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The following report follows the onset, development and eventual resolution of Pemphigus in a young female quarter horse.
Signalment (1-10-02)
Species Equine
Age 9 months
Name KD's Lady Bug (Lady)
Breed Quarter Horse
Weight 700 lb. Sex Female
At birth Lady appeared to be a normal healthy foal. Her development was unremarkable with one exception. Her owner noticed "Lady never really ran and played the way a filly should".
Lady's outward
symptoms started at approximately 4 months of age.
At this time, she began developing open draining sores that would scab or
crust over. This continued and eventually covered a large portion of her body.
>
Lady was presented for her initial veterinary exam on 11-30-01 by Dr. Dan Craven. After the physical exam, Lady's blood was drawn for pack cell volume (PCV) and a fecal sample was taken for intestinal parasite evaluation.
The dermatosis was described as DERMATOPHYLUS INFECTION ? Her PACKED CELL VOLUME showed moderate anemia at 29%. FECAL SHOWED NUMEROUS STRONGYLE EGGS. Lady was tranquilized and tube wormed with 20 cc. Panacur (Fenbendazole) and 7 cc. Of EQ valen (Ivermectin). A 20 cc. Injection of PROCAINE PENICILLIN G was given IM. The sores were treated with Nolvasan.
MEDICATIONS DISPENSED WERE ....1 bottle Equine Medicated Shampoo, 320 ml. Nolvasan (Chlorhexadine acetate 2%) to be diluted, 1 oz. per 1 spray bottle of water to be applied twice daily to the affected areas, and 1 bottle (100 ml.) of Procain Penicillin G 20ML/DAY to be administered IM.
Lady was given the Penicillin as directed and continued to receive medicated shampoo and topical Nolvasan as directed for the next several months. Lady's symptoms showed no sign NO SIGN OF IMPROVEMENT and continued to worsen.
On 1-9-02 hair and skin biopsies were taken and sent to Texas Veterinary Medical Diagnostic Laboratory System. The laboratory test results were reported as follows:
Accession#:
C020100214
Fungal culture
Routine culture Histopath
H&E Biopsy
Histopathology
Histopath:
H&E Biopsy
Date Completed: 01/14/02 Date report
Entered: 01/14/02, Lady, Equine
Pathologist:
Vicek,
Tom Sections/Slides: 3/1 #
Tissues: I
DESCRIPTION:
Three specimens of haired skin are examined. One sample exhibits poorly
defined, intracorneal and subcorneal pustules. The pustules contain neutrophils
and prominent acantholytic keratinocytes. All specimens exhibit mild to moderate
epidermal and infundibular hyperplasia with mild hyperkeratosis. The superficial
dermis has vascular hypertrophy with a loose, often perivascular infiltrate
of mixed mononuclear cells and neutrophils. Gross
Lesion examples
& Microscopic
example
HISTOPATHOLOGIC
DIAGNOSIS:
Chronic subcorneal pustular dermatitis with acantholysis, skin
COMMENT:
The microscopic findings are characteristic of pemphigus foliaceus.
Thomas J. Vicek, DVM, PhD/lak
Comment: Isolate
Growth Staphylococcus
sp. (Coagulase Negative) Bacillus cereus Streptococcus spp. (Alpha hemolytic)
Fungi
Giemsa Stain Neg. Dermatophilus
Lady was tranquilized with Acepromazine and tube wormed with 30 cc. Panacur & 5 cc. Ivermectin. Acepromazine was dispensed to be administered at 2 cc. Orally or IM. On 1-18-02, a second bottle of Acepromazine was dispensed. On 1-31-02, 400 x 20 mg. Prednisolone tablets were dispensed to be administered at a rate of 15 tablets twice a day for 4 days, then 15 tablets daily for 4 days, then 15 tablets every other day until gone.
Lady's skin lesions
responded favorably to the steroids (Prednisolone); however, the attending
veterinarian forewarned the owner about the
long-term use of corticosteroids.
The following is a paraphrasing of his comments: "Pemphigus Foliaceus is an autoimmune problem and was considered by Texas A &M to be incurable. The owner was told that the filly would have to remain on steroids. Without them the muscle wasting and sores would reappear." " "THEY SUGGESTED THAT EUTHANASIA BE CONSIDERED AS THE OUTLOOK WAS GRIM". She would never be able to ride or breed Lady.
On 2-25-02, Lady's owner, with the supervision of her attending vet, Dr. Craven began slowly reducing the Prednisolone and concurrently started administering 4Life Research's newly developed equine product containing Transfer Factor™, i.e. Equine Performance & Show™ at a rate of 1 scoop daily.
On 3-2-02, she was started simultaneously on another 4Life product containing Transfer Factor™, i.e. Animal Stress Pack™ at a rate of 1 oz. twice daily for 1 week. She continued to receive 1 scoop daily of Equine Performance & Show™.
Lady was continued on 1 scoop of Equine Performance & Show™ daily for several months and now receives 1 scoop 3-4 times a week. At the time of this writing, the owner reports that Lady shows no skin lesions, has developed a beautiful haircoat, has doubled in size, and has regained all the muscle mass she previously lost.
Medical information on Pemphigus
"AUTHORITIES STATE THAT 90% OF HORSES DIAGNOSED WITH PEMPHIGUS FOLLIACEOUS DIE OR ARE EUTHANIZED WITHIN ONE YEAR OF DIAGNOSIS"
