Marked autoagglutination
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) IMMUNE-MEDIATED THROMBOCYTOPAENIA
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) 2.IMMUNE-MEDIATED THROMBOCYTOPAENIA • Serious and life-threatening condition. • Immune disorder in which the platelet count falls below reference values, as the patient's immune system destroys them. • Common clinical disorder in which platelets are destroyed by antiplatelet specific antibodies in circulation or at the level of the bone marrow . • This can lead to excessive or spontaneous bleeding when platelet counts are less than 30 000 to 50 000/μL. • Antibodies (mainly IgG) bound to the surface of platelets result in their premature destruction by macrophages in the spleen and liver.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) Primary IMTP •Idiopathic IMTP
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) Secondary IMTP • Infectious diseases (ehrlichiosis, babesiosis, leishmaniasis, leptospirosis, dirofilariasis, FIV, FIP, and other viral or bacterial infections such as cystitis, prostatitis) • Neoplasia ( lymphoma, hemangiosarcoma, mammary tumors) • Drugs ( Sulfonamides, vaccines, cephalosporins, phenobarbital) • Blood transfusions
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) CLINICAL SIGNS Bleeding disorders Hepatitis Neurological signs Internal Hematomas
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) CLINICAL SIGNS Petechia Hemorrhage CMM/OMM Pallor Anemia GI Bleeding
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) GLUCOCORTICOID THERAPY • Glucocorticoids have multiple effects on the immune system, but the most important effect for IMHA patients is inhibition of macrophages within the mononuclear phagocytic system. • Response to glucocorticoids often takes between 3 and 7 days. Dexamethasone A dosage of 0.3 to 0.5 mg/kg IV Q 24 H is often administered in both cats and dogs. Prednisolone Dogs-1 to 2 mg/kg PO Q 12 H, Cats-4 mg/kg PO Q 24 H
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) • Romiplostim is a thrombopoietin receptor agonist that activates intracellular transcriptional pathways via c-Mpl to increase production of platelets. • It also works similarly to thrombopoietin (TPO), an endogenous glycoprotein hormone that regulates the production of platelets in the bone marrow.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) The extract of papaya leaves has been shown to increase ALOX12 (arachidonate 12- lipoxygenase or platelet type lipoxygenase) by 15 times. This enzyme promotes platelet production via the increased number and differentiation of megakaryocytes.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) IMMUNE-MEDIATED POLY ARTHRITIS
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) INTRODUCTION • Immune-mediated polyarthritis (IMPA) is a disease in which the immune system mounts an inflammatory response within the joints causing pain, swelling and difficulty walking. • MPA is seen more commonly in dogs than cats, but can occur in both species. • Because the white blood cells are attacking the joints inappropriately, IMPA is referred to as an auto-immune disease. • Rheumatoid arthritis is a form of IMPA in people.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) CLINICAL SIGNS Reluctance to move Severe joint pain Odematous joints Pyrexia
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) CLINICAL SIGNS Lethargy Shifting lameness Joint effusions Joint Fibrosis
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) DIAGNOSIS Joint Tap Fluid Cytology Arthroscopy Pedigree Chart Radiography
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) GENERAL DIAGNOSTIC ALGORITHM
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) TREATMENT PREDNISOLONE PHYSIOTHERAPY
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) MYASTHENIA GRAVIS
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) INTRODUCTION • Myasthenia gravis is a disease in which there is a malfunction in the transmission of signals between the nerves and muscles. • Dogs with myasthenia gravis exhibit extreme weakness and excessive fatigue. • Some breeds are predisposed to an inherited/congenital form of this disease, including Jack Russell Terriers, English Springer Spaniels, Smooth Fox Terriers, and Smooth-haired Miniature Dachshunds. • "Most cases are acquired, not inherited."
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) CLINICAL SIGNS Voice changes Exercise Intolerance Inability to close the eyes Excessive drooling Difficulty breathing Cramping with mild exercise
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) DIAGNOSIS 1.Edrophonium Test 2.Ice Pack Test 3.Imaging Test 4.Nerve Simulus Test 5.Pulmononary Test
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) TREATMENT • Class of medication that inhibits a nervous system enzyme called acetylcholinesterase (Anti-acetylcholinesterase). • Because of their compromised ability to swallow, some dogs will actually inhale food, liquid, or vomit, resulting in aspiration pneumonia. • Aspiration pneumonia is extremely serious and often requires aggressive intensive care including oxygen therapy, antibiotics, IV fluid therapy, and supportive care. • If the dog is unable to eat or drink without regurgitation, a feeding tube may be advised.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) ASSOCIATED DISEASES MEGAESOPHAGUS PARALYTIC ILEUS MEGACOLON
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) IMMUNE MEDIATED SKIN DISEASES
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) MAIN DISEASES PEMPHIGUS COMPLEX SYSTEMIC LUPUS ERYTHEMATOSES DISCOID LUPUS ERYTHEMATOSES BULLOUS PEMPHIGOID
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) PEMPHIGUS COMPLEX • Pemphigus is a group of five autoimmune skin diseases characterized by vesicles and bullae (large and small "blisters") in the mouth and at mucocutaneous junctions (the junction between skin and mucosal tissues). • Commonly affected areas include the eyelids, lips, nostrils, and anus.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) Pemphigus Foliaceus (PF) • "leaf-like pemphigus" • Most common • Pemphigus foliaceus is rarely found in the mouth or at mucocutaneous junctions. • In this form of pemphigus, the patient develops crusts (scabs) and ulcers around the eyes, ears, footpads, groin and bridge of the nose. • Chow chow, akita, cocker spaniel, Labrador retriever, dachshund, English bulldog, Finnish spitz, and schipperke. • Pemphigus foliaceus usually appears suddenly without a recognized cause.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) LESION DISTRIBUTION
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) Pemphigus vulgaris (PV) • The term means "common pemphigus" and it is the most frequent form of pemphigus in humans. • Fluid filled blisters called "vesicles" form in and around the mouth, eyelids, lips, nostrils, anus, prepuce or vulva. • These vesicles rupture easily, creating painful ulcers. • This condition is rare in dogs.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) Clinical characteristics of feline pemphigus vulgaris. a-d, f, g: generalized, usually bilaterally symmetrical erosive and ulcerative dermatitis; e: erosive glossitis – a-to-g were taken from the same Siamese cat
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) Pemphigus erythematosus (PE) • The term means "red and inflamed pemphigus" and its most common symptom is redness, crusting, scales and hair loss on the nose. • Exposure to ultraviolet light worsens this form of pemphigus. • Breed predispositions include the German shepherd dog, collie, and Shetland sheepdog.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) Pemphigus vegetans(PV) • This form is typified by thick and irregular vegetative lesions or lumps associated with chronic "oozing" and pustules. • It is believed to be a more benign form of pemphigus vulgaris. • This condition is rare in dogs.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) Paraneoplastic pemphigus (PNP) • The least common (considered extremely rare) • most severe type of pemphigus. • This condition is associated with the presence of an underlying malignant tumor.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) SYSTEMIC LUPUS ERYTHEMATOSES • Commonly referred to as lupus. • Lupus is often called the "great imitator" because it can mimic almost any other disease state. • The signs of SLE may be acute (sudden onset) or chronic, and usually they wax and wane. • A fluctuating fever that does not respond to antibiotics is one of the classic clinical signs of SLE. • Stiffness in the legs or shifting-leg lameness. • Blood abnormalities such as hemolytic anemia, thrombocytopenia (low platelet numbers), leukopenia (a low white blood count), and symmetrical dermatitis, especially over the bridge of the nose (often called a "butterfly lesion"). • Common in dogs and rare in cats. • Nova Scotia duck tolling retriever, Shetland sheepdog, collie, German shepherd dog
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) DISCOID LUPUS ERYTHEMATOSES • Seen in dogs and rarely in cats. • Common name for this condition is "Collie nose," although it can appear in many breeds. • DLE is seen more commonly in Collies, Shetland sheep dogs, German shepherds, and Siberian huskies. • Exposure to sunlight and UV radiation is thought to be a potential cause or trigger. • In most cases, affected dogs lose the pigmentation around the nose, although the skin around the lips, eyes, ears and genitals may be also affected. • DLE can transform the surface of the nose from its normal "cobblestone" texture to smooth, flat and shiny. Ulcerated sores may occur. • Less-serious type of systemic lupus erythematosus (SLE). • It is considered a relatively benign autoimmune skin disease.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) BULLOUS PEMPHIGOID • May sound like a form of pemphigus, but it is actually a different type of autoimmune skin disease. • Bullous is the medical term for a large thin-walled sac filled with clear fluid. • Usually, the skin is very itchy and large red welts and hives often appear before or during the formation of blisters. • Vesicles and ulcers may be found in the mouth, at mucocutaneous junctions, and in the axillae (armpits) and groin. • Evaluation of the vesicles is critical to the diagnosis. • Because vesicles rupture quickly after formation, the dog must often be hospitalized and examined every two hours until adequate biopsies can be obtained. • Bullous pemphigoid resolves spontaneously in many cases. • It is considered rare in dogs and cats.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) B M C
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) KERATOCONJUNCTIVITIS SICCA
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) INTRODUCTION • Keratoconjunctivitis sicca (KCS) is a frequent canine ophthalmic disease. • Dry eye syndrome, is a chronic ophthalmic disease resulting from deficiency of one or more elements in the precorneal tear film. • Inflammatory condition of the ocular surface caused by a pathologic reduction in the aqueous component of the tear film. • Aetiology: congenital, metabolic, infectious, drug induced, neurogenic, radiation, iatrogenic, idiopathic, and immune mediated. • Immune mediated: It is a widely primarily accepted cause of KCS. • It is generally bilateral • Confirmation: Tear Gland Histopathology
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) CLINICAL SIGNS Mucopurule nt discharge Conjunctiviti s Blepharospa sm
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) CLINICAL SIGNS Dry Cornea Ulcerative Keratitis Corneal Pigmentati on
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) SHIRMER TEAR TEST
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) SURGICAL CORRECTION Parotid duct transpositi on Punctal occlusion Permanen t partial tarsorrhap hy
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) MEDICAL MANAGEMENT
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) A BETTER RESEARCH TOPIC
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) GLOMERULONEPHRITIS
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) INTRODUCTION • Inflammation of the glomerulus. • Occurs when immune complexes are filtered out of the bloodstream and become trapped within the glomeruli. • When these compounds are trapped, the body responds by activating its immune defenses, resulting in further damage to the glomeruli.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) INTRODUCTION TYPE III REACTION IMMUNE COMPLEX MEDIATED
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) DIAGNOSIS HEMATOLOGY SEROLOGY ULTRASOUND SCANNING RENAL BIOPSY RADIOGRAPHY URINALYSIS
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) MANAGEMENT • 1.Treat Underlying Cause • 2.Extensive Fluid Therapy (if anuric????) • 3.Mild Immunosuppression • 4.Repeated Hematology & Serology Estimation.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) NOTES! • Leakage of plasma proteins, principally albumin, across the damaged glomerular capillary walls results in persistent proteinuria--the clinicopathological hallmark of glomerulonephritis. • Persistent proteinuria is associated with progressive glomerular and tubulointerstitial lesions and loss of additional nephrons • In cases of idiopathic glomerulonephritis, angiotensin-converting enzyme inhibitors have been shown to decrease proteinuria and potentially slow disease progression.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) IMMUNE MEDIATED INTESTINAL DISEASE
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) INTRODUCTION • Mammalian gastrointestinal tract is colonized by a large number of microorganisms, known as gut microbiota, that play a key role in the physiological and pathological states. • In particular, the gastrointestinal tract of dogs and cats harbors a complex and highly biodiverse microbial ecosystem. • Due to beneficial effects-GUT MICROBIOTA-”ORGAN”. • The immune system produces Ab against the beneficial organism resulting in CHRONIC ENTEROPATHY. • Idiopathic Inflammatory Bowel Diseases (IBD). • Lymphocytic- plasmacytic enteritis (LPE) is considered to be the most common form of IBD in dogs and, particularly, in cats.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) ROLE OF GUT MICROBIOTA • Digestion • Host metabolism • Vitamins synthesis (vit. K and complex B) • Biotransformation of bile acids • Xenobiotics metabolism • Correct maturation of gastrointestinal cells • Défense against pathogenic bacteria • Transformation of primary bile acids • Framing of Gut Immune System
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) CAUSES 1.Idiopat hic 2.Genetic 3.Drug Associate d 4.Toxin Associate d 5.Food Associate d
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) CAUSES Dysfunction of gut-associated lymph tissue Nutritional imbalance Dietary Imbalance Over Vaccination Modern Life style
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) DIAGNOSIS HEMATOLOGY RADIO- GRAPHY HP FAECAL SAMPLING ENDOSCOPIC FNAC
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) FIGURE 5. Endoscopic images of dogs with IBD consistent with (A)increased small intestinal friability (B) increased small intestinal granularity (C) intestinal mucosal erosions (D) Endoscopic image showing the advancement of biopsy forceps to obtain partial-thickness biopsy samples in a dog with inflamed GI mucosa and IBD.
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) TREATMENT MANAGEMENT
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine)
Dr Abhijith S.P. (M.V.Sc Veterinary Medicine) THANK YOU

More Related Content

PPTX
Canine Distemper
byGanes Adhikari
 
PDF
Canine babesiosis Dr.Jibachha Sah,M.V.Sc ,Lecturer NPI
byDr. Jibachha Sah
 
PPTX
Infectious Canine Hepatitis
byDr Abhijith S.P.
 
PPTX
FRACTURE PPT.pptx
byRekha Pathak
 
PPTX
Diseases of Mammry gland/udder.
byAmin Mirza
 
PPTX
Estrus cycle of bitch
byDr. Muhammad Awais
 
PPTX
Ascites in domestic animals
byDr. Prabhu kumar
 
PPTX
Impaction
byahmed esmail
 
Canine Distemper
byGanes Adhikari
 
Canine babesiosis Dr.Jibachha Sah,M.V.Sc ,Lecturer NPI
byDr. Jibachha Sah
 
Infectious Canine Hepatitis
byDr Abhijith S.P.
 
FRACTURE PPT.pptx
byRekha Pathak
 
Diseases of Mammry gland/udder.
byAmin Mirza
 
Estrus cycle of bitch
byDr. Muhammad Awais
 
Ascites in domestic animals
byDr. Prabhu kumar
 
Impaction
byahmed esmail
 

What's hot

PPTX
Blood transfusion in animals
byObli Rajendran VinodhKumar, ICAR- Indian Veterinary Research Institute, Bareilly
 
PPSX
Common blood parasites in dogs
byDr.ABHISHEK KALUNDIA
 
PPT
Calf diarrhoea
byDr Vinod Gupta
 
PPT
Diabetes mellitus in Dogs.
byRaaz Eve Mishra
 
PPTX
Pregnancy toxemia pptx
byL.A. Mir
 
PPTX
Navel ill and joint ill.pptx
byHajee Mohammad Danesh Science and Technology University, Dinajpur-5200,Bangladesh
 
PPTX
Canine distemper
byDr Abhijith S.P.
 
PPTX
Feline panleukopenia by Dr Nadir Khosa
byNadir Hussain
 
PPTX
Lumpy skin disease
byveterinary worlds
 
PPTX
Blue tongue in India
byBhoj Raj Singh
 
PPTX
Blue tongue
byRanjini Manuel
 
PDF
Lumpy skin disease
byhamed attia
 
PDF
Azoturia- Paralytic myoglobinuria-
byDr-Mohamed Ghanem
 
PDF
Cesarean section in Bovines
byDrDushyant Yadav
 
PPTX
Footrot
bymuna tawfeeq
 
PPTX
Peste des Petits Ruminants ( PPR ) in Goat
byAhmed Rafique
 
PPTX
Management of dystocia in bovines
byBharat Regmi
 
PPTX
Equine strangles
byChristina Garloff
 
PPTX
Atresia ani complication in calf
byRubiat Ferdous
 
PPTX
Diseases of skin - Veterinary Dermatology
byAjith Y
 
Blood transfusion in animals
byObli Rajendran VinodhKumar, ICAR- Indian Veterinary Research Institute, Bareilly
 
Common blood parasites in dogs
byDr.ABHISHEK KALUNDIA
 
Calf diarrhoea
byDr Vinod Gupta
 
Diabetes mellitus in Dogs.
byRaaz Eve Mishra
 
Pregnancy toxemia pptx
byL.A. Mir
 
Navel ill and joint ill.pptx
byHajee Mohammad Danesh Science and Technology University, Dinajpur-5200,Bangladesh
 
Canine distemper
byDr Abhijith S.P.
 
Feline panleukopenia by Dr Nadir Khosa
byNadir Hussain
 
Lumpy skin disease
byveterinary worlds
 
Blue tongue in India
byBhoj Raj Singh
 
Blue tongue
byRanjini Manuel
 
Lumpy skin disease
byhamed attia
 
Azoturia- Paralytic myoglobinuria-
byDr-Mohamed Ghanem
 
Cesarean section in Bovines
byDrDushyant Yadav
 
Footrot
bymuna tawfeeq
 
Peste des Petits Ruminants ( PPR ) in Goat
byAhmed Rafique
 
Management of dystocia in bovines
byBharat Regmi
 
Equine strangles
byChristina Garloff
 
Atresia ani complication in calf
byRubiat Ferdous
 
Diseases of skin - Veterinary Dermatology
byAjith Y
 

Similar to Canine Immune Mediated Diseases short lecture

PPTX
Immune mediated haemolytic anemia in dogs
byRaaz Eve Mishra
 
PDF
Canine ehrlichiosis - Dr. Jibachha Sah,M.V.Sc,Lecturer
byDr. Jibachha Sah
 
PPTX
Blood transfusion & its complication in dogs.pptx
byarmanbinshahid
 
PPTX
Canine ehrlichiosis
byDr. Ram Chander Tiwari
 
PPTX
Ich by dr rashmi singh
byshailendrasingh598
 
PPTX
Blood transfusion in Dogs &Cats by Dr.Mahdi Falsafi
byMahdi Falsafi
 
PPT
ANTI-ANEMIC DRUGS IN VETERINARY PRACTICE
byDr. Sindhu K., Asst. Prof., Dept. of VPT, VCG.
 
PPTX
Anemia and its types in Veterinary Medicine.pptx
byDrDesh
 
PPTX
Myasthenia Gravis in Golden Retriever
bySushan Dhakal
 
PDF
Ehrlichiosis based presentation in dog and cat.pdf
byDrGopalSamanta1
 
PDF
BSAVA_-_Hematology.pdf
bymeliandrade4
 
PPTX
Reproductive system.pptx
byradhika145263
 
PPTX
IMHA and ITP
byivsdsm
 
PDF
Canine anemia VETERINARY DOCTORS AND PET OWNERS.pdf
byTatendaMageja
 
PDF
Evaluation of immunosuppressive ahai.pdf
byleroleroero1
 
PPTX
Grand Rounds Presentation
byGlynn Woods
 
PPT
Practical hematology transfusion
byOther Mother
 
PPT
Neuromuscular diseases in animals
byDrNKvpt
 
PDF
Clopidrogel en AHAI en caninos.pdf
byleroleroero1
 
PPT
Transfusion OF blood in anemic animals
byYASMEEN AHMED
 
Immune mediated haemolytic anemia in dogs
byRaaz Eve Mishra
 
Canine ehrlichiosis - Dr. Jibachha Sah,M.V.Sc,Lecturer
byDr. Jibachha Sah
 
Blood transfusion & its complication in dogs.pptx
byarmanbinshahid
 
Canine ehrlichiosis
byDr. Ram Chander Tiwari
 
Ich by dr rashmi singh
byshailendrasingh598
 
Blood transfusion in Dogs &Cats by Dr.Mahdi Falsafi
byMahdi Falsafi
 
ANTI-ANEMIC DRUGS IN VETERINARY PRACTICE
byDr. Sindhu K., Asst. Prof., Dept. of VPT, VCG.
 
Anemia and its types in Veterinary Medicine.pptx
byDrDesh
 
Myasthenia Gravis in Golden Retriever
bySushan Dhakal
 
Ehrlichiosis based presentation in dog and cat.pdf
byDrGopalSamanta1
 
BSAVA_-_Hematology.pdf
bymeliandrade4
 
Reproductive system.pptx
byradhika145263
 
IMHA and ITP
byivsdsm
 
Canine anemia VETERINARY DOCTORS AND PET OWNERS.pdf
byTatendaMageja
 
Evaluation of immunosuppressive ahai.pdf
byleroleroero1
 
Grand Rounds Presentation
byGlynn Woods
 
Practical hematology transfusion
byOther Mother
 
Neuromuscular diseases in animals
byDrNKvpt
 
Clopidrogel en AHAI en caninos.pdf
byleroleroero1
 
Transfusion OF blood in anemic animals
byYASMEEN AHMED
 

More from Dr Abhijith S.P.

PPTX
Babesiosis in Canine and Feline and Bovine patients .pptx
byDr Abhijith S.P.
 
PDF
Mega Oesophagus canine gastrointestinal tract disease and conditions.pdf
byDr Abhijith S.P.
 
PPTX
Glanders
byDr Abhijith S.P.
 
PPTX
Listeriosis
byDr Abhijith S.P.
 
PPTX
Kyasanur Forest Disease in animals and humans .pptx
byDr Abhijith S.P.
 
PPTX
Leptospirosis
byDr Abhijith S.P.
 
PPTX
Bovine Theileriosis The Haemoprotoan Disease.pptx
byDr Abhijith S.P.
 
PPTX
Rabies
byDr Abhijith S.P.
 
PPTX
HA&HI is the agglutination reaction in immunology
byDr Abhijith S.P.
 
PPTX
Rose bengal plate test
byDr Abhijith S.P.
 
PPTX
Mallein test
byDr Abhijith S.P.
 
PPTX
Bovine Mastitis mechanism pathogenesis prevention care and treatment and clas...
byDr Abhijith S.P.
 
PPTX
Amitraz Poisoning in animals due to regular usage.pptx
byDr Abhijith S.P.
 
PPTX
Ivermection Mechanism of action
byDr Abhijith S.P.
 
PPTX
BRACHYCEPHALIC OBSTRUCTIVE AIRWAY S.pptx
byDr Abhijith S.P.
 
PPTX
Mc fadyean reaction
byDr Abhijith S.P.
 
PPTX
Diabetes Mellitus leads to Cataract.pptx
byDr Abhijith S.P.
 
PPT
Mastitis The Most Common Large Animal Disease.ppt
byDr Abhijith S.P.
 
PPTX
Mao ; mao inhibitors
byDr Abhijith S.P.
 
PPTX
Genesis of Cabot Rings in Blood Abnormalities.pptx
byDr Abhijith S.P.
 
Babesiosis in Canine and Feline and Bovine patients .pptx
byDr Abhijith S.P.
 
Mega Oesophagus canine gastrointestinal tract disease and conditions.pdf
byDr Abhijith S.P.
 
Glanders
byDr Abhijith S.P.
 
Listeriosis
byDr Abhijith S.P.
 
Kyasanur Forest Disease in animals and humans .pptx
byDr Abhijith S.P.
 
Leptospirosis
byDr Abhijith S.P.
 
Bovine Theileriosis The Haemoprotoan Disease.pptx
byDr Abhijith S.P.
 
Rabies
byDr Abhijith S.P.
 
HA&HI is the agglutination reaction in immunology
byDr Abhijith S.P.
 
Rose bengal plate test
byDr Abhijith S.P.
 
Mallein test
byDr Abhijith S.P.
 
Bovine Mastitis mechanism pathogenesis prevention care and treatment and clas...
byDr Abhijith S.P.
 
Amitraz Poisoning in animals due to regular usage.pptx
byDr Abhijith S.P.
 
Ivermection Mechanism of action
byDr Abhijith S.P.
 
BRACHYCEPHALIC OBSTRUCTIVE AIRWAY S.pptx
byDr Abhijith S.P.
 
Mc fadyean reaction
byDr Abhijith S.P.
 
Diabetes Mellitus leads to Cataract.pptx
byDr Abhijith S.P.
 
Mastitis The Most Common Large Animal Disease.ppt
byDr Abhijith S.P.
 
Mao ; mao inhibitors
byDr Abhijith S.P.
 
Genesis of Cabot Rings in Blood Abnormalities.pptx
byDr Abhijith S.P.
 

Recently uploaded

PPTX
Endotoxin Testing Using LAL: Practical GMP Approach
byshawkyabdo1
 
PPTX
Disease, Spectrum of disease, Iceberg phenomenon of disease
byBindu Nepal
 
PPTX
MICROSPORIDIAL KERATITIS , CLINICAL FEATURES , TREATMENT
byDr Aarushi Choudhary
 
PPTX
HSV KERATITIS . CLINICAL FEATURES , TYPES , DIAGNOSIS , TREATMENT , HEDS TRIAL
byDr Aarushi Choudhary
 
PPTX
Seminar on Ebola virus , سیمینارێکی ئامادەکراو لەسەر Ebola virus
bydanaShalal2
 
PDF
Dyes/ Stain Used In Ophthalmology - Clinical uses, Indication & Side effects....
bySamikshaRai22
 
PPTX
Imaging of benign focal lesions of the Liver
byDr. Aryan (Anish Dhakal)
 
PDF
Regal Best Kidney Multispecialty Hospital
bysekhardigitalmarketi
 
PDF
Food Safety دبلومة دحاتم البيطار 01005684344.pdf
byد حاتم البيطار
 
PPTX
Unit- II (Bioavaliability & Bioequivalence).pptx
byUditiHanda
 
PPTX
IMMUNITY ppt.pptx by Dr. Rakesh Prasad Sah
byDr. Rakesh Prasad Sah
 
PPTX
Chronic Viral Hepatitis HEP B HEP C HEP D
byNAWEEN KUMAR
 
PPTX
Transport of Oxygen& CO2.pptx by dr ambareesha
byDr K Ambareesha Goud PhD
 
PPTX
EYELID TUMOURS . CLINICAL FEATURES . DIAGNOSIS . SURGICAL MANAGEMENT
byDr Aarushi Choudhary
 
PDF
स्वास्थ्यकर्मी_पारिश्रमिक_तथा_सेवा_सुविधा_प्रतिवेदन_२०८२
byPublic Health Concern Nepal
 
PPTX
Pressure ulcer Internal KPIs results for July,2024.pptx
byprofyasser95
 
PPTX
Structural Elucidation of Squalene of AMC
bySumitSharma743530
 
PPTX
Mental Health Awareness Campaign 2025 PPT.PPTX
byBirendra Bhatt
 
PPT
Forging New Paths With Earlier Use of ADCs in Breast Cancer: From Clinical Br...
byPVI, PeerView Institute for Medical Education
 
PPTX
Basic overview and structural elucidation of Morphine
bySumitSharma743530
 
Endotoxin Testing Using LAL: Practical GMP Approach
byshawkyabdo1
 
Disease, Spectrum of disease, Iceberg phenomenon of disease
byBindu Nepal
 
MICROSPORIDIAL KERATITIS , CLINICAL FEATURES , TREATMENT
byDr Aarushi Choudhary
 
HSV KERATITIS . CLINICAL FEATURES , TYPES , DIAGNOSIS , TREATMENT , HEDS TRIAL
byDr Aarushi Choudhary
 
Seminar on Ebola virus , سیمینارێکی ئامادەکراو لەسەر Ebola virus
bydanaShalal2
 
Dyes/ Stain Used In Ophthalmology - Clinical uses, Indication & Side effects....
bySamikshaRai22
 
Imaging of benign focal lesions of the Liver
byDr. Aryan (Anish Dhakal)
 
Regal Best Kidney Multispecialty Hospital
bysekhardigitalmarketi
 
Food Safety دبلومة دحاتم البيطار 01005684344.pdf
byد حاتم البيطار
 
Unit- II (Bioavaliability & Bioequivalence).pptx
byUditiHanda
 
IMMUNITY ppt.pptx by Dr. Rakesh Prasad Sah
byDr. Rakesh Prasad Sah
 
Chronic Viral Hepatitis HEP B HEP C HEP D
byNAWEEN KUMAR
 
Transport of Oxygen& CO2.pptx by dr ambareesha
byDr K Ambareesha Goud PhD
 
EYELID TUMOURS . CLINICAL FEATURES . DIAGNOSIS . SURGICAL MANAGEMENT
byDr Aarushi Choudhary
 
स्वास्थ्यकर्मी_पारिश्रमिक_तथा_सेवा_सुविधा_प्रतिवेदन_२०८२
byPublic Health Concern Nepal
 
Pressure ulcer Internal KPIs results for July,2024.pptx
byprofyasser95
 
Structural Elucidation of Squalene of AMC
bySumitSharma743530
 
Mental Health Awareness Campaign 2025 PPT.PPTX
byBirendra Bhatt
 
Forging New Paths With Earlier Use of ADCs in Breast Cancer: From Clinical Br...
byPVI, PeerView Institute for Medical Education
 
Basic overview and structural elucidation of Morphine
bySumitSharma743530
 

Canine Immune Mediated Diseases short lecture

  • 1.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) Immune Mediated Diseases (Canine & Feline) Abhijith S.P MVSc Scholar Department of Veterinary Medicine
  • 2.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) INTRODUCTION • A strong and healthy immune system is necessary for combating many types of diseases and infections. • In healthy dogs and cats, the immune system is tasked with recognizing foreign cells like bacteria or fungi, and then destroying and/or removing them from the body. • There are diseases, however, in which the immune system responds inappropriately, and may begin attacking the animal’s own cells. • These conditions, as a group, are called immune-mediated disease.
  • 3.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) PATHOGENESIS Destruction of these vital cells can lead to dangerous anemia, cardiac arrhythmias, and clotting disorders. The body creates inflammation, but instead of directing the inflammation at a pathogen, it directs this inflammation towards the tissues of the body. The most common immune-mediated diseases in animals are those in which the immune system destroys circulating cells like red blood cells or platelets.
  • 4.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) MAIN IMMUNE MEDIATED DISEASE • Immune-mediated hemolytic anemia • Immune-mediated thrombocytopenia • Immune-mediated polyarthritis • Myasthenia gravis • Immune-mediated skin diseases • Keratoconjunctivitis Sicca • Glomerulonephritis • Immune mediated intestinal disease
  • 5.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) IMMUNOSUPPRESSIVE THERAPY • To reduce and/or eliminate the inappropriate immune response. • Mostly, dogs and cats will remain on some kind of immune-suppressive therapy for 4-6 months. • Sometimes : therapy continues lifelong. • While these immune-suppressive medications are helpful for treating disease, they also pose their own risks. • Risk of other infection: HIGH. • Basically, immunosuppressants is the basic treatment protocol.
  • 6.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) BLOOD TRANSFUSION? • Immune-mediated diseases are not limited to the bloodstream. • There are diseases of many body systems that can develop an inappropriate immune response. • For the immune-mediated diseases that attack red blood cells, many dogs and cats will require a blood transfusion to help stabilize them.
  • 7.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 8.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 9.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) IMMUNE-MEDIATED HEMOLYTIC ANEMIA
  • 10.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) 1.IMMUNE-MEDIATED HEMOLYTIC ANEMIA • Serious and life-threatening condition. • Formation of antibody against RBC Surface Antigen/ Direct Macrophage Clearance. • With careful treatment, up to 75% of dogs with IMHA can make a full recovery and go on to lead a normal life. • Most common immune-mediated hematologic disorders in dogs and cats • In dogs, IMHA is commonly primary or idiopathic in origin, but also occurs secondary to triggers, such as infectious, inflammatory, neoplastic diseases, drugs, vaccines, toxins. • In cats, the condition is usually secondary to an underlying cause. • New protocols have a much better chance of survival than previously.
  • 11.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) CLINICAL SIGNS Collapse Weakness Increased breathing rate Yellow or pale gums Red or black urine Hyporexia/vomiting
  • 12.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 13.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) PAPERY WHITE ORAL MUCOSAL MEMBRANE
  • 14.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 15.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 16.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 17.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 18.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 19.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) DIAGNOSIS There is no single test that is definitively diagnostic for IMHA.
  • 20.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) 1.HEMATOLOGY & SERUM BIOCHEMISTRY • “PCV” (Packed Cell Volume) which gives you a quick count red blood cells, reported as a percentage. • Normal level of PVC is between 35-55%, with anything less than 35% indicating that your dog is anemic. • Total Bilirubin • % Reticulocytes / RDW Value
  • 21.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) 2.SALINE AGGLUTINATION TEST • It is used to determine whether red cell agglutinates are present in a blood sample. • When red cell agglutinates are present this indicates that Anaemia is due immune-mediated hemolysis. • A blood sample from a dog with IMHA. • Note that the blood is "agglutinating” or clumping together – this is a classic sign of IMHA. • Note that the plasma (liquid) in the blood is a yellow color, also commonly seen with IMHA.
  • 22.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) SALINE AGGLUTINATION TEST Examine the slide on 10x objective of your microscope or higher if needed. Place a coverslip on top of the saline. Mix the sample by rocking the slide backwards and forwards lengthways. Add 2 drops of EDTA Vial Blood Place a few drops of saline onto a glass slide.
  • 23.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) SALINE AGGLUTINATION TEST A positive agglutination test - sample on gross exam (left) and under the microscope (right)
  • 24.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 25.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 26.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 27.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) THERAPEUTIC APPROACH The cornerstone of treatment for IMHA is immunosuppressive therapy. Immunosuppression is usually accomplished with glucocorticoids, with the addition of a second immunosuppressive agent, if needed. Therapy consists of 2 phases: 1. Acute phase, with induction of remission 2. Chronic maintenance phase
  • 28.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) GLUCOCORTICOID THERAPY • Glucocorticoids have multiple effects on the immune system, but the most important effect for IMHA patients is inhibition of macrophages within the mononuclear phagocytic system. • Response to glucocorticoids often takes between 3 and 7 days. Dexamethasone A dosage of 0.3 to 0.5 mg/kg IV Q 24 H is often administered in both cats and dogs. Prednisolone Dogs-1 to 2 mg/kg PO Q 12 H, Cats-4 mg/kg PO Q 24 H
  • 29.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) Prednisone is a prodrug that is metabolized into prednisolone. When cats receive oral prednisolone, higher plasma concentrations of prednisolone are achieved compared with cats administered oral prednisone; therefore, prednisolone is preferred for use in cats.
  • 30.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) SECOND-LINE IMMUNOSUPPRESSIVE THERAPY • Criteria that should prompt consideration of additional immunosuppressive agents include: • Severe disease (intravascular hemolysis or transfusion dependency) • Marked autoagglutination
  • 31.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 32.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) IMMUNE-MEDIATED THROMBOCYTOPAENIA
  • 33.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) 2.IMMUNE-MEDIATED THROMBOCYTOPAENIA • Serious and life-threatening condition. • Immune disorder in which the platelet count falls below reference values, as the patient's immune system destroys them. • Common clinical disorder in which platelets are destroyed by antiplatelet specific antibodies in circulation or at the level of the bone marrow . • This can lead to excessive or spontaneous bleeding when platelet counts are less than 30 000 to 50 000/μL. • Antibodies (mainly IgG) bound to the surface of platelets result in their premature destruction by macrophages in the spleen and liver.
  • 34.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) Primary IMTP •Idiopathic IMTP
  • 35.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) Secondary IMTP • Infectious diseases (ehrlichiosis, babesiosis, leishmaniasis, leptospirosis, dirofilariasis, FIV, FIP, and other viral or bacterial infections such as cystitis, prostatitis) • Neoplasia ( lymphoma, hemangiosarcoma, mammary tumors) • Drugs ( Sulfonamides, vaccines, cephalosporins, phenobarbital) • Blood transfusions
  • 36.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) CLINICAL SIGNS Bleeding disorders Hepatitis Neurological signs Internal Hematomas
  • 37.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) CLINICAL SIGNS Petechia Hemorrhage CMM/OMM Pallor Anemia GI Bleeding
  • 38.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) GLUCOCORTICOID THERAPY • Glucocorticoids have multiple effects on the immune system, but the most important effect for IMHA patients is inhibition of macrophages within the mononuclear phagocytic system. • Response to glucocorticoids often takes between 3 and 7 days. Dexamethasone A dosage of 0.3 to 0.5 mg/kg IV Q 24 H is often administered in both cats and dogs. Prednisolone Dogs-1 to 2 mg/kg PO Q 12 H, Cats-4 mg/kg PO Q 24 H
  • 39.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) • Romiplostim is a thrombopoietin receptor agonist that activates intracellular transcriptional pathways via c-Mpl to increase production of platelets. • It also works similarly to thrombopoietin (TPO), an endogenous glycoprotein hormone that regulates the production of platelets in the bone marrow.
  • 40.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) The extract of papaya leaves has been shown to increase ALOX12 (arachidonate 12- lipoxygenase or platelet type lipoxygenase) by 15 times. This enzyme promotes platelet production via the increased number and differentiation of megakaryocytes.
  • 41.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) IMMUNE-MEDIATED POLY ARTHRITIS
  • 42.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) INTRODUCTION • Immune-mediated polyarthritis (IMPA) is a disease in which the immune system mounts an inflammatory response within the joints causing pain, swelling and difficulty walking. • MPA is seen more commonly in dogs than cats, but can occur in both species. • Because the white blood cells are attacking the joints inappropriately, IMPA is referred to as an auto-immune disease. • Rheumatoid arthritis is a form of IMPA in people.
  • 43.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 44.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 45.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 46.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) CLINICAL SIGNS Reluctance to move Severe joint pain Odematous joints Pyrexia
  • 47.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) CLINICAL SIGNS Lethargy Shifting lameness Joint effusions Joint Fibrosis
  • 48.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 49.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 50.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) DIAGNOSIS Joint Tap Fluid Cytology Arthroscopy Pedigree Chart Radiography
  • 51.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) GENERAL DIAGNOSTIC ALGORITHM
  • 52.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) TREATMENT PREDNISOLONE PHYSIOTHERAPY
  • 53.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 54.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) MYASTHENIA GRAVIS
  • 55.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) INTRODUCTION • Myasthenia gravis is a disease in which there is a malfunction in the transmission of signals between the nerves and muscles. • Dogs with myasthenia gravis exhibit extreme weakness and excessive fatigue. • Some breeds are predisposed to an inherited/congenital form of this disease, including Jack Russell Terriers, English Springer Spaniels, Smooth Fox Terriers, and Smooth-haired Miniature Dachshunds. • "Most cases are acquired, not inherited."
  • 56.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 57.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 58.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 59.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) CLINICAL SIGNS Voice changes Exercise Intolerance Inability to close the eyes Excessive drooling Difficulty breathing Cramping with mild exercise
  • 60.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) DIAGNOSIS 1.Edrophonium Test 2.Ice Pack Test 3.Imaging Test 4.Nerve Simulus Test 5.Pulmononary Test
  • 61.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 62.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 63.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 64.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 65.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 66.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) TREATMENT • Class of medication that inhibits a nervous system enzyme called acetylcholinesterase (Anti-acetylcholinesterase). • Because of their compromised ability to swallow, some dogs will actually inhale food, liquid, or vomit, resulting in aspiration pneumonia. • Aspiration pneumonia is extremely serious and often requires aggressive intensive care including oxygen therapy, antibiotics, IV fluid therapy, and supportive care. • If the dog is unable to eat or drink without regurgitation, a feeding tube may be advised.
  • 67.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 68.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) ASSOCIATED DISEASES MEGAESOPHAGUS PARALYTIC ILEUS MEGACOLON
  • 69.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) IMMUNE MEDIATED SKIN DISEASES
  • 70.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) MAIN DISEASES PEMPHIGUS COMPLEX SYSTEMIC LUPUS ERYTHEMATOSES DISCOID LUPUS ERYTHEMATOSES BULLOUS PEMPHIGOID
  • 71.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) PEMPHIGUS COMPLEX • Pemphigus is a group of five autoimmune skin diseases characterized by vesicles and bullae (large and small "blisters") in the mouth and at mucocutaneous junctions (the junction between skin and mucosal tissues). • Commonly affected areas include the eyelids, lips, nostrils, and anus.
  • 72.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) Pemphigus Foliaceus (PF) • "leaf-like pemphigus" • Most common • Pemphigus foliaceus is rarely found in the mouth or at mucocutaneous junctions. • In this form of pemphigus, the patient develops crusts (scabs) and ulcers around the eyes, ears, footpads, groin and bridge of the nose. • Chow chow, akita, cocker spaniel, Labrador retriever, dachshund, English bulldog, Finnish spitz, and schipperke. • Pemphigus foliaceus usually appears suddenly without a recognized cause.
  • 73.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) LESION DISTRIBUTION
  • 74.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 75.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 76.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 77.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 78.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 79.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 80.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 81.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) Pemphigus vulgaris (PV) • The term means "common pemphigus" and it is the most frequent form of pemphigus in humans. • Fluid filled blisters called "vesicles" form in and around the mouth, eyelids, lips, nostrils, anus, prepuce or vulva. • These vesicles rupture easily, creating painful ulcers. • This condition is rare in dogs.
  • 82.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 83.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) Clinical characteristics of feline pemphigus vulgaris. a-d, f, g: generalized, usually bilaterally symmetrical erosive and ulcerative dermatitis; e: erosive glossitis – a-to-g were taken from the same Siamese cat
  • 84.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) Pemphigus erythematosus (PE) • The term means "red and inflamed pemphigus" and its most common symptom is redness, crusting, scales and hair loss on the nose. • Exposure to ultraviolet light worsens this form of pemphigus. • Breed predispositions include the German shepherd dog, collie, and Shetland sheepdog.
  • 85.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) Pemphigus vegetans(PV) • This form is typified by thick and irregular vegetative lesions or lumps associated with chronic "oozing" and pustules. • It is believed to be a more benign form of pemphigus vulgaris. • This condition is rare in dogs.
  • 86.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) Paraneoplastic pemphigus (PNP) • The least common (considered extremely rare) • most severe type of pemphigus. • This condition is associated with the presence of an underlying malignant tumor.
  • 87.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) SYSTEMIC LUPUS ERYTHEMATOSES • Commonly referred to as lupus. • Lupus is often called the "great imitator" because it can mimic almost any other disease state. • The signs of SLE may be acute (sudden onset) or chronic, and usually they wax and wane. • A fluctuating fever that does not respond to antibiotics is one of the classic clinical signs of SLE. • Stiffness in the legs or shifting-leg lameness. • Blood abnormalities such as hemolytic anemia, thrombocytopenia (low platelet numbers), leukopenia (a low white blood count), and symmetrical dermatitis, especially over the bridge of the nose (often called a "butterfly lesion"). • Common in dogs and rare in cats. • Nova Scotia duck tolling retriever, Shetland sheepdog, collie, German shepherd dog
  • 88.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) DISCOID LUPUS ERYTHEMATOSES • Seen in dogs and rarely in cats. • Common name for this condition is "Collie nose," although it can appear in many breeds. • DLE is seen more commonly in Collies, Shetland sheep dogs, German shepherds, and Siberian huskies. • Exposure to sunlight and UV radiation is thought to be a potential cause or trigger. • In most cases, affected dogs lose the pigmentation around the nose, although the skin around the lips, eyes, ears and genitals may be also affected. • DLE can transform the surface of the nose from its normal "cobblestone" texture to smooth, flat and shiny. Ulcerated sores may occur. • Less-serious type of systemic lupus erythematosus (SLE). • It is considered a relatively benign autoimmune skin disease.
  • 89.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) BULLOUS PEMPHIGOID • May sound like a form of pemphigus, but it is actually a different type of autoimmune skin disease. • Bullous is the medical term for a large thin-walled sac filled with clear fluid. • Usually, the skin is very itchy and large red welts and hives often appear before or during the formation of blisters. • Vesicles and ulcers may be found in the mouth, at mucocutaneous junctions, and in the axillae (armpits) and groin. • Evaluation of the vesicles is critical to the diagnosis. • Because vesicles rupture quickly after formation, the dog must often be hospitalized and examined every two hours until adequate biopsies can be obtained. • Bullous pemphigoid resolves spontaneously in many cases. • It is considered rare in dogs and cats.
  • 90.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) B M C
  • 91.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) KERATOCONJUNCTIVITIS SICCA
  • 92.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) INTRODUCTION • Keratoconjunctivitis sicca (KCS) is a frequent canine ophthalmic disease. • Dry eye syndrome, is a chronic ophthalmic disease resulting from deficiency of one or more elements in the precorneal tear film. • Inflammatory condition of the ocular surface caused by a pathologic reduction in the aqueous component of the tear film. • Aetiology: congenital, metabolic, infectious, drug induced, neurogenic, radiation, iatrogenic, idiopathic, and immune mediated. • Immune mediated: It is a widely primarily accepted cause of KCS. • It is generally bilateral • Confirmation: Tear Gland Histopathology
  • 93.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 94.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) CLINICAL SIGNS Mucopurule nt discharge Conjunctiviti s Blepharospa sm
  • 95.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) CLINICAL SIGNS Dry Cornea Ulcerative Keratitis Corneal Pigmentati on
  • 96.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 97.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) SHIRMER TEAR TEST
  • 98.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) SURGICAL CORRECTION Parotid duct transpositi on Punctal occlusion Permanen t partial tarsorrhap hy
  • 99.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) MEDICAL MANAGEMENT
  • 100.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) A BETTER RESEARCH TOPIC
  • 101.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) GLOMERULONEPHRITIS
  • 102.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) INTRODUCTION • Inflammation of the glomerulus. • Occurs when immune complexes are filtered out of the bloodstream and become trapped within the glomeruli. • When these compounds are trapped, the body responds by activating its immune defenses, resulting in further damage to the glomeruli.
  • 103.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) INTRODUCTION TYPE III REACTION IMMUNE COMPLEX MEDIATED
  • 104.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) DIAGNOSIS HEMATOLOGY SEROLOGY ULTRASOUND SCANNING RENAL BIOPSY RADIOGRAPHY URINALYSIS
  • 105.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) MANAGEMENT • 1.Treat Underlying Cause • 2.Extensive Fluid Therapy (if anuric????) • 3.Mild Immunosuppression • 4.Repeated Hematology & Serology Estimation.
  • 106.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) NOTES! • Leakage of plasma proteins, principally albumin, across the damaged glomerular capillary walls results in persistent proteinuria--the clinicopathological hallmark of glomerulonephritis. • Persistent proteinuria is associated with progressive glomerular and tubulointerstitial lesions and loss of additional nephrons • In cases of idiopathic glomerulonephritis, angiotensin-converting enzyme inhibitors have been shown to decrease proteinuria and potentially slow disease progression.
  • 107.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) IMMUNE MEDIATED INTESTINAL DISEASE
  • 108.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) INTRODUCTION • Mammalian gastrointestinal tract is colonized by a large number of microorganisms, known as gut microbiota, that play a key role in the physiological and pathological states. • In particular, the gastrointestinal tract of dogs and cats harbors a complex and highly biodiverse microbial ecosystem. • Due to beneficial effects-GUT MICROBIOTA-”ORGAN”. • The immune system produces Ab against the beneficial organism resulting in CHRONIC ENTEROPATHY. • Idiopathic Inflammatory Bowel Diseases (IBD). • Lymphocytic- plasmacytic enteritis (LPE) is considered to be the most common form of IBD in dogs and, particularly, in cats.
  • 109.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 110.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) ROLE OF GUT MICROBIOTA • Digestion • Host metabolism • Vitamins synthesis (vit. K and complex B) • Biotransformation of bile acids • Xenobiotics metabolism • Correct maturation of gastrointestinal cells • Défense against pathogenic bacteria • Transformation of primary bile acids • Framing of Gut Immune System
  • 111.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 112.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) CAUSES 1.Idiopat hic 2.Genetic 3.Drug Associate d 4.Toxin Associate d 5.Food Associate d
  • 113.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) CAUSES Dysfunction of gut-associated lymph tissue Nutritional imbalance Dietary Imbalance Over Vaccination Modern Life style
  • 114.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 115.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 116.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) DIAGNOSIS HEMATOLOGY RADIO- GRAPHY HP FAECAL SAMPLING ENDOSCOPIC FNAC
  • 117.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) FIGURE 5. Endoscopic images of dogs with IBD consistent with (A)increased small intestinal friability (B) increased small intestinal granularity (C) intestinal mucosal erosions (D) Endoscopic image showing the advancement of biopsy forceps to obtain partial-thickness biopsy samples in a dog with inflamed GI mucosa and IBD.
  • 118.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) TREATMENT MANAGEMENT
  • 119.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 120.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 121.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 122.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine)
  • 123.
    Dr Abhijith S.P.(M.V.Sc Veterinary Medicine) THANK YOU