Pemphigus is a general designation for a group of autoimmune skin diseases involving ulceration and crusting of the skin, as well as the formation of fluid-filled sacs and cysts (vesicles), and pus filled lesions (pustules). Some types of pemphigus can also affect the skin tissue of the gums. An autoimmune disease is characterized by the presence of autoantibodies: antibodies that are produced by the system, but which act against the body's healthy cells and tissues – just as white blood cells act against infection. In effect, the body is attacking itself. The severity of the disease depends on how deeply the autoantibody deposits into the skin layers.
The hallmark sign of pemphigus is a condition called acantholysis, where the skin cells separate and break down because of tissue-bound antibody deposits in the space between cells. There are three types of pemphigus that affect cats: pemphigus foliaceus, pemphigus erythematosus, and pemphigus vulgaris.
In the disease pemphigus foliaceus, the autoantibodies are deposited in the outermost layers of the epidermis, and blisters form on otherwise healthy skin. Pemphigus erythematosus is fairly common, and is a lot like pemphigus foliaceus, but less afflictive. Pemphigus vulgaris, on the other hand, has deeper, and more severe ulcers, because the autoantibody is deposited deep in the skin.
Your veterinarian will perform a thorough physical exam on your cat, including a blood chemical profile, a complete blood count, a urinalysis and an electrolyte panel. Patients with pemphigus will often have normal bloodwork results. You will need to give a thorough history of your cat's health, onset of symptoms, and possible incidents that might have precipitated this condition.
A skin exam is crucial. A skin tissue sample will be taken for examination (biopsy); and pustule and crust aspirates (fluid) will be wiped onto a slide to diagnose pemphigus. A positive diagnosis is achieved when acantholytic cells (i.e., separated cells) and neutrophils (white blood cells) are found. A bacterial culture of the skin may be used for identification and treatment of any secondary bacterial infections, and antibiotics will be prescribed in the event that there is a secondary infection present.
Only severely affected patients need to be hospitalized for supportive care. Steroid therapy may be prescribed briefly to bring the condition under control. If corticosteroid and azathioprine therapy is prescribed, your cat will be switched to a low-fat diet, since these medications can dispose animals to pancreatitis. Your veterinarian will treat your cat with the drugs that are specifically suited to the form of pemphigus it has.
Your veterinarian will schedule follow-up appointments to see your cat every one to three weeks. Standard blood-work will be performed at each visit to check for progress. Once your cat's condition has gone into remission, it may be seen once every one to three months. The sun can worsen this condition, so it is important to protect your cat from excessive exposure to the sun.
A product made of fluid, cell waste, and cells
Having the ability to produce disease
A lesion on the skin that is filled with pus
The disappearance of the signs and symptoms of a particular disease; this is often used in association with cancer
An in-depth examination of the properties of urine; used to determine the presence or absence of illness
A medical condition in which the pancreas becomes inflamed
Any type of pain or tenderness or lack of soundness in the feet or legs of animals
The process of removing tissue to examine it, usually for medical reasons.
Any disease in which an animal's body creates antibodies that are used against itself.
The outside layer of the skin
The area between the abdomen and thighs; the inguinal area
A protein in the body that is designed to fight disease; antibodies are brought on by the presence of certain antigens in the system.
Small structures that filter out the lymph and store lymphocytes