Case of the month: Buster

Posted by Vetcall on 10 June 2013

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BusterReason for visit:

Buster is a two year old Border Collie cross. His owner was concerned because over the previous few months Buster had been rubbing his face on the ground and with his paws a lot more than was normal. His nose was starting to get crusty and sore and one area of his lip was very red and swollen.

Symptoms:

  • Mild crusting and redness of the skin on the bridge of his nose and about his nostrils
  • Depigmentation of the central area of his black muzzle and his muzzle was generally quite dry looking
  • Lower right lip red and inflamed near the corner of his mouth
  • The affected areas of skin and muzzle were sensitive and sore

These symptoms made Claire very suspicious of an autoimmune skin condition called DLE (Discoid Lupus Erythematosis) which is relatively common in the Border Collie breed.

Investigations:

Buster was booked in for a general anaesthetic and multiple punch biopsies were taken from affected areas and sent to the laboratory for histopathology.

Results:

Histopathology confirmed that Buster was suffering with DLE and sunburn. With DLE the body produces autoantibodies that attack the skin’s ability to stay attached. Collies, Shetland Sheep Dogs, German Shepherds and Siberian Huskies are predisposed breeds. Disease most often involves the nose, although lips, eyelids, footpads, inner surface of the ear flaps and the mouth can also be affected. Initially affected areas look red or depigmented and over time slowly become eroded ulcerated and crusty. Affected areas are invariably itchy and sore and may bleed a lot following minor trauma like rubbing and scratching. Sunburn exacerbates the symptoms and may play a role in causing DLE. In very rare cases dogs affected with DLE may develop a very serious form of the disease which affects multiple organs in the body (SLE – Systemic Lupus Erythematous).

Plan:

DLE is treated with immunosuppressive drugs at the lowest controlling dose in conjunction with sun avoidance. The prognosis is fair to good. Most animals require life long treatment. Buster was started on a combination of steroid tablets (Prednisone), and daily application of steroid spray (Cortavance) and Filtaclear sun block to his nose. His owners set up a sun shade in the garden to try and minimize Buster’s exposure to the sun during time spent outdoors.

Progress:

Buster was re-examined after 2 weeks of treatment. His nose was comfortable on examination and all redness and crusting had resolved. He was also no longer rubbing his face. With such an excellent response to treatment we were able to start tapering off the steroid tablets and reduce the steroid spray application to every second day along with continued daily sun block application. On re-examination 10 days later Buster’s nose was completely back to normal and the normal black pigmentation on his muzzle was starting to return. The steroid tablets were stopped and we will continue to manage Buster’s condition with steroid spray, sun block and sun avoidance long term.