Companion Animals: Advanced Disease Topics Dr. N. Matthew Ellinwood, D.V.M., Ph.D. April 4, 2012 IOWA STATE UNIVERSITY COLLEGE OF AGRICULTURE AND LIFE SCIENCES Disease • Immune mediated disease • Dermatology • Endocrine disease Immune Mediated Disease • Disease with an immune system component – Versus • Autoimmune disease – A specific class of immune mediated disease Immune System • Non-specific immune response – Not associated with a memory response – Not associated with a specific recognition of antigens – Can include non-immune cells – Example • Type I interferon • Fast (within a few hours) • “Generic” activity against many agents (viruses) Specific Immune Response (Adaptive Immunity) • Cell mediated Immunity – Cytotoxic response (cell killing response) – T cells • Humoral immunity – Antibody response – B cells – plasma cells Immune Responses • Innate immune response participate in – Innate immunity – Adaptive immunity • Ex: Complement system • Ex: T-cells function in both cell mediated and humeral immunity Tolerance • Mechanism whereby immune response “learns” to distinuish self from non-self • Thymic “education” • Self reactive immune cells are targeted for physical or functional elimination – Clonal elimination – Anergy – Immunoregulation Immune Mediated Conditions • Auto immune disease –Lupus • Atopy/Allergy Lupus • Systemic lupus erythematosus • Multisystem connective tissue disease • Autoantibodies – Antinuclear antibodies – Double stranded DNA • Unknown triggers but enviornmental triggers suspected. • Genetic predisposition • Females affected more commonly Atopy/Allergy • Immune mediated condition involving IgE • Causes intense puritis in dogs and cats • Animal equivalent to “hay fever” Causes • Flea bite sensitivity • Food allergy • Environmental allergies – house dust mites, house dust, human dander, feathers, molds, and pollens from trees, weeds, and grasses Diagnosis • Food trials – Restricted food source as trial • Extreme restriction necessary • Can be used as a maintenance • Skin testing – Desensitization • Vaccination to induce IgG that will out bind IgE and hence eliminate allergic response. Food Allergy versus Food Intolerance • Allergy is a specific immune mediated IgE based response to a food antigen • Gluten sensitivity – Food intolerance that is not allergy based Additional Immune Mediated Disease • Hemolytic anemia – American cocker spanials • Immune mediated hypothyroidism – Canine condition Endocrine Disorders • Thyroid disorder – Hypothyroidism • Aquired: Canine • Congenital: Feline > Canine (rare) • Treatments – Hyperthyroidism • • • • Feline Aquired Age related Treatments Adrenal Disease (Canine usually) • Too little of steroid function – Addison’s Disease – Signs; muscle weakness, neuropathy, low blood sugar, skin darkening, low heart rate – Genetic predisposition – Managed medically by replacing adrenal steroids • Glucocorticoids • Mineralocorticoids Adrenal Disease • Too much steroid function – Cushing’s Disease – Signs; weight gain/redistribution, thinning hair, pendulous abdomen, muscle wasting, PU/PD – Imitates steroid immunosuppression sysmptoms – Genetic predisposition – If adrenal in origin can selectively target adrenal steroid production for destruction – If create an Addisonian dog, can supplement Endocrine Diseases • Alternative mechanisms • Cancer • Pancreatic disease – Diabetes – Insulinoma • Special cases – Ferrets