Pemphigus in cats - Symptoms and treatment

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Cats can be affected by autoimmune diseases in which their own immune system plays a trick on them. Pemphigus is characterized by the formation of primary lesions consisting of vesicles or blisters in different locations, depending on the type of pemphigus. While they are more frequent in the oral cavity or in the mucocutaneous folds in pemphigus vulgaris, in the foliaceous one it usually affects the skin exclusively; erythematous is restricted to the feline face only, and paraneoplastic is rare and occurs as a consequence of an underlying tumor. Of these, the most common in small cats is pemphigus foliaceus.

Treatment of pemphigus should be based on immunosuppressive therapy to stop the immune system responsible for the process. Keep reading this AnimalWised article where we explain what the pemphigus in cats, its symptoms and treatment.

You may also be interested in: Pemphigus in Dogs - Causes, Symptoms and Treatment Index
  1. What is feline pemphigus?
  2. What types of pemphigus exist in cats?
  3. Symptoms of pemphigus in cats
  4. Diagnosis of feline pemphigus
  5. Treatment of pemphigus in cats

What is feline pemphigus?

The feline pemphigus is a autoimmune disease in which the cat's immune system does not recognize part of its body as its own and creates an immune reaction against it. It consists of cutaneous or mucocutaneous disorders due to a type II hypersensitivity reaction that begins with the participation of immunoglobulins G and M, which bind to target cells and activate complement, inducing phagocytosis. This leads to autoantibody production against certain components of the epidermis.

It is a dermatological disease characterized by an acantholysis or detachment of each cell of the epidermis that creates vesicles within it. These vesicles can infiltrate with eosinophils or neutrophils and become pustules..

What types of pemphigus exist in cats?

In cats, according to the distribution of the lesions and their pathological characteristics, they can be classified into four types:

  • Pemphigus vulgaris: It consists of the formation of vesicles or blisters in the oral cavity, skin and mucocutaneous junctions, such as the armpit and the inguinal region. These lesions, due to their fragility, evolve into collarettes, erosions, ulcers and scabs..
  • Pemphigus foliaceus: autoantibodies are produced against proteins of the spinous stratum of the epidermis. It is characterized by the formation of vesicles, bullae or, less often, subcorneal pustules that affect follicles and interfollicular skin. Secondary lesions are erythema, exudation, scabs, alopecia, and collarettes. These are generally distributed symmetrically on the face, muzzle, ears up to the extremities, and the abdomen. Lesions occur on the skin, without affecting the oral cavity or mucocutaneous junctions.
  • Erythematous pemphigus: It is considered an intermediate form between lupus erythematosus and pemphigus or as the benign form of pemphigus foliaceus. Vesicles and blisters and pustular lesions form on the ears and head. It is to be considered that solar radiation can aggravate the pathology.
  • Paraneoplastic pemphigus: vesicles and blisters occur in multiple organs other than the skin. It is a disease associated with an underlying cancer, generally of lymphoproliferative origin.

Symptoms of pemphigus in cats

Cats with pemphigus present, in addition to the lesions described above, depending on the type they develop, nonspecific signs What:

  • Fever.
  • Anorexy.
  • Lethargy.
  • Apathy.
  • Pain.
  • Lymphadenopathy.

In cats, pemphigus foliaceus is the most common autoimmune disease. More than subcorneal pustules, more frequent in dogs, in cats with pemphigus foliaceus they are observed more frequently yellowish crusts. A characteristic lesion of this pemphigus in cats is paronychia (inflammation of the skin around the nail) and pruritus (itching).

Diagnosis of feline pemphigus

Due to the itching produced by pemphigus foliaceus in cats, a differential diagnosis among other diseases that cause itching in this species, such as allergies and parasitic diseases. In addition, the following tests will be carried out:

  • Blood test: before this type of lesion in a cat, a blood test should be started, which may be normal or present an increase in the neutrophil and eosinophil count. Blood chemistry is normal if there is no concurrent disease.
  • Cytology: Cytology of the lesions can aid in the diagnosis if neutrophils and acantocytes are observed. It is also useful to assess whether there is a bacterial infection. In that case, the cat would be treated with antibiotics before taking and sending the biopsy to the laboratory..
  • Histopathological examinationHowever, the definitive diagnosis is achieved with the histopathological examination. To do this, biopsies of recent primary lesions must be collected, being important that the cat has not received immunomodulatory or immunosuppressive treatment in the previous days, as it can alter the results. The biopsy will find subcorneal pustules with neutrophils and a variable number of acantocytes and eosinophils. If these are not observed, a presumptive diagnosis can be made if serocellular scabs with acantocytes and neutrophils are seen.

As a curiosity, in 90% of the diagnoses of pemphigus vulgaris, oral lesions are detected. Paronychias would be seen in 30% of pemphigus foliaceus and itching in 80%.

Treatment of pemphigus in cats

The treatment must contain immunosuppressive drugs such as prednisolone at a dose of 2-8 mg / kg every 24 hours by mouth. Immunosuppressive doses should be reduced when remission of clinical signs begins, down to the minimum dose that will keep the disease in resolution..

If the clinical signs are not reduced one month after the start of immunosuppressive treatment, it is recommended to switch to dexamethadone or methylprednisolone, decreasing to the minimum effective dose.

If no response is observed with these treatments or side effects such as polyphagia, polyuria-polydipsia, apathy, diarrhea, diabetes or urinary tract infections appear, you should add chlorambucil (0.1-0.2 mg / kg every 24-48 h). In some cases, corticosteroids can be suppressed and maintained with chlorambucil alone twice a week or every other day. The beneficial effects of this drug can take weeks to appear. It should be taken into account that chlorambucil is a cytotoxic drug, so periodic blood tests should be performed every 2-4 weeks for the first 3 months, until passing to every 6 months thereafter..

On the other hand, it has been determined that the use of cyclosporine at doses of 4.4 to 7.4 mg / kg every 24 hours it can be effective for feline pemphigus, even being able to suppress corticosteroids and with efficacy similar to chlorambucil.

In addition, drugs for cats with pemphigus may also contain immunomodulators such as mycophenolic acid and leflunomide.

And if you can't get your cat to take his pill, we recommend you take a look at this other article on Tips for giving a cat a pill.

This article is merely informative, at we do not have the power to prescribe veterinary treatments or make any type of diagnosis. We invite you to take your pet to the vet in the event that it presents any type of condition or discomfort.

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